Pain - Byron Bay Acupuncture and Chinese Medicine

Break the cycle. Live life without pain.

Headache & Migraine

Migraine, headache, or regular discomfort in your head and neck, can be debilitating, making even the simplest tasks a challenge.

Olivia uses acupuncture as an effective treatment for both migraine and headache (tension-type and chronic). Acupuncture is able to alleviate pain, and prevent migraines and headaches from coming back.

A 2015 review of large and well-designed trials of acupuncture for migraine prevention as well as the effectiveness of acupuncture against proven migraine preventative medications, found that acupuncture was at least as effective as conventional drug preventative therapy for migraine and is safe, long lasting, and cost-effective (22).

Furthermore, a brief review (2016) of the current, published evidence (systematic reviews and meta-analyses) demonstrated that acupuncture is associated with improved clinical outcomes compared to routine care only, medical management, and sham acupuncture 2 months after randomization role (23).

Recent high quality analysis of the current research on acupuncture for chronic pain concluded that ‘acupuncture is effective for the treatment of chronic… headache. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain’ (16).

16. Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain Off J Am Pain Soc. 2018 May;19(5):455–74
22. Da Silva AN. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470–3. 
23. Coeytaux RR, Befus D. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238–40

Musculoskeletal Pain

Acupuncture is safe and effective treatment for musculoskeletal pain and injury.

Olivia has a special interest in musculoskeletal injury, and is also a qualified master dry needler.

Cupping, moxibustion and massage feel great and are routinely incorporated into musculoskeletal treatments.

Recent high quality analysis of the current research on acupuncture for chronic pain concluded that ‘acupuncture is effective for the treatment of chronic musculoskeletal...and osteoarthritis pain. Treatment effects of acupuncture persist over time... and referral for a course of acupuncture treatment is a reasonable option for a patient with chronic (musculoskeletal) pain'. (2)

Modern research supports the use of acupuncture for a wide variety of musculoskeletal conditions including,

• A 2023 systematic review and meta-analysis of randomized controlled trails including 2,662 participants concluded that acupuncture is an effective and safe treatment for patients with sciatica, and it can be considered a suitable replacement for medical treatment. The results of the integration of clinical outcomes showed that the clinical efficacy of acupuncture was superior to that of medical treatment in improving the total effective rate, reducing the pain score, increasing pain threshold and decreasing the recurrence rate . In addition, few adverse events were reported during the intervention, which indicated that acupuncture was a safe treatment option. Future randomised control trials should be well-designed according to the rigorous methodology.

Zhang Z, Hu T, Huang P, Yang M, Huang Z, Xia Y, Zhang X, Zhang X, Ni G. The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Front Neurosci. 2023 Feb 9;17:1097830. doi: 10.3389/fnins.2023.1097830. PMID: 36845439; PMCID: PMC9948020.

• A 2016 comparison of 20 treatments for sciatica ranked acupuncture as 2nd most effective after the use of biological agents, outperforming manipulation, epidurals, disc surgery, opioids, exercise, and an invasive procedure called radio-frequency denervation, which came in last.

Ji M, Wang X, Chen M, Shen Y, Zhang X, Yang J. The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2015;2015:192808. doi: 10.1155/2015/192808. Epub 2015 Sep 6. PMID: 26425130; PMCID: PMC4575738.

• A 2022 systematic review and meta-analysis demonstrated that acupuncture as an adjunct to standard therapy is a safe and effective method in reducing pain and disability among adults with nonspecific chronic low back pain. The study showed that acupuncture as an adjunct to standard therapy had clinically meaningful reduction in self-reported pain at post-treatment and at intermediate term, compared with standard care. Levels of disability showed similar clinically meaningful reduction at post-treatment and intermediate term.

Asano H, Plonka D, Weeger J. Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Med Acupunct. 2022 Apr 1;34(2):96-106. doi: 10.1089/acu.2021.0057. Epub 2022 Apr 19. PMID: 35509875; PMCID: PMC9057891.

• A 2023 systematic review and meta-analysis involving 1 087 patients concluded that acupuncture is more effective in reducing pain in patients with lumbar myofascial pain syndrome than oral non-steroidal anti-inflammatory medication, low-frequency electrical stimulation, tuina, and electromagnetic wave irradiation combined with piroxicam gel. Acupuncture also exhibited advantage over lidocaine injection in improving pain rating index score and showed better outcomes over tuinaand low-frequency electrical stimulation in improving the pain rating index score and present pain intensity scores.

