Recently, I was asked to do the honor of being the Medical Reviewer for an article on acupuncture for incontinence, through the nonprofit agency The Simon Foundation for Continence. This piece was recently published on their site, and I am happy to repost it on this blog, with permission. If you know anyone who suffers with the symptoms of an incontinent bladder or bowel, please refer them here. Enjoy!
Interest in acupuncture and acupressure are growing as people with incontinence (bowel or urinary) seek treatment options in complementary and alternative forms of medicine. Most people with incontinence would prefer not to have surgery or take drugs, if at all possible.
Acupuncture and acupressure for incontinence are based on ancient Chinese Medicine, which designates incontinence to be a deficiency of energy. In Chinese Medicine urinary incontinence is due to a deficiency of kidney or, occasionally, urinary bladder energy, so acupressure and acupuncture treatments work on nourishing and supporting these energetic pathways. The bladder and anal sphincters also need a lot of energy to perform correctly. Likewise with bowel incontinence, acupuncture attempts to restore strength to the anal sphincter.
A certified acupuncturist will select key points to improve strength, such as Kidney 3 between the inner ankle bone and Achilles tendon, to improve kidney strength. Other complementary points will be selected based on the differential diagnosis developed during the patient’s initial health history intake. There are several other points that are also used, depending on the type of incontinence.
Electroacupuncture is being studied and researched for chronic bowel and bladder problems. Percutaneous tibial nerve stimulation(PTNS) is considered to be a variation of the electroacupuncture technique because it uses an acupuncture needle and is derived from the ancient practice of acupuncture. The stimulation site used in PTNS is the Spleen 6 acupuncture point. There are many clinical studies on PTNS showing promising results.
Currently, the use of acupuncture and acupressure as a proven incontinence therapy lacks rigorous randomized clinical trials (RCTs) to show their effectiveness. In other words, does acupuncture really work and if so, how well and why? One of the major problems in trying to answer this question is that most of the studies done through 2013 do not show that acupuncture worked any better than the other therapy being studied. The studies also did not indicate the depth of the needle placement or indicate a standard measurement for needle placement, which can vary between acupuncturists. Past studies have shown some positive results on overactive bladder symptoms (OAB) and quality of life. But we need further large, well-controlled studies to show that acupuncture and acupressure really work better than other therapies or in combination with other treatment strategies, and provide real relief from incontinence symptoms.
A new RCT was published in November 2014 that demonstrated that acupuncture is safe with significant improvements in patient assessment of OAB symptoms and may be considered as a clinical alternative treatment for OAB in the female adult. This may be the first of some much needed information to help us all know more about the potential and positive effects of this alternative therapy. (Yuan Z, et al, World J Urol2014).
If you are interested in trying acupuncture, discuss it with your healthcare provider and only seek a certified acupuncturist after your provider’s approval to proceed. When choosing an acupuncturist, be sure to only enlist the resources of a licensed acupuncturist (they will have the initials LAc. after their names), and not chiropractors, medical doctors, or physical therapists that offer similar services.
NOTE: Each form of incontinence treatment you have should be thoroughly discussed and tried under your physician’s care. This is so a complete record of all incontinence management methods that are tried are recorded with your provider, and a complete medical record is maintained. If there are any contraindications (medical reasons that you should not try certain therapies), your healthcare provider will let you know. Be sure you let your healthcare provider know the success (or failure) of each therapy you try.
You can find a certified acupuncturist using this link: http://mx.nccaom.org/FindAPractitioner.aspx
Michael A. Sassack is a licensed and board certified acupuncturist serving the northwest suburbs of Chicago.