Richard G. Petty, MD

Acupuncture and Acupressure for Morning Sickness

Although I am most definitely of the male persuasion, I know that morning sickness can be an awful problem, though there is some evidence that it is an attempt by the body to rid itself of toxins that could otherwise harm the baby.

I have had a longstanding interest in the use of acupuncture and acupressure for the treatment of nausea and vomiting, whether pregnancy related or caused by infections, anesthesia or chemotherapy. Over twenty years ago my committee at the Research Council for Complementary Medicine helped fund research on the topic at the University of Belfast, and I have used both acupuncture and acupressure to treat many hundreds of people with nausea and vomiting. Before I left England, we were planning to do a clinical trial of acupuncture on morning sickness at Queen Charlotte’s hospital in London.

So I was delighted to see a meta-analysis published in the journal Explore.

The authors identified 14 eligible trials that had been completed over the last sixteen years, involving a total of 1615 women who had been treated with either acupressure, acupuncture or electrical stimulation at acupuncture points.

The conclusions were that these methods may reduce nausea by more than 50% compared with controls and vomiting by around 40%. These figures look about right, though acupuncture and acupuncture are very “operator-dependent:” some therapists get better results than others. What was interesting was that the effect was all due to acupressure: acupuncture was not shown to be effective, but acupressure was.

The analysis also points out a potential weakness in other meta-analyses. It is not wise to lump all acupuncture and acupressure together, since each may work somewhat differently.

As a sidebar, when we use acupuncture or acupressure, we always tailor the treatment to the individual, but the most commonly used points are Liver-3 on the top of the foot between the big toe and second toe, and Pericardium-6, which lies on the inside of the forearm, about two inches above the wrist.

Back Pain, The Brain and Pain Cycles

A German research team using a specialized imaging technique called diffusion tensor imaging (DTI) to look at the differences between back pain sufferers’ and healthy volunteers’ brains found that individuals suffering from chronic low back pain also had micro-structural changes in their brains. The findings were presented at the annual meeting of the Radiological Society of North America in Chicago by the lead researcher Dr Jurgen Lutz, a radiologist at Ludwig-Maximilians University in Munich, Germany.

DTI tracks the movement of water molecules in the brain’s gray and white matter. Individual water molecules are constantly in motion, colliding with each other and other nearby molecules, causing them to spread out, or diffuse. DTI allows us to analyze water diffusion in the tissues of the brain. In normal white matter, water diffuses in only one direction. So if they are moving in the “wrong” direction, we can use this as an indication that there are changes in the fiber pathways.

The investigators studied 20 patients who were experiencing chronic back pain with no precisely identifiable cause and 20 age- and gender-matched healthy volunteers. DTI was performed to measure the diffusion in several areas of each patient’s brain.

They discovered the brains of patients with chronic back pain had a more complex and active microstructure compared with the healthy volunteers’ brains.

The changes were found in regions of the brain associated with pain-processing, emotion and stress response, including the cingulate gyrus, postcentral gyrus and superior frontal gyrus.

Although it is possible that theses structural disturbances are a cause of chronic pain, it is more likely to be the other way round.

This leads us to a very important concept that is not talked about as much as it should be: it is the idea of pain cycles. Pain cycles can have a physical or psychological origin and are thought to be maintained by some of the centers in the brain that process pain and emotional distress. The two are often mixed together: pain is extremely common in both depression and in bipolar disorder, and pain can, of course, make you feel depressed.

Theses pain cycles will often persist for long periods after the original cause of the pain has gone. So we may continue to feel pain long after a broken bone has healed, or we may continue to suffer emotionally long after a bad relationship should have been dead and buried. Many interventions like acupuncture or injecting steroids or anesthetics into trigger points can interfere with the pain cycle. Similarly there are many therapies, including some of the tapping therapies, that seem to “re-set” some of the systems in the nervous and subtle systems of the body.

In my forthcoming book Sacred Cycles, I talk a lo about these vicious pain cycles and how to interrupt them.

“Pain is part of being alive and we need to learn that. Pain does not last forever, nor is it necessarily unbeatable, and we need to be taught that.”
–Rabbi Harold S. Kushner (American Rabbi Aligned with the Progressive Wing of Conservative Judaism and Writer, 1935-)

“Softness is a dream in every ache to become a better soul.”
–John Kells (Irish-born British Grand Master of T’ai Chi Ch’uan, 1940-)

Acupuncture and Parkinson's Disease

Over the last 25 years I have used acupuncture to try and help a great many people with Parkinson’s disease. It has certainly helped a lot of the symptoms, but in my experience has not often done much to change the course of the illness. That being said, I have seen a few people who had remarkable improvements that were sustained for months and even years. The best results have usually come when we have used a combination of acupuncture, diet and homeopathy, in addition to regular medications.

