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ARTICLES
Piezoelectric
Stimulation Technique
Of Acupuncture Points: Clinical Application
Richard C. Niemtzow, MD*
Ruben T. Ong, MD+
Peter A. S. Johnstone, MD*
ABSTRACT
Background Piezoelectric stimulation is a useful clinical technique
to treat acupuncture points.
Objective To demonstrate the usefulness of piezoelectric stimulation
on acupuncture points for simple and safe clinical use.
Patients Three cases of treating pain are depicted.
Intervention Two-hand approach technique.
Main Outcome Measures Variable duration of pain and nausea-free
periods.
Results Rapid reduction of pain and other symptoms with variable
relapse periods.
Conclusion Piezoelectric stimulation is a useful clinical modality
that can be integrated into the clinical medical acupuncture practice.
KEY WORDS
Piezoelectric Stimulation, Quartz, Pain, Cancer, Nausea and Vomiting,
Hoarseness, Headaches, Musculoskeletal Pain
INTRODUCTION
Piezoelectric stimulation of acupuncture points has immediate medical
applications in the clinic. It offers rapid relief of acute pain, migraine
headaches, musculoskeletal pain, nausea and vomiting, and hoarseness
due to viral laryngitis. It should not be considered a substitute for
comprehensive acupuncture treatment; nevertheless, the clinician will
appreciate its clinical usefulness if applied properly. This article
discusses the appropriate technique to employ such devices.
There are many piezoelectric devices readily available to the clinician.
The authors have not found any particular manufacturer superior. These
devices do not require an electrical source.
Piezoelectric Properties
The word piezo is derived from the Greek word for "pressure."
In 1880, Jacques and Pierre Curie discovered that pressure applied to
a quartz crystal creates an electrical charge in the crystal; they called
this phenomenon the piezo effect. Mechanical squeezing of certain crystals
can produce electrical energy, arising directly from the crystal structure.
Piezoelectricity depends on the absence of a certain kind of symmetry:
inversion symmetry. The inverse of a figure is its inverse mirror image.
If the figure and its inversion look the same, as with a cube, then
the figure has inversion symmetry. If they do not look the same, as
with a tetrahedron, then the figure does not have inversion symmetry.
Crystals that lack inversion symmetry usually can be mechanically squeezed
so that the positive and negative charges of the atoms do not shift
equally, generating an electrical potential.1
In the typical piezoelectric device used with acupuncture points, the
case contains a spring plunger that mechanically impacts and deforms
the quartz crystal. The metal housing of the crystal is conductive and
may be considered positive with respect to the negative output of the
crystal. The negative voltage output of the crystal is carried to the
insulated tip of the device by means of a wire. Interesting to note
is that the case of the piezoelectric stimulator is grounded to the
metal housing of the crystal that the operator grasps. The output of
a typical piezoelectric stimulator is in the range of about 6000 V.2
The current is extremely low as not to be dangerous. However, the authors
caution that stimulation over and near the heart, carotid arteries,
and head should be scrupulously avoided. The output of the piezoelectric
stimulator is difficult to measure and is best achieved by an oscilloscope;
its wave pattern is similar to an electrical spark emission. The emission
is chaotic and brief, covering a wide frequency spectrum with overlying
harmonics. This is contrasted to the typical square wave pattern that
acupuncturists typically employ in treating ear and body points.
Acupuncture Point-Stimulation Technique
The correct technique of employing the piezoelectric stimulator is to
grasp the device with one hand with the thumb on the plunger. When depressed,
the device produces a "click" when it is activated. The tip
of the stimulator is placed on the acupuncture point of interest. The
index finger of the other hand is used to touch another acupuncture
point. The unit is activated and a series of stimulations are produced
up to 1 minute or longer. Both the operator and the patient will feel
the electrical stimulation. This technique was first described by Ong
(author unpublished data).
Piezoelectric Stimulation of Clinical Useful Points
The authors have found that stimulation of LI 4 bilaterally with the
piezoelectric device is useful to alleviate migraine headaches when
auriculotherapy points are added; namely, Shen Men, Point Zero, and
Omega 2 in both ears.3 Stimulation of LI 4 and acupuncture points on
the neck and back are useful for back musculoskeletal and metastatic
cancer bony spine and hip pain. LI 4 and ST 43 appear helpful to alleviate
hoarseness due to viral laryngitis. Musculoskeletal pain of the upper
and lower extremities may be treated with combinations of LI 4 and appropriate
acupuncture points on the meridians at the choice of the clinician.
The authors have also found that combinations of points other than LI
4 are of clinical interest.
Effectiveness of Piezoelectric Stimulation
Piezoelectric stimulation may provide quick and temporary relief, and
sometimes may be the only treatment necessary to the patient. Its usefulness
is especially appreciated when the debilitated patient is unable to
undress or lay on a treatment table without considerable discomfort.
It is beneficial for some patients in that it frequently relieves enough
pain for them to undergo definitive acupuncture therapy without discomfort.
CASE REPORTS
Patient 1 was an 81-year-old man with a recurrent squamous cell
carcinoma of the lip in a submental lymph node. This lesion underwent
excision with bilateral supraomohyoid lymph node dissections revealing
no other metastases in 49 sampled nodes. He was undergoing postoperative
radiotherapy and noted that his shoulders were too painful and restricted
in range of motion for him to carry out his physical therapy. He underwent
piezo stimulation of LI 4 and SI 3 bilaterally, with the circuit completed
at SI 13 on the right and SI 11 on the left (these were Ashi points).