Zhang R, Wen SY, Zhan HS, Lin X, Zhang M, Pang J, Cao YL, Chen B. Acupuncture for lumbar myofascial pain syndrome: systematic review and Meta-analysis. Zhongguo Zhen Jiu. 2023 Sep 8;43(11):1324-1332. English, Chinese. doi: 10.13703/j.0255-2930.20221120-0002. PMID: 37986258.

• A 2017 systematic review concluded that acupuncture treatment appears to relieve the signs and symptoms of pain in myofascial temporo-mandibular disorder. The study showed that acupuncture yielded results similar to those observed in groups treated with occlusal splints and were significantly superior than those obtained from placebo acupuncture-treated groups. More controlled and randomised clinical trials with larger sample sizes are needed in this field of research to verify these initial findings.

Fernandes AC, Duarte Moura DM, Da Silva LGD, De Almeida EO, Barbosa GAS. Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. J Oral Facial Pain Headache. 2017 Summer;31(3):225-232. doi: 10.11607/ofph.1719. PMID: 28738107.

• A 2022 Systematic Review and Meta-Analysis assessing the effectiveness of acupuncture in the treatment of Frozen Shoulder concluded that acupuncture could be safe and effective for pain reduction, restoring shoulder function, and restoring flexion range of motion for frozen shoulder patients in the short term and midterm. More high-quality and longer studies are needed in order to robust the evidence.

Ben-Arie E, Kao PY, Lee YC, Ho WC, Chou LW, Liu HP. The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2020 Sep 25;2020:9790470. doi:
10.1155/2020/9790470. PMID: 33062030; PMCID: PMC7532995.

• A 2022 clinical study on acupuncture and moxibustion for frozen shoulder found that acupuncture and moxibustion is advantageous as an adjunctive therapy for frozen shoulder. The outcomes considered in the current trials focus on clinical effective rate, the score of shoulder pain, the score of shoulder function and the score of quality of life. The study indicated that the clinical evidence needs improvement on information regarding the recurrence rate and safety.

Meng X, Xiu WC, Hu XY, Jiao RM, Shi LJ, Yang JW, Gang WJ, Jing XH. [Clinical study on acupuncture and moxibustion for frozen shoulder: an evidence map]. Zhongguo Zhen Jiu. 2022 Feb 12;42(2):227-30. Chinese. doi: 10.13703/j.0255-2930.20210820-k0002. PMID: 35152592.

• A 2015 network meta-analysis comparing treatments in addition to exercise for shoulder impingement syndrome found that acupuncture was the most effective adjunctive treatment out of 17 interventions, outperforming all other adjuncts such as steroid injection, NSAIDs, and ultrasound therapy.

Dong W, Goost H, Lin XB, Burger C, Paul C, Wang ZL, Zhang TY, Jiang ZC, Welle K, Kabir K. Treatments for shoulder impingement syndrome: a PRISMA systematic  review and network meta-analysis. Medicine (Baltimore). 2015 Mar;94(10):e510. doi:10.1097/MD.0000000000000510. Erratum in: Medicine (Baltimore). 2016 Jun 10;95(23):e96d5. PMID: 25761173; PMCID: PMC4602475.

• A 2021 randomized controlled trial assessed the efficacy of intensive acupuncture (3 times weekly for 8 weeks) versus sham acupuncture for knee osteoarthritis (OA) in 442 patients. Patients with knee OA were randomly assigned to receive electroacupuncture (EA), manual acupuncture (MA), or sham acupuncture (SA) 3 times weekly for 8 weeks.The primary outcome measure was response rate, which is the proportion of participants who simultaneously achieved minimal clinically important improvement in pain and function by week 8. The response rates at week 8 were 60.3%, 58.6%, and 47.3% in the EA, MA, and SA groups, respectively. The between-group differences were 13.0% for EA versus SA and 11.3% for MA versus SA. The response rates in the EA and MA groups were both significantly higher than those in the SA group at weeks 16 and 26. Among patients with knee OA, intensive EA resulted in less pain and better function at week 8, compared with SA, and these effects persisted though week 26. Intensive MA had no benefit for knee OA at week 8, although it showed benefits during follow-up.

Tu JF, Yang JW, Shi GX, Yu ZS, Li JL, Lin LL, Du YZ, Yu XG, Hu H, Liu ZS, Jia CS, Wang LQ, Zhao JJ, Wang J, Wang T, Wang Y, Wang TQ, Zhang N, Zou X, Wang Y, Shao JK, Liu CZ. Efficacy of Intensive Acupuncture Versus Sham Acupuncture in Knee Osteoarthritis: A Randomized Controlled Trial. Arthritis Rheumatol. 2021 Mar;73(3):448-458. doi: 10.1002/art.41584. Epub 2021 Jan 15. PMID: 33174383.

