Acupuncture for Stroke Recovery

If you or someone you know has had a stroke, you may be well aware that the road to recovery after treatment can be long and often frustrating. Rehabilitation begins as early as possible, often during the initial hospital stay, and may include rehabilitation nursing, physical and occupational therapy, speech therapy, and social work.

Older woman having acupuncture performed on her
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In addition to standard rehabilitation, some people turn to acupuncture, a type of needle-based alternative therapy long used in traditional Chinese medicine. As many as 46% of stroke survivors turn to complementary and alternative medicine to help alleviate their complications, with acupuncture being a common choice.

During an acupuncture treatment, the practitioner inserts fine needles into specific points on the body. The therapy is said to ease pain, improve quality of life and emotional well-being, and possibly help with activities of daily living such as walking or self-care.

Acupuncture and Stroke Recovery

While some studies suggest that acupuncture may benefit people who have had a stroke, there haven’t been enough well-designed, large-scale clinical trials to reach a conclusion.

A research review published in the Cochrane Database of Systematic Reviews in 2016 sized up 31 studies (with a total of 2257 participants) on acupuncture for stroke rehabilitation. According to the study's authors, acupuncture may have effects on improving dependency, global neurological deficiency, and some specific neurological impairments for people with stroke. The authors cautioned, however, that most of the studies in their analysis did not have adequate quality or size, making it difficult to draw conclusions.

In a research review published in Acupuncture in Medicine in 2015, scientists examined previously published clinical trials comparing acupuncture and rehabilitation therapy to rehabilitation alone in people who were three months or less post-stroke. In their conclusion, the authors state that acupuncture with rehabilitation may have benefits over rehabilitation alone.

Findings from a few studies suggest that acupuncture may have specific benefits during stroke rehabilitation:

Swallowing Difficulties After Stroke

After a stroke, some people have difficulty swallowing (a condition known as dysphagia) which makes eating and drinking challenging and can result in choking and aspiration. For a report published in the Cochrane Database of Systemic Reviews in 2012, researchers sized up 33 previously published studies (with a total of 6779 participants) comparing different treatments for dysphagia in people who had a stroke within six months of enrolling in the study. In their review, the report authors found evidence that acupuncture reduced dysphagia.

Spasticity

Some people have muscle stiffness and involuntary contraction (known as spasticity) after a stroke, which can make performing daily activities difficult. A report published in the Archives of Physical Medicine and Rehabilitation in 2017 analyzed 22 previously published trials of electroacupuncture use on stroke-related spasticity. The report's authors found that electroacupuncture within the six months post-stroke combined with conventional care may help to reduce spasticity in the upper and lower limbs.

An earlier report (published in the Journal of Alternative and Complementary Medicine), however, concluded that the effectiveness of acupuncture on spasticity after stroke was uncertain due to the poor quality of available research. The authors recommend larger, well-designed studies.

Guidelines for Acupuncture in Post-stroke Recovery

In joint guidelines, the American Heart Association and American Stroke Association recognize acupuncture as a potentially beneficial adjuvant (add-on) therapy for certain post-stroke complications, including dysphasia and shoulder pain. The groups note the evidence isn't sufficient to recommend acupuncture for improving walking ability or motor function, and specifically recommend against the use of acupuncture in helping improve ability to perform activities of daily living and upper extremity activity.

Side Effects and Adverse Reactions

When using acupuncture for stroke rehabilitation, it's important to work with a qualified medical acupuncturist who has experience with stroke recovery therapy. Only sterile, single-use acupuncture needles should be used.

While the risks are generally considered low if acupuncture is done by a competent, licensed acupuncturist, possible side effects can include pain, soreness, swelling, bruising, or bleeding at the needle location, as well as fainting, organ injury, hematomahemiplegia, and infections.

Acupuncture was considered "relatively safe" according to one review on acupuncture for stroke, however, another research review found that adverse events following acupuncture included pneumothorax, fainting, cardiovascular injuries, and hemorrhage.

If you have a bleeding disorder, are taking blood thinners such as warfarin, have a pacemaker, are pregnant, or have a compromised immune system, you may not be a good candidate for acupuncture.

The Takeaway

Stroke rehabilitation is a lengthy and often complex process, which can make you feel dissatisfied with your recovery and seek additional therapies for help. While there isn't enough evidence from large-scale clinical trials to form a conclusion about acupuncture's effectiveness, for some people, it may help improve quality of life and have positive effects on concerns such as swallowing or spasticity.

If you're thinking of trying acupuncture, it's crucial that you consult your physician first. He or she may help you determine whether including it as part of your rehabilitation therapy may be beneficial and safe.

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