Volume 11, Number 3 | Fall 2016

Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (21)Industrial Health Field
Kenta Sawazaki

1. Current Status of Clinical Studies in Japan andOverseas
A search in PubMed for papers related toindustrial health and acupuncture yielded 44 results
as of November 2010, and indicated the existence ofa small accumulation of studies. Randomized
controlled trials (RCT; 4 cases) have begun to appear
from around 1993, which mostly assessed rotator
cuff tendinitis and apoplexy in terms of visual analog
scale (VAS), Short Form 36 (SF-36), and activities ofdaily living (ADL), against a control group of shamexercise,physicaltherapyandoccupational therapy.
A study by Szczurko et al.1) examined andcompared rotator cuff tendinitis in postal workers in
a prospective RCT, by randomly dividing thesubjects into an acupuncture treatment group andphysicaltherapy

group.

Work-related

musculoskeletal disorders have one of the highest
incidence rates in the field of industrial health, andare a major cause of sick leaves2). Compounded with
the increase in medical expenses under healthinsurance,

establishingmeasuresfor

theirprevention is an important issue not only forenhancing workers’ health and quality of working
life (QWL), but also for preventing work loss andmaintaining high productivity2). An economicallyeffective means is therefore sought to address such
sick leaves and increases in medical expenses.
Acupuncture treatment could be one such means, as
it is less expensive compared to conventional healthcare in terms of facilities and consumables. However,studies have hardly been made on the economic
assessmentofacupunctureindustrial health field.

Studies in Japan(a) Studies in the industrial health field in Japan
There are few full-fledged studies of the industrial
health field in Japan, but a paper on “TheA. Industrial Healthacupuncture,

2. Present State and Future Prospects of Clinicaltreatmentin

thePossibilities of Acupuncture in the Workplace”3) waspresented at the Industrial Health and Alternative
Medicine symposium sponsored by the Japan Society
for Occupational Health in 2003. In it, a study by
Sawazaki4) et al. is introduced in reference to theeconomic assessment of acupuncture treatment in
the industrial health field.
In the study, acupuncture treatment was provided
to 117 blue collar workers from a certain workplace
who complained of pain in their neck and shoulders,lower back, or knee. The pain lessened by half insome 80% to 90% of the subjects, and the Profile ofMood States (POMS) before and after treatment also
showed a significant decrease in total score.
Furthermore, the numbers of subjects and thenumber of days that the subjects visited a medical
institution due to a musculoskeletal disorder halved
during the period they received acupuncture
treatment, and the medical expense they paid underhealth insurance decreased to roughly one-third.
The same examination was conducted at anothersimilar workplace, but there was no conspicuous
difference

regardingthefactors

relatedto

musculoskeletal disorders. In a study5) of lumbago
patients, a significant decrease was seen in theirpain, POMS, and medical expenses under healthinsurance. These studies suggest that acupuncture
treatment

iseffective

againstwork-related

musculoskeletal disorders in the industrial healthfield. Moreover, the improvement of POMS indicatesthe possibility of increasing QWL and productivity,and is thought to be widely economical, combinedwith the decrease in medical expenses.
Workers’ work postures and actions are diverse.
Work-related
seriousissue

musculoskeletal
inThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

bothdisorders

industrialized

areaand17

Volume 11, Number 3 | Fall 2016industrializing countries alike6), and individualized
approaches must be made to each work action in thepossible, to ensure neutrality.
4) Analysis method

workplace. In related studies, acupuncture treatment

In recent years, it is considered important to haveis applied based on M-Test7), 8). M-Test is thought toknowledge

be useful as an individualized method for preventing

subjective health-related QOL and satisfaction.

work-related musculoskeletal disorders, as it indexes

Therefore, proper analysis of cost effectivenesseach individual’s physical symptoms according toand cost utility based on patients’ subjectiveaction. The M-Test is discussed in detail under “C.

views is expected in the future.

ofhealthcare

quality,suchasSpecial Diagnostic Techniques” in Chapter 4.
3. Conclusion(b)

Prospectsoffuturestudies(economicStudies in the field of industrial health will beassessment)

needed in the future, as a means for demonstrating

1) Subjects

the roles of acupuncture treatment in society.

It is not easy to determine who shall be included

Toward this end, a steady improvement in theamong the subjects, but it is necessary to find newquality of studies and investments in studies in thissubjects from diverse occupations.

field are desired.

2) Design
Prospective studies by RCT are thought to be best

References

at present, but as such studies are costly and take1) Szczurko O, Cooley K, Mills EJ, et al.:time, public investment is necessary to also

Naturopathic treatment of rotator cuff tendinitis

ensurebyamong Canadian postal workers: a randomized

Sawazaki et al. is a case-controlled retrospective

controlled trial. Arthritis Rheum 61(8): 1037-1045,

study of medical expenses under health insurance

2009

neutralassessment.

The

study

within the design of a before-and-after trial.

2) Itani, Toru and Norihide Tachi: “Prevention ofRealistically speaking, it is most easy to set aWork-related

Musculoskeletal

control group, but various biases must beSituation in Japan and International Trends.”

considered. It is ideal to conduct an economic
assessment based on a perfect design, but from aIgaku no Ayumi (Journal of Clinical andExperimental Medicine), 173(13): 970-971, 1995.

practical perspective, it is also necessary to3) Iwa, Masahiro and Tadashi Yano: “Possibilities ofthe Application of Acupuncture in the Workplace.”

accumulate partial assessment data.
In the study by Sawazaki et al., there was aSangyo
Eiseigaku
Zasshi(JournalOccupational Health), 45: 114-115, 2003.

decrease in medical expenses under health4) Sawazaki, Kenta, Fujihisa Kinoshita, Osamu

3) Assessment (Result)insurance,

after

applying

treatment.

TheHirano,etal.:Effectsof“Studyof

theofTreatmentofMusculoskeletal

assessment of medical expenses may produce

Acupuncture

different conclusions depending on from whose

Symptoms in Corporate Workers and Theirstandpoint it is analyzed, also in consideration ofRelationship to Medical Expenses.” Zen Nihon

expenses paid by the patient and the patient’sfamily. As the standpoints of evaluators areShinkyu Gakkai Zasshi (Journal of the Japan
Society of Acupuncture and Moxibustion), 51(4):diverse, it is preferable to conduct an assessment

492-499, 2001.

from a broad social standpoint as much as18

Disorders-The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 11, Number 3 | Fall 20165) Sawazaki K, Mukaino Y, Kinoshita F, et al.:Acupuncture can reduce perceived pain, mood
disturbances and medical expenses related to low
back pain among factory employees. Ind Health46(4): 336-340, 2008
6) Itani, Toru: “Voluntary Activities for thePreventionofWork-relatedMusculoskeletalDisorders.” Ningen Kogaku Senmonka Bukaiho(CPEJ Newsletter): 7:1, 2006.
7) Yoshito

Mukaino,TatsuroHonda,Kenta

Sawazaki, et al.: Illustrated manual of M-Test,
Ishiyaku Publisher, Inc. 20128) Yoshito

Mukaino,TatsuroHonda,

Kenta

Sawazaki, et al.: Sports Acupuncture, The
Meridian Test and its Applications, Eastland
Press, 2008

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