Acupuncture helps pelvic pain

Research about acupuncture for pelvic pain is common question from my patients who are seeking help. There have been a number of studies focusing on acupuncture for pelvic pain, each showing acupuncture has a strong effect on pain and function. Here’s a summery of a few which I think are interesting.

1. Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomised trial. (1)

Thirty-six men with CP/CPPS were randomised to three treatment groups: advice and exercise plus 12 bi-weekly sessions of electro-acupuncture (EA), advice and exercise with sham electro-acupuncture (SEA), and advice and exercise (AE) alone. Acupuncture points used included bilateral stimulation of Ciliao BL-32, Zhongliao BL-33 and Huantiao GB-30. The needles were stimulated at 4 hertz for 20 minutes with a tolerable intensity of between five and 10 milliamps. All twelve participants in the EA group had at least a six-point reduction in total National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores compared to only two of the 12 in the SEA group. The reduction in the EA group was significant compared to both the SEA and AE groups in terms of both NIH-CPSI total score and pain levels. Other aspects such as urinary symptoms and quality of life scores showed no difference.

2. A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain. (2)

Ten males with category III CP/CPPS were given a standardised acupuncture treatment twice weekly for six weeks. Deqi was obtained at acupuncture points including Waiguan SJ-5, Zulinqi GB-41, Taichong LIV-3, Hegu L.I.-4, Diji SP-8 and Sanyinjiao SP-6, and the auricular points Shenmen, Kidney, Liver, Lung and Spleen were needled unilaterally, alternating ears between visits. The needles were retained for 20 to 25 minutes and re-stimulated utilising the scraping and even needle techniques. The decrease in NIH-CPSI scores after three and six weeks following treatment were significant (P<.006), as were decreases in total symptoms and improvement in quality of life (P<.0002). Improvement in the Short Form 36 (SF-36) quality of life survey also showed significant improvement in quality of life in categories such as physical function, role limitations, emotional heat, vitality, social functioning, and bodily pain. There were no adverse effects.

3. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. (3)

Twelve men with CP/CPPS received acupuncture twice a week for six weeks. The treatment protocol included three sets of acupuncture points, which were alternated at each visit. The initial set that focused on uniting the Bladder and Kidney divergent channels included Tianzhu BL-10, Shenshu BL-23, Pangguangshu BL-28, Weizhong BL-40, Yingu KID-10, Yongquan KID-1 and Zhiyin BL-67, all bilaterally. The second set included Zhongji REN-3, Guanyuan REN-4 and Changyi- M-CA-17 needled with electro-stimulation at five hertz, and Sanyinjiao SP-6 needled manually. The last set included Shenshu BL-23, Zhibian BL-54, Huiyang BL-35, Zhibian BL-54, Weiyang BL-39 and Sanyinjiao SP-6, with Huiyang BL-35 and Zhibian BL-54 needled with three-inch needles and stimulated at 20 hertz. Improvement was seen in NIH-CPSI overall score (28.2 to 8.5), pain sub-score (14.1 to 4.8), urinary sub-score (5.2 to 1.3) and quality of life sub-score (8.8 to 2.3), and was maintained at 12-week and long-term (33 week average) follow up.

These clinical studies each took a different approach to the treatment of CP/CPPS, and all showed positive results in reducing the symptoms of CP/CPPS. While the trials are small, they show potential for the acupuncture treatment of the symptoms of CP/CPPS. Larger studies are required to properly examine acupuncture’s ability to treat CP/CPPS as well as explore whether particular approaches are more successful.

In my clinic, I have found that an approach similar to the third study has worked very well.  Additional acupuncture points that address trigger points in the gluteus Maximus and adductors are often required,

1. Lee SH & Lee BC (2009). Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Urology. May, 73(5), 1036-41.

2. Capodice JL, Jin Z, Bemis DL, et. al. (2007) A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain. Chin Med, Feb 6(2).

3. Chen R & Nickel JC. (2003) Acupuncture Ameliorates Symptoms in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Urology, June, 61(6), 1156-1159.