Acupuncture & Allergic Rhinitis
Globally, allergic rhinitis affects a considerable portion of the population, ranging from 10-30%. However, in certain countries, this prevalence can skyrocket to a staggering 54%. It is worth noting that allergic rhinitis does not discriminate based on age or gender, affecting individuals across the board, although it tends to be more prevalent in children.
Allergic rhinitis is divided into two categories: seasonal/intermittent and perennial/persistent. Seasonal triggers, such as pollen, tend to instigate episodes of allergic rhinitis during specific times of the year. On the other hand, persistent triggers, including animal hair and dust-mites, can cause year-round discomfort.
When allergic rhinitis strikes, it brings about a host of unpleasant symptoms, including
sneezing,
a runny nose,
itchiness in the nasal area (and occasionally the eyes), and
nasal congestion that can interfere with sleep, result in fatigue, and hinder concentration.
The negative impact of allergic rhinitis extends beyond these immediate symptoms, greatly affecting an individual's quality of life and work performance. In fact, the resulting decrease in productivity can lead to financial losses amounting to billions of dollars annually.
Furthermore, it is not uncommon for individuals with allergic rhinitis to also suffer from other allergic conditions, such as asthma and skin rashes. This correlation can be attributed to the interconnectedness between the nose, lungs, and skin, an observation uncovered in the Yellow Emperor's Classic of Internal Medicine more than two millennia ago. From a biomedical standpoint, this correlation can be attributed to the fact that all three areas are lined with some form of epithelial tissue.
Acupuncture for the Treatment of Allergic Rhinits
According to the most up to date evidence, acupuncture is an effective treatment for allergic rhinitis. Studies also suggest that acupuncture is safer than current commonly-used medications and may be more cost-effective.
In 2017, the Acupuncture Evidence Project was published to provide a comprehensive update on the clinical and scientific evidence for the effectiveness of acupuncture. The project, co-authored by Dr. John McDonald, PhD, and Dr. Stephen Janz, included two systematic reviews, two high-quality randomized controlled trials, a clinical practice guideline, and two cost-effectiveness studies. The evidence overwhelmingly supported the use of acupuncture for allergic rhinitis, with symptoms like sneezing, itchy nose, itchy eyes, runny nose, blocked nose, and interrupted sleep showing significant improvement. Even studies conducted after the project's publication consistently found that real acupuncture was more effective than sham acupuncture and medication. These studies also revealed that the positive effects of acupuncture continued for up to three months after treatment, and some even showed reductions in inflammatory mediators like substance P, vasoactive intestinal peptide, interleukin 4, and dust-mite specific IgE. Consequently, the Otolaryngology Head Neck Surgery Foundation in the US included acupuncture as a recommended non-pharmacological treatment option in their clinical practice guideline for allergic rhinitis.
Acupuncture for Allergic Rhinits
Acupuncture can help reduce the symptoms of allergic rhinitis and improve people's ability to tolerate potential allergens. Allergic rhinitis occurs when the immune system mistakenly identifies harmless irritants as threats, creating antibodies called IgEs in response to each perceived allergen. These antibodies attach to mast cells, which, when encountered with an allergen like pollen, release substances that cause inflammation in the nasal lining.
When the lining of the nose swells up, the nerves in the lining also release certain substances that cause inflammation. These substances make the nose itchy, cause sneezing, make the nose runny, and block the nose. The nose becomes overly sensitive and reacts to things like perfume, smoke, and changes in temperature or humidity, in addition to allergens.
The allergic inflammatory response involves many interactions between receptors and mediators. The main receptors involved in allergic rhinitis are the histamine receptor and another receptor called the transient receptor potential vanilloid 1 (TRPV1). Itchy nose and eyes, sneezing, and a runny nose are closely related to the activation of TRPV1. Acupuncture has been shown to decrease levels of IgE and the expression, sensitivity, and activation of TRPV1 through various pathways. Acupuncture has also been shown to reduce substance P (SP) by 77.8% within the first 24 hours after the initial treatment, as well as vasoactive intestinal peptide (VIP) in allergic rhinitis and calcitonin gene-related peptide (CGRP) in migraines.
Conventional Treatment
The conventional treatment of allergic rhinitis involves avoidance of triggers, oral medications, nasal sprays and allergen immunotherapy. Pollen-sensitive people can take several steps to reduce their exposure to pollen. They can remove plants from their gardens that produce pollen, wear surgical masks when they expect to be around pollen, or even consider moving to a different location where there is less pollen. To reduce dust, they can use covers on their mattresses and pillows that reduce allergens and get rid of carpets and curtains in their homes and workplaces. If pets trigger allergic reactions, they may need to be kept out of the bedroom or, in extreme cases, given to another home. Avoiding triggers can help manage symptoms, but it's not always feasible or practical.
