Acupuncture Continuing Education

Acupuncture, Tuina, & Moxa Osteoporosis Pain Relief Found

Researchers find Traditional Chinese Medicine (TCM) modalities including acupuncture, tuina, and moxibustion effective for the treatment of pain associated with osteoporosis. Conclusions reached across several studies delineate specific benefits resulting from the application of acupuncture. Acupuncture outperformed estrogen replacement therapy for bone pain reduction in women with osteoporosis. Related studies confirm the benefits of TCM therapies. Moxibustion (a warming technique employing the use of burning mugwort) at four key acupoints was found successful at regulating blood plasma estradiol levels.

 

Human spine as seen through transparent human

 

Additional studies are consistent with these findings. Another recent study finds acupuncture combined with tuina (traditional Chinese medical massage) beneficial for bone metabolism. In addition, acupuncture outperformed drug therapy for the treatment of osteoporotic spinal compression fracture related pain. The aforementioned study confirms the analgesic effects for which acupuncture is renown. 

Finally, Chinese herbal medicine combined with acupuncture outperformed supplementation with calcium combined with miacalcine (calcitonin-salmon), a synthetic hormone used for the treatment of osteoporosis. Patients receiving herbs and acupuncture had greater bone mineral density improvements and greater reductions of pain, dizziness, and numbness than the supplement group. Let’s take a closer look at these important findings.

Hematologic findings confirm the efficacy of TCM. Wu et al. performed moxibustion at acupoints DU4 (Mingmen), ST36 (Zusanli), UB20 (Pishu), and DU14 (Dazhui). They that this combination of acupoints increased the levels of estradiol in the blood plasma of elderly men and women. (1) Yue and Zeng compared acupuncture therapy to estrogen replacement therapy in 60 women with postmenopausal osteoporosis. They found that acupuncture was more effective in lowering the bone pain score, the osteoporosis symptom score, and the kidney deficiency symptom score than estrogen replacement therapy. (2)

Wang et al. compared two protocols in 64 patients with age related osteoporosis due to calcium calcium deficiencies. The first therapeutic protocol combined acupuncture and tuina (Chinese medical massage); the second protocol combined oral administration of calcium carbonate and vitamin D3 into a therapeutic regimen. Biochemical indices of bone metabolism improvements were similar in both test groups, indicating that acupuncture plus tuina provides many of the benefits afforded by supplementation. Biomechanical indices demonstrated significant improvements. The acupuncture and tuina combination caused a direct improvement measured in the lumbar lordosis index and sacral inclination angle changes. This demonstrates therapeutic effects on the lumbar spine. (3)

Specific acupuncture protocols have been tested for their efficacy in enhancing osteoporosis drug therapies. Zhang et al. conclude that abdominal acupuncture combined with drug therapy is more effective than drug therapy alone for the treatment of pain caused by osteoporotic spinal compression fractures. Furthermore, Zhang et al. find abdominal acupuncture points especially effective when compared with the application of local acupuncture points. (4)

In a similar study, Yuan et al. tested the efficacy of electroacupuncture and herbs (Jiawei Shentong Zhuyu decoction) in conjunction with a protocol of calcium carbonate, vitamin D, and calcitonin-salmon supplementation. Patients in the treatment group receiving the TCM protocols combined with supplements had a 92.5% total effective rate for the relief of pain, numbness, and dizziness. Additionally, functional improvement of walking was significant. Patients receiving only supplements achieved an 80% total effective rate. Objective measurements revealed something very important. Bone mineral density improved more significantly in the TCM plus supplements group than in the group receiving only supplements. (5)

Laboratory findings are consistent with the aforementioned clinical trials. Zhao et al. determined that moxibustion combined with acupuncture has an additive or synergistic effect when combined with drug therapy for regulation of estradiol levels in the blood. (11) Liu et al. found that treatment with acupuncture and moxibustion on acupoints including UB11 (Dazhu), DU14 (Dazhui), and Mingmen (DU4) had a similar effect as treatment with estradiol in regulating levels of estradiol and parathyroid hormone (PTH). (12) Li et al. demonstrated that acupuncture along the governor meridian (Du Mai) can increase bone density. (13) Lab studies conducted by Zhou et al. show that electroacupuncture improves bone mineral density and prevents bone loss. (14)

