Electroacupuncture relieves pain in CP/CPPS

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Acupuncture much better than placebo

Post by webslave »

Am J Med. 2008 Jan;121(1):79.e1-7

Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain.

Lee SW, Liong ML, Yuen KH, Leong WS, Chee C, Cheah PY, Choong WP, Wu Y, Khan N, Choong WL, Yap HW, Krieger JN.
School of Pharmaceutical Science, University of Science, Malaysia.


BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) afflicts 2%-10% of adult men. Available therapies offer little or no proven benefit. Because acupuncture represents an attractive "natural" therapy, we compared the efficacy of acupuncture to sham acupuncture for CP/CPPS.

METHODS: Participants met US National Institutes of Health (NIH) consensus criteria for CP/CPPS, were aged > or = 20 years old, and had a total score > or = 15 on the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and symptoms for at least 3 of the preceding 6 months. They were randomized 1:1 to acupuncture or sham acupuncture. Treatment consisted of twice-weekly 30-minute sessions for 10 weeks (20 sessions total) without needle stimulation, herbs, or adjuvants. The primary response criterion was a 6-point decrease from baseline to week 10 in NIH-CPSI total score (range 0-43).

RESULTS: Thirty-two (73%) of 44 participants responded in the acupuncture group compared with 21 (47%) of 45 sham group participants (relative risk 1.81, 95% confidence interval, 1.3-3.1, P = .02). Long-term responses 24 weeks after completing therapy without additional treatment occurred in 14 (32%) of 44 acupuncture group participants and in 6 (13%) of 45 sham group participants (relative risk 2.39, 95% confidence interval, 1.0-5.6, P = .04).

CONCLUSIONS: After 10 weeks of treatment, acupuncture proved almost twice as likely as sham treatment to improve CP/CPPS symptoms. Participants receiving acupuncture were 2.4-fold more likely to experience long-term benefit than were participants receiving sham acupuncture.

PMID: 18187077 [PubMed - in process]

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Older research on this topic can be seen here.
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Re: Acupuncture much better than placebo

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Acupunct Med. 2007 Dec;25(4):198-9.

Chronic prostatitis/chronic pelvic pain syndrome and acupuncture - a case report.

Rosted P.

A 47 year old man had suffered from chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) for eight years, and received conventional treatment from a university clinic without effect during the entire period. The patient presented for acupuncture treatment, complaining of constant pain in the perineal region, varying in severity from 5 to 9 on a 0 to 10 pain scale. After three treatments with acupuncture, the pain was reduced to 3.5; after a further three treatments the pain was reduced to 2.5; and after 10 months, the pain was reduced to either 2 or 3 and has remained stable for two years since then. The acupuncture points used were BL28, BL29 and KI3, all located within the S2-S4 segments. It seems likely that the reported beneficial effect may be due to the acupuncture treatment and further cases should be studied.

PMID: 18160930 [PubMed - in process]
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Electroacupuncture relieves pain in CP/CPPS

Post by webslave »

Urology. 2009 May;73(5):1036-41.

Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial.

Lee SH, Lee BC.
Department of Internal Medicine, Division of Urology and Nephrology, College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea.


OBJECTIVES: To investigate the clinical effect of electroacupuncture (EA) for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

METHODS: We recruited 63 participants meeting the U.S. National Institutes of Health (NIH) consensus criteria for CP/CPPS. After the inclusion/exclusion criteria were applied, 39 men were randomized to 3 treatment groups: group 1, advice and exercise plus 12 sessions of EA; group 2, advice and exercise plus 12 sessions of sham EA (SEA); and group 3, advice and exercise alone (A&E) for 6 weeks. A total of 6 acupuncture points were used to stimulate the sacral nerve and release the piriformis muscle using an electrical pulse generator. Symptoms related to CP/CPPS were assessed using the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI). Prostaglandin E(2) and beta-endorphin levels in postmassage urine samples were measured using an enzyme-linked immunosorbent assay.