So I was very interested to see a study in the journal Brain Research, even though the work used animals, and I’ve had a longstanding aversion to animal experiments.

There is a chemical called MPTP (1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine) that damages and kills some types of dopaminergic neurons in the brain, so it can produce Parkinsonian symptoms in humans and in some animals.

Mice were injected with MPTP and then some of them received acupuncture every two days in two spots, one behind the knee and one on top of the foot. In humans, these are two of the points that are traditionally considered to be involved in muscle movement. Another group of mice received acupuncture in two spots on the hips that are not believed to be effective for acupuncture. A third group had no acupuncture at all.

By the end of seven days, the MPTP injections had decreased dopamine levels both in the mice that had not received acupuncture, and in the mice that received fake acupuncture, to about half the normal amount. But in the acupuncture-treated group, dopamine levels declined much less steeply, and nearly 80% of the dopamine remained.

The mechanism for such an effect remains unknown. The most likely mechanism is that it is reducing the inflammation in the brain often accompanies and worsens other symptoms of Parkinson’s disease. So acupuncture might maintain dopamine levels by preventing this inflammation. The same team of researchers from South Korea has already reported that acupuncture also prevents loss of dopamine neurons in rats.

The clinical studies in humans have been less encouraging, and more closely reflect my clinical experience. The problem is that by the time most people get to see an acupuncturist, they have already lost huge numbers of dopamine neurons and it is difficult to do very much. If acupuncture is to be helpful, we would probably need to be able to identify someone with Parkinson’s disease extremely early, perhaps even before clinical signs have appeared, and so far we have no reliable way of doing that.

Acupuncture and Depression

I have been using acupuncture for over 25 years and one of the reasons for doing my advanced training in China was to examine its use in neurological and psychiatric disorders.

It was interesting to discover that even in hospitals specializing in traditional Chinese medicine, the doctors usually used conventional antidepressants and antipsychotics rather than acupuncture, although I had seen many Western acupuncturists claim that they could treat depression.

My own experience with treating acupuncture has been disappointing. By contrast, it is often very good indeed for anxiety, and I have shown many people how to follow up with simple acupressure if they experience anxiety or panic.

There is new research that seems to endorse my lack of success in treating depression and why the Chinese doctors used Western medicine.

There had been a number of small studies (e.g. 1. 2. 3. 4. 5. 6.) of acupuncture in depression that had shown promise, as well as some huge Chinese studies that had claimed good results.

One of the problems with much of the Chinese research is that it is normally done without control groups and with very broad criteria. Many only rate whether someone is “cured,” “much better” or “no better.”

Despite the promise of the early studies, three recent reviews (1. 2. 3.) suggested that the evidence for acupuncture in depression was inconclusive.

This new study was published in the Journal of Clinical Psychiatry in November of this year and involved 151 patients with Major Depressive Disorder. The study ran for four years. This was a well-conducted clinical trial by researchers who had originally found some promising results in a pilot study (Allen JBJ, Schnyer RN, Hitt SK. The efficacy of acupuncture in the treatment of major depression in women. Psychological Science 1998; 9: 397-401). Although well tolerated, the research failed to support the use of acupuncture as a single therapy for depression.

This is important: depression carries an appreciable mortality and morbidity and there are real ethical problems about withholding treatments that have been shown to work.

It also does not mean that acupuncture has no place in the treatment of depression: it may be a useful adjunctive treatment – particularly if the individual has comorbid anxiety – and it may help with treating the side effects of conventional medicines. There is also another important point: we need to be sure that we are measuring the right thing when doing studies on acupuncture: the Western doctor may want to see if depression gets better. The acupuncturist may be more interested in improving the overall well being of the individual as well as helping an individual’s search for meaning

Regular readers will remember that last month I commented on some promising research on the use of qigong in depression. Why the different results from the different studies? There are many schools of acupuncture, t’ai chi ch’uan and qigong, as there are many different medicines for depression. One of the difficulties in the critical evaluation of these forms of treatment is that we have to assess the effectiveness not just of acupuncture, but of different schools of acupuncture and sometimes of different practitioners: a daunting but not impossible task. Not only are there many school in China, there are also Japanese, Korean and Vietnamese variants of traditional acupuncture, Western acupuncture and electro- and laser acupuncture. We use clinical observations to guide us to research the most promising types of intervention, whether they are forms of acupuncture, herbal remedies, homeopathy or anything else.

