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Research Shows Which Nerve Fibers Get the Point

May 3rd, 2010 3 comments

Let the good times roll.  Another study, as reported in various articles online, shows evidence that acupuncture works.  Ho hum, what’s new?

The difference is the method of evaluating the effect.  Instead of asking patients, hey does it hurt less?  They did Quantitative sensory testing.

What’s that?

The University of Chicago website defines quantitative sensory testing as:

Quantitative sensory testing (QST) is a method used to assess damage to the small nerve endings, which detect changes in temperature, and the large nerve endings, which detect vibration.

QST is used to diagnose and assess the severity of nerve damage, especially in the small nerve endings. It can also help determine if a neuropathy is responding to treatment. It is used to diagnose many different types of neuropathies, including peripheral neuropathies. It may also be used to identify where the nerves are damaged.

(It) ses a computer testing system to measure how the nerves involved react to vibration and changes in temperature. The test results are compared to a series of “normal” patients as well as to the patient’s unaffected side. (from http://peripheralneuropathycenter.uchicago.edu/

learnaboutpn/evaluation/quant/index.shtml or http://bit.ly/bb7gfC)

qst2 Research Shows Which Nerve Fibers Get the Point

Quantitative Sensory Testing

Photo from http://www.neurology.upmc.edu/neuromuscular/patient_info/testing.html

Pretty objective, if you ask me.

So what does the article say?

Dr. Philip Lang and colleagues of the University of Munich used quantitative sensory testing to identify changes in pain sensitivity with acupuncture in 24 healthy volunteers.
After applying acupuncture to the leg, the researchers found that pain thresholds increased by up to 50 per cent. Effects were noted in both the treated leg and the untreated (contralateral) leg.

…It includes tests of both thermal perception (heat and cold), and mechanical perception (pressure applied to the skin).

The patterns of response provide diagnostic information in patients with nerve injury regarding the type of nerve involved, and possible treatments.

Okay, in real life this is how it goes.  Sometimes people have nerve damage.  This obviously leads to decrease in sensations.  A perfect example would be a diabetic with peripheral neuropathy.  Peripheral neuropathy means that the nerve damage occurs at the very ends of the body – fingers and toes.  This test serves to try to measure the nerve response to various external stimuli. In this case, temperature change and pressure, among others.

It is also quantitative, meaning it is measured with numbers.  No more “uh I think it hurts a bit less” here.  Stimulus is given and we see how the nerves respond.

In this case, the body’s threshold of pain is increased – meaning treatment is effective and that a patient can tolerate pain better.

The results pointed to two nerve fibres-the ‘A delta’ pain fibers and the ‘C’ pain fibers-as being specifically affected by acupuncture.

Confirms what Berman, Pomeranz and Stux have been saying for decades.

Although the effects were modest, the researchers believe they provide the basis for future studies in individuals with chronic pain, where the effects might be more dramatic.

Here’s the crazy part.  An objective mind sees it this way, while a skeptic will say the effects are negligible so why bother.  A skeptic will also point out that it’s “just” a pilot study. Excuse me while I go find a toilet to relieve my nausea in.

Oh, and remember how I said that acupuncture can be dependent on the practitioner?

An experienced acupuncturist performed all treatments, applied to acupuncture points commonly used in pain management.

No newbies here who might eff things up!  I’m sure this acupuncturist had good skeeeelz.

And finally,

The results provide a scientific background for the ancient practice of acupuncture, according to Dr. Dominik Irnich, the study’s leading author.
“Our results show that contralateral stimulation leads to a remarkable pain relief. This suggests that acupuncturists should needle contralaterally if the affected side is too painful or not accessible-for example, if the skin is injured or there is a dressing in place,” added Irnich.
Dr. Steven L. Shafer, Editor-in-Chief of Anesthesia & Analgesia and Professor of Anesthesiology at Columbia University, views the results as an important preliminary finding.
“Reproducible findings are the cornerstone of scientific inquiry. The authors have clearly described their methodology, and their findings. If other laboratories can reproduce these results in properly controlled studies, then this provides further support for the scientific basis of acupuncture. Additionally, the ability of quantitative sensory testing to identify specific types of nerves involved in pain transmission may help direct research into the mechanism of acupuncture analgesia,” commented Shafer.
The study has been published in the May issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Note that the authors mention that contralateral needling works.  This is not a new discovery.  It fits perfectly with the Chinese theory of meridians and collaterals.  According to this, the meridians go up and down and are the big lines you see in point charts.  However, the collaterals also exist that connect one side to another.  While the existence of meridians may be doubted by some, the implication of this belief in meridians and collaterals indicates that what we are verifying scientifically now has been long known by the Chinese since ancient times.  May I also add, that the ancient Chinese put much weight in clinical experience.  They didn’t know how it was happening, but they saw what treatments work through trial and error.  I am glad that, thousands of years later, their hard work is paying off handsomely.

http://timesofindia.indiatimes.com/Life/Health-Fitness/Health/Acupuncture-the-best-bet-to-ease-pain/articleshow/5883083.cms

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