Philip A.M. Rogers MRCVS

AP in Pain and Painful Conditions


Agasarov_LG; Krasnova LB; Malygina SI; Bragin EO (1993) [The function of the hypophysis gonadal system in lumbar osteochondrosis in men and its changes during AP and EAP]. Vopr Kurortol Fizioter Lech Fiz Kult Jan-Feb 1:61-63.

Amelin_AV; Vasil'ev IuN; Ignatov IuD; Skoromets AA (1991) The combined use of AP and antidepressants to manage spondylogenic lumbosacral pain Syndrome. Farmakologiia i Toksikologiia Sep-Oct 54(5):123. In Russian. The effects of antidepressants amitriptyline and pyrazidol on the analgesic action of AP in patients with lumbosacral radiculitis was studied by the double blind control method. AP combined with antidepressants enhanced the effectiveness of treatment, to increase the duration of analgesia by a mean by 5-6 h within 24 h after each procedure and to reduce the duration of treatment by a mean of 4-5 d. The data indicate the clinical usefulness of AP combined with antidepressants.

Baldry_P (1996) Whiplash Injuries. Paper to the BMAS Spring Scientific Meeting, Bristol, May 1996. Sites from which whiplash injury pain (acute neck sprain) may arise include myofascial TPs (MTrPs), facet joints and the intervertebral discs. Many methods can deactivate MTrPs; that recommended is superficial dry needling. Pain referral patterns from facet joint and MTrP nociceptors are similar, so failure to obtain appreciable pain relief from MTrP deactivation necessitates a diagnostic, fluoroscopically controlled, facet joint block. Disc pain may occur either because of damage to the innervated annulus fibrosus of an intact disc, or because of nerve root pressure when a disc ruptures. Most whiplash patients (75%) become pain free within 3-6 mo. The remainder are said to have the late whiplash Syndrome. This was formerly thought to be due to neuroticism or compensation seeking avarice, but it is currently considered to have a genuine organic basis. Possible causes include overlooked facet joint damage, undetected disc damage and various self perpetuating MTrP pain persisting mechanisms.

Chan_Gunn C (1991) Treating Myofascial Pain. Am Acad of Med AP Review 3(2):4-6. Neuropathic pain invariably affects the musculoskeletal system, causing muscle contracture and shortening: "Myofascial Pain". Spondylosis, the universal outcome of age, wear and tear, is probably the main cause of neuropathic pain. By irritating nerve roots, spondylosis can lead to peripheral neuropathy and muscle shortening. Many myofascial Syndromes (from Achilles Tendonitis to Tennis Elbow) caused by muscle shortening of spondylotic origin are customarily misconstrued as mundane local conditions. The spondylosis and muscle-shortening model can explain many musculoskeletal pain problems for which no alternative clinical diagnosis exists; it also enables these disparate Syndromes to be grouped under one aetiological classification. Im stimulation effectively relieves pain by releasing muscle, which in turn relieves paraspinal muscle shortening and pressure on nerve roots, as well as stimulating the production of platelet-derived growth factor to promote healing.

Cui_S (1992) 100 cases of acute lumbar sprain treated with AP at Zhibian (BL54). JTCM Jun 12(2):119. Dept of AP, Liaoning College of TCM, Shenyang, PRC.

Ernst_E; Fialka V (1993) Conservative therapy of backache. Part 5: TENS, AP, biofeedback, traction, cryotherapy, massage and ultrasound. Fortschr Med Sep 30 111(27):420-422. Klinik fur Physikalische Medizin und Rehab, Univ Wien. The usual therapies in back pain were discussed in earlier sections. As well as these methods, alternative methods, some of which have a solid scientific basis, are used commonly. Subthreshold TENS is not effective in low back pain. Whether this is also true of higher-dose TENS is not yet clear. EAP, however, seems to be effective, but not biofeedback or traction. As controlled trials have not been done, one cannot definitively assess other common treatment modalities, such as cryotherapy, heat, massage or ultrasound.

