A Review of the Medical Literature
This past week in one of the online lymphedema support groups, we had discussions involving a new “type” of treatment method. It is called auricular therapy and it claims to treat and cure a number of serious ailments by acupuncture in the ear.
While this is a spin-off on the ancient Chinese practice, the new concept referred to as ear reflexology is actually of a recent origin. A French doctor by the name of Nogier, writing in a German acupuncture periodical in 1957, put forth the theory that there was a “tie-in” between specific sites on the ear and other parts of the body. Eventually, more then 200 sites were identified as having a commonality.
Clinical studies have been conducted, but they are consistently criticized for poor quality control and methodology (inconsistency in the treatment protocol). Thus, no solid evidence has been put forth that this alternative medicine treatment is effective in actually any disease, much less lymphedema.
I was unable to find any study done on auricular therapy and lymphedema. The information contained herein does not constitute an endorsement of auricular therapy and as always the patient should discuss any treatment program with their doctor and lymphedema therapist.
Definition: The insertion of needles into acupuncture points in the ear that relate to specific parts of the body. Used frequently for quit smoking and weight loss therapy.
Also Known As: Ear acupuncture
Editor’s Note: Perhaps the clearest explanation of Auricular Therapy comes from the website called Dr. Feely.com. Again, this is for information only and inclusion does not consitute any endorsement of this proposed but untested treatment modality for lymphedema
Ear acupuncture is needle stimulation to the auricle, or external ear, using fine acupuncture needles.
Auricular therapy uses electricity to diagnose auricular acupoints. It uses electricity, laser or colored filters to treat auricular acupoints. It is performed by a physician, acupuncturist or therapist Auricular therapy is the bioenergetic and biomechanical approach to wholistic health care and pain management. It is a form of needle-less acupuncture. It is a diagnostic method and a therapeutic treatment of the microsystem. It is rooted in acupuncture teachings and research and it is the easiest and most “western” approach to acupuncture
Auriculotherapy works by stimulating the central nervous system through the cranial nerves/spinal nerves on the auricle of the ear. This stimulation results in a neurotransmitters being stimulation within the periactal ductal gray and pituitary and spinal cord of the central nervous system. This stimulation of neurotransmitters modulates the pain and modulates nerve function beginning the healing process within the body to that organ or body part.
Using acupuncture needles on the ear, pain may last one to three seconds with the placing of the needle. Otherwise, acupuncture needles should not hurt on the ear. If electrical stimulation is used or lasers are used on the ears, there should be little to no pain at all perceived by the patient.
Auriculotherapy is good for acute painful problems alleviating pain almost immediately or within 24 to 48 hours. Auricle therapy is good for chronic degenerative conditions such as osteoarthritis, rheumatoid arthritis and other chronic painful conditions like spinal stenosis and other chronic central nervous system conditions such as multiple sclerosis. Other conditions include diseases and dysfunctions of the gastrointestinal, genital urinary and cardiovascular systems. Auricular therapy should not take the place of acute orthodox medical care in life threatening situations.
In most cases, treatment for most chronic conditions may be treated once or twice per weeks. However, in some acute conditions and very serious conditions auriculotherapy may be applied daily for approximately one week to 10 days.
It is performed by a therapist using electrical means to diagnose auricular acupoints. There are over 200 auricular acupoints on each ear that represent all parts of the body and many functional areas of the human organism. These points represent anatopical and neurological and physiological functions.
The physician therapist uses a hand held wand and a diagnostic probe similar to a pen that measures differences in skin conductivity between the hand and the acupoint on the ear. The positive and negative polarity of that relationship and if it is extremely negative or extremely positive, with the touch of a button, the instrument stimulates the ear with electrical stimulation either positively or negatively as needed. With this the physician auricular therapist will be able to diagnose pain, dysfunction and disease whether it be somatic, visceral or psychological in origin. These diagnostic aids, through research performed at UCLA, prove to be quite accurate for a simple test – on study yielding over 75% accuracy in a double-blind study.
People who do not want ear acupuncture or auricular therapy should, obviously, not have it, but it would be wise for anyone with the following conditions to abstain from ear acupuncture or auricular therapy. These conditions include:
Individuals with a known genetic abnormalities of CCK enzyme produced in the central nervous system. (This enzyme, which is produced in the brain, neutralizes the neuroprotients that are released with acupuncture. Only a very small percentage of the population is affected. As of today, there is no simple test to identify these patients other than a trial of acupuncture or auricular therapy.
The primary side effect of ear acupuncture or auricular therapy is tenderness or inflammation to the ear itself. Auricular therapy and acupuncture generally have almost no side effects, especially if one is using auricular therapy with electrical stimulation. If the therapist is using the Elector-Therapy Association's guidelines for treatment, there are virtually no negative side effects.