• A 2013 network meta-analysis comparing physical treatments for osteoarthritis of the knee found that, when looking at high quality studies, acupuncture had the largest effect compared to usual care out of the conditions evaluated, out-performing exercise, sham acupuncture, and weight-loss.

Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, Sutton AJ, Macpherson H, Woolacott NF. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8. doi: 10.1016/j.joca.2013.05.007. PMID: 23973143; PMCID: PMC3769860.

• A 2023 review assessed the efficacy of dry needling acupuncture as a treatment modality for tendinopathy. The following sites were studied: wrist common extensor origin, patellar tendon, rotator cuff, and tendons around the greater trochanter.There was a statistically significant improvement in the patient-reported symptoms in most studies. Some studies reported an objective improvement assessed by ultrasound.It seems that tendon needling is minimally invasive, safe, and inexpensive, carries a low risk, and represents a promising area of future research. In further high-quality studies, tendon dry needling should be used as an active intervention and compared with appropriate sham interventions.

Stoychev V, Finestone AS, Kalichman L. Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review. Curr Rev Musculoskelet Med. 2020 Feb;13(1):133-140. doi: 10.1007/s12178-020-09608-0. PMID: 31942676; PMCID: PMC7083985.

• A 2021 systematic review that included 211 participants, assessed the efficacy of acupuncture on foot and ankle for Pain Intensity, Functional Status, and General Quality of Life in Adults. The study concluded that acupuncture was shown to be efficacious for participants with plantar fasciitis for pain relief and functional status improvement at short-and intermediate-term follow-ups. Acupuncture was also shown to be efficacious for participants with Achilles tendinopathy for pain relief at short- and intermediate-term follow-ups. No adverse events were reported. The results of this systematic review should be interpreted with caution due to the limited evidence.

Trinh K, Belski N, Zhou F, Kuhad A, Luk D, Youn E. The Efficacy of Acupuncture on Foot and Ankle for Pain Intensity, Functional Status, and General Quality of Life in Adults: A Systematic Review. Med Acupunct. 2021 Dec 1;33(6):386-395. doi: 10.1089/acu.2021.0006. Epub 2021 Dec 16. PMID: 35003508; PMCID: PMC8734447.

Electro–acupuncture is particularly effective for pain management as extensive studies over the last decade have found that it alleviates both sensory and affective inflammatory pain, and inhibits inflammatory and neuropathic pain by activating a variety of bioactive chemicals through peripheral, spinal and supraspinal mechanisms. (3)

Clinical trials have found that acupuncture is safe to use immediately after injury, and immediately after surgery for post-operative pain when practised by a suitably qualified professional.

• A systematic review and meta-analysis of 13 RCTs in 2016, found that acupuncture, electro-acupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS) improved pain on day one after surgery and reduced opioid use.

Wu MS, Chen KH, Chen IF, Huang SK, Tzeng PC, Yeh ML, Lee FP, Lin JG, Chen C. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLoS One. 2016 Mar 9;11(3):e0150367. doi: 10.1371/journal.pone.0150367. PMID: 26959661; PMCID: PMC4784927.

2. (Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, Irnich D, Witt CM, Linde K; Acupuncture Trialists' Collaboration. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018 May;19(5):455-474. doi: 10.1016/j.jpain.2017.11.005. Epub 2017 Dec 2. PMID: 29198932; PMCID: PMC5927830.).
3. Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. 2014 Feb;120(2):482-503. doi: 10.1097/ALN.0000000000000101. PMID: 24322588; PMCID: PMC3947586.

Fibromyalgia and Chronic Pain Management

Acupuncture therapy is an effective and safe treatment for patients with fibromyalgia. Clinical trials studying the treatment of fibromyalgia with acupuncture have shown improvement in pain, quality of sleep, and quality of life (29).

An increasing number of studies support the utilization of acupuncture for the treatment of fibromyalgia (30) however more rigorous studies are required to determine the full effects of traditional Chinese medicine in the treatment of fibromyalgia.

Efficacious treatment requires long-term treatment.

29. Zhang XC, Chen H, Xu WT, Song YY, Gu YH, Ni GX. Acupuncture therapy for fibromyalgia: a systematic review and meta-analysis of randomized controlled trials. J Pain Res. 2019 Jan 30;12:527-542. doi: 10.2147/JPR.S186227. PMID: 30787631; PMCID: PMC6365227.

30. Berger AA, Liu Y, Nguyen J, Spraggins R, Reed DS, Lee C, Hasoon J, Kaye AD. Efficacy of acupuncture in the treatment of fibromyalgia. Orthop Rev (Pavia). 2021 Jun 22;13(2):25085. doi: 10.52965/001c.25085. PMID: 34745475; PMCID: PMC8567806.