Medication
The most common forms of medication used to treat allergies include over-the-counter antihistamines and decongestants, as well as oral steroids and mast-cell stabilizers prescribed by a doctor. These medications can be combined with corticosteroid nasal sprays for temporary relief of symptoms. Allergen immunotherapy (AIT) is another treatment option. It usually involves a series of injections under the skin over an extended period of time. However, sublingual AIT, which involves placing a tablet under the tongue, is also becoming available. Unlike medications that only provide temporary relief, AIT is considered the only treatment that can change the course of the disease.
Conclusion
Recent research indicates that acupuncture is a good and reasonably safe treatment choice. It can provide temporary relief from symptoms and also has long-lasting benefits for up to three months after the treatment. Real acupuncture has been found to be more effective than fake acupuncture and oral medication commonly used. If you prefer a non-medicine approach, acupuncture is recommended for treating allergic rhinitis.
About the Author:
Riccardo Galeotti (BHSc.Acu, Lic Acu.) is a rehabilitative acupuncturist and the founder of The Body Lab. He is a passionate, nationally qualified and registered acupuncturist, with special interests in women’s health, hormonal issues, digestive health, biomechanics and movement-based exercises to eliminate pain. . Learn more about Riccardo here.
References:Li W, Zhong, G.W., Qi, M., Liu, W.P., Wang, S., Wen, L.B. et al. Acupuncture treatment of migraine and plasma CGRP and SP content changes. World Journal of Acupuncture-Moxibustion. 2001;11(3):11-4Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A, et al. Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America. Clinical and experimental allergy: Journal of the British Society for Allergy and Clinical Immunology. 2012;42(2):186-207.Chen Y, Jin X, Yu M, Qiu H, Fang Y, Zhang S, et al. [Efficacy of acupuncture on moderate and severe allergic rhinitis]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2015;35(4):339-43.Dykewicz MS, Hamilos DL. Rhinitis and sinusitis. The Journal of allergy and clinical immunology. 2010;125(2 Suppl 2):S103-15.Chen S, Wang J, Bai P, Zhao Q, Tan C, Wang B, et al. [Moderate and severe persistent allergic rhinitis treated with acupuncture: a randomized controlled trial]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2015;35(12):1209-13.Reinhold T, Brinkhaus B, Willich SN, Witt C. Acupuncture in patients suffering from allergic asthma: is it worth additional costs? J Altern Complement Med. 2014;20(3):169-77.Kim SY, Lee H, Chae Y, Park HJ. A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture. Acupuncture in medicine: Journal of the British Medical Acupuncture Society. 2012;30(4):273-85.Feng S, Han M, Fan Y, Yang G, Liao Z, Liao W, et al. Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. American journal of rhinology & allergy. 2015;29(1):57-62.Taw MB, Reddy WD, Omole FS, Seidman MD. Acupuncture and allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg. 2015;23(3):216-20.Xue CC, Zhang AL, Zhang CS, DaCosta C, Story DF, Thien FC. Acupuncture for seasonal allergic rhinitis: a randomized controlled trial. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 2015;115(4):317-24.e1.Choi SM, Park JE, Li SS, Jung H, Zi M, Kim TH, et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013;68(3):365-74.Rao YQ, Han NY. [Therapeutic effect of acupuncture on allergic rhinitis and its effects on immunologic function]. Zhongguo zhen jiu = Chinese acupuncture & moxibustion. 2006;26(8):557-60Xue CC, English R, Zhang JJ, Da Costa C, Li CG. Effect of acupuncture in the treatment of seasonal allergic rhinitis: a randomized controlled clinical trial. Am J Chin Med. 2002;30(1):1-11.Ng DK, Chow PY, Ming SP, Hong SH, Lau S, Tse D, et al. A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics. 2004;114(5):1242-7.Xue CC, An X, Cheung TP, Da Costa C, Lenon GB, Thien FC, et al. Acupuncture for persistent allergic rhinitis: a randomised, sham-controlled trial. Med J Aust. 2007;187(6):337-41.Brinkhaus B, Witt CM, Jena S, Liecker B, Wegscheider K, Willich SN. Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology. 2008;101(5):535-43.Li YM, Zhuang LX, Lai XS, Jiang GH. [Effects of electroacupuncture on plasma vasoactive intestinal peptide and substance P in perennial allergic rhinitis patients]. Zhen ci yan jiu = Acupuncture research / [Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 2007;32(2):136-8.Brinkhaus B, Ortiz M, Witt CM, Roll S, Linde K, Pfab F, et al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Annals of internal medicine. 2013;158(4):225-34.McDonald JL, Cripps AW, Smith PK. Mediators, Receptors, and Signalling Pathways in the Anti-Inflammatory and Antihyperalgesic Effects of Acupuncture. Evidence-based complementary and alternative medicine : eCAM. 2015;2015:975632.