Background

Auriculotherapy applies the principles of to specific points on the ear. It is a treatment modality where the specific malfunctioning organ or a systemic illness can be treated by application of a laser and/or (transcutaneous electrical nerve stimulation) unit to a correlating part of the external ear.

The point on the ear is located according to a somatotopic map, where each part of the auricle, or external ear, corresponds with a part of the body. The most popular somatotopic map is the "inverted fetus" image, where the organs correspond to the superimposed image of an upside-down person. However, at least four other maps exist to locate and treat maladies of the body. Practitioners may use the somatotopic map to correct imbalances or disease in nearly any part of the body, including chronic health conditions and diseases.
Auriculotherapy was discovered by Dr. Paul Nogier in the 1950s, a French practitioner who treated sciatica by cauterizing, or destroying by burning, searing, or scarring, an area of the ear.

Dr. Nogier's success with this treatment led him to investigate the insertion of acupuncture needles into the ear as a treatment for pain. Proponents believe that auriculotherapy works because many of the nerve endings in the ear connect to hormonal parts of the brain and organs within the body.

Auriculotherapy is most popularly used to treat substance abuse and chronic pain. Some hospitals offer auriculotherapy for post-operative pain management. Some detox centers provide auriculotherapy for the treatment of drug addiction.

Auriculotherapy can and should be used to maintain health and promote recovery from almost any condition. Uses of auriculotherapy based on tradition or theory include addiction, adrenal disorders, analgesia, chronic pain, high blood pressure, inflammation, musculoskeletal disorders, pain, relaxation, sciatica, stress, and swelling. Advocates claim that because of the wide range of point functions and locations on the ear, auriculotherapy has a promising future alongside conventional Western treatment of nearly every condition. Despite its claimed uses, there are currently no available high quality trials confirming its efficacy.

Auriculotherapy applies the principles of to specific points on the ear. It is a treatment modality where the specific malfunctioning organ or a systemic illness can be treated by application of a laser and/or (transcutaneous electrical nerve stimulation) unit to a correlating part of the external ear.

The point on the ear is located according to a somatotopic map, where each part of the auricle, or external ear, corresponds with a part of the body. The most popular somatotopic map is the "inverted fetus" image, where the organs correspond to the superimposed image of an upside-down person. However, at least four other maps exist to locate and treat maladies of the body. Practitioners may use the somatotopic map to correct imbalances or disease in nearly any part of the body, including chronic health conditions and diseases.
Auriculotherapy was discovered by Dr. Paul Nogier in the 1950s, a French practitioner who treated sciatica by cauterizing, or destroying by burning, searing, or scarring, an area of the ear. Dr. Nogier's success with this treatment led him to investigate the insertion of acupuncture needles into the ear as a treatment for pain. Proponents believe that auriculotherapy works because many of the nerve endings in the ear connect to hormonal parts of the brain and organs within the body.
Auriculotherapy is most popularly used to treat substance abuse and chronic pain. Some hospitals offer auriculotherapy for post-operative pain management. Some detox centers provide auriculotherapy for the treatment of drug addiction.

Proponents claim that auriculotherapy can and should be used to maintain health and promote recovery from almost any condition. Uses of auriculotherapy based on tradition or theory include addiction, adrenal disorders, analgesia, chronic pain, high blood pressure, inflammation, musculoskeletal disorders, pain, relaxation, sciatica, stress, and swelling. Advocates claim that because of the wide range of point functions and locations on the ear, auriculotherapy has a promising future alongside conventional Western treatment of nearly every condition. Despite its claimed uses, there are currently no available high quality trials confirming its efficacy.

Technique

During a typical treatment, the practitioner, called an auriculotherapist, takes the complete medical history of the patient. The practitioner often examines the ear for slight variations in coloring, flaking skin, large veins, and other topical irregularities. The ear may also be palpated with the finger or special instruments for patient sensitivity. Treatment focuses on the presenting concern. Sessions may be as brief as 10 minutes or may last as long as an hour. The duration of the therapy varies according to the response of the patient to treatment and the severity of their condition.

A treatment may occur in an individual or group setting. The treatment is usually relatively painless, and some patients fall asleep during treatment.

Auriculotherapy is often combined with somatic acupuncture because of the synergy between the two treatment systems.

Auriculotherapists perform this therapy with a variety of tools, including TENS unit, a laser, press balls, or a magnet. Though a TENS unit involves the insertion of needles into the ear, the needles are not similar to those used for acupuncture. However, both of these practices might use the electrical current of the TENS unit to enhance stimulation of a point. Practitioners might also treat the patient's prescribed ear points with a laser, where the ray of a laser focuses on a particular point on the ear. Or, magnets or press balls may be taped to the auricle with medical tape. Press balls are small seeds, which are typically held against the ear.

