Introduction
Complementary and alternative medicines (CAM) have always played a significant role in maintaining human health and wellbeing, and many cultures have explored various techniques for obtaining better results. Due to the few side effects and high accessibility, in many cases, CAM is seen as a better therapeutic option in human beings for treating various diseases and improving quality of life.
Statistics indicate that in the Unites States alone, an estimated 59 million people aged 4 years and over had at least one expenditure for some type of complementary health approach, resulting in total out of-pocket expenditures of $30.2 billion (1). In addition, traditional Chinese medicine (TCM), which was commonly used in North America, Japan, Korea, and other countries, was included in the International Classification of Diseases 11th revision by the World Health Organization (WHO) (2).
Acupressure has its roots in ancient China (3), and is one form of CAM. Its principle resides from activation of acupoints across the meridians using fingers or other types of devices. This hands-on therapy is used more frequently today than previously because of various holistic trends that have raised awareness of its benefits.
Acupressure, a form of acupuncture, is based on the same fundamental principle of acupoints activation across the meridians, but acupressure generally uses hands or other non-invasive tools, while acupuncture uses special needles (4).
Meridians are the channels within the human body which helps to maintain Qi and are connected to various organs and tissues of the human body. When applying pressure on a specific point, its activation produces an analgesic effect both locally, and on other parts of the body (5).
Acupoint is the point closest to the surface of the skin, and the entire human body is a cluster of these elements (6). They are specific points used for needle insertion in acupuncture, with high electrical conductance on the body surface (7). Location of each acupoint on a specified meridian is determined in terms of body inch (BI) or Cun. One BI/Cun equals one thumb width at the base of the fingernail.14 BI/Cun are known as acupressure units of measurement (AUM)(8).
Qi is the philosophy of energy life force, but it is the quality attribute that determines the state of one’s health. In accordance with traditional Chinese medicine (TCM), acupressure uses pressure to stimulate specific acupoints for therapeutic purposes, and stimulating these points can correct imbalance between Qi through channels (meridians), and subsequently treat the diseases (9).
Acupressure can be combined to grounding techniques in order to enhance the potential health benefits. Grounding or Earthing refers to direct skin contact with the surface of the Earth. The grounding effect can be obtained using bare feet or hands, or with various grounding systems.
Recent studies have revealed that electrically conductive contact of the human body with the surface of the Earth influences processes such as inflammation, immune responses, and wound healing, so this method can be used in pursuit of prevention and treatment of chronic inflammatory and autoimmune diseases (10).
The grounding systems are simple conductive systems in the form of sheets, mats, wrist or ankle bands, adhesive patches that can be used inside the home or office, and offer a convenient and routine, user-friendly approach to grounding or Earthing. These applications are connected to the Earth via a cord inserted into a grounded wall outlet or attached to a ground rod placed in the soil.
Mechanism of action
Acupressure can correct imbalance between Qi energy through channels, and subsequently treat diseases (9). This technique passes pleasurable impulses to the brain at a rate four times faster than painful stimuli (11). Continuous impulses reduce the pain signal, and influence pain perception in the body. Acupressure also exhibits potential for affecting primary somatosensory processing (12).
Biochemical mechanism of acupressure involves complex neuro-hormonal circuits. The main hormonal circuit that is influenced by acupressure is the hypothalamic-pituitary adrenocortical axis, and by lowering the levels of stress hormones (cortisol), the organism enters into a state of relaxation (13). Also, it increases serotonin transmittance to the brain and specific organs through nerves and meridians (14).
Acupressure mediates the nitric oxide (NO) signal, known to improve local microcirculation via vasodilation (15).
Current research suggests that grounding the human body strongly influences the bioelectrical, bioenergetics, and biochemical processes, and appears to offer a significant modulating effect on chronic illnesses and dysfunction (16).
Moreover, Oschman and colleagues hypothesized that connecting the body to the Earth enables free electrons from the Earth’s surface to spread into the body where they can have antioxidant effects, and also electrons from the Earth can prevent or resolve so-called “silent” or “smoldering” inflammation (10). More studies will be needed to confirm these hypotheses, but they seem to be supported by some researchers.
Acupressure and grounding devices
A wide range of portable acupressure and grounding devices are available. Most of the available acupressure devices exert the constant level of pressure at a specific pressure point. Due to the limitation of nerve accommodation, automatically modulating acupressure devices have been introduced on the market in order to enhance the therapeutic effect.
But very few, if any, combine the effects of acupressure and grounding. A device that could satisfy this need might consist of a modified acupressure probe that has at one end a conductive cable for grounding, and at the other end a tip for applying various levels of pressure on specific points along meridians (figure 1).
Fig. 1. Schematic device for combining acupressure and grounding techniques.
In a study by Mehta et al.(8), the authors synthetized the main types of acupressure devices (figure 2), and all of them can be combined with grounding in order to obtain synergistic effects.