RESULTS: At 6 weeks, the NIH-CPSI total score had decreased significantly in the EA group compared with the SEA and A&E groups (P < .001). On a subscale analysis of the NIH-CPSI, the EA group showed significant decreases in pain-related symptoms compared with the SEA and A&E groups (P < .01). All 12 EA participants experienced at least a 6-point decrease in the NIH-CPSI total score compared with 2 of 12 SEA participants (16.7%) and 3 of 12 A&E participants (25.0%; P < .0001). The mean prostaglandin E(2) level in the postmassage urine samples had significantly decreased in the EA group (P = .023). In contrast, it had increased in the other 2 groups.

CONCLUSIONS: In a 3-arm randomized trial investigating the clinical effects of EA on CP/CPPS, EA therapy proved to have independent therapeutic effects, particularly for pain relief superior to SEA or A&E therapy.

Publication Types: * Research Support, Non-U.S. Gov't
PMID: 19394499 [PubMed - in process]
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by RichieRich »

Hi can you tell me where i can get more information on this, and what the points on the body were please. Thanks!
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by coppertop »

I asked my former acupuncturist about this. He said that it most likely involves needles in the perineum attached to a low voltage stimulator.

I tried this for two sessions (out of the 12 I had) when I had acupuncture in December-January of 2008 without much relief.
Age: 40 | Onset Age: 38 | Symptoms: Pain in buttocks & ischial tuberosity/lower psoas especially while sitting. Occasional urethra burning. Diagnosis: CPPS/Pudendal Neuralgia | Helped By: Tramadol/Ultracet, Low dose Valium, Q-Urol, Yoga, Stretching regimen, swimming, relaxation, distraction. | Worsened By: Extended sitting at work or in the car, stress. Current Meds: Low dose valium, tramadol, Q-Urol, Omega III Fish Oil
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Re: Electroacupuncture relieves pain in CP/CPPS

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Thanks for your reply
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by wrcftw »

Accupuncture studies are very dependent on how well they define sham accupuncture. The best studies from the best research universities all point the accupuncture being useless....I'm skeptical!
Age:26 | Onset Age:22 | Symptoms:Burning/tingling just under head of penis, or tip, perineum aching/pain, rectal pain, feeling the need to urinate constantly | Helped By: Light exercise, anxiety medication, positive attitude, healthy distraction | Worsened By: Sitting on hard surfaces, pelvic clenching, STRESS
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by webslave »

Before you dismiss acupuncture, have a look at this (unpublished as yet) abstract from the latest (2009) AUA meeting
American Urological Association Annual Meeting, 25-30 April, 2009. Chicago, Illinois, USA

Success of acupuncture in the treatment of Painful Bladder Syndrome (Interstitial Cystitis)
Felicity A Reeves*, Christopher R Chapple, Mike Pullman, Sheffield, United Kingdom

Introduction and Objective: Painful Bladder Syndrome (Interstitial Cystitis) (PBS/IC). Is an important clinical condition of unknown aetiology and affects between 0.01% and 0.5% of the female population. The goal of management is to ameliorate the associated pain and storage symptoms and improve quality of life. Available evidence on conservative and supportive therapy suggests limited efficacy for most therapies. Our objective was to determine how effective acupuncture is at reducing symptoms and improving quality of life in a group of individuals who had failed to respond to conventional conservative therapy.

Methods: We conducted a retrospective case note review on symptomatic patients (n=15) with PBS/IC who had failed to respond to therapy and who were referred for acupuncture. Demographic details, symptoms at presentation, previous treatments were considered. A standard acupuncture technique was performed by a Consultant Anaesthesiologist. MYMOP visual analogue scores were completed by patients pre and post therapy/course. The worst symptom was scored and how their lives were affected. This gave a calculated score for comparison. Treatment was considered successful if the score improved and the patient reported feeling better/ improved quality of life.

Results: Prior to therapy, pain and frequency were experienced by all patients and dyspareunia reported by 20%. The average age was 45 years (range 33 - 60). All patients had received at least one treatment before acupuncture was considered. 73% of patients had received intravesical sodium hyaluronate solution of which only four reported success (36%). 80% had received cystodistension with only one (8%) finding it beneficial. Four patients were treated with gabapentin, none of which found it to help. Pre and post acupuncture MYMOP visual analogue symptom scores improved in all patients. Quality of life improved post treatment in 13 out of the 15 patients. Pre-treatment leisure was affected the most (67%), followed by work (20%), followed by intercourse (13%). The average number of sessions required to feel a subjective improvement in symptoms was three (Minimum of 1, maximum of 6). No complications of the treatment was documented for any of the patients.