Fisher_HW (1992) Acute low back pain treated by spinal manipulation and EAP. J Manipulative Physiol Ther Mar-Apr 15(3):199-202.

Galliamov_AG; Valeev RG (1990) [Radon therapy and the use of AP reflexotherapy in patients with cervical and lumbar osteochondrosis]. Vopr Kurortol Fizioter Lech Fiz Kult Nov-Dec 6:50. In Russian.

Harman_JC (1993) Backs, performance, and AP. Proc Ann Conv Am Assoc Equine Pract Lexington, Ky. Meeting held on November 29-December 2, 1992, Orlando, Florida, pp 337-348.

Hu_Ra2 (1993) Treatment of acute lumbar sprain with AP at Fuyang (BL59). JTCM Dec 13(4):264-265. Dept of AP, Fengcheng City People's Hospital, Jiangxi Province, PRC.

Hu_S; Zhong Y (1992) Clinical observations on the treatment of 50 cases of stiff neck by AP. JTCM Mar 12(1):57-58. Hospital of Gymnasium Road, Chong Wen District, Beijing PRC.

Janssens_LAAx1 (1985) The treatment of canine cervical disc disease by AP: a review of thirty-two cases. J Small Anim Pract 26(4):203-212. Oudestraat 37, Wilryk, Belgium.

Janssens_LAAx2; De_Prins EM (1989) Treatment of thoracolumbar disk disease in dogs by means of AP: a comparison of two techniques. J Am Anim Hosp Assoc Mar-Apr 25(2):169-174. Oudestraat 37, Wilryk, Belgium.

Janssens_LAAx3 (1992) AP for the treatment of thoracolumbar and cervical disc disease in the dog. Probl Vet Med Mar 4(1):107-116. Oudestr 37, B-2610 Antwerp, Belgium. Thoracolumbar disc disease (TLDD) and cervical disc disease (CDD) occur regularly in veterinary small animal practice, mainly in chondrodystrophic breeds and mostly around the age of 5-6 yr. CDD is responsible for circa 15% and TLDD for circa 85% of disc herniations. Treatments may consist of surgery or medication or both. AP can also be used as a treatment for TLDD and CDD. With a few exceptions, the results of AP treatment for TLDD and CDD are favourable and comparable to those of surgical treatments. The AP techniques presented here are relatively simple and can be learned in a minimum of time. [See also: Janssens_L (1991) Acupuncture in thoracolumbar disc disease [letter]. J S Afr Vet Assoc Mar 62(1):2].

Ji_X (1990) AP treatment of cervico-omalgia in 62 cases. JTCM Sep 10(3):204-206. Inst of AP, Acad of TCM, PRC.

Kuno_RC; Cerqueira MD (1995) Enhanced bone metabolism induced by AP. J Nucl Med Dec 36(12):2246-2247. Dept of Radiology, Univ of Washington Sch of Med, Seattle, USA. A 29-yr-old man with several years of back pain was referred for a bone scan. High-resolution regional spot images of the skeleton were obtained after iv injection of 20 mCi 99mTc-methylene diphosphonate. Posterior and lateral images of the skull showed focal increased uptake in several regions of the skull. Upon questioning, the patient stated that he had received AP treatment for his back pain several times in the same regions as the increased uptake. The needle placement was confirmed by the patient's acupuncturist. As shown by increased activity on bone scans, AP can cause enhanced bone metabolism.

Marchuk_GS; Gubenko VP; Novikov IuO; Sandomirskii ME (1991) [Automated system of diagnosis of reflex syndromes in patients with lumbar osteochondrosis: manual and AP therapy of these patients]. Vrach Delo Jun 6:84-85. In Russian.

Martin BB_Jr2; Klide AM (1992) AP for the treatment of chronic back pain in 200 horses. Proc Ann Conv Am Assoc Equine Pract Lexington, KY, USA. 37:593-601. New Bolton Centre, Kennett Square, PA.

