This article discusses the treatment of Parkinson’s Disease (PD) using acupuncture. It is based off a case report published in Frontiers of Neurology in 2024. If you are reading this, it would give you a better sense of what the research says about acupuncture for PD.
Overview of Parkinson’s Disease
Parkinson’s Disease is a progressive neurological disorder characterized by tremors, bradykinesia, and rigidity. According to the Parkinson’s Foundation, approximately 10 million people worldwide are living with PD. In Singapore, we know that 3 out of a 1000 people above 50 years of age are at some stage of Parkinson’s Disease.
Traditional treatments primarily focus on dopaminergic medications, but these often come with significant side-effects and reduced effectiveness over time. That is why most PD patients and their children are looking for something more to complement their existing interventions.
Relevance of Combining Acupuncture and Parkinson’s Research
Even though acupuncture is not recommended by neurologists in Singapore, this form of treatment is commonly used alongside pharmaceutical interventions in China.
Recent studies and anecdotal reports suggest that acupuncture may improve motor function and quality of life in PD patients, prompting further exploration through case studies and clinical trials.
Patient Background
This case report involves a 75-year-old male diagnosed with Parkinson’s Disease one years prior to seeking acupuncture treatment. He came from Hubei in central China, and worked as a farmer with notable exposure to herbicides and pesticides.
For a year after getting diagnosed, he did nothing about the condition. He did not use any of the common PD drugs, nor did he sign up for Deep Brain Stimulation DBS).
A year later, as his condition worsened, he decided to seek out acupuncture at Wuhan hospital.
What Were His Symptoms?
At this point, the patient exhibited classic PD symptoms including:
- Limb tremors
- Rigidity and bradykinesia
- Fatigue
- Stiffness from the neck to the back
- Difficulty in swallowing hard food
- Drooling upon lowering his head
- Occasional nocturnal foot cramps
- Dry mouth
- Constipation
What Assessments Did He Have To Do?
This patient had to undergo assessments before and after the treatment regimen. We explain below the assessments done on him:
- Unified Parkinson’s Disease Rating Scale (UPDRS) is for assessing PD severity and progression. It is the most common assessment used.
- Parkinson’s Disease Questionnaire (PDQ-39) is scored using a 5-point scale and a range of 0–100, with higher scores indicating a lower quality of life (QoL)PDQ-39and quality of life,
- Non-Motor Symptoms Scale (NMSS)
- Hamilton Anxiety Scale (HAMA)
- Berg Balance Scale
- Footscan V9
- TUGT
- 30-m Walking Test
Choice of Acupuncture Points for Parkinson’s
Acupuncture has been reported to have possible therapeutic effectiveness for PD in clinical trials, as manifested by
1. Improvement in clinical symptoms such as tremor
2. A decrease in the dosage of anti-parkinsonian drugs
3. A decrease in side effects
4. Improvements in daily life, such as improved sleep and bowel motility
In the case of this particular patient, acupuncture sessions were administered thrice weekly over a period of four weeks. Each session lasted approximately 45 minutes, during which needles were retained for 20 to 30 minutes to maximize therapeutic benefits.
Acupuncture to Calm the Nervous System
The first group of points are meant to calm the nervous system. In the language of Chinese medicine, the following points will calm the heart-mind.
- Si Shen Chong set of 4 points
- GV 24 (Shen Ting)
- EX-HN 3 (Yin Tang)
These second group of points for the nervous system are meant to regulate liver qi.
- LI 4 (He Gu)
- SP 6 (San Yin Jiao)
- LR 3 (Tai Chong)
Acupuncture to Treat Constipation in Parkinson’s
Constipation is a common problem for people with Parkinson’s disease (PD), affecting up to 98% of people. Acupuncture can be useful for regulating bowel function and facilitating peristalsis. In this particular patient, the following acupuncture points were used.
- ST 25 (Tian Shu)
- CV 4 (Guan yuan)
- ST 37 (Shang Ju Xu)
Acupuncture for Lower Extremity Tremors
Lower extremity tremors can appear in Parkinson’s patients, usually much later after the hand tremors appear.
Resting tremor often appears in the hands, but they also appear in the legs, usually the foot, but sometimes also the thigh. Resting tremors are most evident when the feet are dangling or when the person is lying down.
Orthostatic tremor are a less common type of tremor in the lower limbs and happens when the patients is standing. Interestingly, the tremors disappear when walking or leaning on a solid structure.
