How to Get Maximum Benefits From Acupuncture Treatment for Neuropathy

A sound mind resides in a sound body. For the body to be fit, it is essential for a person to get proper rest, exercise regularly, maintain a well-balanced and nutritious diet, get six to eight hours of sleep and keep away from habits like smoking, drinking and eating fast foods. When a person experiences numbness or weakness in his or her hands, legs or other parts of the body or demonstrates impaired reflexes, this may be a sign of peripheral neuropathy.

Peripheral neuropathy can affect any or all of the nerve groups, including sensory nerves, motor nerves and autonomic nerves. People with peripheral neuropathy may show the following signs:

  • Numbness and tingling sensations in the hands or feet,
  • Acute stabbing pain
  • Drop in the blood pressure
  • Heaviness in arms and legs
  • Weakness of the hands and legs

Causes of Peripheral Neuropathy

Various factors leading to nerve damage are enumerated below-

  • Pinched nerves due to herniated disc or muscle spasm
  • Glucose intolerance
  • Reynaud’s disease
  • Lupus
  • Diabetes
  • Kidney disorders
  • Hypothyroidism
  • Vitamin deficiency, especially of C, B-1, B-6, or B-12

Consulting a neurologist or neurosurgeon who would assess your present health condition and diagnose your nervous disorder would help you get a picture of your prognosis.

Treatment of Peripheral Neuropathy

Before finalizing the right course of treatment for peripheral neuropathy, it is essential to find out the exact cause that has led to this disorder. If it is caused by a vitamin deficiency, then a change in the diet along with vitamin therapy would be helpful. Likewise, if the nerve damage is due to alcohol abuse or taking a certain medication or toxic substance, then avoiding the substance can restore the health of nerves. One main factor contributing to nerve inflammation is a high sugar and high salt diet. Even you do not have diabetes, avoiding processed food and sweets will save your nerve function, so that, when you reach 90 years old, you still can walk and think normally.

Alternative Medical therapy for Peripheral Neuropathy

Acupuncture has been found to be highly effective for patients with peripheral neuropathy. Besides the pain relief, patients also experience a marked improvement in nerve conduction after completing the acupuncture course specified by the acupuncturist. The number of treatments depends on each person’s medical condition; for a chronic condition, a few months will be required to recover the nerve function.

Researchers have revealed that electro-acupuncture has helped regenerate nerve cells in rats suffering from spinal cord injuries. There are also human studies that have indicated that acupuncture can bring back the normal sensation of the nerves in the hands and feet. Furthermore, acupuncture can help the hands regain their strength. If after a nerve injury, you still have developed muscle atrophy after doing physical therapy for a few months, it is the right time to start acupuncture treatment to help the nerves regenerate as soon as possible.

Nervous disorders that acupuncture can correct

Whether it is alcohol, tobacco or junk food addiction, or it is Bell’s palsy, dementia, headache or a migraine or stroke, getting acupuncture treatment from a specialist and completing a 12 to 24 course of treatments would provide sufficient blood flow to the nerves. If diabetes is the major cause of nerve damage, then acupuncture treatment can also prevent a spike in blood sugar level induced by sugar intake and will help stabilize the sugar level in the blood.

Complications of peripheral neuropathy include falls, infection, burns and skin trauma. Besides getting specialized acupuncture treatment, patients should make healthy choices related to their food, exercise and lifestyle. This would help them minimize the risk factors and prevent any further nerve damage, thereby enabling them to enjoy a long and healthy life.

Some of the important things you need to take care are as follows:-

  • Include fruits, green vegetables, whole grain and protein in your diet for healthy nerves
  • Exercise 30 minutes-1 hour three times a week to improve the circulation to the peripheral nerves
  • Avoid smoking or excess drinking, spicy food, exposure to drugs or toxic chemicals.

Clean Needle Technique for Acupuncture

Clean Needle Technique

Infection Control – Practitioner’s Hygiene

Physical cleanliness includes not only adequate hand washing but it also includes such things as wearing clean clothes (i.e. lab coat), long hair being tied back, and nails being kept clean and short. Cuts/abrasions should be covered by and band-aid and/or glove. Do not work with an upper respiratory condition.

