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A new study concludes that acupuncture reduces knee pain and increases mobility for patients with osteoarthritis. This new randomized, controlled, double-blinded study also revealed some differences in acupuncture treatments. The researchers compared non-specific (sham) needling, modern acupuncture and classical acupuncture treatments.

The results showed that sham acupuncture only achieved a patient pain reduction rate in 48% of patients while modern acupuncture achieved a 64% rate and classical acupuncture achieved a 73% rate. Sham acupuncture did not improve knee mobility but modern and classical acupuncture made significant, measurable improvements in knee mobility. The researchers concluded that there is “a specific effect of acupuncture in knee mobility.” The researchers also note, “With respect to knee motility, individualised classical acupuncture achieved twice the effect of semistandardised modern acupuncture.”

Acupuncture for knee osteoarthritis. Acupuncture for KneesThe sham acupuncture bodily points were those not specifically noted for the treatment of knee pain in Chinese medicine texts. The modern acupuncture points were those suggested based on the biomedical condition of knee osteoarthritis. The acupuncture points were: ST36, ST34, EX32, SP9, SP10, SP6, GB34, LI4. The classical acupuncture points chosen were based on a customized differential diagnosis based on tissue tenderness, tongue diagnosis, pulse diagnosis, syndrome differentiation and symptoms. Needles chose for the study in all cases were 0.22 X 40mm copper needles. Ear and hand points were excluded from the study. Needle stimulation was applied and needle retention was a total of 30 minutes per treatment.

The researchers note, “This suggests a considerable specific effect of acupuncture in objective knee flexibility, an effect that appears to be method-specific as well… we observed a rapid improvement of knee flexibility immediately after classical acupuncture, which was twice the effect observed after modern acupuncture and absent after non-specific needling.”

This is not the first study showing the effectiveness of acupuncture for the treatment of knee disorders. One recent study discovered that acupuncture is more effective than both sham acupuncture and biomedicine for the treatment of knee pain. A meta-analysis of 14 random controlled clinical trials involving 3,835 patients states, “Acupuncture provided significantly better relief from knee osteoarthritis pain and a larger improvement in function than sham acupuncture, standard care treatment, or waiting for further treatment.” The study notes that acupuncture for the treatment of knee osteoarthritis is “better at relieving pain and restoring function” than both standard biomedical care and sham acupuncture.


References:
Max Karner, Frank Brazkiewicz, Andrew Remppis, et al., “Objectifying Specific and Nonspecific Effects of Acupuncture: A Double-Blinded Randomised Trial in Osteoarthritis of the Knee,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 427265, 7 pages, 2013. doi:10.1155/2013/427265


Sau. Med J. 2012 May;33(5):526-32. Needle acupuncture for osteoarthritis of the knee. A systematic review and updated meta-analysis. Cao L, Zhang XL, Gao YS, Jiang Y. Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.

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The California Acupuncture Board publishes its acupuncture exam results. This documents the total number of students taking the exam and pass rates for each acupuncture school. To become a licensed acupuncturist in California, passing the state board exam is prerequisite.

Acupuncture TreatmentAcupuncture TreatmentNationally, most other states require passing the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) exams. California licensed acupuncturists are not required to hold NCCAOM certification. However, many acupuncturists sit for these exams to have the freedom to practice in other states.

Largest Number of Students
The acupuncture university with the most students sitting for the California Acupuncture Board exam in 2011 is South Baylo University. A total of 52 students sat for the boards for the very first time and 101 students, including re-examinees, took the exams. This is by far the largest number of students from any college or university qualifying to sit for the California Acupuncture Board exam. The same was true in 2010 when South Baylo University sent 84 first-time takers and 120 total takers to sit for the acupuncture exam. South Baylo University has two campuses, one in Anaheim and one in Los Angeles, California.

