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Headache and acupuncture: analysis of cases treated at the Local Health Centre of Integrated Medicine ASL 4, Prato
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Oral Presentations / European Journal of Integrative Medicine 4S (2012) 9–123
in hair loss, in acne, in phlebology, in asthma and bronchial disorders, in gynaecology, in headaches and in impotence, to name only the most common fields of employment. http://dx.doi.org/10.1016/j.eujim.2012.07.542
Headache and acupuncture: analysis of cases treated at the Local Health Centre of Integrated Medicine ASL 4, Prato Raffaelli Francesca 1 , Fantacci Gianluca 2 , Benelli Nicola 1 , Antonucci Giuseppe 1 2 Azienda
Integrated therapy between acupuncture and block of the impar ganglion for the treatment of chronic idiopathic anal pain: preliminary data Gagliardi Giuseppe 1 , Ceccherelli Francesco 2
OP-048
1 Azienda
OP-049
Sanitaria Prato USL 3 Pistoia, Pescia, Italy
Background: There is some clinical evidence on the effectiveness of acupuncture in the treatment of headache (Linde 2009, Allais 2002). In our Centre of Integrated Medicine many cases of headache are treated, mainly by somatic acupuncture. Aim: This preliminary study is to evaluate the change of use of analgesics after acupuncture treatment and the change in the number and intensity of the crisis. Methods: The study investigates patients treated for headache in the years from 2006 to 2011 using data taken from medical records and from a questionnaire completed after a direct contact with the patient. The questionnaire investigated the number of days with headache and the intensity of the crisis and the consequent change in the use of analgesic drugs. Results: Ninety-five patients were treated for headache between 2006 and 2011. Patients with a migraine diagnosis according to the International Headache Society (IHS) 2004 classification (IHS classification) were included. Patients with incomplete medical records, patients who discontinued the treatment prematurely and those who were untraceable or refused to submit to our questionnaire were excluded. A total of 38 patients (average age 54 years S.D. 12; mean duration of illness 28 years, S.D. 11) diagnosed with cephalea, receiving treatment for this type of pathology, were included in the study. Of these, eight patients completely stopped using drugs after the treatment, 15 out of 38 reduced the use of triptans by more than 50% and four of whom ceased to take them. Fifteen patients out of 38 reduced the use of non-steroidal anti-inflammatory drugs (NSAIDs) by more than 50%, 10 of whom stopped using them. Nineteen patients out of 38 decreased their sick days per month by more than 50%, in eight cases there was a disease-free interval of over a month, three patients reported no more headache after the treatment and three patients did not respond to the treatment. The final results will be presented at the conference. Conclusions: The preliminary results of this study highlight problems and concerns and also satisfactory results of treatment by somatic acupuncture, particularly in terms of reducing the number of days of headache, pain intensity and consumption of drugs. http://dx.doi.org/10.1016/j.eujim.2012.07.543
1 A.I.R.A.S.,
Department of Anaesthesia and Intensive Care, S. Antonio Hospital, Padua, Italy, Spinea 2 A.I.R.A.S. and FISA, Padua, Italy Background: Chronic idiopathic anal pain is a common and benign disease, which has different clinical manifestations: syndrome of proctalgia fugax, anorectal neuralgia and coccygodynia. The diagnosis is very difficult and the treatment is usually empirical and ineffective. The aetiology remains unclear; several hypotheses have been advanced, including a pelvic floor disorder and pudendal neuropathy, but these hypotheses have not been confirmed. The psychological aspects, such as depression, play an important role in the maintenance of pain. These patients are always having a constant pain, poorly localised–it is reported to the anus and perineum area–and it involves an exacerbation after defecation, with burning sensation, tenesmus, without any anal lesion. These characteristics are typical of neurogenic pain, which is mediated by different mechanisms, including hypersensitivity of nociceptors, sympathetic hyperactivity and neurogenic inflammation. Aim: On this hypothesis of the genesis of pain two techniques were integrated, which are the sympathetic block and electroacupuncture that through the modulation of the sympathetic nervous system and neurogenic inflammation (5) can act on the genesis of pain. Methods: Eight patients were treated, six females and two males; their average age is 57.4 ± 17.5 years; the duration of the pain was on average 20 months. The treatment, performed once a week, includes impar ganglion block with paramedial ganglion approach and injection of 10 ml 0.25% L-bupivacaine and acupuncture. The acupuncture points used were 3 SI, 60 UB, 2 GV and 54 UB, stimulated manually. Electroacupuncture was applied on the points 50 UB and 30 UB with 2 Hz frequency and intensity to the threshold of the patient. The duration of the session was 30 min. The pain was evaluated with the visual analogue scale (VAS) and the McGill Pain Questionnaire and a subjective rating scale of function recovered. Results: The average of an acupuncture session was 12 for acupuncture and eight blocks of impar ganglion. The indicators show a significant pain relief at the end of therapy. The improvement of pain was prolonged in the follow-up. Conclusion: The proposed integrated treatment appears to be effective in pain control and has no adverse effect. The reduction of regional sympathetic tone and specific effect of acupuncture on analgesia and modulation of neurogenic inflammation has a good analgesic effect and may interfere with the mechanism of pain. http://dx.doi.org/10.1016/j.eujim.2012.07.544
