Philip Niño Tan-Gatue
The Achilles Heel
Ever since I personally got involved in sports medicine, I’ve been getting questions about acupuncture for Achilles Tendinitis. While the mechanisms for acupuncture treatment in muscle spasms has long been theorized, the question is asked – what about tendons?
Soon-to-be-published research by Zhang et al may help shed some light on the subject.
Acupuncture for chronic achilles tendnopathy: A randomized controlled study. (http://www.ncbi.nlm.nih.gov/pubmed/23263998)
The sample size is a bit small – only 64 patients aged 18-70. However, I very much like the standards for control vs experimental treatment and the evaluation methods used.
These patients were randomly allocated into an acupuncture treatment group (acupuncture group) and an eccentric exercises group (control group). The validated Victorian Institute of Sports Assessment- Achilles (VISA-A) questionnaire was completed at baseline and 8, 16, and 24 weeks. The pain at rest and after activity was accessed at baseline and 8 weeks with Visual Analogue Scale (VAS).
It’s not the most objective way to measure pain, but at least it’s validated.
After randomization into the acupuncture group or control group, one patient was loss of follow-up. The mean VISA-A score improved significantly after 8 weeks in the acupuncture group to 67.1 points [95% confidence interval (CI), 64.1-70.2] and in the control group to 48.5 points (95% CI, 45.5-51.6) with an additional 18.6 points increase in acupuncture treatment patients (P =0.0000). Acupuncture treatment resulted in a significant increase from baseline in VISA-A of 25.8 after 16 weeks and 28.4 after 24 weeks. Whereas, in the control group the increase from baseline in VISA-A were 10.0 and 16.6 after 16 and 24 weeks, respectively (P =0.0000). The VAS diminished by 2.0 cm after activity, and by 1.5 cm at rest after 8 weeks in the control group. In the acupuncture group, the pain scores diminished significantly more than in the control group, with pain reduction of 3.7 cm after activity (P =0.0000) and 3.2 cm at rest (P =0.0000).
For laymen: by significantly we mean statistically significant. This research shows that acupuncture may have a role in the management of achilles tendinitis. I hope to get a copy of this article as the following questions bug me: how is chronicity defined, and what points and techniques were specifically used.
Original study: Zhang et al. Acupuncture for chronic achillies tendinopathy: A randomized controlled study. Chin J Integr Med. 2012 Dec 21.