In the number two slot for the most students sitting for the acupuncture exam, the Pacific College of Oriental Medicine sent 24 first-time takers and a total of 32 total takers, including re-examinees, to sit for the acupuncture board. The Pacific College of Oriental Medicine has campuses in San Diego, New York and Chicago. Five Branches University sent 23 first-time takers to the exam and a total of 24 including an additional re-examinee. Five Branches has campuses in San Jose and Santa Cruz, California. The University of East West Medicine sent 16 first-time takers and 26 including re-examinees. They have a campus in Sunnyvale, California. Emperor’s College of Traditional Oriental Medicine sent 16 first-time takers and 18 including re-takers. Emperor’s College is located in Santa Monica, California. Dong-guk University, located in Los Angeles, sent 17 first-time takers and 32 including re-examinees.  The Acupuncture & Integrative Medical College, Berkeley sent 18 first-time takers and 22 including re-examinees.

The American College of Traditional Chinese Medicine (ACTCM), located in San Francisco, sent 13 first-time takers and 15 takers including re-examinees to sit for the California Acupuncture Board exam. Notably, every ACTCM first-time taker passed the exam. As a percentage, that feat was only matched by Nine Star University of Health Sciences and Santa Barbara College of Oriental Medicine. However, these schools each sent only one first-time taker to sit for the boards. In 2010, ACTCM had an 88% pass rate for first-time takers. The only school beating this number was Five Branches University with a passage rate of 89%. The Southern CA University of Health Sciences sent 14 first-time takers to the boards and 23 including re-examinees. The Southern CA University School of OM & Acupuncture sent 7 first-time takers and 19 including re-examinees. The Academy of Chinese Culture & Health Sciences, Oakland sent 7 first-time takers and 16 total including re-examinees.

Exam Pass Rates 2011
ACTCM had a 100% exam pass rate in 2011 amoung first-time takers. The University of East West Medicine had a 94% pass rate. In 2010, ACTCM had an 88% pass rate and the University of East West Medicine had an 86% pass rate. Of the larger schools also showing very strong pass rate numbers were Five Branches University (78%), Emperor’s College of Traditional Chinese Medicine (75%) and South Baylo University (67%). These schools continue to show consistent pass rates year over year.
 
Differences in acupuncture exam pass rates are not only a reflection of educational quality but also reflect admissions policies and language issues amoung a diverse student body. Smaller schools with strong pass rates include YoSan University of TCM, Southwest Acupuncture College, Samra University, Life University, Bastyr University, and Acupuncture & Integrative Medical College, Berkeley.

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The Healthcare Medicine Institute (HealthCMi) has selected its winner for the best acupuncture app of 2012 for the iPhone, iPad and iPod Touch. The year draws to a close and even the Year of the Dragon begins its shift to the Year of the Snake.  An enormous amount of innovation, research and changes have come to Chinese medicine, acupuncture and herbal medicine. One app stands above the rest in 2012 as the most practical, user-friendly and accurate acupuncture tool for licensed acupuncturists and students. The Manual of Acupuncture iOS app is this year’s winner.

iPhone and iPad iPhone & iPad Acupuncture AppAt HealthCMi, we feel that Chinese medicine involves a lifelong process of learning. The Manual of Acupuncture iPhone/iPad app infuses fun into this clinical and scholarly adventure. Based on the source text A Manual of Acupuncture by Peter Deadman & Mazin Al-Khafaji with Kevin Baker, this app adds new value with its audiovisual clips demonstrating location and needling tips for each acupuncture point.

The textbook, DVD-ROM and Windows PC digital download versions provide an in-depth analysis and commentary on the acupuncture points. The iPhone/iPad app version summarizes each point in a clear and concise manner and adds friendly search features, videos, the option to add personal notes and flag points and a self-testing module. In this way, the iOS app functions as a handy reference tool and the textbook provides deep analysis including quotes from classical acupuncture works. Both are highly recommended.

This acupuncture iOS app includes all of the channels and extra points included in the textbook. Each point is referenced by its number, English translation, pinyin and Chinese character. There are diagrams and illustrations for individual acupoints, primary channels, luo-connecting channels, divergent channels and sinew channels. Simply tap on a diagram and it zooms in for a closer look! Reference material includes information on cun measurements, location tips, needling guidelines and a glossary. The videos provide audiovisual support making every point easily located.

Listing the features of this acupuncture app doesn’t begin to share the elegance and simplicity with which a wealth of information is presented. At your fingertips are the needling techniques, location, indications and functions of each acupuncture point. All data is easily accessible, accurate and concise. Appropriate needling precautions are added for sensitive points such as ST9 (Renying) and ST1 (Chengqi).