Conclusions: Acupuncture was successful in 100% of patients in terms of improving symptoms and 86% felt an improvement in quality of life. The success rate is particularly important as it occurred after failure of cystodistension and both oral and intravesical therapy in this group.
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Re: Electroacupuncture relieves pain in CP/CPPS

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I find this really interesting and a viable treatment method to work into my recovery plan. My main question with this - How do you explain what you want to the acupuncturist? I've never had acupuncture performed on me, but I would imagine they approach things different if your shoulder hurts or you are trying to treat CPPS.

Can anyone suggest what I should ask for if I visit a reputable acupuncturist? In the recent study webslave is referencing, I wonder what method / type of acupuncture was performed.
Age:35 | Onset Age:31 | Symptoms:Frequent urination w/ high urine output each time, (good day 6 times - bad day 12 times) continuous sensation of having to urinate; burning, raw feeling throughout abdomen; Bowel patterns changed (increased); cramping | Helped By:External & Internal Massage, Hot Tub, Playing sports, stretching, alcohol
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by coppertop »

With my acupuncturist, he didn't know CPPS, but he did know BPH. Since they work in "meridians" of the body, the bladder and the prostate fall in the same meridian I believe, so needle placement should be similar.

He showed me one spot just above the ankle bone on the inside of the leg where if you press and it is tender, shows a bladder dysfunction.

(Or you could photocopy select pages from "Headache in the Pelvis" and share it with him/her,
Age: 40 | Onset Age: 38 | Symptoms: Pain in buttocks & ischial tuberosity/lower psoas especially while sitting. Occasional urethra burning. Diagnosis: CPPS/Pudendal Neuralgia | Helped By: Tramadol/Ultracet, Low dose Valium, Q-Urol, Yoga, Stretching regimen, swimming, relaxation, distraction. | Worsened By: Extended sitting at work or in the car, stress. Current Meds: Low dose valium, tramadol, Q-Urol, Omega III Fish Oil
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Re: Electroacupuncture relieves pain in CP/CPPS

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That's where the confusion about acupuncture comes into play for me. I would think the treatment for BPH would be different then the approach for CPPS. CPPS is nerve and muscle related (in my opinion) while BPH is related to the actual enlargement of the prostate. One of the studies that were referenced earlier mentioned treating the sacral nerve via acupuncture.

Even though the two disorders are in the same area of the body, I can see a treatment for BPH not having an effect on CPPS patients. The benefit I see to acupuncture would be calming and quieting the nerves in that area so the muscles can relax and return to a neutral state.

Did you feel you benefited from your acupuncture treatments Coppertop?
Age:35 | Onset Age:31 | Symptoms:Frequent urination w/ high urine output each time, (good day 6 times - bad day 12 times) continuous sensation of having to urinate; burning, raw feeling throughout abdomen; Bowel patterns changed (increased); cramping | Helped By:External & Internal Massage, Hot Tub, Playing sports, stretching, alcohol
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by Dimdem »

RichieRich wrote:Hi can you tell me where i can get more information on this, and what the points on the body were please. Thanks!
The EA therapy protocol included a total of 6 acupuncture points at the bilateral BL32 (zhongliao), BL33 (ciliao), and GB30 (huantiao) were selected according to the theory of neuroanatomy and myofascial pain syndromes. In brief, both BL32 and BL33, located in the second and third posterior sacral foramen on the sacrum, were selected to stimulate the sacral nerve.11 GB30, located at the junction of the lateral one third and medial two thirds of the distance between the great trochanter and the hiatus of the sacrum, was chosen for releasing the myofascial trigger point of the piriformis muscle.12

All acupuncture points were prepared with 70% alcohol pads, and disposable stainless steel needles (40 × 0.25 mm, Dongbang Acupuncture, Chungnam, Republic of Korea) were used. With participants lying prone, the needles were placed perpendicularly about 30 mm deep and stimulated electrically at both right and left acupuncture points with a frequency of 4 Hz and an intensity of 5-10 mA (tolerable strength) with continuous stimulation by the pulse generator (PG-306, Suzuki Iryoki, Japan).13 At GB30, disposable stainless steel needles (70 × 0.30 mm, Dongbang Acupuncture) were inserted deeply to reach the myofascial trigger point of the piriformis muscle.
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by coppertop »