Infection is possible when the skin is pierced with the acupuncture needle, but is almost never heard of in auricular therapy. If the patient is afraid of needles, auricular therapy, rather than ear acupuncture should be performed.
In the 1980s, Drs. Oleson, Kroening, and Bresler, UCLA, in a paper entitled, “An experimental evaluation of auricular diagnosis: The somatotopic mapping of the musculoskeletal pain at the ear acupuncture points.” This study verified the somatotopic auricular map in a blinded experiment using electrical skin conductivity to 40 musculoskeletal pain subjects with a 75.2% accuracy. (Reference: PAIN, 8, 1980, PP. 217-229.)
1985 UCLA Kroening and Oleson, “Rapid narcotic detoxification and chronic pain patients with auricular electro acupuncture and Maloxon.” Twelve out of 14 chronic pain subjects, or 85.7%, were completely withdrawn from narcotic medication within two to seven days with no side effects through the use of auricular electrical stimulation and acupuncture needling of two auricular points used. (Reference: International Journal of Addictions, 20 (9), PP. 1347-1360, 1985.)
1993, UCLA, Drs. Simmons and Oleson, “Auricular electrical stimulation and dental pain thresholds.” Auricular electrical stimulation increased dental threshold by 19% and was partially reversed by Maloxone . (Reference: American Dental Society of Anesthesiology, 4:14-19, 1993.)
1993, Drs. Oleson and Flocco, “Randomized control study of premenstrual syndromes triggered with ear, hand and foot reflexology.” Results show a significant decrease of 46% in premenstrual symptoms from true reflexology compared with placebo. (Reference: Obstetrics and Gynecology, 86, NO. 6, DEC 1993, PP. 906-911.) inhibitory system.
Complement Ther Nurs Midwifery. 2001 Aug
Suen LK, Wong TK, Leung AW. Department of Nursing and Health Sciences,The Hong Kong Polytechnic University, Hung Hom Correspondence to: Ms. Lorna Suen, Department of Nursing and Health Sciences, The Hong Kong Polytechnic University, HungHom, Hong Kong. Tel.: +(852) 2766 6758; Fax: +(852) 2364 9663; E-mail: firstname.lastname@example.org
Several theories, such as the 'homuncular reflex theory' 'delta reflex theory', and 'meridian theory' point to the fact that the ear is related to all parts of the human body and internal organs. Being one of the approaches in traditional Chinese medicine, auricular therapy is a therapeutic method by which specific points on the auricle are punctured or pressed. Auricular therapy can activate meridians and collaterals, regulate the Qi and blood, help to achieve the balance between Yin and Yang status of internal organs, and is therefore suitable for treating many disorders of the body. Successful examples of previous studies using this therapy including insomnia, weight reduction, hypertension, treatment of addiction, and pain reduction. However, inconsistency in the treatment protocol among studies, or the use of combined therapies, makes it impossible to draw a strong causal relationship between this therapy and the treatment effect. More appropriate clinical trials are therefore necessary to understand in depth the therapeutic effect of auricular therapy. Ideally, these trials can take place in the context of nursing practice so as to explore the application of this therapy in the realm of nursing, and to enable nurses to make a more effective contribution to primary health care.
J Altern Complement Med. 2007 Jul-Aug Chen HY, Shi Y, Ng CS, Chan SM, Yung KK, Zhang QL. School of Chinese Medicine, Hong Kong Baptist University, Hong Kong. email@example.com
OBJECTIVES: To review trials on the efficacy and safety of auricular acupuncture (AA) treatment for insomnia and to identify the most commonly used auricular acupoints for treating insomnia in the studies via a frequency analysis.
DATA SOURCES: The international electronic databases searched included: (1) AMED; (2) the Cochrane library; (3) CINAHL; (4) EMBASE; and (5) MEDLINE. Chinese electronic databases searched included: (1) VIP Information; (2) CBMdisc; and (3) CNKI.
STUDY SELECTION: Any randomized controlled trials using AA as an intervention without using any co-interventions for insomnia were included. Studies using AA versus no treatment, placebo, sham AA, or Western medicine were included.
DATA EXTRACTION: Two (2) independent reviewers were responsible for data extraction and assessment. The efficacy of AA was estimated by the relative risk (RR) using a meta-analysis.
RESULTS: Eight hundred and seventy eight (878) papers were searched. Six (6) trials (402 treated with AA among 673 participants) that met the inclusion criteria were retrieved. A meta-analysis showed that AA was chosen with a higher priority among the treatment subjects than among the controls (p < 0.05). The recovery and improvement rates produced by AA was significantly higher than those of diazepam (p < 0.05). The rate of success was higher when AA was used for enhancement of sleeping hours up to 6 hours in treatment subjects (p < 0.05). The efficacy of using Semen vaccariae ear seeds was better than that of the controls (p < 0.01); while magnetic pearls did not show statistical significance (p = 0.28). Six (6) commonly used auricular acupoints were Shenmen (100%), Heart (83.33%), Occiput (66.67%), Subcortex (50%), Brain and Kidney (each 33.33%, respectively).
