Chronic fatigue syndrome is characterised by severe disabling fatigue, accompanied by four of more of the following symptoms: unrefreshing sleep, exertional malaise, impaired concentration, sore throat, tender lymph nodes, headaches and musculoskeletal pain.

The cause is not fully understood but there are various hypotheses including immunological, endocrine and viral illness. CBT and graded exercise programmes are the more common treatment approaches.

LI4 is often described as the universal ‘pain point’ and features often in the traditional literature.

We use LI4 in medical acupuncture, often but not exclusively in the treatment of chronic headache such as migraine and tension headache.

 Here I am referring to actual neck pain, not a noisy neighbour or the like!

Fact, medical acupuncture for neck pain is an effective form of treatment. Findings from an Individual Patient Data Meta-Analysis showed an effect size of 0.8 for neck pain, this is considered a large effect, a clear indication of clinical effectiveness.¹

There are five physiological mechanisms which can be used to explain how medical acupuncture works. Each can be used for a different purpose which is why anyone using medical acupuncture must be able to make a conventional medical diagnosis and have an understanding of the underlying pathology to be effective when using a medical approach.

The different mechanisms require variations in the treatment technique and so this needs to be tailored to the individual patient.

Local effects:
This refers to the ability of acupuncture to activate specific sensory nerve fibres in the skin and muscle. Needling near the sensory nerve endings sets off action potentials (nerve impulses) which spread around and along the local network of nerve fibres – this is called an axon reflex. Various substances are released as a result including adenosine and calcitonin gene related peptide (CGRP) both of which cause local blood vessels to dilate causing an increase in local blood flow. The blood flow is also increased in the deeper tissues which encourages tissue healing. Adenosine also has a mild local pain relieving effect effect, while CGRP may also promote healing and repair.

Last Saturday I attended the autumn scientific meeting of the British Medical Acupuncture Society in London, an annual event which usually attracts some top speakers from around the world giving an insight into their areas of clinical interest and research.

This year we got to hear from Vitaly Napadow, a Ukrainian-born American neuroscientist and acupuncturist. He is associate professor at Harvard Medical School and the Martinos Center for Biomedical Imaging. He is also the director of the Center for Integrative Pain NeuroImaging and the co-president of the Society for Acupuncture Research.

Vitaly gave a a very interesting presentation based on his recent pilot study¹ which showed that acupuncture can in effect ‘rewire’ the brain when using the technique to treat carpal tunnel syndrome.