An updated version coming in 2013 will include additional easy swipe features, more live links, additional diagrams and functional enhancements. We applaud this continued commitment to an already superb acupuncture app. Available in the Apple App Store online, this app is priced at $35.99 USD and is an excellent value.

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New research reveals how acupuncture protects the brain in areas damaged by Parkinson’s disease. Scientists at the World Health Organization Collaborating Center for Traditional Medicine have discovered two acupuncture points that prevent the breakdown of an important brain protecting enzyme, tyrosine hydroxylase. This enzyme helps the body to create L-DOPA, an important dopamine precursor and drug used in the treatment of Parkinson’s disease. It is now known that acupuncture prevents decreases of the L-DOPA creating enzyme in the thalamic portions of the brain thereby improving the motor function that is destroyed by Parkinson’s disease.

MRI of the brain with Parkinson's disease is depictedHealthy Brain MRILoss of dopamine neurons in the substantia nigra portion of the brain is a key pathology in Parkinson’s disease and tardive dyskinesia. The World Health Organization (WHO) scientists have discovered that acupuncture inhibits decreases of tyrosine hydroxylase in nigrostriatal dopaminergic neurons thereby protecting dopamine neuron levels in the substantia nigra portion of the brain. Depletion of these neurons leads to Parkinson’s disease and acupuncture stimulation of acupoints GB34 and LV3 prevents depletion by sustaining tyrosine hydroxylase levels.

About the Acupoints
Acupuncture point LV3 has been historically used to treat tremors such as those associated with Parkinson’s disease. It is located on the dorsum of the foot in the fossa between the first and second metatarsal bones. Its traditional classifications in Chinese medicine theory include: shu-stream point, source point, earth point, heavenly star point. Traditional functions of the point include: move Liver Qi, quell Liver Yang and wind, nourish the Liver, regulate menstruation, stop pain and clear the head and eyes. Common applications for the use of LV3 (Great Rushing, Taichong) include the treatment of menstrual disorders, headaches, dizziness, epilepsy, tremors, high blood pressure, insomnia and blurry vision.

Acupuncture point GB34 has been historically used to treat a variety of conditions including hemiplegia, total paralysis of the arm, leg and trunk on one side of the body. Common usage by licensed acupuncturists includes the treatment of tendon, ligament and joint disorders. Traditional classifications for this acupoint are: He-Sea, earth point, influential point of the tendons, heavenly star point. GB34 is indicated for the treatment of pain related conditions such as sciatica, hip pain, joint pain, muscle pain, tendon pain and knee pain.

According to Chinese medicine theory, both acupuncture points harmonize the Shaoyang channel. This makes both points well suited to treat disorders associated with tremors and other symptoms associated with Parkinson’s disease. Further research is required to determine whether or not other acupoints that harmonize the Shaoyang channel prevent decreases of tyrosine hydroxylase in the brain.


Reference:
Gene. 9 December 2012. Neuroprotective Changes of Thalamic Degeneration-Related Gene Expression by Acupuncture in an MPTP Mouse Model of Parkinsonism: Microarray Analysis. Sujung Yeo, Yeong-Gon Choi, Yeon-Mi Hong, Sabina Lim. Research Group of Pain and Neuroscience, WHO Collaborating Center for Traditional Medicine, East–west Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea. Department of Basic Oriental Medical Science, College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea.

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New acupuncture research shows that acupuncture is effective for the treatment of neck spondylosis, a type of degenerative osteoarthritis. This condition often causes pain, numbness and weakness of the limbs. The researchers compared to approaches to treatment.

Acupuncture for Neck PainAcupuncture for Neck PainGroup 1 consisted of 55 subjects who received acupuncture at acupoints Bailao (Ex-HN15), Ht7 (Shenmen), and SI4 (Wangu). Next, Group 1 received moxibustion treatment at GV14 (Dazhui), UB15 (Xinshu) and UB23 (Shenshu). In the third stage of care, group 1 received intradermal needling at Bailao (Ex-HN15), UB15 and UB23. Group 2 consisted of 56 subjects who received acupuncture at acupoints Bailao and TB3 (Zhongzhu). Next, group 2 subjects received intradermal needling at Bailao and SI15.