Auriculotherapists may also practice bleeding, which is removing a couple drops of blood at certain points of the ear, or electroacupuncture, which is sending small electric currents through the ear or the body, to treat a variety of conditions.

Auriculotherapists must be licensed health care providers, such as an acupuncturist or chiropractor, to put needles into the ear. However, any individual may practice auriculotherapy with lasers, tape magnets, or press balls.

Theory/evidence

Whereas the acupuncture diagnostic and treatment system focuses on paths of energy running through the body, auriculotherapy focuses on connections between the ear, the affected organ(s), and the central nervous system. While ear acupuncture uses needles without an electrical current, auriculotherapy uses a TENS unit or a laser.

The exact mechanism of auriculotherapy's action is unclear, and the efficacy of this therapy is controversial. However, a 1980 study partially designed by contemporary auriculotherapy expert Terry Olsen and published in the journal Pain found a significant correlation between the "inverted fetus" somatotopic map and localized musculoskeletal pain. Auriculotherapy is currently under investigation to treat pain and neurological disturbances.

The capability of reflex points on the external ear to alter neuromuscular and neuropathic disorders has been attributed to the descending pain inhibitory pathways of the central nervous system. The inverted fetus perspective of the somatotopic arrangement of auricular acupuncture points was first described in the 1950s by Dr. Paul Nogier of France, and has received scientific support from double-blind studies examining auricular diagnosis of musculoskeletal and of coronary disorders. Acupuncture points on the ear and on the body have lower levels of electrical skin resistance than surrounding tissue. These electrodermal differences are apparently related to autonomic control of blood vessels rather than increased sweat gland activity. The heightened tenderness of reactive acupuncture points may be explained by the accumulation of noxious, subdermal substances. Electrical stimulation of specific points on the external ear leads to site-specific neural responses in different regions of the brain. Behavioral analgesia produced by auricular acupuncture can be blocked by the opiate antagonist naloxone, indicating the role of endorphinergic systems in understanding the underlying mechanisms of auriculotherapy. The anatomical structures and electrical application of the auricle are described as they relate to the localization of master points, musculoskeletal points, internal organ points, and neuroendocrine points.

The scientific community has not reached a consensus on the efficacy of auriculotherapy. Most trials of this practice are of poor design quality; the results are often difficult to analyze. Based on one randomized, controlled trial, auriculotherapy appears to have no effect for the treatment of cervical myofascial pain. In this study, somatic acupuncture was used together with auriculotherapy, and although both somatic acupuncture alone and the combined technique had positive effects in reducing pain, there was no significant difference between the two groups, indicating that auriculotherapy did not have any strong additive effects.
A study that tested auriculotherapy as an aid for smoking cessation found that after two months of treatment, 15 people (38.5%) had stopped completely and 24 people had reduced their smoking by more than half. Details of this study are unclear, and more research is needed to confirm these findings.

Safety

Caution is advised in pregnant women. Acupuncture somatotopic systems strictly prohibit the needling of some points in pregnant women, because they theoretically move vital essences and might induce a miscarriage.
Some patients may become lightheaded during treatment.


Bibliography
Auriculotherapy.com. www.auriculotherapy.com. Last accessed May 30, 2006.
Auriculotherapy Training Institute. www.auriculotherapy.org. Last accessed October 4, 2007.
Ceccherelli F, Tortora P, Nassimbeni C, et al. The therapeutic efficacy of somatic acupuncture is not increased by auriculotherapy: a randomized, blind control study in cervical myofascial pain. Complement Ther Med. 2006 Mar;14(1):47-52.
Electrotherapy Association. www.electrotherapy.com. Last accessed October 4, 2007.
King CE, Clelland JA, Knowles CJ, et al. Effect of helium-neon laser auriculotherapy on experimental pain threshold. Phys Ther. 1990 Jan;70(1):24-30.
Oleson T. Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation. 2002;17(1):49-62.
Oleson TD, Kroening RJ, Bresler DE. An experimental evaluation of auricular diagnosis: the somatotopic mapping or musculoskeletal pain at ear acupuncture points. Pain. 1980 Apr;8(2):217-29
Oleson, T. Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture. London: Churchill Livingstone. 2002.

I received a comment - Quote from

"Mr. Vinod Kumar Singhal
on Wednesday, 21st-April-2010 at 6:03 PM

Basically I am Metallurgist/Scientist but for last 16 years I am associated with Acupressure Therapy and following Foot Reflexology and getting very good results in all types of diseases including psycho cases.Some of the Dr's and hospitals rfering the hopeless cases to us. Mr.Sunil Dutt, Actor and MP had been our One of successful and satisfied patient.
In our opinion Acupressure is much better than Acupuncture and have no side effects.
vinod singhal,Mumbai"

Acupressure is one of the several modalities of Acupuncture such as Moxibustion, Press Tags, Hot Needle, LASER and Electro Acupuncture. Acupressure is absolutely safe and follows the TCM paradigm of 5 Elements & 10 stems with palpation as a main diagnostic modality. It uses the meridian channels and points to tonify or disperse Qi and Blood. The basic pattern recognition and balancing Yin and Yang applies to acupressure. The beauty of Acupressure is that a TCM Acupuncturist Doctor can teach a few pressure points to the patient for home treatment especially in cases with Carpal Tunnel Syndrome, Tourettes and certain chronic pain cases.