Based on the findings cited here, we would like to see a large, multi-centered controlled clinical trial focusing on subjective and objective improvements through the use of TCM for patients with osteoporosis. Blood samples, imaging technology, and biomechanical testing are adequate measures in human clinical trials to avoid any need for continuance of animal experimentation. Further, establishing accepted protocols for integrative medicine approaches to osteoporosis care are of paramount importance. At the Healthcare Medicine Institute (HealthCMi), we are encouraged by the current research and look forward to seeing new research focusing on practical methods of TCM protocol integration into standard care settings.


References:
(1) Wu ZC, Wang LL & Xu LF et al. (1996). Effect on plasma testosterone and estradiol of old people. Chinese acupuncture & moxibustion. (8): 27-28.

(2) Yue YR & Zeng ZP. (2001). The contrastive study is between before and after acupuncture for estrogen in postmenopausal osteoporosis. China medical herald. 20(10): 641.

(3) Wang T, Pang L, Huang H, Wang WY. Zhongguo Zhen Jiu journal. 2012 Jan; 32(1):13-6. Observation on influence of bone metabolism biochemical indices of senile osteoporosis treated with distant acupuncture and nearby tuina). Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China.

(4) Zhang, W., Qiu, X. Y. & Wang, J. (2015). Clinical study on abdominal acupuncture for osteoporotic vertebral compression fracture. Journal of Acupuncture and Tuina Science. 13(4).

(5) Yuan LM, Li YM, Chen LM, Lei XH & Jia SJ. (2015). Therapeutic Effect on Primary Osteoporosis Treated by Electro-acupuncture Combined with Jiawei Shentong Zhuyu Decoction. Journal of Clinical Acupuncture and Moxibustion. 31(8).

(6) Jin, Yuelong, Lianping He, Quanhai Wang, Yan Chen, Xiaohua Ren, Hui Tang, Xiuli Song, Lingling Ding, Qin Qi, Zhiwei Huang, Jiegen Yu, and Yingshui Yao. "Serum Calcium Levels Are Not Associated with Coronary Heart Disease." Vascular Health and Risk Management. Dove Medical Press, 3 Sept. 2013. Web. 16 Sept. 2016.

(7) Morley, Paul, James Whitfield, and Gordon Willick. "Parathyroid Hormone An Anabolic Treatment for Osteoporosis." CPD Current Pharmaceutical Design 7.8 (2001): 671-87. Web.

(8) Chinese Medical Association of Osteoporosis and Bone Mineral Disease Branch. Treatment Guidelines of Osteoporosis. (2011). Chinese Journal of Osteoporosis and Bone Mineral Research. 4(1): 2-15.

(9) Meng XW. (2012). The risk factors and assessment of primary osteoporosis. Journal of Diagnostics Concepts & Practice. 11(1): 1-4.

(10) Office of the Surgeon General (US). "Bone Health and Osteoporosis: A Report of the Surgeon General." The Basics of Bone in Health and Disease. U.S. National Library of Medicine, n.d. Web. 16 Sept. 2016.

(11) Zhao Yingxia, Yan Zhenguo, Shao Shuijin. (1999). The effect of acupuncture and moxibustion on experimental osteoporosis. Chinese acupuncture and moxibustion. (19): 301-303.

(12) Liu XX, Wu Mx, Wu BH et al. (2000). The effect of acupuncture and moxibustion on osteoporosis experimental and clinical studies. China journal of orthopaedics and grammatology. 13(9): 519-521.

(13) Li Y, Xu GS, Liu GX et al. (2006). The influence of acupuncturing Du Meridian to cure osteoporosis rats model serum cytokines and bone mineral density. Journal of Anhui TCM College. 25(6): 27-29.

(14) Acupunct Med 2012;30:37-43 doi:10.1136/acupmed-2011-010114. Electroacupuncture prevents ovariectomy-induced osteoporosis in rats: a randomised controlled trial. Jun Zhou, Shiju Chen, Hua Guo, Lu Xia, Huifang Liu, Yuxi Qin, Chengqi He.

 

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