My "job" is to bring you the best and most rigorous research so that you can make decisions about what is most likely to help you.

Acupuncture, Qigong and Fibromyalgia

As we have discussed before fibromyalgia can be difficult to treat, so any decent research indicating a new approach is always welcome.

Two recent studies have indicated that acupuncture may be helpful in the treatment of fibromyalgia. In the first, published in Alternative Therapies in Health and Medicine, 21 patients completed the study, which consisted of 16 treatments in eight weeks. The patients all know that they were getting acupuncture, and there was no attempt to “blind” the study. The investigators used something called the Fibromyalgia Impact Questionnaire, and found an improvement. One of the problems with the study was that there were so many measurements done in so few people that there’s always a worry that something positive will turn up by chance. This may explain an odd observation: sicker people did better and it didn’t matter how long they had been in treatment.

The second study was a partially blinded, controlled, randomized clinical trial of 25 patients and 25 controls done at the Mayo Clinic. Acupuncture seemed to be more effective in improving pain, fatigue and anxiety, than putting needles at ineffective points.

One of the biggest practical problems is that some people with fibromyalgia are so sensitive that they cannot tolerate even the mild discomfort of acupuncture, which is usually all but painless if done by an expert.

So I was interested to see a small pilot study from the Department of Psychiatry in the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School in Piscataway, New Jersey, of the use of external qigong in fibromyalgia. A qigong practitioner worked to stimulate the flow of Qi in people with fibromyalgia, on the principle that in traditional Chinese medicine, pain is usually conceived as a blockage of the free flow of Qi. The results were very strongly positive, thought the trial only involved ten people.

Clearly more research is needed, but these preliminary results are all very encouraging.

Cluster Headache: A New Approach

By a strange "coincidence", just a couple of days after posting about cluster headaches, the BBC is carrying an article about a woman with cluster headache who was successfully treated by a neurosurgeon who implanted a nerve stimulator attached to the greater occipital nerve at the back of the skull.

It has been known for some time that there is a type of atypical cluster headache that can be treated by blocking these nerves. Some experts feel that since cluster headache
is usually driven by the hypothalamus, headaches that can be stopped by
nerve blockade or nerve stimulation are not cluster headaches at all.

That is something for us to sort out at scientific conferences.

But for now, there is at least one person – who was featured in the BBC’s article – who has been cured after everything else failed.

But here’s the strange thing: none of the neurologists or neurosurgeons has a clue how the treatment works.

Yet anyone versed in Traditional Chinese Medicine would tell you immediately the nerve runs directly above a key acupuncture point – Fengchi, or Gallbladder 20 – that is often used in treating severe headaches. Because disturbances in the subtle systems of the liver and gallbladder are common in many types of headache.

In other words, knowledge of the subtle anatomy of the body can explain how the nerve stimulator is working, but the best of current Western neurological science cannot.

A beautiful example of how the combined approaches of Integrated Medicine can help and inform everyone involved.

And it is the patient who gets all the benefits.

Multiple Sclerosis and Integrated Medicine

Although there are some fairly effective conventional therapies for multiple sclerosis (MS), many people with MS explore complementary and alternative medicine (CAM) therapies for their symptoms. The most effective strategies are to combine conventional and unorthodox treatments that address the physical, psychological, social, subtle and spiritual aspects of the illness. This combined approach also avoids the problem of people taking herbs or supplements that may either interact with each other or with conventional treatments.

It is also essential for us to get over the idea that MS is just something to be conquered. That may seem like an odd comment, but the language and the mindset of fighting, battles and warfare can be problematic. Let me explain something that I discuss at length in Healing, Meaning and Purpose.

There have been two distinct approaches to health in the Western medical tradition. The first is that the role of a physician is to treat diseases. That is the way that all my colleagues and I were trained. The second approach is to consider that health is the natural order of things. So in the first case we constantly hear the use of military metaphors: People speak of  “a war on cancer,” “killer cells,” “magic bullets,” and the need to adopt a “fighting spirit.” Sadly this aggressive attitude by the medical profession may be at odds with the wishes and needs of an individual, the family and the other people in a person’s life. We have to try to strike a balance between the whole instinct to fight and expressions of healing and acceptance.

