Thursday, 19 October 2017

The Real Worth Of Acupuncture For Pain

Today's post from (see link below) looks at new research on acupuncture as an alternative, or extra treatment for pain conditions such as neuropathy. Acupuncture treatment is thousands of years old, yet somehow it's built up a reputation as being a somewhat vague, hippy-like alternative therapy, with less value than chemical medications that we're all used to. This is more than likely, completely unjust although the research does show that it sometimes doesn't work (but name me a neuropathy pill that works 100% - there aren't any!). Dr Takahiro Takano's research has found that an important natural pain suppressor in the body (Adenosine) is released at acupuncture pressure points, thus reducing pain. He also found that certain enzymes that suppress adenosine itself, can be targeted, so that more is produced, bringing about natural pain relief. This is a fascinating article that attempts to lay out some of the science behind acupuncture and may change your opinion completely. It is however, advisable to choose the right acupuncturist - there are so many fakers out there - and preferably someone also qualified as a medical doctor. P.S. Bad news for coffee lovers - caffeine is an adenosine suppressant! An educative article - worth a read.

Chronic pain and acupuncture: from needles to analgesia
By researchfeatures on August 21, 2017 Research Focus
With millions of people suffering from long-term pain, acupuncture is a popular, but mysterious, alternative to painkilling drugs.

 Research carried out by Dr Takahiro Takano, at the University of Rochester Medical Center, not only sheds light on how acupuncture works – and why it sometimes does not – but may lead to a whole new line of pain-relieving treatments. Chronic (or persistent) pain, often defined as pain lasting for at least twelve weeks, affects huge numbers of people, including over one-third of the American population. Existing treatments for chronic pain heavily depend on opioid drugs, such as morphine, codeine and tramadol. However, these drugs have disadvantages including side effects, addiction and tolerance, which cause many pain sufferers to turn to alternative treatments, such as acupuncture.

While acupuncture has many devotees, its efficacy has proven hard to document and its success is often highly variable. However, ground-breaking research by Dr Takahiro Takano is beginning to shed light on the physiological basis of acupuncture, and opens up new possibilities for chronic pain treatment that may bridge the gap between conventional and alternative medicine.

Peripheral pain relief

Unlike mainstream painkillers, which target the central nervous system (the brain and spinal cord) where pain is perceived, acupuncture targets the peripheral nerves in the rest of the body. Developed in China over 4,000 years ago, it is perhaps the most widely-accepted of all the ‘alternative’ forms of medicine. Over ten million treatments are carried out each year in the US, with the World Health Organization endorsing it for over two dozen medical conditions. Acupuncture is now even available on the UK’s National Health Service.

The solution for those using acupuncture to treat chronic pain?

Lay off the coffee!

A transverse section of mouse leg integumentary tissue showing nuclei (blue), nerve bundle (green) and sensory neurones (red), where acupuncture can induce extracellular adenosine increase. The fluorescence image was taken with a 10x magnification lens. Acupuncture claims to be a side effect-free form of pain relief – when it works. But so far there is no scientific explanation for its action, and its effects vary significantly from patient to patient, and even day to day. Some of acupuncture’s effects are thought to result from the release of opioid chemicals in the central nervous system, but this by no means explains its entire action, particularly at a more peripheral level. This is where Dr Takano’s research comes in. His work at the University of Rochester Medical Center has helped demonstrate not only how acupuncture works, but also why its effects are so unpredictable. His findings may ultimately help improve the efficacy of acupuncture itself, and enable us to exploit its underlying mechanisms in developing new treatments for chronic pain.

Chronic pain may be of two types: inflammatory pain associated with tissue damage, and neuropathic pain associated with nerve damage. Dr Takano’s team developed mouse models to characterise both these situations, and showed that acupuncture suppresses both types of pain in these animals. Simultaneously, they found that a small molecule, adenosine, was released at the site of the acupuncture treatment. They later confirmed that the same ‘neuromodulator’ is released during acupuncture treatment in human patients.

Adenosine was already known to have pain-relieving properties, mediated through receptor molecules called ‘adenosine A1 receptors’, which are found throughout the human body. Dr Takano’s research showed that these A1 receptors are essential for the adenosine released during acupuncture to cause pain relief. He also found that injecting mice with CCPA, a molecule that mimics adenosine’s interaction with A1 receptors, brings relief from pain without the need for acupuncture itself. Finally, he showed that inhibiting certain enzymes that degrade adenosine, thus allowing it to build up in the body, could prolong the effect of acupuncture treatment. These findings offer a fascinating insight into an entirely new form of pain relief based around stimulating A1 receptors in the peripheral nervous system.
Wake up and smell the coffee…

Dr Takano’s research in mice clearly explains how acupuncture works at the molecular level: the insertion and particularly the rotation of acupuncture needles causes localised stretch of tissue, which stimulates the body to produce adenosine. The adenosine interacts with A1 receptors, initiating a pathway of molecular changes resulting in pain relief throughout the peripheral nervous system. But, if this pathway is clear, why does acupuncture produce such variable results in humans?

Ground-breaking research by Dr Takahiro Takano is beginning to shed light on the physiological basis of acupuncture, and open up new possibilities for chronic pain treatment

Acupuncture’s effect on the pain network. Step up one of the most ubiquitous drugs in modern society – caffeine. Present in coffee, tea, chocolate, energy and diet drinks, and some pain medicines, it is estimated that around 90% of the US population consumes caffeine in some form every day. Unfortunately, caffeine also binds to the adenosine A1 receptor, blocking its reception of adenosine and compromising the pain relief pathway. In a paper published last month, Dr Takano and colleagues showed that even very low doses of caffeine interfere significantly with acupuncture’s painkilling action. Thankfully, the effect is transient and usually wears off within 24 hours. This phenomenon may well explain why acupuncture sometimes works and sometimes does not, and suggests an easy solution to those using acupuncture to treat chronic pain: lay off the coffee!

Pathway to pain relief 

Dr Takano’s research does not stop at vindicating acupuncture – he now wants to use his findings to develop new therapies for chronic pain. Aside from further exploring the role of the A1 receptor and the impact of caffeine in mouse models, his latest research project, funded by the US National Institutes of Health, will investigate other ways to manipulate the pain relief pathway that is stimulated during acupuncture treatment.

Acupuncture is not a quick fix therapy: it often provides only a few hours respite, with long-term relief coming only after multiple treatments. However, now that its mechanism of action is known, it may be possible to manipulate the physiological pathways involved to achieve more effective or longer-lasting relief. One potential player in this is an enzyme known as CD73, which can cause the human body to make adenosine from a molecular precursor. Takano’s investigations so far suggest that administration of CD73 may contribute to long-lasting, side-effect-free, analgesia, in cases of both inflammatory and neurological, acute and chronic pain.

There is much still to discover but, through Dr Takano’s research, we could be on the cusp of a new paradigm for pain relief, bringing hope to many millions of sufferers.

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