Philip A.M. Rogers MRCVS

AP in Pain and Painful Conditions


Carlsson_CP; Sjolund BH (1994) AP and subtypes of chronic pain: assessment of long-term results. Clin J Pain Dec 10(4):290-295. Dept of Anaesthesiology, Malmo General Hospital, Sweden. Patients' opinions of pain relief for a longer time were determined after one treatment period of AP for chronic pain. 211 patients had AP treatment for chronic pain at the Pain Clinic of Malmo Univ Hospital during 1983-5. Their mean pre-treatment duration of pain was 10.4 yr. They were treated with needle AP with a combination of local and distal points every 1-2 wk for a mean of 8 times. Both manual AP and EAP stimulation was utilized. In 1988, all patient documents were screened, and the pain conditions were classified as nociceptive, neurogenic, or psychogenic. Initial results were evaluated from the clinic records of 202/211 patients treated. 85 of these patients (42%) had pain relief immediately after the treatment period. These patients were sent a 1-page questionnaire by mail in 1988. Pain relief over defined time periods (yes/no); do more work at home or at workplace (yes/no); analgesic consumption. Only 35 patients (17% of all patients) still had pain relief 6 mo after treatment. Among those with nociceptive pain, 70/142 (49%) had pain relief initially; those with neurogenic or psychogenic pain had relief in only 11/34 and 4/26 cases, respectively. 33/142 patients with nociceptive pain had pain relief for >6 mo, but 2/34 patients with neurogenic pain, and no patient with psychogenic pain had long-lasting pain relief. Only patients with nociceptive pain can be expected to get pain relief for >6 mo after one treatment period of AP, and of these only a small proportion will be helped.

Cummings_TM (1996) A Computerised Audit of AP in Two Populations: Civilians and Armed Forces. Adapted from WWW. This is a retrospective review and comparison of AP in 2 distinct populations over 2 yr: an armed forces general practice and a civilian private practice. A computerised database is used to draw comparisons between the groups and the results of AP within those groups. Computerised graphic representations of the results are shown. AP was most successful in treating myofascial pain with associated tender points.

Eadie_MJ (1990) AP and the relief of pain [editorial]. Med J Aust 20 Aug 153(4):180-181.

Ernst_E (1994) Is AP effective for pain control? [letter]. J Pain Symptom Manage Feb 9(2):72-74.

Harman_JC (1996) Quick Introduction to AP. Equine Pract May 18(5):33-34. Harmany Equine Clin, POB 8, Washington,VA 22747 USA; Also, Harman_JC (1994) The Effects of AP on the Performance of Horses. Proceedings from 12th Meeting of the Equine Practitioners' Assoc: 48-51. JC Harman, Harmanny Equine Clin, Orlean, VA.

Jones_WE (1992) Sports medicine for the race horse. 2nd Ed Wildomar CA: Veterinary Data 307pp.

Kendall_DE (1994) Neurophysiology and Science of AP. Proceedings from 12th Meeting of the Equine Practitioners' Assoc: 76-82

Klide AM (1992) Use of AP for the control of chronic pain and for surgical analgesia. In: Animal pain, Eds Charles E Short & Alan Van Poznak, Churchill Livingstone, New York, pp249-257. Univ of Pennsylvania School of Veterinary Med, Philadelphia, PA.

Medina_Mirapeix F; Brotons Roman J; Manrique Sanchez J (1995) Comparative study on the influence of health education on perceived recurrences after physiotherapy. Aten Primaria Nov 15 16(8):464-468. Departamento de Fisioterapia, Universidad de Murcia. This study compared the repercussion of the inclusion of health education in the physiotherapist's primary care work on requests for follow-up treatment. Two settings (A=Health Centre, B=Hospital) were studied. Patients for study over a 6-mo period were attending two physiotherapy units (A=50 patients; B=97 patients) for therapy of back-ache, cervical pain or a painful shoulder. The groups were homogeneous by age (A=47+13.4; B=45+12.1 yr) and gender (A=64% women; B=69% women). The % of pathologies was also homogeneous with a p>.1 in back-ache and cervical pain and p>.90 for painful shoulders. At A (catchment population 16000) there was a complete intervention plus health education. At B (catchment 73000) individualised therapy (electrotherapy) was used. For both groups, a monitoring period was set up for the next 6 mo to observe the number who requested Physiotherapy for the same pathology. The Chi2 statistical analysis was used to contrast the equality of proportions by analysing contingency tables. During the monitoring period, 5 new treatments in group A (10%) and 29 in B (30%) were requested, which was a significant difference between the two groups. The inclusion of health education seemed to reduce the demand for repeat treatment for the same conditions.

