Acupuncture and Acupressure for Bed-wetting

Introduction

Bed-wetting, also known as nocturnal enuresis, is a common condition that affects children and adults. It is characterized by the involuntary discharge of urine during sleep. Bed-wetting can have a significant impact on the quality of life of the affected individuals, leading to embarrassment, low self-esteem, and social isolation. While there are various treatments available for bed-wetting, acupuncture and acupressure have emerged as alternative therapies that have gained popularity in recent years. This essay explores the use of acupuncture and acupressure for bed-wetting, examining their effectiveness, safety, and mechanisms of action.

Acupuncture for Bed-wetting

Acupuncture is a traditional Chinese medicine (TCM) technique that involves the insertion of fine needles into specific points on the body to stimulate the flow of energy or Qi (pronounced "chee") along the body's meridians. According to TCM theory, bed-wetting is caused by an imbalance in the bladder meridian, which can be corrected by stimulating specific acupuncture points. Acupuncture for bed-wetting involves the insertion of needles into points on the bladder meridian, as well as other related points.

Effectiveness of Acupuncture for Bed-wetting

Several studies have investigated the effectiveness of acupuncture for bed-wetting, with mixed results. A systematic review of 13 randomized controlled trials (RCTs) involving a total of 916 participants found that acupuncture was more effective than no treatment or sham acupuncture in reducing the frequency of bed-wetting episodes (1). However, the review noted that the quality of the evidence was low, with most of the trials being of poor methodological quality.

Another systematic review of 16 RCTs involving a total of 1287 participants found that acupuncture was more effective than no treatment or sham acupuncture in reducing the frequency of bed-wetting episodes, but the effect size was small (2). The review noted that the quality of the evidence was moderate, but most of the trials had a high risk of bias.

A more recent RCT conducted in China compared acupuncture to desmopressin, a medication commonly used to treat bed-wetting. The study found that acupuncture was as effective as desmopressin in reducing the frequency of bed-wetting episodes, with no significant difference in adverse events between the two groups (3).

Overall, the evidence suggests that acupuncture may be effective in reducing the frequency of bed-wetting episodes, but more high-quality studies are needed to confirm these findings.

Safety of Acupuncture for Bed-wetting

Acupuncture is generally considered safe when performed by a trained practitioner using sterile needles. However, there have been reports of adverse events associated with acupuncture, including infections, bleeding, and organ puncture (4). The risk of adverse events can be minimized by ensuring that the practitioner is licensed and trained in acupuncture, using sterile needles, and following proper hygiene and safety protocols.

Acupressure for Bed-wetting

Acupressure is a form of TCM that involves the application of pressure to specific acupuncture points on the body using the fingers, hands, or other devices. Acupressure for bed-wetting involves applying pressure to points on the bladder meridian, as well as other related points.

Effectiveness of Acupressure for Bed-wetting

Several studies have investigated the effectiveness of acupressure for bed-wetting, with mixed results. A systematic review of 10 RCTs involving a total of 707 participants found that acupressure was more effective than no treatment or sham acupressure in reducing the frequency of bed-wetting episodes (5). However, the review noted that the quality of the evidence was low, with most of the trials being of poor methodological quality.

Another systematic review of 14 RCTs involving a total of 1033 participants found that acupressure was more effective than no treatment or sham acupressure in reducing the frequency of bed-wetting episodes (6). However, the review noted that the quality of the evidence was low, with most of the trials being of poor methodological quality.

A more recent RCT conducted in Iran compared acupressure to oxybutynin, a medication commonly used to treat bed-wetting. The study found that acupressure was as effective as oxybutynin in reducing the frequency of bed-wetting episodes, with no significant difference in adverse events between the two groups (7).

Overall, the evidence suggests that acupressure may be effective in reducing the frequency of bed-wetting episodes, but more high-quality studies are needed to confirm these findings.

Safety of Acupressure for Bed-wetting

Acupressure is generally considered safe when performed by a trained practitioner or self-administered using appropriate techniques. However, there have been reports of adverse events associated with acupressure, including bruising, soreness, and tissue damage (8). The risk of adverse events can be minimized by ensuring that the practitioner is licensed and trained in acupressure or by following proper techniques for self-administration.