Hand Washing –

A practitioner should wash their hands before and after each patient contact. Soap with an antibacterial agent is preferred and strongly recommended. Clean paper towels should be used to dry the hands. When washing your hands, friction and running water are very important to help remove surface germs from the epidermal layer of the skin.

Germ Theory –

If a sterile object touches a non-sterile surface, the object is no longer sterile. All needles must be properly sterilized for needle insertion. The shafts of the needle, especially longer needles, can be stabilized with a sterile cotton ball or sterile gauze. If the needle touches any object (i.e. pants, clothing, bed) or if it is dropped on the floor, the needle is considered contaminated and should not be used. All used alcohol swabs and needle packaging must be disposed of from the clean area. Suction cups that come in contact with the skin require either sterilization or disinfection prior to each use.

Packaging –

All needles that are packaged should be checked for sterilization expiration dates. Any package that is wet, torn or expired is no longer considered sterile.

Types of Sterilization

1. Steam

2. Boiling

3. Dry heat sterilization

4. Chemical sterilization

Disinfection

3 Types of Disinfection

1. Halogen – includes chlorine and

2. Phenol – pure phenol is derived from coal tar

3. Alcohol – two types of alcohol: Isopropyl and Ethyl

Antisepsis

There are 3 types of Antisepsis

1. Iodine

2. Alcohols

3. Hexachlorophenes

Iodine is a popular antiseptic, and it is used in concentrations of 70%-90%. Be careful with using iodine, as it can leave permanent stains on clothing. Isopropyl Alcohol is an effective antiseptic as well. Always keep lids of alcohol bottles closed to keep the 100% concentration. When swiping the skin, the cotton ball or swab should be applied in one fluid wipe. Do not swipe the skin in a back and forth or circular motion. Alcohol should not be applied to mucous membranes or open wounds.

Needle Disposal

All needles must be discarded in proper sharps containers according to Public Health Regulation. Alcohol swabs or cotton balls should be discarded into the trash unless they are completely soaked in blood.

Iatrogenic Complications

1. Forgotten Needle: There have been instances where a practitioner has forgotten to take a needle out. Practitioners should try to keep a needle count. This may reduce the risk of forgotten needles. A forgotten needle could cause possible harm/injury.

2. Broken Needle: Very thin needles (> 34 gauge) are more susceptible to break during insertion. A broken needle with the shaft visible above the skin may be safely removed in a sterile clamp, but if a needle has broken and it is beneath the surface of the skin, it will require a medical referral.

3. Locked or Stuck Needle: Locked or a stuck needle can result from muscle spasms or if the patient moves. The result in a stuck needle because the muscle tissue around the needle spasms and locks the needle in place. When this occurs the needle should never be forcibly removed. You must stop the electro-acupunctoscope and allow the patient to rest. Gently massage the area or meridian of the stuck needle helps with the release of the needle. If the stuck needle is a result of the patient moving, the patient should assume original position then the needle can be taken out.

Pneumothorax

It is one of the most commonly reported complications of Acupuncture in the Medical Literature. A pneumothorax occurs when the surface of the lung is punctured, allowing air to leave from the lung into the pleual cavity. The most common point involved is GB21 and points around the neck and shoulder girdle. The best prevention is the use of correct needle depth and angle.

Blood Vessel

Puncture of small superficial veins is not uncommon. When this occurs, one must apply pressure on the affected site for about one minute. The Practitioner should always inform the patient of a hematoma. Arterial puncture is more serious. You must apply firm pressure for about 3-5 minutes for bleeding of a small artery.

Organ Puncture

All organs are susceptible to being punctured if needled incorrectly. The organs that are more susceptible to being punctured are the bladder, kidneys, enlarged spleen or liver. And the peritoneal cavity. If one is needling lower abdominal points, as the patient to empty their bladder.

Spinal Cord Trauma

Loss of sensation or movement can result from a needle that penetrates the spinal cord.

Neuritis

Inflammation of the nerve can result from needling directly over nerves or from needling using strong electric stimulation. If the nerve is inflamed, the patient could experience numbness, electrical sensation or motor weakness.

Infection

Allergic Dermatitis

Signs and symptoms include redness of skin, an itching/burning sensation, and pain or discomfort at the site of insertion. Acupuncture needles containing nickel and chromium have been known to cause allergic dermatitis.