In the second case, the philosophy is grounded in the idea that we need to work in harmony with nature. The maintenance of health and well being comes from reestablishing balance and harmony not just in ourselves but also in our relationships with each other, with society and with the entire environment around us.

Some of the most commonly CAM therapies include dietary modification, nutritional and herbal supplementation, and mind-body therapies. There has been a revival of interest among MS researchers about the therapeutic potential of low-fat diet and essential fatty acid supplementation in MS. The research on CAM therapies in MS is still exploratory, but considering peoples’ interest and common use of these therapies, further research in this area is clearly warranted. Many sufferers show “spontaneous” recoveries, so reports of cures with unorthodox remedies are often treated with skepticism.

Diet, Vitamins and Supplements: There have been scattered reports of symptoms improving after the removal of dental amalgam, but there is scant evidence that this is really worthwhile. There is some evidence 1. 2. 3. 4. that polyunsaturated fatty acid (PUFA) supplementation may help MS. There used to be a lot of support for something called the “Swank diet,” but over the years the evidence has not been very good. In a small number of people with MS certain foods can make them worse. This is to expected if there is an autoimmune component to the illness. It is always a good idea to see if there is something that makes a person feel worse. The other important qestion is whether food additives may be causing symptoms. Although this must be uncommon, I have written elsewhere about occasional cases of MS symptoms with all the classical neurological, biochemical, radiological and electrical signs that have improved or become completely better after removing aspartame from the diet.

Physical exercise: Exercise is highly recommended for people with MS, though it is best to avoid it during an attack. There is evidence that over-exertion can actually bring on an attack. There is some literature about the use of Feldenkrais bodywork in MS, but a study from the University of North Carolina failed to find any benefit. T’ai Chi Ch’uan, qigong, yoga and graduated exercise have all been helpful to some people with MS, but it is essential to discuss it with a healthcare provider to see how any one of these fits in to an package of care. There is no published data on the use of Pilates in MS. At least not in any of the languages that I can read. But since it has been shown to improve posture and flexibility, it is logical to think that Pilates might be helpful, and it would be very valuable to see some research on it.

Acupuncture: Although widely used, the research on acupuncture in MS is not yet convincing. Like most acupuncturists I’ve had some good results in treating pain, muscle stiffness and fatigue. I’ve also seen people achieve some remarkable recoveries, but there are two issues: MS is a relapsing and remitting illness. And second, many of the people who did well only did so because they shifted their thinking: acupuncture became the vehicle for their personal transformation rather than a device for removing nasty symptoms.

Homeopathic remedies: Even the most enthusiastic homeopaths have fairly limited expectations of what homeopathy can achieve in MS.

From the point of view of homeopathy there is little point in making the diagnosis on multiple sclerosis because the disease has such a variable course with highly variable symptoms. To a homeopath the diagnosis is not useful: it is the symptoms that are all important. The homeopathic treatment of MS is highly individualized: one of the key items is the timing of symptoms and associated features. Some of the most common remedies for people with MS are:

  • Agaricus
  • Alumina
  • Argentum Nitricum
  • Arsenicum
  • Aurum Metallicum
  • Causticum
  • Cocculus
  • Conium Maculatum
  • Ignatia
  • Lachesis
  • Nux Vomica
  • Natrum Muriaticum
  • Phosphorus
  • Plumbum

This is not the whole list of homeopathic remedies that we have sometimes found helpful, but it highlights some of the more commonly used ones in people with the symptoms of MS.

Herbal remedies: Many herbal remedies have been tried in MS, and many experts have told me that they have had some good results. There is an important issue in MS called “apitherapy,” a.k.a. bee venom therapy (BVT). Several reports suggest that bee venom may be an effective treatment for patients with MS. But formal trials suggest that although the treatment appears relatively safe apart from itching and swelling of the skin, it does not seem to be helpful

The best approach is to embrace the best of what conventional medicine has to offer, combine unorthodox approaches and to realize that management of a chronic illness is not about dominating it but learning from it and learning strategies for peacefully co-existing with it.

Qigong Therapy at a Distance

I just had a very nice question from someone who had seen my article in which I commented on the way in which I had seen qigong masters treat patients without touching them.

Dear Dr. Petty,
That’s really interesting, and if it’s true, it would be very important for the future of therapy. Is that actually any scientific evidence to support what you said?

