Comparing the analgesic efficacy between 100 Hz and 2 Hz electroacupuncture on patients with lumbar osteoarthritis

Background and Objective: Chronic low back pain (CLBP) represents one of the major causes of increasing disability worldwide. Electroacupuncture with different frequencies at the Hua Tuo Jia Ji acupoints has been used to treat CLBP in patients with lumbar osteoarthritis. Basic studies demonstrate that 100 Hz or 2 Hz electroacupuncture has pain-relief effects on CLBP; however clinical evidence for choosing which frequency is still limited. Thus, our study aims to compare the effects of 100 Hz to 2 Hz electroacupuncture for CLBP on patients with lumbar osteoarthritis. Methods: A randomized controlled trial of 124 patients with lumbar osteoarthritis at the Traditional Medicine Hospital at Ho Chi Minh City from September 2018 to July 2019. Patients were randomly allocated to either intervention group (n = 62) with 100 Hz electroacupuncture or control group (n = 62) with 2 Hz electroacupuncture at the L2-S1 Hua Tuo Jia Ji acupoints for 14 days. Du Huo Ji Sheng Tang decoction was also administered in both groups. Primary trial outcomes were QDSA score and the proportion of patients who achieved pain relief thresholds. Results: After 14 days of treatment, QDSA score in intervention group decreased significantly compared to control group. 87% of patients in intervention group had pain relief of ≥70%, and only 45% patients in control group had such result. Lumbar flexion range of motion in 100 Hz group tended to be better than in 2 Hz group. Conclusion: 100 Hz electroacupuncture had superior analgesic effects on lumbar osteoarthritis to 2 Hz electroacupuncture.

Electroacupuncture at Hua Tuo Jia Ji Acupoints Reduced Neuropathic Pain and Increased GABAA Receptors in Rat Spinal Cord

Chronic constriction injury- (CCI-) induced neuropathic pain is the most similar model to hyperalgesia in clinical observation. Neuropathic pain is a neuronal dysfunction in the somatosensory system that may lead to spontaneous pain. In this study, electroacupuncture (EA) was applied at bilateral L4 and L6 of Hua Tuo Jia Ji points (EX-B2) for relieving neuropathic pain in rats. Eighteen Sprague-Dawley rats were randomly assigned to three groups: sham, 2-Hz EA, and 15-Hz EA groups. Following von Frey and cold plate tests, both the 2- and the 15-Hz EA groups had significantly lower mechanical and thermal hyperalgesia than the sham group. Western blot analysis results showed that γ-aminobutyric acid A (GABAA), adenosine A1 receptor (A1R), transient receptor potential cation channel subfamily V member 1 (TRPV1), TRPV4, and metabotropic glutamate receptor 3 (mGluR3) were similar in the dorsal root ganglion of all three groups. Furthermore, levels of GABAA receptors were higher in the spinal cord of rats in the 2- and 15-Hz EA groups compared with the sham control group. This was not observed for A1R, TRPV1, TRPV4, or mGluR3 receptors. In addition, all the aforementioned receptors were unchanged in the somatosensory cortex of the study rats, suggesting a central spinal effect. The study results provide evidence to support the clinical use of EA for specifically alleviating neuropathic pain.

Conquest of Pain: Analgesics: From Morphine to Lyrica

To live is to endure pain has been understood by almost everybody who is mature enough to gain some philosophical perspective on life. C’est la vie! as the French would say. Indeed, pain existed before the dawn of humanity—some research suggests that even plants respond to pain. According to ancient Greek myth, Prometheus stole fire from Olympus to give it to mortals. Zeus punished him by chaining him to a rock and having a great eagle feast on his liver daily, inflicting unbearable agony. Zeus also sent Pandora to Earth, unleashing pain (one of the items in Pandora’s box) and many evils as a vengeance to mankind. Without an understanding of pain, our ancestors resorted to many measures to ease pain; some were successful to some extent, and some were completely futile. Witches and shamans were sought out to exorcise pain from the body. From a psychological perspective, they might be effective for some believers. The hypnotizing technique reached its crescendo in the 18th century in France when Monsieur Anton Mesmer “mesmerized” many French citizens, liberating them from their pains. As civilization progressed, alcohol became more and more a universal painkiller after it was observed that drunkards were oblivious to pain. Chinese surgeon Hua Tuo (115–205 ad) gave his patients an effervescent powder (possibly cannabis) in wine that produced numbness and insensibility before surgical operations. Another ancient invention in Chinese medicine was the use of acupuncture to ease pain. Acupuncture, now an increasingly popular treatment for persistent as well as intermittent pain, is thought to work by increasing the release of endorphins, chemicals that block pain signals from reaching the brain. A recent survey by the National Institute of Health (NIH) indicated that acupuncture showed efficacy in adult postoperative pain, chemotherapy nausea and vomiting, and postoperative dental pain. There is no doubt that acupuncture works for some patients’ minor pain, through either physiological or psychological means, or both. or both. During the hype of the Great Culture Revolution (1966–1976), it was even claimed that major operations were carried out using acupuncture without any other anesthetics.