Nissel_H (1993) Pain treatment by means of AP. AETRIJ Jan-Mar 18(1):1-8. Ludwig Boltzmann AP Inst, Vienna. AP has an important part in pain research. Bischko was the first to undertake surgery (tonsillectomy, 1972) using APA in the Western hemisphere. Decisive research has been carried out at the Ludwig Boltzmann AP Inst in Vienna. We now know much more about the importance of the basic system. We know also that the theories on chaos research, and, especially fractals play an important role. Various ways to use AP in pain relief are discussed: e.g. body AP (with or without supportive TENS); treatment via the so-called somatotopies (ear, oral mucous membrane, scalp AP according to Yamamoto etc). In Vienna, the Ludwig Boltzmann AP Inst and the 2nd Dept of Internal Med at the Kaiserin-Elisabeth Hospital showed that AP significantly reduced the quantity of analgesics required by inpatients with many clinical conditions.

Omura_Y1; Losco BM; Omura AK; Takeshige C; Hisamitsu T; Shimotsuura Y; Yamamoto S; Ishikawa H; Muteki T; Nakajima H; et al (1992) Common factors contributing to intractable pain and medical problems with insufficient drug uptake in areas to be treated, and their pathogenesis and treatment: Part 1: Combined use of medication with AP, (+) Qigong energised material, soft laser or electrostimulation. AETRIJ 17(2):107-148. Heart Disease Research Foundation, New York. Most frequently encountered causes of intractable pain and intractable medical problems, including headache, post-herpetic neuralgia, tinnitus with hearing difficulty, brachial essential hypertension, cephalic hypertension and hypotension, arrhythmia, stroke, osteo-arthritis, Minamata disease, Alzheimer's disease and neuromuscular problems, such as Amyotrophic Lateral Sclerosis, and cancer are often found to be due to co-existence of 1) viral or bacterial infection, 2) localized microcirculatory disturbances, 3) localized deposits of heavy metals, such as lead or mercury, in affected areas of the body, 4) with or without additional harmful environmental EM- or electric- fields from household electrical devices in close vicinity, which create microcirculatory disturbances and reduced ACh. The main reason why medications known to be effective prove ineffective with intractable medical problems, the authors found, is that even effective medications often cannot reach these affected areas in sufficient therapeutic doses, even though the medications can reach the normal parts of the body and result in side effects when doses are excessive. These conditions are often difficult to treat or may be considered incurable in both Western and Oriental medicine. As solutions to these problems, the authors found some of the following methods can improve circulation and selectively enhance drug uptake: 1) AP, 2) Low frequency electrostimulation (1-2 Hz), 3) (+) Qigong energy, 4) Soft lasers using Ga-As diode laser or He-Ne gas laser, 5) Certain EMFs or rapidly changing or moving electric or magnetic fields, 6) Heat or moxibustion, 7) Individually selected Calcium Channel Blockers, 8) Individually selected Oriental herb medicines known to reduce or eliminate circulatory disturbances. Each method has advantages and limitations and therefore the individually optimal method has to be selected. Applications of (+) Qigong energised paper or cloth every 4 h, along with effective medications, were often found to be effective, as materials charged with Qigong can often be used repeatedly, as long as they are not exposed to rapidly changing electric, magnetic or EM fields. Application of (+) Qigong energy-stored paper or cloth, soft laser or changing electric field for 30-60 s on the area above the medulla oblongata, vertebral arteries or endocrine representation area at the tail of pancreas reduced or eliminated microcirculatory disturbances and enhanced drug uptake.

Omura_Y2; Beckman SL (1995) Application of intensified (+) Qigong energy, (-) electrical field, (S) magnetic field, electrical pulses (1-2 Hz), strong Shiatsu massage or AP on the accurate organ representation areas of the hands to improve circulation and enhance drug uptake in pathological organs: clinical applications with special emphasis on the "Chlamydia-(Lyme)-uric acid syndrome" and "Chlamydia-(cytomegalovirus)-uric acid syndrome". AETRIJ Jan-Mar 20(1):21-72. Heart Disease Research Foundation, New York, USA. Various methods of improving circulation and enhancing drug uptake which were used in treating some intractable medical problems caused by infections, and 2 syndromes based on the co-existence of Chlamydia trachomatis infection (mixed with either Lyme Borrelia burgdorferi or Cytomegalovirus) with increased Uric acid are described. The principal author's previous studies have indicated that there are 2 opposite types of Qigong energy, positive (+) and negative (-). Positive (+) Qigong energy is used clinically to enhance circulation and drug uptake in diseased areas where there is a micro-circulatory disturbance and drug uptake is markedly diminished. (-) Qigong energy has completely the opposite effect and therefore has not been used although there may be some as yet undiscovered application. Since the late 1980's the senior author has succeeded in storing (+) Qigong energy on a variety of substances, including small sheets of paper. Recently he was able to concentrate this energy as it passed through a cone-shaped, tapered glass or plastic object placed directly on the (+) Qigong energised paper. Application of (+) Qigong energised paper on the cardiovascular representation area of the medulla oblongata at the occipital area of the skull often improved circulation and enhanced drug uptake. If the drug-uptake enhancement was still not sufficient for the drug to reach therapeutic levels in the diseased organ, direct application of (+) Qigong from the practitioner's hand often enhanced the drug uptake more significantly. However, this direct method often results in the practitioner developing intestinal micro-haemorrhage within 24 h which may or may not be noticed as mild intestinal discomfort with soft, slightly tarry stool. A cone is one of the most efficient shapes to intensify (+) Qigong energy; increased power occurs at an optimal height. However, the power decreases when the total mass and the total distance from base to peak is increased beyond an optimal limit. Clinical application of Intensified (+) Qigong stored energy was evaluated in this preliminary study: intensified (+) Qigong energy applied to the heart representation area of the middle finger on the hands markedly improved circulation in the heart, and increased drug uptake and ACh even more effectively than some of the previously used drug enhancement methods (Shiatsu massage of the organ representation areas and/or application of (+) Qigong energised paper to the occipital area above the cardiovascular representation area of the medulla oblongata).