Fig. 2 (Metha et al.). Patented devices (A–J). Acupressure device name: A. Acupressure foot board, B. Acupressure device for fingers, C. Acupressure and reflexology clamp, D. Acupressure device for treating insomnia, E. Automatically modulating acupressure device, F. Adjustable foot acupressure and pain relief platform, G. Electrical plus acupressure system, H. Finger acupressure apparatus, I. Hand-held acupressure device, and J. Massage footwear.
Comparative approach of acupressure and grounding
Both, grounding acupressure and acupressure are effective, safe, simple and economical therapies, but the first seems to be more efficient due to its dual nature.
A comparative analysis of the main health benefits comprised by these two complementary therapies would provide a consistent basis for further research.
The first analyzed effect refers to the inflammation and immunological responses. In the last few years, multiple studies have demonstrated benefits for both grounding and acupressure, so that their synergistic effects could be efficient in reducing this type of immunologic response.
In a study by Oschman et al., the authors demonstrated that grounding can reduce pain and alter the numbers of circulating immune cells (neutrophils and lymphocytes), as well as the circulating levels of chemical factors related to inflammation (figure 3) (10). This discovery suggests that the earth has powerful anti-inflammatory effects. An explanation for this phenomenon could be that Earthing allows a huge number of free electrons to enter the body via nervous, meridian, and circulatory systems in order to neutralize free radicals (positive charged molecules produced by our metabolism with damaging effect on cells) (10, 17, 18).
Figure 3. Summary of central hypothesis of Oschman et al. Notes: (A) After an injury, the ungrounded person (Mr Shoes) will form an inflammatory barricade around the injury site. (B) After an injury, the grounded person (Mr Barefoot) will not form an inflammatory barricade, because reactive oxygen species that could damage nearby healthy tissue (collateral damage) are immediately neutralized by electrons semi-conducted from the electron-saturated ground substance via the collagen network.
On the other hand, it has been demonstrated that acupressure alone was used as a treatment for asthma, allergic rhinitis, pruritus or other allergies, and all these conditions have an important inflammatory physio-pathological background (19-22).
The analgesic effect is dominant for both acupressure and grounding. Three studies evaluated the effect of grounding on delayed onset muscular soreness (DOMS) that refers to the pain, tenderness, and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise, and concluded that this technique significantly reduced the degree and duration of pain and inflammation (23-25).
Recent research suggests that the rapid impact of grounding can’t be explained by slow-moving nerve impulses or chemical reactions, but rather by the influx of anti-inflammatory electrons that are able to quickly transit the conductive infrastructure of the body, and target sites of inflammation, as described by Oschman (10, 17).
In a study by Kirca et al., acupressure had a significant analgesic effect on the postpartum perineal pain comparative with ice package and control groups (26). A systematic review demonstrated the efficacy of acupressure for the treatment of different types of pain (dysmenorrhea, labor pain, low back pain, chronic headache, and other traumatic pains) (27).
Another major documented benefit of grounding is improvement of blood circulation. In a 2013 study, the researchers concluded that grounding “reduces blood viscosity and clumping” and “appears to be one of the simplest and yet most profound interventions for helping reduce cardiovascular risk and cardiovascular events.” This might be explained due to the increased negative charge on the erythrocytes (the Zeta potential), which further determines greater distance between the blood elements (28).
The increase in blood flow was evaluated in two other studies. The first study provided imaging evidence showing that grounding determined a rapid improvement in facial blood flow, and enhanced ANS regulation of peripheral circulation (29). The other study used thermal imaging to outline the enhanced blood flow effect of grounding throughout the torso (30).
A study by Li et al., evaluated the effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases, and concluded that acupressure caused significant increases in the lower limb blood flow of stage II peripheral arterial occlusive diseases (PAOD) patients (31).
The last major effect of these techniques is the influence over autonomic nervous system (ANS). A study on premature infants showed that grounding produced immediate and significant improvements in measurements of ANS functioning, which is critically important in the regulation of inflammatory and stress responses in these babies (32). This might be due to the rapid electron transit activity that stimulates the vagus nerve.
On the other hand, acupressure alone can be effective in reducing the gastric tachyarrhythmia symptoms along with termination of paroxysmal supraventricular tachycardia, and the proposed mechanism is the vagus nerve stimulation (33).
Conclusions
Both acupressure and grounding are simple, non-invasive, and accessible techniques that when combined could have a beneficial role in the regulation or treatment of inflammation, pain, circulation, and autonomic dysfunctions.
A device that could use both techniques simultaneously poses a tremendous opportunity to (a) increase the results of a typical acupressure session through dramatically increased, targeted and controlled ion passage through and around the meridian point, (b) enhancing the effects of grounding through allowing for a pinpointed ion gateway and (c) might be effective in potentiating their biological and clinical benefits, while reducing costs at the same time.
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