Miscellaneous Infections

Miscellaneous infections that can occur, include septicemia, osteomylitis, bacterial endocarditis, meningitis and hepatitis. The only methods of prevention for these conditions are the use of sterile needles and identification of high-risk patients.

Other Complications or Side Effects

1. Nausea – nausea may be experienced by the patient if strong parasympathetic stimulation occurs during needling. Needles should be withdrawn immediately if nausea or vomiting persist.

2. Normal Side Effects – You will often hear comments such as “I feel light-headed” or “mild disorientation” or “euphoria”. These are all normal side effects of acupuncture. Sometimes the patient may also feel cold with prolonged needle retention (more than 20-30 minutes).

Contraindications to Treatment

People who are under the influence of drugs or alcohol, those with an empty stomach, those who are emotionally unstable or those who have just finished physical exertion should not be treated with acupuncture.

Contraindications of Electro-acupuncture

When using the electro-acupunctoscope, the current should never cross the back or the chest. The two branches of the same electrode should always be on the same side of the patient’s body. Electro-acupuncture is contraindicated during pregnancy and in those patients with any type of cardiac pacemaker.

Pregnancy

Traditional Chinese Medicine recommends against needling during any asymptomatic, normal pregnancy. If there are symptoms, needling specifically towards the symptom is allowed.

Electrical Stimulation & Acupuncture

Waveform/Frequency/Intensity

Specifications for model AWQ-104E

• Pulse Shape: Biphasic Rectangular Wave

• Pulse width: 350 uS at X1, 40us at X10

• Pulse rate (frequency): 1-120Hz at X(1) 10-1200Hz at X(10)

• Wave form: adjustable, dense-disperse, intermittent

• Output current (intensity): 0-18mA (Lo) 0-40mA(Hi)

• Channel: 4

• Point detector

Manipulation

• Make sure that you examine the electro-acupunctoscope before each use.

• Insert the needle (with metal handle) and get Qi sensation

• Make sure all the knobs are turned to zero before hooking the electro-acupunctoscope to the needles.

• Connect the electrical stimulator with needles.

• Turn power on.

• Adjust the electro-acupunctoscope to the appropriate waveforms and frequency

• Adjust the intensity to a comfortable level.

• If intensity “Hi-Lo”switch, or frequency “1-10″switch, or polarity need to be changed, the output intensity (and frequency sometime) should be turned down to zero.

• Treatment should last 15-20min

• Make sure all the knobs to zero before turning off the power and take away the conducting wire.

Notes:

• 2 needles complete a circuit

• Connect negative end to primary point, positive end to secondary point

Waveforms

Dense wave (continuous)

High frequency: 50-100 pulses per second

Function and indications:

Inhibit sensory nerves and motor nerves

Relieve pain, calms the mind, relieve spasm of the muscles

Disperse /Sparse wave (continuous)

Low frequency: 2-5 pulses per second

Function: Induce the contraction of muscles, and enhance the tension of muscle and ligament.

Indication: injury of muscle, ligament and joints.

Dense-disperse wave

Disperse wave and dense wave appear alternately, each last about 1.5 s. Prevent the body’s adaptation

Function:

Relieve pain, improve function of the organs, improve qi and blood circulation, improve nourishment of tissues, reduce inflammation

Indication: Pain, trauma, sprain, arthritis, sciatica, facial paralysis, weakness of muscles, etc.

Intermittent wave

A wave appears on and off rhythmically. Interval: 1.5s

Function: Stimulate the muscles

Indication: Paralysis.

Precautions/Contraindications

• Turn up the intensity of the electro-acupunctscope gradually so we can avoid incidences such as muscle contraction, broken needle and bent needle resulting from increased intensity.

• Number one priority is to keep the patient comfortable at all times.

• Mild stimulation is required when applying electro-acupuncture near the spine and brain stem.

• When applying electro-acupuncture on chest and back area in the region of the heart, do not connect points across two sides of the body to avoid the current passing through the heart.

• Do not apply stimulation in the region of the heart.

• Do not apply stimulation to patients with pacemakers or other electronic implants.

