Acupuncture Continuing Education

Acupuncture Relieves Dizziness and Vertigo

Acupuncture is safe and effective for the treatment of dizziness and vertigo for emergency room patients. Subjective and objective measures document significant positive patient outcomes in a recent investigation. Close up of needling. HRV (heart rate variability), Dizziness Handicap Inventory (DHI), and the Visual Analog Scale (VAS) of dizziness and vertigo show that acupuncture has an immediate and significant therapeutic effect.

The researchers note that although acupuncture has been used for the alleviation of dizziness and vertigo for over a thousand years, few modern studies investigated this clinical phenomenon. The goal of the study was to determine the safety and efficacy of acupuncture for the treatment of dizziness and vertigo in the emergency department of a hospital. Patients were recruited from the emergency department at the Changhua Christian Hospital, Taiwan. All patients were screened by an otolaryngologist and a neurologist for inclusion and exclusion criteria. Inclusion criteria included dizziness, vertigo, vertebrobasilar artery syndrome, Ménière’s disease, and vestibular neuritis.

Acupuncture
Patients were divided into acupuncture and control groups. Patients in the acupuncture group had acupoints ST36 (Zusanli) and PC6 (Neiguan) applied with single-use, sterile, 40 x 0.25 mm silver handled acupuncture needles. The needles were manually stimulated to achieve the de qi sensation. Needle retention time was 30 minutes per acupuncture session. The control group received sham acupuncture. Pasting of seed patches were applied to areas approximately 1 cm away from true acupuncture points. Massage and acupressure were not applied to either group.

The study conclusively demonstrates that the application of acupuncture to PC6 and ST36 results in immediate reductions in discomfort and improvements of VAS for dizziness and vertigo. The researchers note that the “study provided clinical evidence on the efficacy and safety of acupuncture to treat dizziness and vertigo in (the) emergency department.”

The choice of acupuncture points is consistent with Traditional Chinese Medicine (TCM) theory. PC6 is indicated for the treatment of nausea, vomiting, asthma, swollen and painful throat, epilepsy, painful ribs and chest, gastralgia, hiccups, palpitations, and asthma. PC6 is located 2 cun above the transverse wrist crease between the tendons of the palmaris longus and flexor carpi radialis. PC6 is a luo point and a confluent point of the yinwei channel. It functions to calm the heart, pacify the spirit, regulate qi, and suppress pain. 

ST36 is 3 cun below ST35 and is one finger breadth from the anterior crest of the tibia in the tibialis anterior muscle. ST36 is a he sea, earth, lower he sea of the stomach, gao wu command, heavenly star, and sea of nourishment point. ST36 functions to order the spleen and stomach, regulate qi and blood, and tonify qi. ST36 is indicated for the treatment of gastroenteritis, ulcers, bellyache, abdominal bloating, constipation, dyspepsia, hypertension, epilepsy, and appendicitis. 

Leg shot of ST36, Zusanli.

Heart Rate Variability
A heart rate monitor was used to determine heart rate variability. HRV is the variation in time between heart beats and is an index of the body’s ability to maintain control of the heart beat rate and rhythm through vagus nerve activity. Prior research, including Anderson et al., demonstrates that acupuncture improves heart rate variability. A lowering of HRV is found in unhealthy and highly stressed individuals.

Acupuncture’s ability to raise HRV is of importance because reduced HRV is linked to mortality after myocardial infarction, congestive heart failure, diabetic neuropathy, and low survival rates in premature babies. In this recent research, HRV changes were documented because predisposition to autonomic nervous system dysfunctions relating to Ménière’s disease and other causes of dizziness and vertigo may be reflected in HRV values. This new study documents acupuncture’s ability to benefit HRV values.

Consumer Electronics
In this study, HRV was measured with an advanced device, the ANSWatch wrist monitor by Taiwan Scientific Corporation. Interestingly, there are consumer level devices that now claim EKG levels of accuracy for measuring HRV. This includes devices that link to an iPhone or other smart device through a chest band heart rate monitor device. Some devices, including the Mio Velo cycling heart rate band, claim “EKG-accurate heart rate data, with no strap required.” The Mio Velo device transmits data to iOS smartphone apps such as the SweetBeatLife app. This empowers the consumer to take their own readings of HRV for purposes of determining health and fitness levels.

The Mio Velo uses pulse oximetry, which measures the heart rate using light pulses to read skin color changes to measure blood flow variations. The Apple Watch also uses pulse oximetry to measure the heart rate. A concern is that pulse oximetry is not as accurate as chest bands and other devices that record heart beats. Over time, consumer electronic wrist technology is expected to improve significantly both in functionality and versatility.


References:
Chiu, Chih-Wen, Tsung-Chieh Lee, Po-Chi Hsu, Chia-Yun Chen, Shun-Chang Chang, John Y. Chiang, and Lun-Chien Lo. "Efficacy and safety of acupuncture for dizziness and vertigo in emergency department: a pilot cohort study." BMC complementary and alternative medicine 15, no. 1 (2015): 173.

Acupuncture and heart rate variability: a systems level approach to understanding mechanism. BMC Complementary and Alternative Medicine. 12 (Suppl 1), P302. B Anderson, A Nielsen, B Kligler, and D McKee.

Kurono Y, Minagawa M, Ishigami T, Yamada A, Kakamu T, Hayano J. Auton Neurosci. Acupuncture to Danzhong but not to Zhongting increases the cardiac vagal component of heart rate variability. 2011 Apr 26;161(1-2):116-20. Epub 2011 Jan 7.

Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh YH, Zee DS. Imprecision in patient reports of dizziness symptom quality: a cross- sectional study conducted in an acute care setting. Mayo Clinic Proc. 2007; 82(11):1329-1340.


Acupuncture Continuing Education Credits

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