Sumio Hoka, M.D., Ph.D. (Japan)
Collateral Meridian Therapy Alleviates Intractable Pain and Disablity in CRPS
Patients
Sumio Hoka, M.D., Akifumi Kanai, M.D., Shan-Chi Ko, M.D., Asaha Suzuki, M.D.
Anesthesiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
Background: Complex regional pain syndrome (CRPS) is a perplexing and challenging disease to
treat. The validity of conventional pharmacologic therapies such as antidepressants and
interventional techniques as sympathetic blockade is variable. Recently, collateral meridian therapy
(CMT) has been reported to be effective on intractable pain in a CRPS patient (1). CMT is based on
using two-point acupressure maneuver at the control point and functional point. The technique can
effectively relieve acute injury-related pain as well as chronic pain and promptly restore physical
function. We, in this study, examined whether CMT, a novel method in alternative medicine, would
reduce pain and improve physical function in patients with CRPS.
Methods: Consecutive ten (two male and eight female) patients aged 15 to 75 years (mean age = 43
years) with CRPS, whose pain had not been changed for at least one month by conventional
therapies, were enrolled in this study. Inclusion criteria was the pain intensity of more than 40 mm
visual analogue scale (VAS) and the daily dose of oral drugs unchanged the last two weeks prior to
enrollment. CMT was performed by applying acupressure maneuvers on meridian points of the
extremities corresponding with the painful area. No needles and drugs were used for CMT. The pains
at rest or touch were assessed with VAS before and after the treatment. Physical function was
evaluated by behavioral changes in daily life two weeks after the treatment.
Results: Symptom onset of CRPS until the initiation of CMT ranged between 1 to 60 months. Two
patients, one with VAS 95 mm at the right leg and the other with VAS 70 mm at the left leg, could
not elicit any pain relief after CMT. In one patient with VAS 75 mm at the left leg, the effect of CMT
was transient and ceased only at several hours. In the other seven patients, however, CMT
significantly (p<0.001) attenuated VAS from 73 (23) mm (mean (SD)) to 19 (15) mm (p<0.001). VAS
of total ten patients was also significantly decreased from 75 (21) mm to 36 (32) mm (p<0.01).
Among the responded seven patients, three patients unable to walk before could become to walk just
after the treatment and even two weeks later. Physical functions of the seven patients significantly
improved. No adverse effects of CMT were observed, except for transient painful sensation during
acupressure applications.
Discussion: Our results have demonstrated that CMT provides a prompt analgesic effect on
persistent pain in CRPS patients with a few exceptions of un-responded patients. CMT is a novel
treatment technique developed by Dr. Ko for various pains including low back pain, shoulder pain,
and the other chronic pain. CMT consists of the idea that pain originates from the stagnation of life
flow and thus pains can be nullified by regulating the stagnation using acupressure maneuver on
corresponding meridians from the painful area. Our results suggest that CMT can be highly effective
on intractable pain in patients with CRPS, and that CMT can improve physical function in disabled
patients due to CRPS.