The ancient Indian custom of Ear Piercing is an example of Auricular Acupressure on the Ear. It boosts the brain power and re-balances the Yin & Yang in a child. The idea stems from the discovery of Homunculus structure of the body in the Ear by Dr. Nogier of France considered to be the father of modern auricular acupuncture.

Interestingly there are points in the Ear that can be used to Jump Start the brain such as Jerome Point is for relaxation that boosts performance. This can be suitably used by students before taking a competitive exam without taking any designer drug. Even race horses respond well to Jerome Point and win races! Certain addictions can be treated with Ear acupressure to stop the craving. In many states in the US people convicted for Addiction are given two options - Option 1 - Acupuncture or Option 2 - Jail.

My congratulations to Mr. Singhal and his team for the good work and humane services that they extend to patients. My suggestion will be to include all modalities of Acupuncture to be a full service TCM clinic.

MedAku Contacts - You can reach me in my cell +91 81220 62636.

Wall Street Journal carried a deeply researched article on Acupuncture. Just sharing this good essay.

Decoding an Ancient Therapy
High-Tech Tools Show How Acupuncture Works in Treating Arthritis, Back Pain, Other Ills

By MELINDA BECK

Acupuncture has long baffled medical experts and no wonder: It holds that an invisible life force called qi (pronounced chee) travels up and down the body in 14 meridians. Illness and pain are due to blockages and imbalances in qi. Inserting thin needles into the body at precise points can unblock the meridians, practitioners believe, and treat everything from arthritis and asthma to anxiety, acne and infertility.
Does It Work?

While scientists say further research is essential, some studies have provided evidence of acupuncture's effects.

* Arthritis of the Knee: Acupuncture significantly reduced pain and restored function, according to a 2004 government study.
* Headaches: Two 2009 reviews found that acupuncture cut both tension and migraine headaches.
* Lower Back Pain: Acupuncture eased it in a big study last year, but so did a sham treatment where needles didn't penetrate the skin.
* Cancer: Has proven effective in reducing nausea and fatigue caused by chemotherapy.
* Infertility: Improves the odds of pregnancy for women undergoing in-vitro fertilization, according to a 2008 review of seven clinical trials.
* Addiction: Often used to help quit smoking, drinking, drug use and overeating, but there is no conclusive evidence that it works.

As fanciful as that seems, acupuncture does have real effects on the human body, which scientists are documenting using high-tech tools. Neuroimaging studies show that it seems to calm areas of the brain that register pain and activate those involved in rest and recuperation. Doppler ultrasound shows that acupuncture increases blood flow in treated areas. Thermal imaging shows that it can make inflammation subside.

Scientists are also finding parallels between the ancient concepts and modern anatomy. Many of the 365 acupuncture points correspond to nerve bundles or muscle trigger points. Several meridians track major arteries and nerves. "If people have a heart attack, the pain will radiate up across the chest and down the left arm. That's where the heart meridian goes," says Peter Dorsher, a specialist in pain management and rehabilitation at the Mayo Clinic in Jacksonville, Fla. "Gallbladder pain will radiate to the right upper shoulder, just where the gallbladder meridian goes."

Many medical experts remain deeply skeptical about acupuncture, of course, and studies of its effectiveness have been mixed. "Something measurable is happening when you stick a needle into a patient—that doesn't impress me at all," says Edzard Ernst, a professor of complementary medicine at the University of Exeter in England and co-author of the book, "Trick or Treatment." Acupuncture "clearly has a very strong placebo effect. Whether it does anything else, the jury is still out."

Even so, the use of acupuncture continues to spread—often alongside conventional medicine. U.S. Navy, Air Force and Army doctors are using acupuncture to treat musculoskeletal problems, pain and stress in stateside hospitals and combat zones in Iraq and Afghanistan. Delegations from Acupuncturists Without Borders are holding communal ear-needling sessions to reduce stress among earthquake victims in Haiti. Major medical centers—from M.D. Anderson in Houston to Memorial Sloan-Kettering in New York—use acupuncture to counteract the side effects of chemotherapy.

In a 2007 survey, 3.2 million Americans had undergone acupuncture in the past year—up from 2.1 million in 2001, according to the government's National Center for Complementary and Alternative Medicine.

