Medical Acupuncture for Perceived Stress
It’s not often I interact with military folk nowadays, but had the pleasure of teaching a US Navy Commander who attended the recent BMAS Foundation Course. Commander Jane Abanes arrived looking rather serious before extending her hand with a warm smile. Before long, we were chatting about her recent research paper, acupuncture mechanisms and the limitations of sham-controlled RCT’s.
Her paper was based on a small pilot study which considered the effects of medical acupuncture as a method of treating stressed US Navy Airmen. To be eligible to join the study, the airmen were required to score above 16 on the PSS-14 (perceived stress score, the maximum score would be 56).1
Commander Jane discussed her positive results using a treatment protocol designed to augment the general or central regulatory effects of acupuncture by using a selection of classical points.
Given I did not have access to the full paper2, I referred to my colleague Dr Mike Cummings’ blog to get the specific outcomes of the study. These were as follows:
“There was a drop in PSS of 6.5 points after the treatment course, as well as significant improvements in 3 of the eight subscales of the SF36 (energy/fatigue, social functioning, emotional wellbeing). The improvement in PSS was statistically significant for the group and reached a clinically relevant change in 63% (10/16).”
A good result which may perhaps be further improved with the use of electro-acupuncture in future studies.3
Thankfully, this was not a sham-controlled study. Given the therapeutic effects are likely to be centrally mediated (i.e. within the brain, due to both specific and non-specific mechanisms),4,5 it is unlikely that point location would be of much relevance.
From a clinical point of view, I often use general acupuncture points. These usually include ST36 as a way to access and effectively ‘calm’ the central nervous system when starting treatment with a client who arrives quite stressed. These sessions usually take a little longer, given it takes about 10 minutes or so to observe a slowing of breathing and easing of muscle tone. However, the extra time is worthwhile as the results of treatment are usually very positive.
1. Cohen S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress. J Health Soc Behav 1983;24:385. doi:10.2307/2136404
2. Abanes J, Hiers C, Rhoten B, et al. Feasibility and Acceptability of a Brief Acupuncture Intervention for Service Members with Perceived Stress. Mil Med 2019;00:7–10. doi:10.1093/milmed/usz132
3. Lund I, Lundeberg T. Mechanisms of acupuncture. Acupuncture and Related Therapies. 2016 Dec 1;4(4):26-30.
4. White A, Cummings TM, Filshie J, editors. An introduction to western medical acupuncture.
5. Cho ZH, Hwang SC, Wong EK, Son YD, Kang CK, Park TS, Bai SJ, Kim YB, Lee YB, Sung KK, Lee BH. Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms. Acta Neurologica Scandinavica. 2006 Jun;113(6):370-7.