Good question, and yes, there is. But not very much of it.

A recent study from South Korea examined the effects of Qi therapy, also known as external qigong. During the study they looked at the effects – if any – of touching the patient. The researchers examined the impact of treatment on anxiety, mood, several hormones and cellular immune function. Whether or not they were touched, the patients showed improvements in anxiety, alertness, depression, fatigue, tension and cortisol levels. Treatment at a distance was just as good as hands-on treatment with one interesting exception: treatment at a distance caused the white blood count to rise slightly, while the effect wasn’t seen in people who were touched.

There is also another type of research in which qigong practitioners have tried to influence either animals or cells in culture. In one recent study practitioners directed their intention toward cultured brain cells for 20 minutes from a minimum distance of 10 centimeters. The first study seemed to show an effect on the proliferation of the cultured cells, but the second did not, showing the difficulty of doing experiments like these.

More experiments like these are underway in centers throughout the world, and I shall continue to report on both the positive and negative studies.

Acupuncture Points

The Pacific College of Oriental Medicine publishes a newspaper entitled Oriental Medicine, that carries a great many interesting articles mainly written by practicing acupuncturists. In the current issue there is a nice article entitled “What are Meridians and Points?” by Iona Marsaa Teeguarden a therapist who has developed some very interesting acupressure techniques for dealing with an array of problems. This is a very interesting topic to me: you may have seen some of those pictures of acupuncture points that look like tramlines traversing the body.

Over the last few years I’ve read everything about the acupuncture points that I could get my hands on. If it’s in one of the ten or twelve languages that I can read, then I’ve probably got a reprint of the paper, and people have been kind enough to send me translations of at least parts of papers in Chinese, Japanese and Korean. Some of the research has been excellent, and some less so.

The first point (ha ha…), often controversial when I am talking to classically trained acupuncturists, is that although some of the large well-known acupuncture points are usually in the same place in different individuals, many of the lesser known points are not. Of the 361 main named acupuncture points only a couple of dozen seem to be fixed on the body. Most of the rest can be some way off from the pictures in books. I learned that first when I was an apprentice in London, and then during my studies in China. The top Chinese acupuncturists search for the right points to use. It’s one of the reasons why modern Chinese acupuncturists have identified over a thousand “extra points.”

Although people usually talk about “meridians” joining the acupuncture points together, the Chinese usually refer to them as “channels and collaterals.”

There does not seem to be any neurological or vascular structure at the site of an acupuncture point. Taken together with he fact that acupuncture points tend to be tender and to have characteristic electrical properties, both of which get better with treatment, suggests that they are functional rather than structural entities. Most experienced acupuncturists have noticed that the points vary not just with treatment, but also with mood, the weather and in women, during the menstrual cycle.

In the late 1930s, a French physician named Niboyet was probably the first to find indications that the main acupuncture points have lowered electrical resistance compared with surrounding skin. Some other studies (1, 2, 3, 4, 5.)have provided some support for these findings, although it is difficult to known precisely what to make of the finding that these areas of reduced electrical resistance can also be located on fresh but not dried cadavers. Some people have invoked some mechanism involving electrolytic fluxes along connective tissue or fascial planes of the body. But that’s all just speculation backed by some research correlating acupuncture points and fascial planes.

An additional problem for simple electrical models is that some of the acupuncture points also respond to polarized light, which would be odd if the primary mechanisms of acupuncture points were electrical.

Another set of experiments sought to exploit the phenomenon of “propagated needle sensation.” If acupuncture is done well, then this happens very frequently. It is a subjective sensation of warmth, heaviness, numbness or bursting, that moves at between 1 and 10 centimeters per second, which is much slower than a nerve impulse. This sensation moves along the proposed channels along which the Qi is supposed to flow. But this is the interesting bit: the sensations are not related to any known neurological pathways. The precise nature of this propagated needle sensation remains elusive, with reports of it being interrupted by chilling, local anesthetics and mechanical pressure, whilst it has also been shown to travel to phantom limbs in amputees.

Attempts have been made to trace out acupuncture points and their associated channels by the use of radioactive tracers and by measuring electrical propagation along the channels. 99-Technetium has been the most widely used, and it has been claimed that the tracers diffuse from acupuncture points along the classical acupuncture channels, whilst tracer injected at non acupuncture points diffuses without showing any such linear pattern. The speed of the linear migration of the tracer injected into acupuncture points was accelerated by the use stimulation of appropriate acupuncture points.

