Medical Acupuncture

Erythromelalgia, which has primary and secondary presentations, causes heat, pain, and redness in the skin. The condition seems to have an autonomic basis, with vasomotor dysfunction causing dilatation of some blood vessels and constriction of others. No consistently effective treatments have been reported. Anticonvulsant, antidepressant, antihistamine, anti-inflammatory, antihypertensive, analgesic, nutritional, and topical approaches have been tried as were lidocaine infusions, nerve blocks, and thoracic and lumbar sympathectomies. Interosseous membrane stimulation appears to affect the local autonomic milieu in the extremity being treated. This approach was used on a patient with erythromelalgia.

A 36-year-old woman with erythromelalgia was treated with interosseous membrane stimulation. Eight treatments were given over a 1-year timeframe at 1–3-month intervals.

This patient repeatedly experienced much relief from her burning paresthesias, swelling, diaphoresis, and ruddy discoloration of her extremities for 6–8 hours following each treatment. The intensity of her discomfort subsided gradually over time.

Interosseous membrane stimulation is a safe, simple, and effective treatment for erythromelalgia, which is notoriously refractory to treatment. This patient's response to treatment might have been a result of localized derangement of her autonomic nervous system. It is possible that manipulation of the autonomic milieu of an extremity is a significant factor in the mechanism of action of interosseous membrane stimulation.

Emergency-department (ED) staff may experience psychologic distress due to the stressful nature of their work. The COVID-19 pandemic exacerbated this distress. Emotional Freedom Techniques (EFT) tapping, a somatic psychophysiologic intervention combining vibratory acupressure with elements of cognitive–behavioral and exposure therapies, can reduce psychologic distress. This study tested the short-term effect of 10-minute EFT tapping on the psychologic distress of pediatric ED staff responding to COVID-19.

During the COVID-19 pandemic, diverse staff in the pediatric ED of a New York City teaching hospital participated in this single-group study. A licensed creative arts therapist led participants in 10-minute EFT tapping sessions. A self-report questionnaire with 7 items based on the Trauma Exposure Response framework was administered immediately pre- and postintervention. Standardized mean differences between both timepoints were calculated.

There were statistically significant reductions for 6 of the 7 items studied, including stress (3.32–2.14), obsessive and intrusive thoughts (2.50–1.85), feelings of pressure (3.20–2.17), loneliness (1.84–1.44), and emotional and physical pain (2.28–1.70); all P < 0.001. No significant changes in professional satisfaction were reported following the intervention.

Despite the limitations of a single-arm study design, a 10-minute brief EFT tapping session was a promising way to reduce short-term psychologic distress in pediatric ED health care workers. Future studies, including rigorous randomized controlled trials, are needed to evaluate the effectiveness of brief EFT tapping interventions in other settings.

Ear acupuncture, as a system for treating and preventing diseases through stimulation of points on the auricle, has been systematically introduced during the last 60 years. Although the auricular cartography was described somatotopically as an inverted fetus by Paul Nogier, MD, the underlying mechanism of auricular stimulation remains unclear. The aim of this research was to gain an understanding of the structural basis of auricular stimulation, as well as showing the distribution of the nerve fibers, and the blood and lymphatic vessels.

The distribution of nerve fibers, and blood and lymphatic vessels was examined in whole-mount auricular skins of mice by combining the biomarkers protein gene product 9.5, cluster of differentiation 31, and lymphatic-vessel endothelial hyaluronan receptor–1 following tissue-clearing treatment with multiple immunofluorescent staining.

The labeled nerve fibers, and the blood and lymphatic vessels were distributed extensively in the inner and outer parts of the auricular skin. Auricular nerves aligning with blood vessels ran from the basal region to the peripheral region and crossed over lymphatic vessels, thus forming the neural, vascular, and lymphatic networks.

As these are important tissue components of auricular skin, this result implies that the auricular nerve fibers, and blood and lymphatic vessels may coordinate with each other to respond directly to auricular stimulation.

A definitive meaning for the notion of Qi is elusive. Theoretical explanations range from the rational physiologic to the subtle energetic, from the tautological to the Tao. In this article, the author suggests a practical approach that frames the concept contextually, illustrating differences with three case-histories.

