Urolithiasis (stones in the urinary tract) is a common medical problem with a prevalence of around 2–3% in the general population.(Srisubat 2009) Fifty per cent of patients with previous urinary stones have a recurrence within 10 years (Portis 2001 ), and they are at least twice as common in men as in women.(Pearle 2007)
Kidney stones are small, hard deposits of mineral and acid salts that separate out from urine in the urinary tract. They can vary in size and location. While small stones can pass through the urinary system without causing symptoms, larger stones can cause serious morbidity, pain, haematuria, infection, decreased kidney function and kidney failure can cause severe pain. This pain typically starts in the side or back and radiates to lower abdomen and groin. The mechanisms of kidney stone formation are complex and involve both metabolic and environmental risk factors (Satyanand 2012).
About 10–15% of the adult western population have gallstones and they are more common in women (NIH 1992; Halldestam 2004). The annual incidence of gallstones is about 1 in 200 people (NIH 1992), but only 1% to 4% of people with gallstones become symptomatic in a year (NIH 1992; Halldestam 2004). Symptoms include pain and jaundice, and complications such as pancreatitis, cholangitis, and cholecystitis.
Conventional treatment for kidney stones includes extracorporeal shockwave lithotripsy, drugs and dietary measures, and surgery. Gallstones are usually treated with ‘watchful waiting’ if they are asymptomatic, with painkillers if symptoms are mild and intermittent, and surgically (laparoscopic or open cholecystectomy) if there are symptoms.
Halldestam I et al. Development of symptoms and complications in individuals with asymptomatic gallstones. The British Journal of Surgery 2004; 91: 734–8.
NIH consensus statement on gallstones and laparoscopic cholecystectomy. National Institutes of Health Consensus Development Conference Statement September 14-16, 1992. Available:http://consensus.nih.gov/1992/1992GallstonesLaparoscopy090html.htm
Pearle MS, Lotan Y. Urinary lithiasis: etiology, epidemiology, and pathogenesis. In: Campbell MF, Wein AJ, Kavoussi LR editor(s).Campbell-Walsh Urology. 9th Edition. Philadelphia: Saunders Elsevier, 2007.
Portis AJ, Sundaram CP. Diagnosis and initial management of kidney stones. American Family Physician 2001;63(7):1329-38.
Satyanand T et al. Review on kidney stones. J Biomed Pharm Res 2012; 1; 6-9.
Srisubat A et al. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD007044. DOI: 10.1002/14651858.CD007044.pub2.
How acupuncture can help
This factsheet focuses on the evidence for acupuncture for kidney stones and gallstones.
Most of the randomised controlled trials (RCTs) in this area relate to acupuncture used as an adjunct to lithotripsy, and there is evidence that it may reduce anxiety and sedative/analgesic drug requirements (Miyaoka 2009). It was found to provide more effective analgesia than pethidine and diazepam in one trial (Hodzic 2007) and to be at least as good as midazolam in another (Resim 2005). Likewise, acupuncture may be a useful addition for cholecystectomy (Gu 2010).
However, the extent to which it can benefit people with kidney or gall stones outside of assisting with these biomedical procedures has scarcely been addressed in the research literature. One controlled study showed a significant advantage for electroacupuncture over medication for stones in the upper urinary tract (Lin 2005). Others have found it to be beneficial when compared to Chinese herbal medicine (Song 2006; Xuemei 2006).In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.
Research has shown that acupuncture treatment may specifically help in the management of kidney stones and gallstones by:
- Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
- Increasing the release of adenosine, which has antinociceptive properties (Goldman 2010);
- Improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling;
- Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007);
- Increasing the distribution of cholecystokinin – and vasoactive intestinal peptide -containing cells in duodenum and the sphincter of Oddi, thus improving biliary tract motility (Kuo 2005).