Objective: The purpose of this study was to compare the effects of superficial and deep insertion of acupuncture needles in the treatment of patients with neck-shoulder pain and to search for more effective acupuncture methods. Methods: The subjects were patients seen at the Meiji University of Integrative Medicine’s Department of Orthopedic Surgery Clinic. A randomized controlled clinical trial was conducted in which 20 patients with neck-shoulder pain were randomly allocated to either a superficial acupuncture group (n=10) or a deep acupuncture group (n=10). Treatment was applied to points where patients experienced the most pain. The maximum number of stimulation points for both groups was 10. In the superficial acupuncture group, the needle was only inserted to a depth of 5 millimeter. In the deep acupuncture group, the needle was inserted to a depth of 15 to 20 millimeter. Both groups were manually stimulated using a sparrow pecking method over 20 seconds, after which the needle was removed. Both groups were treated weekly for four weeks. The primary outcome measurement was intensity of pain evaluated using a Visual Analogue Scale (VAS). The secondary outcome measurement was the Neck Disability Index (NDI) for the purpose of evaluating the grade of disability in daily life due to neck-shoulder pain. Results: There were no significant differences in age, male-female ratio, disease duration, or the initial scores of VAS and NDI between the two groups. VAS and NDI scores indicated significant differences between the groups (VAS: <0.0001, NDI: p<0.0001) in change over time, with the deep acupuncture group having more favorable results than the superficial acupuncture group. The degree of change from the baseline at the time of each evaluation was calculated, and results for the two groups were compared. The deep acupuncture group showed significantly better improvement in the sustained effects after completion of treatment (VAS: p<0.05). There were no significant differences directly after the first treatment (VAS: p=0.72) or in cumulative effect after repeated treatment (VAS: p=0.24). Discussion and Conclusion: The results of this study suggested it would be more efficient to insert the needle to deep tissues when performing acupuncture treatment on subjective pain sites. The difference in the effects between the two acupuncture methods may be due to the difference in tissue stimulation received. The difference in effect is thought to be due to the differing influence of treatment on pain threshold, muscle blood flow, and muscle tones.

Objective: We applied acupuncture to the cervical region of patients suffering from upper extremity radicular symptoms due to cervical spondylotic radiculopathy (CSR) and verified clinical efficacy. Methods: 16 extremities of 15 patients were selected as subjects diagnosed with CSR and suffering from upper extremity pain and/or dysaesthesia. All of the patients were treated with acupuncture once a week for four weeks, on up to ten sites where tension/induration was recognized in the cervical paraspinal region centered around the affected area. A stainless steel needle 0.18mm in diameter was inserted 10 to 20mm, manipulated using the sparrow pecking method (1Hz, 20sec) and removed. The severity of symptoms was recorded before each treatment and one month after the completion of the treatments using a Visual Analogue Scale (VAS) and evaluated. In addition, a Quality of Life (QOL) evaluation was conducted before treatment, after four treatments, and one month after the completion of the treatments using the Neck Disability Index (NDI) and CSR treatment effectiveness metrics. Results: VAS plots show a significant change in pattern over time in all cases (Neck-shoulder pain: p<0.0001, upper extremity pain: p<0.0001, upper extremity dysaesthesia: p<0.001). Furthermore, in QOL evaluation, both NDI and CSR treatment effectiveness metrics similarly showed a significant change (NDI: p<0.0001, CSR treatment effectiveness metrics: p<0.0001). Because there was a significant difference (p<0.001) between symptoms before treatment and before the fourth treatment, the efficacy of continued treatments was verified. Meanwhile, there was no significant difference between the symptoms at the completion of the treatments and the symptoms one month after the completion of the treatments; thus, the sustained efficacy of treatments over a certain period was verified (p=0.52). Discussion and Conclusion: These results verified that acupuncture treatment to the cervix has continued and sustained efficacy not only on the symptoms of neck and shoulders due to CSR, but also on upper extremity pain and/or dysaesthesia; therefore, we think this is a promising treatment as the first choice for conservative therapy. The mechanism that alleviates upper extremity pain and/or dysaesthesia through acupuncture treatment to the cervix via the stimulation of the posterior branch of the spinal nerve dominating the cervical paraspinal muscle creates a reflex effect in the anterior branch of the same nerve; as a result, it is beneficial for suppressing upper extremity pain dominated by the anterior branch as well as improving nerve blood flow.