The most common uses are for chronic pain conditions like arthritis, lower back pain and headaches, as well as fatigue, anxiety and digestive problems, often when conventional medicine fails. At about $50 per session, it's relatively inexpensive and covered by some insurers.
Journal Community

It is also generally safe. About 10% of patients experience some bleeding at the needle sites, although in very rare cases, fatalities have occurred due to infections or injury to vital organs, mostly due to inexperienced practitioners.

Most states require that acupuncturists be licensed, and the Food and Drug Administration requires that needles be new and sterile.

Diagnoses are complicated. An acupuncturist will examine a patient's tongue and take three different pulses on each wrist, as well as asking questions about digestion, sleep and other habits, before determining which meridians may be blocked and where to place the needles. The 14 meridians are thought to be based on the rivers of China, and the 365 points may represent the days of the year. "Invaders" such as wind, cold, heat, dampness, dryness factor into illness, so can five phases known as fire, earth, metal, water and wood.
Using Acupuncture to Treat Stress

View Interactive

"It's not like there's a Merck Manual for acupuncture," says Joseph M. Helms, who has trained some 4,000 physicians in acupuncture at his institute in Berkeley, Calif. "Every case is evaluated on an individual basis, based on the presentation of the patient and the knowledge of the acupuncturist."

Dr. Helms notes that Western doctors also examine a patient's tongue for signs of illness. As for qi, he says, while the word doesn't exist in Western medicine, there are similar concepts. "We'll say, 'A 27-year-old female appears moribund; she doesn't respond to stimuli. Or an 85-year old woman is exhibiting a vacant stare.' We're talking about the same energy and vitality, we're just not making it a unique category that we quantify."

Studies in the early 1980s found that acupuncture works in part by stimulating the release of endorphins, the body's natural feel-good chemicals, much like vigorous exercise does. Now, a growing body of research suggests that it may have several mechanisms of action. Those include stimulating blood flow and tissue repair at the needle sites and sending nerve signals to the brain that regulate the perception of pain and reboot the autonomic nervous system, which governs unconscious functions such as heart beat, respiration and digestion, according to Alejandro Elorriaga, director of the medical acupuncture program at McMaster University in Ontario, which teaches a contemporary version to physicians.
[healthcolJ] Vitaly Napadow

A specialized MRI scan shows the effects of acupuncture. The top two images show the brain of a healthy subject. In the middle two images, a patient with carpal tunnel syndrome registers pain (indicated by red and yellow). The bottom images show the calming effect (indicated by blue) in the brain after acupuncture.

"You can think Western, you can think Eastern. As long as your needle goes to the nerve, you will get some effect," Dr. Elorriaga says.

What's more, an odd phenomenon occurs when acupuncture needles are inserted into the body and rotated: Connective tissue wraps around them like spaghetti around a fork, according to ultrasound studies at the University of Vermont. Helene Langevin, research associate professor of neurology, says this action stretches cells in the connective tissue much like massage and yoga do, and may act like acupuncture meridians to send signals throughout the body. "That's what we're hoping to study next," she says.
Related

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* Acupuncture Benefit Seen in Pregnancy
* Aches & Claims: Using Acupuncture to Ease Chronic Pain

Journal Community

* discuss

“ My former spouse had shingles. Doctors told her that the terrible pain would probably last 2 or 3 years. She got acupuncture treatments, plus some Chinese herbs, and the pain was totally gone with 6 weeks. ”

—Alan Agardi

Meanwhile, neuroimaging studies at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital in Boston have shown that acupuncture affects a network of systems in the brain, including decreasing activity in the limbic system, the emotional part of the brain, and activating it in the parts of the brain that typically light up when the brain is at rest.

Other studies at the Martinos Center have shown that patients with carpal tunnel syndrome, a painful compression of nerves in the wrist, have heightened activity in parts of the brain that regulate sensation and fear, but after acupuncture, their brain patterns more closely resemble those of healthy subjects. Brain scans of patients with fibromyalgia show that both acupuncture and sham acupuncture (using real needles on random points in the body) cause the release of endorphins. But real acupuncture also increased the number of receptors for pain-reducing neurotransmitters, bringing patients even more relief.

The fact that many patients get some relief and register some brain changes from fake acupuncture has caused controversy in designing clinical trials. Some critics say that proves that what patients think of as benefit from acupuncture is mainly the placebo effect. Acupuncture proponents counter that placebos that too closely mimic the treatment experience may have a real benefit.

"I don't see any disconnect between how acupuncture works and how a placebo works," says radiologist Vitaly Napadow at the Martinos center. "The body knows how to heal itself. That's what a placebo does, too."

Write to Melinda Beck at HealthJournal@wsj.com
weblink: http://online.wsj.com/article/SB10001424052748704841304575137872667749264.html?KEYWORDS=acupuncture