Sandcrab,

I went for a total of 12 treatments. If it helped, it was marginal at best. I enjoyed the "relax time" under a heat lamp while the needles were in place for about 30 minutes or so, but as far as relieving symptoms, it helped for a little while to reduce them for a few days. (Which could have very well been the relaxation too). This is not to say not to try it. My practitioner was good; he was a certified doctor of chinese medicine, trained in China, and a certified acupuncturist. Nice guy too. He said that he had helped several male patients with prostatitis and pelvic pain. He did say that if it didn;t help me after 10-12 treatment, it probably wouldn't help.

I say give it a try. It is non-invasive, relatively painless, and really can't hurt you. It might help!

Let me know.
Age: 40 | Onset Age: 38 | Symptoms: Pain in buttocks & ischial tuberosity/lower psoas especially while sitting. Occasional urethra burning. Diagnosis: CPPS/Pudendal Neuralgia | Helped By: Tramadol/Ultracet, Low dose Valium, Q-Urol, Yoga, Stretching regimen, swimming, relaxation, distraction. | Worsened By: Extended sitting at work or in the car, stress. Current Meds: Low dose valium, tramadol, Q-Urol, Omega III Fish Oil
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Acupuncture for CPPS, 2 recent studies

Post by inflagranti »

http://www.sciencebasedmedicine.org/?p=2945
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a somewhat nebulous diagnosis with unknown etiology and no effective treatment. To make the diagnosis, bacterial infection must be excluded and the symptoms must last at least 3 months. Symptoms include pain in various locations (between rectum and testicle, in the testicles, at the tip of the penis, in the lower back, in the abdomen over the pubic or bladder area), pain or burning with urination, frequent urination, pain or discomfort during or after sexual climax. There are also systemic features like decreased libido, myalgias, and fatigue, and there is a higher incidence of chronic fatigue syndrome in these patients. The connection to the prostate is uncertain; in one study, women with chronic pelvic pain reported more of these symptoms than men did. Diagnosis is based on self-reported symptoms; there are no objective diagnostic markers. Somewhere between 2 and 10% of the male population are reported to suffer from this syndrome.

Since there is no effective mainstream treatment for this disorder, why not try acupuncture? Two randomized, placebo-controlled studies have reported positive results from acupuncture treatment. Is this enough evidence for us to recommend it to patients?
Age: 27 | Onset Age: 18 | Symptoms: glans not as big during errection, pain in penis, sometimes testicles; feeling of a knot in perineum (often feels like after urination there is urin held in); severe pain after low bladder filling above pubis; pain when urinating, when a bowle movement and after ejaculation and during sex | Helped By: not thinking about it; relaxing; | Worsened By: tensing/clinching during urination; sudden tensing; depression
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Re: Electroacupuncture relieves pain in CP/CPPS

Post by NYanchuk »

I've gone for 8 sessions to an acupuncturist named Stephanie here in Victoria, who did a trial on 20 women with pelvic pain, with reasonable success, i think 5 got better, 5 had improvement, 4 felt a little better, and 2 nothing happened to.

It's quite relaxing, and a great time to do body scan meditation, but I'm starting to believe I am in the latter of those 4 categories...:s

and its 75$ a session, and I am out of work now.....
Age: 26 - | Onset Age: 23 - | Symptoms: painful urination, painful ejaculation, cold penis, chronic pain through perenial area and penis esp. at tip of penis, penis desensitization, general pelvic discomfort and pain, dribbling, shooting pains up to abs, VERY easy loss of erection - | Worsened By: cold, sexual activity, alcohol, stress/stressful/strenuous activity, heavy lifting, concentrated urine, marajuana, hiking downhill, running - No Effect: stretching, acupuncture, mindfullness, relaxation, meditation, a blockers (alfuzosin, tamsulosin), antibiotics, painkiller, muscle relaxents, valerian root, quercetin (3 months...tried twice), low oxylate diet, herbal tinctures - Currently Trying: Lyrica 450mg/day + Tegretol 600mg/day. Seems to help a little, but the withdrawal + possibilities of worse pain make it scary to go off...
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