If we cannot find anything anatomical at acupuncture points, and they clearly change place and character as the person changes. Then what do the Chinese have to say about the points and the channels?

They say that the channels are there to distribute Qi, and that the acupuncture points are the control points of the channels. The traditional theory is that Qi flows in response to thoughts and emotions. Perhaps thoughts and emotions have effects on muscle contraction and that pushes the Qi along, but I thin that we have to step away from the physical body. I can well remember one of the first people whom I ever treated. I gently needled a “Liver point” on her foot, and she felt the sensation in her eye on the same side of the body. There is no known neurological connection between the foot and the eye on the same side. But in Chinese medicine, the Liver channel terminates in the eye on the same side of the body. The theory of fascial planes can also not explain that. Neither can the observation that many of us have made in the clinic. In some people, acupuncture reveals their entire acupuncture system: the channels become red.

Even when acupressure is used in the subtle systems around the body. I have seen a Chinese Qigong Master demonstrate this phenomenon in a paraplegic patient.

While the Master’s hands were three feet away for the body.

And that will be the topic of yet another research study.

Shock Waves and Diabetes

A psychiatrist friend once called me to say that he knew that he had to change his job. He was in the second year of his Freudian training analysis, and as he was driving to work he experienced a severe pain in the back. He told me that it felt as if someone had put a knife in his back. This, he told me, was a psychosomatic reflection of the mean back stabbing environment in which he was working. “Tell me more about the pain,” I said. “Just like a knife,” he said, “it’s the most obvious example of my body telling me what’s going on here.” I suggested that he should come over for me to give him a physical check up, but he was having none of it.

The following day he passed a large kidney stone.

It’s important to listen to your body, and to try and understand its message. It’s also important to respect every aspect of your being: physical, psychological, social, subtle and spiritual. A physical pain may be telling you about something in your environment or it may just be telling you that there’s something wrong with your body. Sigmund Freud once famously remarked that “Sometimes a cigar is just a cigar.”

I was reminded of this story as I was reviewing a new report about an association between the use of sound waves – lithotripsy – to shatter kidney stones and the eventual development of diabetes. Approximately 10 percent of men and 5 percent of women under the age of 70 will experience a kidney stone.

Surgery for kidney stones used to be horribly traumatic. As a very young student and junior doctor I assisted in more than one operation to remove them. The invention of the lithotripter – a device that uses ultrasound to break up stones, so that they can be passed out of the body – was a big advance. Though the treatment itself is far from being painless, it is much better than major surgery, It is a shame to learn that the treatment is not as innocuous as we thought. This is important, because about 1 million people in the United States have had shock wave lithotripsy (SWL).

In a study published in the May issue of the Journal of Urology, researchers at the Mayo Clinic followed up on a group of 630 patients who had been treated with SWL in 1985. The Mayo was one of the first centers to use the technique, the hospital keeps wonderful records, and so it was one of the few places in the world where it was possible to follow people 19 years after treatment.

Almost 60 percent of the patients responded to a questionnaire and were matched to an equal number of patients whose kidney stones had been treated by some other method. Among the SWL group, 16.8 percent had developed diabetes, compared with 6.7 percent of the control group, and 36.4 percent had high blood pressure compared with 27.9 percent of the control group. According to the study, the development of hypertension was related to the treatment of stones in both kidneys, while the onset of diabetes bore a relationship to the number of shocks administered and the intensity of the treatment.

This makes sense: the kidneys are key controllers of blood pressure, and it has long been known that stones, inflammation, infection or vascular disease in the kidneys can cause elevated blood pressure. Perhaps the treatment scars the kidneys. And it is not surprising that sound waves powerful enough to shatter a stone might also cause damage to the tissues through which they are passing; which include the pancreas.

These findings will need to be replicated, particularly with newer model lithotripters. But even before that, I’m sure that the criteria for gets the treatment will be modified, and it will also be necessary to re-think how the treatment is done. As an example, instead of shooting one powerful burst of sound waves at the stone, it may be necessary to fire several low intensity burst from different directions that all crisscross in the vicinity of the stone.

For now, if you are one of the unlucky ones who gets a kidney stone, discuss this new research with your doctor before having lithotripsy. And if you have access to a good acupuncturist, naturopath or homeopath, ask them if they have had any success in treating kidney stones, and if “Yes,” whether they would be prepared to work with your physician to help you.

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