Spinal Chord Injury

Traumatic Spinal Cord Injury (TSCI) affects approximately 100 new Zealanders per year. Its physical and emotional impact can be devastating.

Those suffering from a TSCI may experience paralysis, sensory loss, chronic pain, and bladder or bowel incontinence, to name just some of the adverse effects (Dorsher & McIntosh, 2011).

Worse yet, a report by the Spinal Cord Injury Information Network (2008), found fewer than 1% of people who suffer from acute SCI fully neurologically recover, after being discharged from the hospital.

However, there is a ray of hope for TSCI patients.

A strong body of research suggests acupuncture – especially electroacupuncture – can be an effective modality to treat acute and chronic TSCI. In particular, electroacupuncture can improve motor, sensory, and bowel/bladder recovery in acute SCI patients, as well as reduce the chronic pain associated with SCI (Dorsher & McIntosh, 2010).
The best part is, acupuncture treatment is essentially risk-free.

Acupuncture Found Effective for Motor and Sensory Recovery
Looking specifically at motor and sensory recovery, a study by Wong et. al (2003), examined 100 patients with SCI.
Over a one-year period, half of patients received 75 Hz of electroacupuncture stimulation, five times weekly, for 30 minutes. The acupuncture points were targeted to activate the patients’ Governor Vessel meridian. In contrast, the other half of patients received only standard rehabilitation medical care. They were not given any electroacupuncture.

At the 1-year mark, patients’ motor skills and sensory scores were measured…
Results revealed those patients who received electroacupuncture achieved a statistically and clinically significant neurological recovery, compared to those who were given only standard rehabilitation care (Wong, et. al, 2003).

Acupuncture Can Reduce Bladder Dysfunction
Urinary incontinence may be an upsetting issue for patients with SCI. Even more upsetting, studies looking at the long-term prognosis for bladder recovery show grim results (Chou, Hartl & Sonntag, 2006).

Traditionally, treating bladder incontinence has involved the patient undergoing behavioural interventions and a taking variety of medications (Madersbacher, 1999).

However, several studies show acupuncture may also help relieve urinary incontinence.

A study by Wong et. al (2003), found electroacupuncture, in combination with auricular acupoints, helped SCI patients recover enhanced bladder function. After a one-year period, those patients receiving acupuncture intervention showed statistically significant improvements in bladder Functional Independence Measure (FIM) scores, compared to those who were not given acupuncture. (Wong et. al, 2003).

Another study by Honjo et. al (2000), found weekly acupuncture stimulation for one month, improved – and in some cases resolved – urinary incontinence in patients. Average bladder volume also increased 2- to 4-fold after weekly treatments and stayed 70% better, even one month following the last acupuncture treatment (Honjo et. al, 2000).

Acupuncture to Improve Bowel Function
While urinary incontinence can be difficult, bowel incontinence can have devastating consequences for SCI patients trying to re-integrate into work and social routines.

Research by Schönherr et. al (1999) found it was very difficult for those suffering from an SCI to naturally recover full bowel function.

Here, electroacupuncture offers hope.

In the only study conducted on bowel dysfunction following acute SCI, Wong et al. (2003) demonstrated that giving patients electroacupuncture for 1-year improved bowel incontinence at a clinically significant level, compared to those patients who did not receive acupuncture intervention.

These results indicate, acupuncture may be an effective treatment for diminishing the negative consequences of incontinence.

Acupuncture Shown to Reduce Pain
Beyond the devastating injury itself, one of the gravest consequences of SCI is chronic pain.
Research by Cardenas & Jensen (2006) found over 80% of people with SCI experience long-standing pain.

According to Wershagen (2008), this pain adversely affects daily life and even radiates below the level of the spinal injury. Additionally, some people with a SCI may experience musculoskeletal pain from constant use of upper extremities for transfers and wheelchair mobility (Widerstrom-Noga, et. al 2001), (Waring&Maynard, 1991).

Here again, Apuncture offers hope.

A study by Additionally, Rapson et al., 2003 found electroacupuncture improved pain for 66% of patients with central pain symptoms. People with bilateral, burning pain below the SCI lesion were the most likely to feel better.

In addition, Nayak et al., 2001 found some SCI patients who suffered over six-months of moderate to severe shoulder pain felt relief in pain intensity after 15 acupuncture treatments, taking place over a seven-and-a-half-week period.

