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Ask the MD: Acupuncture and Parkinson's

Ask the MD: Acupuncture and Parkinson's

Many people with Parkinson's disease (PD) turn to complementary and alternative therapies, including acupuncture, for management of their motor and non-motor symptoms.

What Is Acupuncture?
Acupuncture is a form of traditional Chinese medicine that has been around for thousands of years. It involves the insertion of tiny needles into the skin at various places of the body (depending on what symptoms are being treated) to redistribute "qi," or energy, which is thought to be out of balance in the setting of disease. Mild electrical currents or diluted bee venom can be applied with the needle to amplify treatment effects.

Does Acupuncture Work for Parkinson's?
Researchers have looked at acupuncture for its potential benefit on Parkinson's motor symptoms as well as several non-motor symptoms: pain, fatigue, depression, anxiety and sleep disturbances. But most data comes from small studies with no comparison group, and results are mixed -- some demonstrate benefit for acupuncture and others don't.

A recent review of research on Parkinson's and acupuncture published in the journal Medicine identified nearly 1,000 articles on the topic. Only 19 were characterized as high-quality trials that compared acupuncture to no treatment or conventional treatment (e.g., levodopa), or compared the combination of acupuncture and conventional treatment to conventional treatment alone. The review authors suggest acupuncture could be a supplementary therapy for PD based on the positive effects seen in these studies, but they do call for more rigorous studies to clarify and confirm potential benefits.

Outside of clinical studies, many individuals anecdotally report improvement in their symptoms with acupuncture. But, benefits appear temporary and regular treatments are necessary to sustain them.

In general, acupuncture appears safe and well tolerated in Parkinson's.

Why Is Acupuncture Difficult to Study?
Acupuncture faces several limitations in the research setting. Like many complementary therapies, acupuncture is associated with a high placebo effect. Researchers sometimes test typical acupuncture treatments against "sham" acupuncture (using blunted needles or different insertion locations) to evaluate for true benefits, but this is understandably challenging. And when administering acupuncture versus a placebo, it's important to "blind" study participants to which treatment they are receiving -- another sometimes tricky task.

Also, standardized acupuncture protocols for Parkinson's do not exist. In other words, there are no strict guidelines on where to insert needles, whether to use electrical current, how long treatments should last, how many sessions are necessary and how to evaluate potential benefit. This could account for some of the discrepancy in results across trials.

Is Acupuncture Right for You?
If you're considering acupuncture, talk with your doctor about whether it may fit into your Parkinson's regimen. It's generally considered safe, but as with any therapy, you should weigh the potential benefits against the possible risks. Side effects could include bruising and soreness at needle insertion sites, fatigue and temporary lightheadedness, or even worsening of your symptoms. And insurance may not cover the cost.

Your physician may be able to refer you to an acupuncturist, or you can search for one in your area online. Ask others in your PD community about their experiences with acupuncture.

Laws for acupuncture licensing and certification vary from state to state. When evaluating an acupuncturist, verify that he or she has completed required training, licensing and certification, and ask about familiarity with treating Parkinson's and your specific symptoms. Have him/her detail your expected treatment course (i.e., how many treatments will be required, when you will see improvement, etc.) and make sure you feel comfortable and your questions are answered.

The Bottom Line
Acupuncture could be a helpful add-on therapy for PD motor and non-motor symptoms, and it appears to be generally safe and well tolerated. Additional rigorous trials with standardized protocols and benefit analyses are necessary to fully evaluate acupuncture's role in the management of Parkinson's.

Listen to a webinar on complementary medicine for Parkinson's.

Read about an MJFF-funded study on acupuncture for Parkinson's fatigue.

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