The following points are useful in the treatment of lower limb tremor and stimulate the sciatic, peroneal and tibialis nerves, which then communicate signals back to the spine and the brain.
- GB 34 (Yang Ling Quan)
- SP 9 (Yin Ling Quan)
- GB 39 (Xuan Zhong)
Acupuncture for Upper Extremity Tremors
Upper extremity tremors are a common symptom of Parkinson’s disease (PD) and are often the first motor symptom to appear. These tremors may appear in one arm, then progress to the other side as the disease progresses.
The following acupuncture points are helpful in regulating peripheral nerve function of the arms as these point may the radial nerve on the arms and connect to the brachial plexus and the central nervous system.
- LI 11 (Qu Chi)
- LI 10 (Shou San Li)
Acupuncture Points for Vestibular Function
Points used include:
- Brain Three Needles (脑三针): GV 17 (Nao Hu) and bilateral GB 19 (Nao Kong)
- Du Three Needles (督三针): GV 14 (Da Zhui), GV 8 (Jin Suo), and GV 4 (Ming Men)
Balance Issues in Parkinson’s Disease
Vestibular dysfunction is common in Parkinson’s disease (PD) and can increase the risk of falls. The vestibular system is the largest sensory system in the body and is responsible for maintaining balance and spatial orientation.
For the lower limbs, two more points are added for stabilizing the legs.
- Lower limb points: BL 40 (Wei Zhong) and BL 57 (Cheng Shan)
Improvement In Symptoms After Acupuncture Treatment
After 4 weeks of acupuncture treatment, the patient reported the following:
- Notably decreased stiffness in the neck and back
- Significant improvements in mood
- Enhanced confidence in managing PD
- Reduced drooling
- Absence of recurring non-motor symptoms such as choking and cramps
Improvement In Assessment Scores After Treatment
- Unified Parkinson’s Disease Rating Scale (UPDRS): 17-point reduction in UPDRS score
- Parkinson’s Disease Questionnaire (PDQ-39): 11-point reduction
- Non-Motor Symptoms Scale (NMSS): 4-point enhancement in fatigue, a 36-point improvement in mood, and the complete resolution of gastrointestinal complications
- Hamilton Anxiety Scale (HAMA): decreased by 5 points
- Berg Balance Scale
- Footscan V9
- TUGT
- 30-m Walking Test: The 30-m walking test revealed a 0.11 m/s increase in walking speed and a 6 cm increase in stride length
Looking Beyond Pharmaceutical Interventions
The management of Parkinson’s disease (PD) primarily relies on pharmaceutical interventions. However, the limitations associated with drug therapies have led healthcare professionals and sufferers alike to investigate the integration of non-pharmacological approaches alongside conventional approaches.
This multifaceted strategy aims to reduce side effects while improving overall therapeutic outcomes for individuals living with PD. Below we list out 3 approaches you have to implement if you or your loved one has been diagnosed with Parkinson’s.
1. Exercise and Its Benefits
Research indicates that exercises involving goal-oriented training and aerobic activity can enhance both cognitive and automatic aspects of motor control in patients with mild to moderate PD. This improvement is believed to stem from experience-dependent neuroplasticity.
Clinical studies have shown that physical exercise can positively influence brain function and structure in PD patients, leading to stabilization of disease progression within the corticostriatal sensorimotor network.
Additionally, exercise has been linked to significant improvements in cognitive abilities and may alleviate sleep disturbances commonly seen in PD.
2. Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is a versatile therapeutic method that employs various techniques to assist individuals in managing the complex challenges associated with Parkinson’s disease.
CBT has proven effective in improving overall well-being and quality of life by addressing common issues such as depression and anxiety, which are frequently experienced by PD patients.
3. Acupuncture’s Role in Parkinson’s Disease
Acupuncture has garnered support from numerous clinical studies demonstrating its effectiveness in alleviating motor symptoms like myotonia in PD patients. As evidenced in the case report above, we know that acupuncture addresses non-motor symptoms such as anxiety, constipation, and insomnia.
Acupuncture for Parkinson’s Disease
I am Dr. Chan and I have had almost 20 years of experience treating patients suffering from Stroke and Parkinson’s. I use a mixture of acupuncture and Chinese herbs to reduce symptoms like constipation, stiffness, tremors as well as slow down the progression of the disease for patients.
Come in for the first session, which will include the consultation, assessment and treatment. See how you feel after the first session before deciding to continue with TCM for Parkinson’s.