Both groups improved significantly in a before and after treatment comparison. When the groups were analyzed for statistical differences between age groups, group 1 showed significantly better results for subjects over 45 years of age. The researchers concluded that the group 1 treatment program demonstrates clinically superior efficaciousness for patients that are 45 years or older with chronic cervical spondylosis.


Reference:
Zhongguo Zhen Jiu. 2012 Sep;32(9):769-75. [Chronic neck pain of cervical spondylosis treated with acupuncture and moxibustion in terms of the heart and kidney theory: a randomized controlled trial]. Xu SJ, Liang ZH, Fu WB. Acupuncture-Moxibustion Department of Guangdong Hospital of TCM, Guangzhou, China.

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Electrical engineers in a medical research team discovered how acupuncture benefits sleep. They did it by measuring brain activity with EEG (electroencephalography) before, during and after an acupuncture treatment. Results were conclusive, acupuncture significantly increases slow wave activity of the brain relative to fast wave activity in both the frontal and central lobes. This phenomena is known to benefit the quality and duration of sleep.

acuEEGst36EEGThe acupuncture point used in this study increases the delta band power density, a known sleep related brain wave band. In addition, acupuncture at this point downregulates alpha and beta band activity relative to delta band activity. The decreases in these bands also enhances sleep quality.

The researchers applied manual acupuncture to humans at acupoint ST36. It was found that this acupoint significantly increases the power ratio index of slow waves to fast waves following an acupuncture treatment. Stainless steel 0.2 mm diameter acupuncture needles were applied to the subjects. The needles were applied and retained for an initial two minutes followed by manual rotation of the needles applied for another two minutes. Measurements were taken throughout the brain of the delta (0 - 4 Hz), theta (4 - 8 Hz), alpha (8 - 13 Hz) and beta (13 - 30 Hz) bands. Notably, there were increases in the delta band power in five major brain areas during and after acupuncture.

The researchers note that “acupuncture at ST36 can induce obvious changes in different EEG rhythms in healthy subjects.” They also note that acupuncture modulations of brain activity resulting from acupuncture point stimulation show “that the  brain plays a key role in acupuncture research.” They also suggest that “cortical electrical activities may be an important mechanism by which acupuncture exerts its complex multisystem effects.”



acupuncturest36thetaST36 Acupuncture EEG


Reference:
Chin. Phys. B Vol. 22, No. 2 (2013) 028703. Modulation of electroencephalograph activities by manual acupuncture stimulation in healthy subjects: An
autoregressive spectral analysis. Yi Guo-Sheng, Wang Jiang, Deng Bin, Wei Xi-Le, and Han Chun-Xiao.
a)School of Electrical and Automation Engineering, Tianjin University, Tianjin, China
b)Tianjin Key Laboratory of Information Sensing & Intelligent Control

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Acupuncture combined with moxibustion is more effective than conventional ‘western’ medicine for the treatment of irritable bowel syndrome (IBS). A new meta-analysis of 11 research investigations with a sample size of over 950 patients shows that acupuncture with moxibustion leads to better clinical outcomes than conventional pharmaceutical drug therapy. In addition, the study shows that acupuncture combined with moxibustion is not only effective but is also safe. The researchers conclude, “Acupuncture-moxibustion for irritable bowel syndrome is better than the conventional western medication treatment.”

Acupuncture at Yintang for relation. Acupoint Relaxation This is not the first time Chinese medicine has been shown effective for the treatment of irritable bowel syndrome. The Journal of the American Medical Association made an impact in the western world with its ground breaking publication of findings showing that Chinese herbal medicine “offer(s) improvements in symptoms for some patients with IBS.” This early study used the modern standards of investigation now commonly employed in acupuncture and herbal medicine studies. It was a randomized, double-blind, placebo-controlled trial. Gastroenterologists worked in combination with herbalists but both groups were blinded to the treatment group. The study discovered that Chinese herbal medicine improved patients’ health with irritable bowel syndrome including significant improvements documented 14 weeks after completion of the herbal medicine treatments.