Martin_BB_Jr1; Klide AM (1987) Use of AP for the treatment of chronic back pain in horses: stimulation of AP points with saline solution injections. JAVMA 1 May 190(9):1177-1180.

Song_Z (1993) Treatment of 1000 cases of lumbar soft tissue injury with AP plus exercise. JTCM Mar 13(1):19-21. Employees' Hospital of Huai Nan Mining Bureau, PLC.

Steiss_JE; White NA; Bowen JM (1989) EAP in the treatment of chronic lameness in horses and ponies: a controlled clinical trial. Can J Vet Res Rev Apr 53(2):239-243.

Still_J (1989) Analgesic effects of AP in thoracolumbar disc disease in dogs. J Small Anim Pract May 30(5):298-301. Med Univ of Southern Africa, Medunsa, Rep of South Africa.

Thomas_M3; Lundberg T (1994) Importance of modes of AP to treat chronic nociceptive low back pain. Acta Anaesthesiologica Scandinavica Jan 38(1):63-69. Dept of Physiol II, Karolinska Inst, Stockholm, Sweden. Patients with clinical chronic low back pain of nociceptive origin cooperated in a controlled study of different modes of AP stimulation. 40 patients were assigned at random to the study. 30 had 3 trial treatments with manual AP-stimulation of needles (MA), low frequency (2 Hz) EAP stimulation (LF), and high-frequency (80 Hz) EAP stimulation (HF). Patients then continued treatment with the mode from which they got most benefit. 10 patients were put on the waiting list for treatment but served as the untreated control group. The results were evaluated after 6 wk and at 6 mo for: activity related to pain; mobility; verbal descriptors of pain and the patient's subjective assessment of his condition. After 6 wk, compared to the untreated controls, treated patients had significant improvement (p <.05 to <.001) on 3/4 measures. After 6 mo a similar significant improvement was seen in patients continuing with low-frequency (LF) AP, but not in those groups continuing with manual stimulation (MS) or high-frequency (HF) AP. EAP at 2 Hz was the mode of choice when using AP to treat chronic nociceptive low back pain.

Tsarev_IuK; Troshina ED (1991) [The combined use of AP and UV irradiation in treating the neurological manifestations of lumbar osteochondrosis]. Vopr Kurortol Fizioter Lech Fiz Kult May-Jun 3:25-29. Erythema field doses of UV radiation according to the segmental-metameric approach were applied in combination with AP to treat lumbar osteochondrosis. Combination of UV and AP gave the best therapeutic response (93%), as compared with AP alone (73%), or UV irradiation alone (68%).

Xie_HS1; Asquith RL; Kivipelto J (1996) A Review of the Use of AP for Treatment of Equine Back Pain. J Equine Vet Sci Jul 16(7):285-290. Univ Florida, Dept Anim Sci, Gainesville, FL 32611 USA. Poor performance due to back pain is common in horses. Alternative modalities using Herbal Med and AP are useful and effective for this condition. This paper summarized 11 AP techniques to treat equine back pain. AP treatment for back muscular atrophy and AP mechanism of pain relief are also discussed.

Zhang_Y; Wang X (1994) 56 cases of disturbance in small articulations of the lumbar vertebrae treated by puncturing the effective points: a new system of AP. JTCM Jun 14: 2, 115-20. Inst of AP and Moxibustion, China Acad of TCM, Beijing, PRC. In this series, the patients with disturbance of small articulations of the lumbar vertebrae were treated by puncturing the effective points and reduction by manual traction with satisfactory results, the cure rate being 39%, the markedly effective rate 29%, with a total effective rate 98%. This method is simple and easy to master, and highly effective. Therefore it is very acceptable to the patients. It is a very excellent therapeutic method for disturbance of small articulations of the lumbar vertebrae, sometimes complicated by acute lumbar sprain and chronic lumbar strain.