By Diana Alejandra Pinzón.

In the wide world of alternative and complementary therapies, ancient practices of oriental medicine such as shiatsu, acupressure and acupuncture stand out. Shiatsu is a Japanese massage technique that translates as “finger pressure” 01. But in China it is known as acupressure. The method consists of applying pressure with the hands, thumbs, fingers, forearms, knees and feet by incorporating stretches and using body weight at specific points called tsubos or in broader channels called meridians. The goal is to restore the flow of energy (ki or chi) whose circulation must be free of obstacles to maintain health in the body in the receiver body.

According to Eastern medicine, channels, also known as meridians, serve as interconnected pathways for the flow of Ki or energy, weaving a complex network with energy and the different organs of the person’s body; In total there are 12 direct channels with bilateral correspondence and 2 secondary ones that are central. 02. Currently these energy pathways lack a solid scientific basis from a biomedical point of view. However, the comparison of the path and function of the meridians with the new knowledge about the anatomy and physiology of the fascial system provided by Western medicine provides points of confluence and rapprochement between both aspects of knowledge. 03.

Specific points are located in the meridians, which are called tsubos, they act as entry and exit doors of the energy body. The exact location of these points makes it easier for the therapist to recognize when a person is in imbalance or energetic blockage and offer a treatment path to influence the physical, emotional and energetic well-being of the person receiving the therapy through different pressure techniques. as are the tonify and dispersion of ki.

On the other hand, in recent years Western medicine has shown greater openness towards the integration of ancient forms of treatment such as Shiatsu, acupressure and acupuncture in its therapeutic approach. Allowing research in clinical fields such as pain in people with cancer. Pain being an unpleasant sensation, such as stinging, tingling, stinging, burning or discomfort. The pain may be sharp or dull. It can be intermittent or constant. People may feel pain somewhere in your body, such as your back, or you may feel generalized pain. 04

Pain helps diagnose a health problem such as cancer and in some people this symptom is of great importance in treatment to obtain a better quality of life.

Research was recently conducted using the method of meta-analysis, which is a statistical technique that combines and summarizes the results of several individual studies. In clinical medicine, what it summarizes is the difference in effect between two medical interventions; generally, some recent and potentially useful treatment, compared to another treatment already proven and established in normal medical practice. By combining the studies there is a notable increase in the sample size, which leads to more easily obtaining a statistically significant and more precise final result. 05.

The research is titled:

‘Clinical evidence for the association of acupuncture and acupressure with improved pain for cancer.’

A systematic review and meta-analysis in the journal JAMA ONCOLOGY, published in February 2020.

The research included 17 randomized controlled trials from different countries like China, United States, Australia, Brazil, France and Korea. The sample included 1111 patients in the randomized controlled trials, of which 920 patients were included in the meta-analysis. The research highlighted the effectiveness of acupuncture and acupressure in reducing pain in cancer patients. The results showed that real acupuncture, compared with sham acupuncture, was associated with a significant decrease in pain intensity (mean difference [MD], -1.38 points; 95% CI, -2.13 to -0.64 points; I2 = 81%). Furthermore, the combination of acupuncture/acupressure with analgesic therapy showed a favorable association in reducing pain intensity and opioid dosage. “A total of 17 RCTs (with 1111 patients) were included in the systematic review, and data from 14 RCTs (with 920 patients) were used in the meta-analysis. Seven sham-controlled RCTs (35%) were notable for their high quality, being judged to have a low risk of bias for all of their domains, and showed that real (compared with sham) acupuncture was associated with reduced pain intensity (mean difference [MD], −1.38 points; 95% CI, −2.13 to −0.64 points; I² = 81%). A favourable association was also seen when acupuncture and acupressure were combined with analgesic therapy in 6 RCTs for reducing pain intensity (MD, −1.44 points; 95% CI, −1.98 to −0.89; I² = 92%) and in 2 RCTs for reducing opioid dose (MD, −30.00 mg morphine equivalent daily dose; 95% CI, −37.5 mg to −22.5 mg). The evidence grade was moderate because of the substantial heterogeneity among studies.”06.

This finding is especially relevant and positive in the management of pain in people with cancer. Since, in 2019, about 136 people died every day from an opioid overdose in the United States and accounted for more than 70% of drug overdose deaths. 07. Finding alternative and complementary therapies for pain management, such as acupuncture, acupressure and Shiatsu, is of utmost importance.

However, it is important to highlight that there was substantial heterogeneity among the included studies, meaning that there were significant differences between the trials in terms of design, study population, intervention and outcomes measured. This led to the quality of the evidence being rated as moderate, indicating that although the results are promising, more rigorous studies are needed to confirm and extend these findings.

In another research published in July 2023 in Medicine magazine titled ‘Massage therapy can effectively relieve cancer pain: a meta-analysis.’

Thirteen randomized controlled trials, containing 1000 patients (498 in the massage therapy group and 502 in the control group), were included in the meta-analysis. Massage therapy could significantly relieve cancer pain in patients (standardized mean difference = −1.16; 95% confidence interval [−1.39, −0.93], P < 0.00001), especially those in the perioperative period and those with hematological malignancies. Foot reflexology and hand acupressure had a moderate effect on cancer pain relief, with hand acupressure being more effective. A massage duration of 10 to 30 minutes and a program duration of ≥1 week had a better effect and could significantly relieve pain.

The conclusion of this research is that Massage therapy can be used as a complementary alternative therapy to relieve cancer pain in patients with hematological malignancies, breast cancer and cancers of the digestive system. It is suggested that chemotherapy patients use foot reflexology and that perioperative patients use manual acupressure. A massage duration of 10 to 30 minutes and a program duration of ≥1 week are recommended for best effects. 08

In conclusion, the studies provide preliminary evidence on the effectiveness of acupuncture, acupressure and shiatsu in pain management in cancer patients. However, more research is required to better understand the underlying mechanisms, identify which cancer types and patients may benefit most from these therapies, and determine how best to integrate them into clinical practice to improve pain management and potentially reduce the use. of opioids. These findings underscore the importance of continuing to research and understand the role of “tsubos, channels or meridians, energy balance and their relationship to the physiological method of action in the body and the relation with the neuro system” in the treatment of cancer-associated pain, as well as the integration of these therapies into clinical practice to potentially reduce opioid use.

References.  01. https://es.wikipedia.org/wiki/Shiatsu#cite_note-02. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/chinese-meridian-theory03. https://www.elsevier.es/es-revista-revista-internacional-acupuntura-279-articulo-meridianos-tendinomusculares-jng-jn-tejido-S188783691630005904. https://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&v%3Asources=medlineplus-bundle&query=pain&_gl=1*1po752p*_ga*MTA2MTk5MTM0MC4xNzEwMjU1MTE1*_ga_P1FPTH9PL4*MTcxMDI1NTExNC4xLjEuMTcxMDI1NTg3OS4wLjAuMA..*_ga_7147EPK006*MTcxMDI1NTExNC4xLjEuMTcxMDI1NTg4NS4wLjAuMA..&_ga=2.73186899.1530161690.1710255115-1061991340.171025511505. https://www.elsevier.es/es-revista-revista-senologia-patologia-mamaria–131-avance-resumen-metaanalisis-una-forma-basica-entender-S021415822030070006. Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis | Complementary and Alternative Medicine | JAMA Oncology | JAMA Network07. https://www.bbc.com/mundo/noticias-5743317208. Massage therapy can effectively relieve cancer pain: A meta-… : Medicine (lww.com)