Acupuncture and Parkinson's Disease

What's the point?

Although dopamine replacement therapy is considered the gold standard treatment for the motor symptoms of Parkinson’s disease, it is not successful at managing all aspects of the disease. More and more, patients are looking towards complementary alternative medicine to help improve their quality of life. Acupuncture falls within this realm.

Originating in China, acupuncture is one of the oldest medical practices in the world, having been used for thousands of years. It involves the insertion of thin needles to different depths through the skin at specific sites on the body. It’s use in Europe followed by North America dates back to the second half of the twentieth century.

According to traditional Chinese medicine, specific energy pathways or meridians connect acupuncture points. Stimulating specific points corrects the flow of this Qi energy which when disrupted, is thought to cause disease. Once realigned, health and balance are restored. Although not always based on scientific evidence, acupuncture is used to treat a variety of medical conditions - from pain to infertility from heartburn to Parkinson’s disease. But does it work?

When looking for scientific evidence, studies have to be well designed. The randomized controlled blinded trial is considered the “gold standard” in study design.  This design is based on randomly allocating eligible participants to one or the other treatment groups (one group may receive a placebo but doesn’t know, i.e. “blinded”).  After randomization, the groups are followed in exactly the same way.  This reduces the amount of bias in a study. In acupuncture trials, “blinding” a patient involves placing the needles in “sham” areas or points. Twostudies showed improved mobility in patients that received acupuncture compared to those that did not receive any intervention. However instudies that used sham procedures as a comparison to actual acupuncture failed to show improvement in the motor and non-motor symptoms of this disease. This suggests that there may in fact be a placebo effect.

Scalp acupuncture is a modern variation of the classic technique using different acupoints corresponding to various areas of the brain and is used to treat neurological disorders such as Parkinson’s in East Asian countries. A systematic review of studies comparing scalp acupuncture to conventional therapies (medications) showed promise but lacked rigorous scientific evidence. In other words we can’t be sure until more extensive studies are conducted.

There is also a practice where small amounts of bee venom are injected under the skin at an acupuncture point. It is theorized that perhaps it may enhance or prolong the effect of acupuncture points, may somehow reduce the inflammation that is present or may in fact be similar to botulinum toxin, temporarily paralyzing the muscle spasm that commonly exists in Parkinson’s. A small study in 2014 compared acupuncture, bee venom acupuncture and conventional medication alone in a group of Parkinson’s patients. There was a noticeable improvement in measurement scales such as the Unified Parkinson’s Disease Rating Scale (UPDRS) for both acupuncture groups, particularly the bee venom group. But the results were limited by the small sample size and not a blinded protocol. The results do support the need for further study into its effectiveness.

So is acupuncture effective in Parkinson’s disease? Bottom line is that there have been studies supporting its use but not enough scientific evidence to definitively recommend it as a proven treatment for Parkinson’s symptoms. Larger, well-designed studies need to be conducted. However there were no major side effects reported and if undergoing acupuncture gives you personal relief, then there does not appear to be any harm in continuing with it.