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.

There is a ray of hope for TSCI patients However, read on. And if you or a loved one is suffering from a debilitating SCI, please get in touch, or use City Acupuncture’s Online Booking System.

A strong body of research suggests acupuncture 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, that 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 the 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 behavioral 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 an 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, Acupuncture 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 which 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.

1. Cardenas DD, Jensen MP. Treatments for chronic pain in persons with spinal cord injury: a survey study. Journal of Spinal Cord Medicine. 2006;29(2):109–117.
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.
7. Honjo H, Naya Y, Ukimura O, Kojima M, Miki T. Acupuncture on clinical symptoms and urodynamic measurements in spinal-cord-injured patients with detrusor hyperreflexia. Urologia Internationalis. 2000;65(4):190–195.
8. https://www.healthlinkbc.ca/health-topics/ug2980
9. Madersbacher H. Neurogenic bladder dysfunction. Current Opinion in Urology. 1999;9:303–307.
10. Nayak S, Shiflett SC, Schoenberger NE, et al. Is acupuncture effective in treating chronic pain after spinal cord injury? Archives of Physical Medicine and Rehabilitation. 2001;82(11):1578–1586.
11. Peng B, Meng XF, Li M, et al. Effects of electroacupuncture on the expression of epidermal growth factor receptor and glial fibrillary acidic protein after spinal cord injury in rats. Zhen Ci Yan Jiu. 2007;32(4):219–223.
12. Politis MJ, Korchinski MA. Beneficial effects of acupuncture treatment following experimental spinal cord injury: a behavioral morphological, and biochemical study. Acupuncture and Electrotherapeutics Research. 1990;15(1):37–49.
13. Rapson LM, Wells N, Pepper J, Majid N, Boon H. Acupuncture as a promising treatment for below-level central neuropathic pain: a retrospective study. Journal of Spinal Cord Medicine. 2003;26(1):21–26.
14. Schönherr MC, Groothoff JW, Mulder GA, Eisma WH. Functional outcome of patients with spinal cord injury: rehabilitation outcome study. Clinical Rehabilitation. 1999;13(6):457–463.
15. Spinal Cord Injury Information Network. January 2008, http://www.spinalcord. uab.edu/show.asp?durki=21446.
16. Uchida S, Hotta H. Acupuncture affects regional blood flow in various organs. Evidence-Based Complementary and Alternative Medicine. 2008;5(2):145–151.
17. Waring WP, Maynard FM. Shoulder pain in acute traumatic quadriplegia. Paraplegia. 1991;29(1):37–42.
18. Wershagen L. Analysis of neuropathic pain after spinal cord injury. Karolinska Intsitutet; 2008. pp. 1–47. Doctoral thesis.
19. Widerstrom-Noga EG, Felipe-Cuervo E, Yezierski RP. Chronic pain after spinal injury:interference with sleep and daily activities. Archives of Physical Medicine and Rehabilitation. 2001;82(11):1571–1577.
20. Wong AMK, Leong C-P, Su T-Y, Yu S-W, Tsai W-C, Chen CPC. Clinical trial of acupuncture for patients with spinal cord injuries. American Journal of Physical Medicine and Rehabilitation. 2003;82(1):21–27.
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.
22. Yang C, Li B, Liu TS, Zhao DM, Hu FA. Effect of electroacupuncture on proliferation of astrocytes after spinal cord injury. Zhongguo Zhen Jiu. 2005;25:569–572.