Fifteen seconds of stimulation was provided bilaterally. After this,
he noted that his pain had decreased from 7/10 to 5/10 with a robust
increase in his bilateral shoulder range of motion.
Patient 2 was a 62-year-old woman with a history of T1, N2b,
carcinoma ex-mixed right parotid gland. She underwent right parotidectomy
with modified radical neck dissection on the right. Subsequently, she
received radiotherapy: 60 Gy to the right side of the neck and 50 Gy
to the left side of the neck, completed in August 1996. The patient
presented in the radiation oncology clinic with a 3/10 chronic muscular
neck pain irradiating to the shoulders and upper extremities. There
was no clinical radiographic evidence of cancer recurrence. Piezo stimulation
was administered on LI 4 bilaterally. Ten seconds of stimulation was
provided. After this, the patient reported that the pain was reduced
to 1/10 and localized only to the cervical neck area, with a substantial
increase in comfort. There were no complications. Subsequent follow-up
visits demonstrated little if any relapse of pain confined to the neck
area. The neck remained supple.
Patient 3 was a 37-year-old man with sarcoma of the right hip
undergoing radiation. The patient complained of nausea and vomiting
while undergoing chemotherapy treatment. Piezoelectric stimulation of
MH 6 was conducted bilaterally for approximately 1 minute; the patient
stated that his nausea disappeared. The patient relapsed about 48 hours
later and the treatment was successfully repeated.
DISCUSSION
All living cells produce small electrical voltages across their membranes.
These electrical voltages, called transmembrane potentials, can be correlated
directly with the state of the membrane and the metabolic process that
alter the movements of molecules across the membrane and the inherent
membrane permeability.4 The complex chaotic electrical stimulation of
the acupuncture point may act as a "trigger" on the acupuncture
channel that assists in regulating total organic homeostatic balance;
this electrical stimulus may interact at the membrane level on cells
and organs corresponding to the meridian channels. It has been demonstrated
that the acupuncture point consists of blood, lymphatic, and nerve components.
The role of the neurovascular bundles in blood supply regulation, and
thus in the function of organs, can explain some spectacular clinical
results in acupuncture practice for reversible dysfunctioning or trophic
and metabolic disturbances.5 The exact mechanism of piezoelectric stimulation
is poorly understood.
CONCLUSION
Piezoelectric stimulation as described herein is a valuable technique
in the acupuncture clinic. It can be delivered in a safe and quick therapeutic
manner for a variety of pain symptoms. Its rapid action and ease of
application make it a useful technique for very ill patients under certain
conditions. The stimulation of acupuncture points with electricity warrants
further research. The optimum current combinations, frequencies, and
acupuncture points are future clinical research challenges.
REFERENCES
-
Quartz
crystals. In: Compton's Encyclopedia 2000 Deluxe [computer program].
Broderbund; 2000.
-
Piezo-DX
manufactured by ITO Co, Ltd, 3-3-3 Toyotama-Minami. Nerima-Ku, Tokyo
176, Japan (Available at: http://www.itolator.co.jp). Web site accessibility
verified November 28, 2000.
-
Oleson
T. Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture.
2nd ed. Los Angeles, Calif: Health Care Alternatives; 1996:57,143.
-
Niemtzow
RC. Transmembrane potentials of human lymphocytes. In: Niemtzow
RC, ed. Transmembrane Potentials and Characteristics of Immune and
Tumor Cells. Boca Raton, Fla: CRC Press; 1985:69-85.
-
Terral
C, Rabischong P. A scientific basis for acupuncture. J Altern Complement
Med. 1997;3:55-65.
AUTHORS'
INFORMATION
Dr Richard C. Niemtzow is a Colonel in the United States Air Force (USAF)
on loan to the United States Navy for a special acupuncture project.
Dr Niemtzow is the first physician practicing acupuncture full-time
at the Naval Medical Center in San Diego, California, with special interest
in oncology patients.
Richard C. Niemtzow,
MD, PhD, MPH*
1835 E Main St
El Cajon, CA 92021-5255
Phone: 619-447-6806 o Fax: 619-447-6881
E-mail: N5EV@AOL.COM
Dr Ruben T.
Ong is a surgeon in Yardville, New Jersey, with more than 20 years of
acupuncture and surgical experience.
Ruben T. Ong, MD+
4228 So Broad St
Yardville, NJ 08620
Phone: 609-585-2421
Dr Peter A.
S. Johnstone, MD, MA, is a Commander in the United States Navy, and
is Chief of Radiation Oncology at the Naval Medical Center, San Diego,
California. Dr Johnstone recently completed the UCLA Medical Acupuncture
Program.
CDR Peter A.S.
Johnstone, MC, USN*
Naval Medical Center San Diego
Radiation Oncology Division
34800 Bob Wilson Dr, Suite 14
San Diego, CA 92134-1014
Phone: 619-532-7274 o Fax: 619-532-8178
E-mail: pajohnstone@nmcsd.med.navy.mil
*Correspondence
and reprint requests to: Dr Richard C. Niemtzow, Radiation Oncology
Division, Naval Medical Center, 3400 Bob Wilson Dr, Suite 14, San Diego,
CA 92134-1014. Phone: 619-532-7274; Fax: 619-532-8178; E-mail: N5EV@AOL.COM.
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