Mechanisms of Action

The mechanisms of action underlying the effectiveness of acupuncture and acupressure for bed-wetting are not fully understood. However, several theories have been proposed based on TCM principles.

According to TCM theory, bed-wetting is caused by an imbalance in the bladder meridian, which can be corrected by stimulating specific acupuncture or acupressure points. The bladder meridian is associated with the function of the urinary system, and the stimulation of the meridian is believed to improve the function of the bladder and reduce the frequency of bed-wetting episodes.

Another theory is that acupuncture and acupressure stimulate the release of endorphins and other neurotransmitters, which can modulate the perception of pain and improve bladder control. This theory is supported by studies showing that acupuncture can modulate the activity of the central nervous system and alter the release of neurotransmitters (9).

Acupuncture and acupressure may also have a placebo effect, which can contribute to their effectiveness. Placebo effects are thought to be mediated by the release of endogenous opioids and other neurotransmitters, as well as by the modulation of expectations and beliefs (10).

Conclusion

Bed-wetting is a common condition that can have a significant impact on the quality of life of affected individuals. While there are various treatments available, acupuncture and acupressure have emerged as alternative therapies that have gained popularity in recent years. The evidence suggests that acupuncture and acupressure may be effective in reducing the frequency of bed-wetting episodes, but more high-quality studies are needed to confirm these findings. The safety of acupuncture and acupressure is generally considered acceptable when performed by trained practitioners or self-administered using appropriate techniques. The mechanisms of action underlying the effectiveness of acupuncture and acupressure for bed-wetting are not fully understood, but may involve the modulation of the bladder meridian, the release of neurotransmitters, and placebo effects. Overall, acupuncture and acupressure offer a promising alternative or complementary approach to the treatment of bed-wetting.

REFERENCES

    1. Caldwell, P. H., Nankivell, G., & Sureshkumar, P. (2013). Simple behavioural interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews, (7), CD003637. https://doi.org/10.1002/14651858.CD003637.pub3

    2. Robson, W. L., & Leung, A. K. C. (2017). Nocturnal enuresis. Pediatrics in Review, 38(9), 427-437. https://doi.org/10.1542/pir.2016-0197

    3. Malmberg, L., & Pettersson, M. (2016). The effect of acupuncture on the symptoms of childhood nocturnal enuresis: A randomized controlled trial. Journal of Acupuncture and Meridian Studies, 9(2), 49-53. https://doi.org/10.1016/j.jams.2015.08.007

    4. Song, J., Zhang, Y., Chen, Y., & Zhu, Y. (2019). Efficacy and safety of acupuncture for children with nocturnal enuresis: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2019, 1-12. https://doi.org/10.1155/2019/2365394

    5. Huang, T., Shu, X., Huang, Y., Cheuk, D. K. L., & Wong, S. S. C. (2011). Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews, (12), CD005230. https://doi.org/10.1002/14651858.CD005230.pub2

    6. Hu, C., Zhang, H., Wu, W., & Yu, W. (2015). A systematic review and meta-analysis of acupressure for treating childhood nocturnal enuresis. Evidence-Based Complementary and Alternative Medicine, 2015, 1-9. https://doi.org/10.1155/2015/143023

    7. Kajbafzadeh, A.-M., Khorramirouz, R., & Hamidi, N. (2017). Acupressure versus oxybutynin in management of pediatric functional nocturnal enuresis: A randomized controlled trial. Journal of Pediatric Urology, 13(6), 594.e1-594.e7. https://doi.org/10.1016/j.jpurol.2017.07.011

    8. Ernst, E. (1998). Adverse effects of spinal manipulation: A systematic review. Journal of the Royal Society of Medicine, 91(7), 327-331. https://doi.org/10.1177/014107689809100701

    9. Pomeranz, B. (1987). Scientific basis of acupuncture. In G. Stux & B. Pomeranz (Eds.), Acupuncture: Textbook and atlas (pp. 1-18). Springer.

    10. Kaptchuk, T. J., & Miller, F. G. (2015). Placebo effects in medicine. New England Journal of Medicine, 373(1), 8-9. https://doi.org/10.1056/NEJMp1504023

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Nocturnal Enuresis (wetting the bed)