• Use electro-acupuncture cautiously for patients have heart diseases, seizure, and pregnant women.

• Electro-acupuncture should be used cautiously for patients who are aged or weak.

Disease treatment

Advantages

1. Better for nerve related problems

2. Stimulation is more measurable than manual

3. Many points can be stimulated at the same time (manual can stimulate only one at a time)

4. Stimulation can last longer. A typical treatment is usually 20 minutes. If you are stimulating manually, you usually only stimulate for a couple of minutes at the most.

• Points are selected in pairs

• Usually unilaterally

(Pair on same side left or right Do not cross from one side to another as that may interfere with heart action)

Acupuncture, Muscle Numbness and Sciatic Pain – A Case Study

Attorney Holmes was born in Boston to a relatively poor family. He took odd jobs shoveling snow and paving streets as a teenager before joining the army for three years, which helped pay for his college tuition. He started drinking alcohol when he was serving the army. In his early forties, he decided to quit drinking alcohol because he finally realized that drinking made him feel horrible afterwards and because he believed the alcohol could cause damage to his brain cells. Since he was trained to be a disciplined person in the US Army, once he decided to quit drinking, he was able to quit completely. But years of drinking had caused hormone imbalances. For example, abnormal estrogen levels stimulated his prostate and when he was in his seventies, he developed prostate cancer. He had radiation treatment and developed impotence for a while after surgery due to nerve and blood vessel damage. However, because he did not eat junk food or drink alcohol any more, he was physically very healthy and was able to put his impotence behind him after about a year.

He came to my clinic four years ago due to hand numbness and weakness as well as muscular atrophy. At the age of 82, he still went to the court a couple of times a week as a defense lawyer. He walked a mile with his dog every day, did not take any medication, and amazingly, could still sleep through the night for 7 to 8 hours. But he drank too much coffee – between 4 to 5 cups a day – before he started acupuncture treatment.

When he first came to see me, I noticed that his thumb muscles were slightly atrophied. His grip was not firm, and sometimes, things dropped out of his hands. First, he went to see a hand specialist, who recommended surgery, but said that although surgery may fix the problem, it may also cause chronic pain, swelling, and even nerve damage. He decided to try alternative medicine.

First of all, I recommended that he cut down his coffee intake to one to two cups a day. Because acupuncture helps his body produce endorphins, serotonin, and dopamine, it became easier for him to cut down his coffee while he was in treatment. Although coffee did not interrupt his sleep, it caused blood vessel constriction in his hands and feet, stimulated his heart rate, and made his upper shoulder muscle very tight. I told him that if he could cut down to one cup each day, he could still stimulate his brain cells without sacrificing his heart and hand health. He gradually cut down his coffee.

I also found out that he loved to sleep on his stomach with his head turned to one side. This may have caused his muscle tightness and pinched his cervical nerves. If the compression of the nerves lasts for too long, his hand muscles could get weaker and weaker. I chose acupuncture points on his neck and foot to deeply relax his neck muscles and then used electrical acupuncture to facilitate the regeneration of the nerves in his hand, which also strengthened his hand muscles. Once the blood circulation in his neck and hand were improved, his hand muscles quickly become stronger. After 24 treatments, his hand function recovered completely and he stopped needing acupuncture.

Two years later, he came back with severe hip, leg, and ankle pain. The pain was so bad that he had to take Aleve in the morning just to be able to walk around. I treated him once with electrical stimulation, combining points on his lower back and leg. He felt instant relief in one day. Then, he had such strong pain in the morning two days later that he had to double his painkiller dosage. He was so afraid that he could not walk that he decided to increase his acupuncture treatments to two or three times a week.

I noticed that his pain was distributed along the L3, L4, and L5 area. In the morning, his pain was the worst and moving around help relieve the pain. Considering his sleeping posture, which may have caused tightness in his periform muscle and irritated his sciatic nerves, I recommended that he sleep on his back. Initially, he had to periodically turn onto his stomach because that had been his preferred sleeping position for the past 84 years. In this way, he could not stay in one position for very long. He might sleep on his back for 3 hours and then sleep on his stomach for another 4 hours. Combining the positional changes and acupuncture treatments twice a week, we successfully got rid of this new pain within three weeks.