Schoen_AM (1992) AP for musculoskeletal disorders. Probl Vet Med Mar 4(1):88-97. Vet Inst for Therapeutic Alternatives, Sherman, Connecticut. Medical and surgical approaches to canine and feline musculoskeletal disorders are numerous. AP was helpful in cases in which analgesics and anti-inflammatory medications were ineffective or had caused side effects, and in cases in which surgery was not recommended. It appears that AP not only provides long-term analgesia but also increases circulation to the affected areas and decreases inflammation. Techniques and selection of appropriate AP points depend on the condition treated.

Sutherland_EC (1994) AP in the Horse. Proceedings from 12th Meeting of the Equine Practitioners' Assoc: 63-64

ter_Riet_G; Kleijnen J; Knipschild P (1990) AP and chronic pain: a criteria-based meta-analysis. J Clin Epidemiol 43(11):1191-1199. Dept of Epidemiol/Health Care Research, Univ of Limburg, Maastricht, The Netherlands. A literature search revealed 51 controlled clinical studies on the effectiveness of AP in chronic pain. These studies were reviewed using a list of 18 predefined methodological criteria. A maximum of 100 points for study design could be earned in 4 main categories: (a) comparability of prognosis, (b) adequate intervention, (c) adequate effect measurement and (d) data presentation. The quality of even the better studies proved to be mediocre. No study earned >62% of the maximum score. The results from the better studies (>/=50% of the maximum score) are highly contradictory. The efficacy of AP to treat chronic pain remains doubtful.

Thomas_M2; Arner S; Lundeberg T (1992) Is (periosteal) AP an alternative in idiopathic pain disorder?. Acta Anaesthesiol Scand Oct 36(7):637-642. Dept of Physiology, II, Karolinska Inst, Stockholm, Sweden. We studied the analgesic effect of intensive periosteal AP stimulation in 12 patients with idiopathic pain (10 F, 2 M; mean age=54 yr; mean duration of pain=12.6 yr). Each treatment consisted of brief but painful manual stimulation of 3-4 periosteal sites. Each patient had a mean of 7 (range 4-11) sessions over a period of 3-8 mo. Patients continued their previous analgesic medication but no other physical or psychological treatment for their pain was used. All responses were assessed on pain scales maintained daily before and during the entire period of treatments. Periosteal AP gave no response, or only transient responses which were not maintained until the next treatment in 10/12 patients (83%); 17% had long periods of good pain reduction. Periosteal AP did not help most patients with idiopathic pain.

Wollgienhahn_D; Kim K (1996) Practical Experiences with AP for Treatment of Lameness in the Dog: 3 Cases. Prakt Tierarzt 1 Apr 77(4):314. Moorkamp 15, D 29223 Celle, Germany. This is a case report of AP treatment in 3 cases of chronic canine lameness (two racing dogs, one geriatric patient). Allopathic treatment had failed, or the owners had refused the treatment offered. The result showed that Western and Eastern diagnosis and therapy can complement each other.

Wong_TW; Fung KP (1991) AP: from needle to laser. Family Practice Jun 8(2):168-170. Dept of Community and Family Med, Chinese Univ of Hong Kong. AP has been used to treat many illnesses for >2000 yr. The practice of AP is based on theory different from our understanding of human anatomy and physiology. It has developed through experience and observation. Stimulation, by inserting needles in selective AP Channel points, is believed to restore bodily functions by promoting the flow of Qi throughout the system. Other forms of stimulation include heat, electrostimulation, magnetism and laser. Laser AP offers distinct advantages over the traditional method because the procedure is pain-free and non-traumatic. Clinical applications include pain-control in osteoarthritis, lumbago and migraine, and analgesia for certain surgical procedures, as well as other ailments of the cardiovascular, respiratory and nervous systems. The method is easy to learn; sophisticated instruments are not needed. Thus it is very useful in developing countries with limited health resources.