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Therapies

acupressure

What Is It?
How Does It Work?
What You Can Expect
Health Benefits

How To Choose a Practitioner
Cautions
References

Evidence Based Rating Scale

 

What Is It?

Acupressure is a type of Bodywork that involves pressing specific points on the body with the fingers, knuckles, and palms (and sometimes the elbows and feet) to relieve pain, reduce stress, and promote general good health. Developed in China some 5,000 years ago, perhaps out of the natural human instinct to hold or rub a place on the body that hurts, acupressure is part of the holistic system of Traditional Chinese Medicine (TCM) that also includes acupuncture. (Interestingly, the use of acupressure predates acupuncture by some 2,500 years.)

In the United States, acupressure is used primarily to relieve pain, reduce stress, and improve overall well-being. In China, the technique is used more like first-aid: The Chinese typically practice it on themselves or on family members to treat everyday ailments such as colds, headaches, sore muscles, and hangovers. Specialists are consulted for problems that are more complicated.

While many people prefer to go to a trained therapist to get acupressure treatments, the techniques, once learned, can be performed on oneself or by a friend.

How Does It Work?

Traditional Chinese medicine views health as the constantly changing flow of vital energy, or qi (pronounced "chee") throughout the body. If that flow is hindered, sickness may develop. The goal of acupressure (and acupuncture) is to release blocked energy by stimulating specific points--called acupoints--along the body's fourteen primary Meridians, or energy channels. It is suggested that pressing firmly and steadily on the proper acupoints,  can promote energy flow to a part of the body that is experiencing disease or discomfort, enabling it to heal itself more readily. While acupuncture involves stimulation with needles, acupressure typically uses only the practitioner's hands to restore the balance of qi.

Although Western science has yet to confirm the anatomical locations of meridians in the body, studies do suggest that pressing on acupoints can release endorphins, the body's natural painkillers.

What You Can Expect

During a treatment, which can last anywhere from fifteen minutes to nearly an hour depending on the severity of the problem, an acupressure therapist may ask patients to sit or lie on a massage table or on the floor with cushions. Some acupressure therapists will work through clothing; others will ask the patient to disrobe and will cover them with a towel or sheet.

The therapist will then locate and work on the specific acupoints that relate to the condition being treated. Pressing a point behind the knee, for example, can help address low back pain. Or pressing a point on the top of the foot may help to ease the pain of migraine.

Typically, the therapist will press each point for about three to ten seconds (longer in some cases). If the problem doesn't respond after about twenty to thirty minutes of treatment, acupressure may not be effective for the patient on that particular day, or for that particular ailment.

After a treatment, a patient will probably feel looser and more relaxed. Some slight achiness may be felt, but patients should not be in pain. Within three to eight visits, a patient should know whether the treatment is working for the ailment. Stress management usually requires a series of about six regular (weekly or monthly) treatments.

There are many different types of acupressure, and each practitioner may draw from a variety of methods. One of the most popular is shiatsu, a Japanese technique based on ancient Chinese principles. Practitioners of Zen shiatsu use their whole bodies as leverage to apply strong pressure. Barefoot shiatsu practitioners bring the feet into play, as well as the hands and elbows, to rub and press acupressure points. In the Chinese acupressure variation known as Tui Na, practitioners use their hands for massage-like kneading motions. Reflexology is a type of acupressure that involves pressure points on the feet and sometimes the hands.

Even if patients prefer to do acupressure on their own bodies, they may wish to see an acupressure practitioner for a visit or two first, particularly when addressing a chronic or complex medical problem. These visits can help determine where the particular acupoints are on the body.

Health Benefits

Many people have reported success using acupressure to relieve pain, reduce muscle tension, and promote relaxation. A number have found the therapy especially helpful for easing back pain and for certain types of headaches, including migraine. Post-operative pain and nausea has been found to respond to pressure point massage. Chronic sinusitis sufferers have also found it useful for easing congestion. Although research results are mixed, acupressure is also commonly used for morning sickness, motion sickness, and other types of nausea. Some people find that treatments improve their overall vitality and well-being.

Specifically, acupressure may help to:

Ease chronic back pain. Preliminary studies have shown that acupressure may be effective in reducing pain and improving mobility in patients with chronic lower back pain. In a preliminary study in 2001, participants reported significant decreases in pain and anxiety within two days after treatment with shiatsu. (1) In a 2004 study of 146 participants with chronic lower back pain, treatment with acupressure for one month was more effective than physical therapy in reducing pain and disability; and the benefits of acupressure were sustained for six months. (2) In 2006, a similar randomized, controlled trial of 129 participants with lower back pain showed that treatment with acupressure for one month was more effective than physical therapy in reducing pain and disability and improving functional status; and the benefits of acupressure were sustained for six months. (3)

Eliminate headache pain. Preliminary studies have shown that acupressure can be useful as an adjunct treatment in between acupuncture treatments for chronic headache, including migraine. In an early, large-scale, two-year study of 500 patients being treated with acupuncture for migraine and tension headaches, outpatient use of self-applied acupressure between acupuncture sessions replaced the need for prescription medicines. (4) However, few studies have examined the use of acupressure since this early study in 1976. In a 2010 randomized, controlled trial of 28 patients with chronic headache, one month of acupressure treatment was more effective in reducing chronic headache than one month of conventional muscle relaxant medication; and the beneficial effects of acupressure lasted six months after treatment. (5) More research is needed.