Clinical Highlights
One effective herbal formula used for the treatment of irritable bowel syndrome is Shu Gan Wan. Often referred to as soothe the liver pills, this formula is known for its ability to prevent Liver Qi stagnation from attacking the Spleen and Stomach. This syndrome is indicated by abdominal discomfort and gas, bloating, hiccups, belching, abdominal pain, erratic stools and poor digestion. In some cases, hypoglycemia or ulcerative gastritis develops. This syndrome is common when emotional, physical and dietary stresses cause stomach and digestive upset. Irritability and anger during or after eating is a common example of when Liver Qi stagnation attacks the Stomach and Spleen. This is why Chinese medicine doctors often recommend not reading the newspaper during meals or eating in rush or under pressure.

One effective acupuncture point for the treatment of irritable bowel syndrome is LV13 (Zhangmen, Completion Gate). LV13 is the Front Mu point of the Spleen, the Influential point of the Zang organs and is the meeting point of the Liver and Gallbladder channels.   This point harmonizes the Liver and Spleen and regulates both the middle and lower burners (jiao). Located anterior and inferior to the free end of the 11th rib, this point is never needled deeply and has many benefits to the digestive system. Indications for the use of this point include pain in the hypochondrium, diarrhea, indigestion, vomiting and abdominal distention.

References:
Zhongguo Zhen Jiu. 2012 Oct;32(10):957-60. [Meta analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome]. Pei LX, Zhang XC, Sun JH, Geng H, Wu XL. Acupuncture and Rehabilitation Department, Jiangsu Province Hospital of TCM, Nanjing, China.

JAMA. 1998 Nov 11;280(18):1585-9. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Research Unit for Complementary Medicine, University of Western Sydney Macarthur, Campbelltown, New South Wales, Australia.

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Investigators now confirm that acupuncture immediately lowers high blood pressure and has long-term anti-hypertensive effects. High blood pressure, hypertension, affects approximately 1 billion people. Seventy patients with hypertension were given acupuncture five times per week over a three month period. An important pattern emerged. Immediately after acupuncture treatments, the blood pressure reduced significantly. More importantly, the overall blood pressure readings began to decrease over time. Before and after each successive acupuncture treatment, both the systolic and diastolic blood pressure readings showed a gradual decrease over time. The researchers concluded that acupuncture decreases blood pressure both immediately and in the long-term.

About the Acupuncture Points
Acupuncture for HBPAcupuncture for ther HeartAcupuncture points used in the study were: ST9 (Renying), LI4 (Hegu), LV3 (Taichong), LI11 (Quchi) and ST36 (Zusanli). ST9 (Renying, Man’s Welcome), located on the neck, is classified as a window of sky point, a sea of Qi point and a meeting point of the Stomach and Gallbladder channels. This point regulates Qi and Blood. ST9 alleviates pain and benefits the throat and neck. ST9 strongly settles uprising rebellious Qi and is therefore effective for the treatment of headaches, hypertension, wheezing and vomiting. The bilateral application of acupuncture points LI4 and LV3 is known as the “four gates.” The pain reducing properties of the four gates is well known. The four gates stimulate the free flow of Qi and Blood circulation. LI11 (Quchi, Pool at the Crook) is a He-Sea and earth point. This anti-inflammatory acupoint may be combined with ST36, an important yangming point often used to nourish the body. This combined pair is often used for the treatment of hypertension when applying a reducing technique to the needles.

How Acupuncture Lowers Blood Pressure
In another recent study, researchers from University of California, Los Angeles and University of California, Irvine discovered how acupuncture lowers blood pressure. Acupuncture reduces hypertension by stimulating brain neurons, electrically excitable cells that transmit information. Acupuncture downregulates neural activity of the rostral ventrolateral medulla of the brain (rVLM) thereby reducing sympathetic nervous system overstimulation and reducing blood pressure. The researchers “have shown that electroacupuncture stimulation activates neurons in the arcuate nucleus, ventrolateral gray, and nucleus raphe to inhibit the neural activity in the rVLM in a model of visceral reflex stimulation-induced hypertension.” In this study, electro-acupuncture at acupoints P5, P6, LI10 and LI11 were shown to reduce hypertension.