Objective: Snapping finger is the result of gliding disorder of the superficial and deep digital flexor tendon and the flexor pollicis longus muscle tendon at the synovial and ligamentous tendon sheath (A1 pulley). In this study, acupuncture was performed at the A1 pulley of the affected finger to determine its effect on pain during snapping and the degree of the snapping phenomenon. Methods: Acupuncture was performed on 19 fingers of 15 patients. No control group of untreated patients was included in the study, and the same acupuncture treatment was used for all of the patients. The acupuncture needles were inserted in the radial and ulnar sides of the flexor tendon (left inserted for 10 min) at the A1 pulley of the affected finger. Treatment was performed a maximum of 5 times (once every 5 to 7 days). Before and after each treatment, the pain during snapping and the degree of the snapping phenomenon were evaluated using a visual analogue scale (VAS) ranging from 0 mm (no symptoms) to 100 mm (intolerable symptoms). Symptoms before the first treatment and before the fifth treatment were compared to determine the degree of change, taking a 50% improvement as the criterion for judging whether there was an improvement or not, and the relationship between improvement or lack of improvement and the duration of the disorder was examined. Results: VAS evaluation showed a significant improvement in pain during snapping and the degree of the snapping phenomenon with scores before the first treatment and before the fifth treatment of 57.1±22.2 (mm, mean±SD)→26.0±29.8, 61.2±23.1→26.1±27.6 respectively. VAS evaluation directly after the first treatment also showed a significant improvement in pain and the degree of the snapping phenomenon with scores of 40.8±19.6 and 44.3±23.9 respectively. Furthermore, by the fifth treatment, pain and the snapping phenomenon were observed to have completely disappeared in 4 and 6 fingers respectively. In patients showing an improvement in pain and the snapping phenomenon, the duration of the disorder was significantly short. Discussion: It is unlikely that acupuncture had an influence on the degeneration and thickening of the ligament tendon sheath. Improvement in the snapping phenomenon is thought to be the result of acupuncture treatment changing regional blood flow and thereby exerting a favorable influence on inflammatory swelling. The alleviation of pain during snapping is believed to be the result of improved flexor tendon gliding as well as the involvement of acupuncture in activation of the pain inhibitory system. Since no control group of untreated patients or sham treatment group were included in the study, the possibility of a placebo effect influencing the results cannot be completely excluded. However, because a difference was observed in the efficacy of the treatment depending on the duration of the disorder, the view is that acupuncture at the impaired A1 pulley could be effective treatment for snapping finger when the main cause is inflammatory swelling of the synovial membrane of the tendon sheath and when the duration of the disorder is short.

Objective: Histological and dynamic assessment to determine the effect of electroacupuncture on tendon repair in a rat model of Achilles tendon rupture. Methods: Sixty 12-week old male Wistar rats were used to prepare an Achilles tendon rupture model. The rats were randomly divided into an electroacupuncture group (EA group) and a control group. The EA group rats were restrained, and under mild anesthesia two acupuncture needles were inserted with the tip of one touching the ruptured tendon on the outer side, and the tip of the other touching it on the inner side. Using the needle on the inner side as the cathode and the needle on the outer side as the anode, electroacupuncture with intermittent direct current was performed (pulse width: 5 ms, stimulation frequency: 50 Hz, stimulation strength: 20 μA, stimulation time: 20 min). Electroacupuncture was performed every day from the day after model preparation until the days of assessment. Rats in the control group were retrained and mildly anesthetized only. Samples from the region of interest were taken 7 and 10 days after model preparation to assess tendon repair. Tissue imaging was performed, using HE staining to measure total cell count and immunohistochemical staining to measure the number of cells positive for TGF-β1 and b-FGF. Tension tests were also performed 10 days after model preparation to measure the maximum failure load of repaired tendon. Results: HE staining showed a significant difference between the assessment results on different days and between the two groups. A clear increase in the cell count was observed in the EA group (day 7: p<0.05, day 10: p<0.001). Immunostaining showed the strongest expression of both TGF-β1 and b-FGF in the EA group 7 days after model preparation, and other significant difference were observed (TGF-β1: day 7 EA group vs. day 10 EA group: p<0.001, vs. day 7 control group: p<0.0001, vs. day 10 control group: p<0.0001) (b-FGF: day 7 EA group vs. 10 EA group: p<0.001, vs. day 7 control group: p<0.0001, vs. 10 day control group: p<0.0001). Maximum failure load of repaired tendon 10 days after model preparation was significantly higher in the EA group (p<0.01). Discussion: Examination in the early stages after Achilles tendon rupture showed an increased cell count and increased expression of growth factors in the EA group, as well as increased tendon strength. These results indicate the beneficial action direct current electroacupuncture has on cell growth and growth factor expression during tendon repair, and suggest it also increases the dynamic strength of repaired tendon. Direct current electroacupuncture is thought to be possibly useful method for promoting tendon repair.

Looking back upon the history of Japanese acupuncture and moxibustion from the Meiji era to the present day, this study (research paper) confirms the changes in Japanese acupuncture and moxibustion according to certain points of specific features such as the education system and the progress, and growth of medical study.

[Objective]To clarify the effects of electroacupuncture (EA) on the menstrual cycle at puberty, we investigated whether or not EA influences the menstrual cycle, the number of ovulations, and the duration of the high-temperature phase. Also we investigated the improvement of menstrual disorder and changes in body mass index (BMI) by EA treatment.
[Methods]Twenty-five female students participated in this study.
Non-treatment periods from three to four months were evaluated before EA treatment. During treatment, EA was performed once a week. We compared the menstrual cycle, the number of ovulations, and the duration of the high temperature phase for non-treatment and EA treatment periods. To evaluate the relation between BMI and improvement of menstrual disorder by EA, female students were divided into two groups, improvement or not-improvement group.
[Results]Twenty female students were analyzed in this study. In those with extended periods of amenorrhea, the menstrual cycle became significantly shorter during EA (P< 0.001). In those with polymenorrhea, the menstrual cycle became significantly longer during EA (P< 0.05), reaching a normal cycle length. Improvement of the menstrual cycle was found in 30.0%of the subjects. However, an increase in the number of ovulations and extended duration of the high temperature phase were found in 20.0%and 25.0%of the subjects, respectively. Although BMI did not vary significantly between the improvement and the not-improvement groups, the percentage of those with normal weight tended to be higher in the improvement group than in the not-improvement group.
[Conclusion]These findings suggest that EA influences follicular growth. However, it had been thought that EA could not influence ovulation or affect luteal function. Additionally, when BMI is nearly normal, it appears more likely that acupuncture is effective for menstrual disorder at puberty.