The cases were as follows. A 74-year-old man had low back, left-hip and lateral left-leg pain. Acupuncture addressed his anatomical/structural issues. A 58-year-old woman had left upper-chest discomfort, restricted left-shoulder movement and periodic left frontal headaches and dry eyes. Acupuncture addressed her Etheric body. A 40-year-old woman had headaches and depression associated with grief over family losses. She visited a clinic and met a former patient there with whom she bonded. Acupuncture addressed her emotional state and she experienced subsequent phenomena that enabled her to release her grief.

All 3 patients experienced resolution of their symptoms, with the exception of the woman's dry eyes in Case 2.

Qi-nature can vary among gross, subtle, and causal levels. These levels can coexist and overlap during treatments of patients. This tripartite explanation may represent the Oriental pictograms better and be consistent with the philosophical root of Chinese Medicine—the Tao.

Due to the limits on treatment for people with attention-deficit/hyperactivity disorder (ADHD), ear acupressure treatment has been considered. This study examined the effect of ear acupressure on behavioral problems of children with ADHD.

This randomized controlled trial was conducted in 70 children with ADHD who were randomized into 2 groups. The intervention group received ear acupressure in treatment points and the control group received massage at neutral points. Behavioral problems were measured 3 times: (1) baseline; week 4; and week 8. The last timepoint was a follow-up, using the Child Behavior Checklist.

The intervention group had fewer behavioral problems at all 3 timepoints than the control group (Cohen's ∂ = 1.49; 95% confidence interval at week 4: 20.97, 47.43).The ear acupressure group had a large effect size with respect to reduction of attention problems at week 4 (∂ = 1.88) and week 8 (∂ = 1.48) than the control group.

Ear acupressure induced significant reduction of the behavioral problems of children with ADHD. Further research can evaluate the use and continuity of the effectiveness of this treatment as a complementary treatment in addition to the usual treatments for these children.

Failure to thrive (FTT) is a challenging childhood condition that may lead to developmental delays and requires immediate therapeutic strategies. Children are diagnosed with FTT when their weight or rate of weight gain is significantly below that of other children of similar age and sex. A Pub Med literature search revealed no published acupuncture treatments for failure to thrive or faltering growth.

A 2 year, 4 month-old female was presented with FTT and a history of multiple severe congenital medical conditions. Western medical treatment with optimization of tube feeds achieved weight scores in the third-to-fifth percentile range. Acupuncture points were electrically stimulated for the child once monthly for 30 seconds with a Pointer Plus™ at each of 12 traditional Chinese/Shu Mu points and at several auricular points: Appetite, Stomach, Small Intestine, and Large Intestine bilateral.

The patient gained weight during the treatment, increasing monthly as shown on fully naked weight measurements to the 25th percentile, 28th percentile, 32nd percentile, 40th percentile, 46th percentile, 61st percentile, and 65^th percentile. Her treatment was spaced to every 2.5 months after the 46th percentile measurement, and her weight started to level off when it reached the 61st percentile.

In this particular case, electroacupuncture (EA) stimulation may have facilitated a weight gain in this female child. EA (nonneedle) research should be explored for FTT.

Urinary retention is the inability to urinate voluntarily and difficulty in urinating even when the bladder is full. Acute urinary retention is most common in men aged 60–80. In the past 5 years, 10% of men older than age 70 and almost a third of men in their 80s have experienced acute urinary retention. Risk factors include prostate enlargement, increasing age, African-American race, obesity, diabetes mellitus, high alcohol consumption, and lack of physical activity. Treatment for urinary retention is mainly urethral catheterization, but it can be uncomfortable for a patient in the long term.

A 68-year-old man was unable to urinate voluntarily for 3 months and was diagnosed with urinary retention caused by a hypotonic bladder and was initially given a catheter. The patient then received manual acupuncture therapy in acupoints ST-28, CV-3, CV-4 and CV-6, and electroacupuncture (EA) therapy in acupoints SP-6, SP-9, BL-23, BL-25, BL-31, BL-32, BL-33, and BL34, with a continuous-wave, at a frequency of 2 Hz. Acupuncture therapy was carried out for 12 sessions, twice per week.

After 5 sessions of acupuncture therapy, the patient's urinary retention was resolved. He felt the urge to urinate and was able to urinate voluntarily even after removing the catheter, He also experienced an increase in his quality of life, as shown on an EQ-5D questionnaire with an increased score from 50 to 80.

A combination of manual acupuncture and EA in an elderly patient can be a safe choice to reduce or resolve symptoms of urinary retention.