Reduce pain during menstruation. Some preliminary evidence indicates that acupressure may help to reduce the severity of dysmenorrhea (menstrual cramps). A 2003 review of studies involving acupuncture and acupressure for the treatment of gynecological conditions found acupressure to be promising in the treatment of dysmenorrhea, or painful cramping during menstruation. (6) A 2007 study of 58 young college women with dysmenorrhea showed that acupressure applied within eight hours of the onset of menstruation significantly reduces the severity of dysmenorrhea immediately after treatment and for up to 12 hours after treatment. (7) In a 2010 study of 40 patients with dysmenorrhea, 20-minutes of treatment with acupressure twice daily from the first to third days of the menstrual cycle led to significant reductions in pain immediately after the 20 minutes of acupressure compared to a control group. Treatment during the three subsequent menstrual cycles effectively relieved pain and menstrual distress in these patients. (8) In a single-blind study of 194 students with dysmenorrhea who received acupressure five days before menstruation for three months either at the Taichong or a placebo point, acupressure on the Taichong point led to a significant decrease in pain by the end of the fourth cycle. (9) In a 2011 meta-analysis of studies involving the use of various forms of acupuncture to treat dysmenorrhea, four trials involving acupressure on 271 patients found that acupressure improved quality of life and reduced pain and menstrual symptoms compared to placebo control. (10) Larger studies are needed.

Clear sinus congestion. Practitioners often use acupressure to treat patients with chronic sinus and nasal symptoms. Several acupoints can be used to help ease sinuses, including the spleen meridian, which can clear a "dampness" creating inflammation and congestion in the mucus membranes. (11) However, research is limited.

Reduce nausea and vomiting. Some acupoints can be addressed to relax the gastrointestinal tract and ease nausea and vomiting. Special spots on the back of the jawbone, the webbing between the thumb and index finger, the top of the foot, the inside of the wrist and the base of the rib cage are pressed to treat nausea and vomiting resulting from pregnancy, chemotherapy or surgery. Preliminary clinical evidence shows that passive acupressure using wristbands (Sea-Band) that hold pressure on the P6 acupuncture point significantly reduce postoperative nausea and vomiting compared to control in patients undergoing gynecological procedures. (12)

Some evidence shows that using the wristbands significantly reduces nausea from motion sickness (27) and from chemotherapy-induced nausea and vomiting compared to usual care in women undergoing chemotherapy for breast cancer. A 2007 randomized, controlled trial found that wearing the wristband for five days after chemotherapy significantly reduced nausea and vomiting compared to a control group. (13) However, in another study in breast cancer patients undergoing chemotherapy, wristband acupressure did not significantly reduce acute nausea and vomiting but did reduce delayed nausea and vomiting. (14) In other evidence, a combination of acupressure and acupuncture did not significantly decrease nausea and vomiting in patients undergoing a form of chemotherapy known to be more highly nausea producing. (15)

Early studies demonstrated superior relief from pregnancy related nausea and vomiting with acupressure compared to placebo. (28) However, a 2007 study in pregnant volunteers with mild to moderate nausea and vomiting during the first trimester showed that using the acupressure wrist bands was not as effective in reducing nausea and vomiting as vitamin B6. (16)

Relieve chronic pain. Some studies have shown that acupuncture and acupressure can prompt the release of pain-relieving opioid and monoamine agents, such as endorphins and serotonin. (17, 18) These beneficial effects may be useful in treating chronic pain conditions such as fibromyalgia, osteoarthritis and general muscle aches and pains. However, research is limited. In a 2007 study of 85 patients with chronic fatigue syndrome (CFS), when combined with massage, acupressure treatment on Back-shu points and acupoints on the head led to an improvement in symptoms such as painful muscle aches in 91.8% of patients. (19) More research is needed.

Improve sleep. Acupressure has been shown to improve sleep quality in patients with insomnia. In a 1999 study of 84 elderly residents in an assisted-living facility, those who received acupressure to the head, neck, and hands felt better, had improved appetites, and awoke fewer times during the night compared with controls who got "sham" body treatments. (20) In a 2005 study of 40 elderly Korean patients with insomnia, those who received acupressure to the ear five times daily for three days felt better and had significantly higher sleep scores than those in a control group. (21) However, a 2007 Cochrane Database review of studies involving several forms of acupuncture, including acupressure, found inconclusive results regarding treatment for insomnia. While small studies showed that acupressure may help to improve sleep quality scores when compared to placebo or to no treatment, the review indicates that the small number of randomized, controlled trials coupled with the poor methodological quality of the studies led to insufficient support to rate any form of acupuncture for insomnia. (22) A small study in 2008 showed improvement in quality of sleep in 60% of patients (15/25) with sleep disorders and 79% (11/14) of cancer patients with insomnia after two consecutive weeks of acupressure treatment on the wrists (with a medical device called H7 Insomnia Control.) (23) A 2010 randomized, controlled study of 50 long-term care residents with insomnia found that acupressure treatment on the HT7 points of both wrists for five weeks led to improved sleep scores during the treatment period and for up to two weeks following treatment. (24) In a 2011 study of 45 women with postmenopausal insomnia, acupressure treatment on five auricular points every night before going to sleep for four weeks improved total sleep duration and sleep efficiency, and sleep latency (the time it takes to fall asleep) was shortened significantly. The study found that acupressure treatment led to more cardiac parasympathetic activity (the part of the autonomic nervous system responsible for regulating the "rest-and-digest" activities of the body during sleep) and less cardiac sympathetic activity (which activates the body's fight-or-flight response under stress). (25)

Treat glaucoma. Preliminary evidence indicates that acupressure may be beneficial as a complementary treatment to relieve intraocular pressure and improve vision in patients with glaucoma. In a 2010 prospective study of 33 patients, acupressure treatment twice daily for four weeks led to significant improvement in intraocular pressure and vision after treatment and at an eight-week follow-up point compared to a "sham" control group. The most significant improvements were noted three to four weeks after treatment began. (26)

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Date Published: 04/19/2005
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