Another recent study shows that acupuncture improves HRV (heart rate variability). HRV measures that body’s flexibility in controlling the heart rate in stressful circumstances. The HRV research notes that acupuncture synchronizes the sympathetic and parasympathetic nervous systems thereby enhancing HRV. This research suggests that acupuncture is an important consideration in the treatment of cardiovascular health.

References:
Zhongguo Zhen Jiu. 2012 Sep;32(9):776-8. [Observation of anti-hypertensive effect on primary hypertension treated with acupuncture at Renying (ST 9) mainly]. Yin C, Du YZ. Graduate Faculty of Tianjin University of TCM, China.

Evidence-Based Complementary and Alternative Medicine. Volume 2012 (2012), Article ID 878673, 9 pages. doi:10.1155/2012/878673. Neuroendocrine Mechanisms of Acupuncture in the Treatment of Hypertension. Wei Zhou and John C. Longhurst. Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA. Department of Medicine, University of California Irvine, Irvine, CA.

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.

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New research concludes that acupuncture is effective for treating plantar fasciitis, a painful inflammatory foot condition. Plantar fasciitis typically presents with pain on the underside of the foot and heel. The pain is often most severe when first stepping out of bed onto the floor in the morning. Another telltale sign of plantar fasciitis is pain upon dorsiflexion, lifting the foot towards the shin.

Acupuncture for PainHealthCMi NewsIn this controlled clinical investigation, the acupuncture group demonstrated a significant reduction in foot pain while the control group showed only minimal changes. The control group received five weeks of analgesic medications, stretching exercises and shoe modifications. The acupuncture group received the same therapies plus electro-acupuncture treatments. The researchers concluded that, “Electro-acupuncture coupled with conventional treatments provided a success rate of 80% in chronic planar fasciitis which was more effective than conventional treatments alone.”

Another recent study demonstrates that acupuncture is effective for the treatment of plantar heel pain. The researchers note that acupuncture has more significant improvements in both pain relief and the restoration of function than a standard regime of care that includes non-steroidal anti-inflammatory medications. Based on these findings, the researchers formally recommend acupuncture for the treatment of plantar heel pain.

In yet another study, investigators concluded that acupuncture at acupoint P7 (Daling, “Big Tomb”) relieves the pain of plantar fasciitis. P7 is located in the middle of the transverse crease of the wrist. P7 is a Shu-Stream point and Yuan (Primary) acupuncture point that is known for the treatment of Heart and Spirit related issues including myocarditis, palpitations, insomnia, mental illness, irritability, and cardiac pain. P7 is also used for Stomach related conditions, however, nearby point P6 is a more common point for the treatment of Stomach issues such as stomachache, nausea, and vomiting.
According to Chinese medicine and acupuncture theory, Shu-Stream points treat a heavy sensation of the of the body and painful joints. P7 is therefore a common point for the treatment of wrist pain because it is a Shu-Stream point located at the wrist . However, the researchers have chosen P7 for the wrist’s distal relationship to the ankle and heel region. At a six month follow-up examination, the P7 acupuncture group showed a significant improvement over the control group.
Plantar fasciitis affects approximately 2 million US citizens annually. These findings demonstrate that acupuncture is an important treatment modality for inflammation of the connective tissue on the bottom of the foot. Advantages to acupuncture treatment are that it is both safe, acupuncture is nontoxic and is nonsurgical, and effective.


References:
The American Journal of Chinese Medicine, An International Journal of Comparative Medicine East and West. Efficacy of Electro-Acupuncture in Chronic Plantar Fasciitis: A Randomized Controlled Trial. Wipoo Kumnerddee and Nitsara Pattapong. Volume 40, Issue 06, 2012.

Shi Ping Zhang, Tsui-Pik Yip, and Qiu-Shi Li.  Acupuncture Treatment for Plantar Fasciitis: A Randomized Controlled Trial with Six Months Follow-Up. Evidence-Based Complementary and Alternative, Medicine, Volume 2011 (2011), Article ID 154108.

Acupunct Med. doi:10.1136/acupmed-2012-010183. The effectiveness of acupuncture for plantar heel pain: a systematic review. Richard James Clark, Maria Tighe.