Oral Presentations / European Journal of Integrative Medicine 4S (2012) 9–123
in hair loss, in acne, in phlebology, in asthma and bronchial disorders, in gynaecology, in headaches and in impotence, to name only the most common fields of employment. http://dx.doi.org/10.1016/j.eujim.2012.07.542
Headache and acupuncture: analysis of cases treated at the Local Health Centre of Integrated Medicine ASL 4, Prato Raffaelli Francesca 1 , Fantacci Gianluca 2 , Benelli Nicola 1 , Antonucci Giuseppe 1 2 Azienda
Integrated therapy between acupuncture and block of the impar ganglion for the treatment of chronic idiopathic anal pain: preliminary data Gagliardi Giuseppe 1 , Ceccherelli Francesco 2
OP-048
1 Azienda
OP-049
Sanitaria Prato USL 3 Pistoia, Pescia, Italy
Background: There is some clinical evidence on the effectiveness of acupuncture in the treatment of headache (Linde 2009, Allais 2002). In our Centre of Integrated Medicine many cases of headache are treated, mainly by somatic acupuncture. Aim: This preliminary study is to evaluate the change of use of analgesics after acupuncture treatment and the change in the number and intensity of the crisis. Methods: The study investigates patients treated for headache in the years from 2006 to 2011 using data taken from medical records and from a questionnaire completed after a direct contact with the patient. The questionnaire investigated the number of days with headache and the intensity of the crisis and the consequent change in the use of analgesic drugs. Results: Ninety-five patients were treated for headache between 2006 and 2011. Patients with a migraine diagnosis according to the International Headache Society (IHS) 2004 classification (IHS classification) were included. Patients with incomplete medical records, patients who discontinued the treatment prematurely and those who were untraceable or refused to submit to our questionnaire were excluded. A total of 38 patients (average age 54 years S.D. 12; mean duration of illness 28 years, S.D. 11) diagnosed with cephalea, receiving treatment for this type of pathology, were included in the study. Of these, eight patients completely stopped using drugs after the treatment, 15 out of 38 reduced the use of triptans by more than 50% and four of whom ceased to take them. Fifteen patients out of 38 reduced the use of non-steroidal anti-inflammatory drugs (NSAIDs) by more than 50%, 10 of whom stopped using them. Nineteen patients out of 38 decreased their sick days per month by more than 50%, in eight cases there was a disease-free interval of over a month, three patients reported no more headache after the treatment and three patients did not respond to the treatment. The final results will be presented at the conference. Conclusions: The preliminary results of this study highlight problems and concerns and also satisfactory results of treatment by somatic acupuncture, particularly in terms of reducing the number of days of headache, pain intensity and consumption of drugs. http://dx.doi.org/10.1016/j.eujim.2012.07.543
1 A.I.R.A.S.,
Department of Anaesthesia and Intensive Care, S. Antonio Hospital, Padua, Italy, Spinea 2 A.I.R.A.S. and FISA, Padua, Italy Background: Chronic idiopathic anal pain is a common and benign disease, which has different clinical manifestations: syndrome of proctalgia fugax, anorectal neuralgia and coccygodynia. The diagnosis is very difficult and the treatment is usually empirical and ineffective. The aetiology remains unclear; several hypotheses have been advanced, including a pelvic floor disorder and pudendal neuropathy, but these hypotheses have not been confirmed. The psychological aspects, such as depression, play an important role in the maintenance of pain. These patients are always having a constant pain, poorly localised–it is reported to the anus and perineum area–and it involves an exacerbation after defecation, with burning sensation, tenesmus, without any anal lesion. These characteristics are typical of neurogenic pain, which is mediated by different mechanisms, including hypersensitivity of nociceptors, sympathetic hyperactivity and neurogenic inflammation. Aim: On this hypothesis of the genesis of pain two techniques were integrated, which are the sympathetic block and electroacupuncture that through the modulation of the sympathetic nervous system and neurogenic inflammation (5) can act on the genesis of pain. Methods: Eight patients were treated, six females and two males; their average age is 57.4 ± 17.5 years; the duration of the pain was on average 20 months. The treatment, performed once a week, includes impar ganglion block with paramedial ganglion approach and injection of 10 ml 0.25% L-bupivacaine and acupuncture. The acupuncture points used were 3 SI, 60 UB, 2 GV and 54 UB, stimulated manually. Electroacupuncture was applied on the points 50 UB and 30 UB with 2 Hz frequency and intensity to the threshold of the patient. The duration of the session was 30 min. The pain was evaluated with the visual analogue scale (VAS) and the McGill Pain Questionnaire and a subjective rating scale of function recovered. Results: The average of an acupuncture session was 12 for acupuncture and eight blocks of impar ganglion. The indicators show a significant pain relief at the end of therapy. The improvement of pain was prolonged in the follow-up. Conclusion: The proposed integrated treatment appears to be effective in pain control and has no adverse effect. The reduction of regional sympathetic tone and specific effect of acupuncture on analgesia and modulation of neurogenic inflammation has a good analgesic effect and may interfere with the mechanism of pain. http://dx.doi.org/10.1016/j.eujim.2012.07.544