Acupuncture in medicine : journal of the British Medical Acupuncture Society
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Although recent prospective studies came to the conclusion that the incidence of adverse events following acupuncture can be classified as minimal, many cases of acupuncture-related pneumothorax have been published over the years, among them some cases of tension pneumothorax. In this case, a slender woman received acupuncture from a fully trained medical acupuncturist including needling of the points LU1 in the subacromial region and BL13, which is a paravertebral point at the level of the spinous process of the third thoracic vertebra. ⋯ On x ray examination a tension pneumothorax was diagnosed. Even though pneumothorax is the most frequently reported serious complication related to acupuncture, it is not an inevitable complication of acupuncture, and in most cases involves negligence from inadequate consideration of basic anatomy.
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Randomized Controlled Trial Clinical Trial
Superficial dry needling and active stretching in the treatment of myofascial pain--a randomised controlled trial.
A pragmatic, single blind, randomised, controlled trial was conducted to test the hypothesis that superficial dry needling (SDN) together with active stretching is more effective than stretching alone, or no treatment, in deactivating trigger points (TrPs) and reducing myofascial pain. Forty patients with musculoskeletal pain, referred by GPs for physiotherapy, fulfilled inclusion/ exclusion criteria for active TrPs. Subjects were randomised into three groups: group 1(n = 14) received superficial dry needling (SDN) and active stretching exercises (G1); group 2 (n = 13) received stretching exercises alone (G2); and group 3 (n = 13) were no treatment controls (G3). During the three-week intervention period for G1 and G2, the number of treatments varied according to the severity of the condition and subject/clinician availability. Assessment was carried out pre-intervention (M1, post-intervention (M2), and at a three-week follow up (M3). Outcome measures were the Short Form McGill Pain Questionnaire (SFMPQ) and Pressure Pain Threshold (PPT) of the primary TrP, using a Fischer algometer. Ninety-one per cent of assessments were blind to grouping. At M2 there were no significant inter-group differences, but at M3, G1 demonstrated significantly improved SFMPQ versus G3 (p = 0 .043) and significantly improved PPT versus G2 (p = 0 .011). There were no differences between G2 and G3. The mean PPT and SFMPQ scores correlated significantly in G1 only, though no significant inter-group differences were demonstrated. Numbers of patients requiring further treatment following the trial were: 6 (G1); 12 (G2); 9 (G3). ⋯ SDN followed by active stretching is more effective than stretching alone in deactivating TrPs (reducing their sensitivity to pressure), and more effective than no treatment in reducing subjective pain. Stretching without prior deactivation may increase TrP sensitivity.
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This is the first reported description, to the author's knowledge, of myofascial pain occurring at a surgical drain site. The patient consulted a medical acupuncturist after suffering five months of continuous chest and arm pain associated with 'tingling' in the forearm and hand. ⋯ However, the drain passed through the free border of pectoralis major, and the myofascial trigger point that appeared to develop as a result of the muscle trauma, or the pain at that site, presented as a chronic and complex post-surgical pain problem. The pain and tingling resolved completely after two sessions of dry needling at a single myofascial trigger point in the free border of the left pectoralis major muscle.
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The aim of this case report is to discuss the subject of acupuncture in pregnancy and which acupuncture points, or areas, are safe to needle. Low back pain in a 21-year-old Caucasian primigravida at 24 weeks gestation was incapacitating and acupuncture was offered. Prior to pregnancy investigations had excluded a serious organic cause and acupuncture was employed successfully to control pain and improve function. Acupuncture can be offered to sufferers of low back pain in pregnancy after risk / benefit analysis is undertaken and informed patient consent is obtained.
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Randomized Controlled Trial Clinical Trial
Validating a new non-penetrating sham acupuncture device: two randomised controlled trials.
For clinical trials of acupuncture, it would be desirable to have a sham procedure that is indistinguishable from the real treatment, yet inactive. A sham needle has been designed which telescopes instead of penetrating the skin. The Park Sham Device involves an improved method of supporting the sham needle and requires validation. ⋯ In conclusion, the results suggest that the procedure using the new device is indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and is inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. It is therefore a valid control for acupuncture trials. The findings also lend support to the existence of de qi, a major concept underlying traditional Chinese acupuncture.