CONCLUSIONS: AA appears to be effective for treating insomnia. Because the trials were low quality, further clinical trials with higher design quality, longer duration of treatment, and longer follow-up should be conducted.
J Altern Complement Med. 2004 Dec
D'Alberto A. firstname.lastname@example.org
BACKGROUND: The United Kingdom has had a significant increase in addiction to and use of cocaine among 16-29-year olds from 6% in 1998 to 10% in 2000. In 2000, the United Kingdom had the highest recorded consumption of “recent use” cocaine in Europe, with 3.3% of young adults. Acupuncture is quick, inexpensive, and relatively safe, and may establish itself as an important addiction service in the future.
AIM: To select investigations that meet the inclusion criteria and critically appraise them in order to answer the question: “Is acupuncture effective in the treatment of cocaine addiction?” The focus shall then be directed toward the use of the National Acupuncture Detoxification Association (NADA) protocol as the intervention and the selection of sham points for the control group. Data sources: The ARRC database was accessed from Trina Ward (M. Phil. student) at Thames Valley University. AMED, MEDLINE and Embase were also accessed along with “hand” searching methods at the British Library.
INCLUSION AND EXCLUSION CRITERIA: People addicted to either cocaine or crack cocaine as their main addiction, needle-acupuncture, single-double-blinded process, randomized subjects, a reference group incorporating a form of sham points. Exclusion Criteria: use of moxibustion, laser acupuncture, transcutaneous electrical nerve stimulation (TENS) electroacupuncture or conditions that did not meet the inclusion criteria.
QUALITY ASSESSMENT: The criteria set by ter Riet, Kleijnen and Knipschild (in 1990); Hammerschlag and Morris (in 1990); Koes, Bouter and van der Heijden (in 1995), were modified into one set of criteria consisting of 27 different values.
RESULTS: Six randomized controlled trials (RCTs) met the inclusion criteria and were included in this review. All studies scored over 60 points indicating a relatively adequate methodology quality. The mean was 75 and the standard deviation was 6.80. A linear regression analysis did not yield a statistically significant association (n = 6, p = 0.11).
CONCLUSIONS: This review could not confirm that acupuncture was an effective treatment for cocaine abuse. The NADA protocol of five treatment points still offers the acupuncturist the best possible combination of acupuncture points based upon Traditional Chinese Medicine. Throughout all the clinical trials reviewed, no side-effects of acupuncture were noted. This paper calls for the full set of 5 treatment points as laid out by the NADA to be included as the treatment intervention. Points on the helix, other than the liver yang points, should be selected as sham points for the control group.
J Chin Med Assoc. 2007 Aug
Wu TP, Chen FP, Liu JY, Lin MH, Hwang SJ. Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
BACKGROUND: Tobacco smoking is responsible for human diseases of the lung, heart, circulatory system and various kinds of cancers, and is a serious public health problem worldwide. Acupuncture has been promoted as a treatment modality for smoking cessation. However, its efficacy still remains controversial.
METHODS: We conducted a prospective, randomized, controlled trial using auricular acupuncture for smoking cessation in 131 adults who wanted to stop smoking. Thirteen subjects withdrew from the study and 118 subjects were included in the final analyses (mean age, 53.7 +/- 16.8 years; 100 males, 18 females). The treatment group (n = 59) received auricular acupuncture in Shen Men, Sympathetic, Mouth and Lung points for 8 weeks. The control group (n = 59) received sham acupuncture in non-smoking-cessation-related auricular acupoints (Knee, Elbow, Shoulder and Eye points). The enrolled subjects were then followed monthly for 6 months after stopping the acupuncture treatment.
RESULTS: Between both groups before acupuncture treatment, there was no significant difference with regard to gender, mean age, education level, and mean values for the age at which smoking started, smoking duration, daily number of cigarettes smoked and nicotine dependent score. At the end of treatment, cigarette consumption had significantly decreased in both groups, but only the treatment group showed a significant decrease in the nicotine withdrawal symptom score. Smoking cessation rate showed no significant difference between the treatment group (27.1%) and the control group (20.3%) at the end of treatment. There was also no significant difference in the smoking cessation rate between the treatment group (16.6%) and the control group (12.1%) at the end of follow-up. There were no major side effects of auricular acupuncture in both groups.
CONCLUSION: Our results showed that auricular acupuncture did not have a better efficacy in smoking cessation compared to sham acupuncture. Combined acupuncture with behavior counseling or with nicotine replacement therapy should be used in further smoking cessation trials to enhance the success rate of smoking cessation.
Inclusion of these pages does not consitute an acceptance of the treatment modality.
The pages are for patient information and education. In situations where I feel the treatments are either ineffective, dangerous or just plain bogus I have added my personal commentary.