Moreover, research looking at the effects of acupuncture in wheelchair-using SCI patients with chronic musculoskeletal shoulder pain, found ten acupuncture treatments, or minimal needling of non-acupuncture points, significantly reduced patients’ shoulder pain (Dyson-Hudson et al., 2007). These studies show, overall, acupuncture may be a useful treatment to help relieve neuropathic and/or musculoskeletal pain, following SCI.

Ongoing Acupuncture for Blood Pressure Control
Autonomic dysreflexia, a syndrome in where there’s a sudden onset of excessively high blood pressure, is more likely to afflict people with SCI (www.healthlinkBC.ca, 2018).

A rigorous study by Flachskampf et. al (2007), provides preliminary evidence to suggest that acupuncture can reduce blood-pressure equally as effectively as ACE-inhibitor medications, or aggressive lifestyle changes, like radical salt reduction.
However, the study found the beneficial blood pressure lowering effects of acupuncture dissipated after three months, post-treatment. This result shows patients using acupuncture to control high blood pressure may need to maintain ongoing treatments to keep blood pressure stable.

How and Why Acupuncture Works
Inquiry into how and why acupuncture helps relieve the negative effects of SCI shows treatment creates physiological changes.

Research by Dorsher & McIntosh (2011), shows stimulation of appropriate spinal cord segmental levels, or peripheral nerves, causes the release of endogenous opioids at the spinal cord level. This release has a positive impact on mitigating the extent of the injury.

With electroacupuncture, in particular, the electrical stimulation results in lowered glial fibrillary acidic protein levels in the injured cord, which reduces scar formation (Yang et. al, 2005), (Peng et. al, 2007) and can increase blood flow (Uchida & Hotta, 2008).

Electroacupuncture can also moderate the central nervous system (Ma, 2004), reduce free radical formation, (Wu et. al, 2002), minimize the swelling associated with secondary spinal cord damage (Han et. al, 2005), and lower the body’s stress response, as measured by cortisol levels (Politis & Korchinski, 1990).

Overall Summary: Acupuncture Can Be Effective For SCI
In conclusion, this substantial body of studies provides strong evidence to show that acupuncture can be beneficial for treating SCI, and enhancing quality of life.

Electroacupuncture, in particular, may significantly improve long-term neurologic recovery, including motor, sensory and bowel/bladder function, as well as chronic neuropathic and musculoskeletal pain.

If you, or a loved one is suffering from a debilitating SCI, please get in touch to discuss treatment options.
To book your acupuncture treatment call 04 4991439 or use City Acupuncture’s Online Booking System. Acupuncture is the 3rd option on the list.

References:
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2. Conus medullaris syndrome without lower-extremity involvement in L-1 burst fractures: report of four cases. Chou D, Hartl R, Sonntag VK J Neurosurg Spine. 2006 Mar; 4(3):265-9.
3. Dorsher, P, McIntosh, P. Acupuncture’s Effects in Treating the Sequelae of Acute and Chronic Spinal Cord Injuries: A Review of Allopathic and Traditional Chinese Medicine Literature. Evidence-Based Complementary and Alternative Medicine. 2011.
4. Dyson-Hudson TA, Kadar P, LaFountaine M, et al. Acupuncture for chronic shoulder pain in persons with spinal cord injury: a small-scale clinical trial. Archives of Physical Medicine and Rehabilitation. 2007;88(10):1276–1283.
5. Flachskampf FA, Gallasch J, Gefeller O, et al. Randomized trial of acupuncture to lower blood pressure. Circulation. 2007;115(24):3121–3129.

6. Han QM, Xie J, Chai ST, Fang J, Liu Q. Effect of Governer Meridian electro-acupuncture on water channel aquaporin-4 in experimental spinal cord injured rats. Zhongguo Zhong Yi Yan Jiu Yuan Zhu Ban. 2005;25(7):637–639.
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8. https://www.healthlinkbc.ca/health-topics/ug2980
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18. Wershagen L. Analysis of neuropathic pain after spinal cord injury. Karolinska Intsitutet; 2008. pp. 1–47. Doctoral thesis.
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21. Wu Y, Sun Z, Li Z, Zhao Y, Sun S. Effect of acupuncture on free radicals in rats with early experimental spinal cord injury. Journal of Traditional Chinese Medicine. 2002;22(1):51–54.
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