Sanjeev Rastogi, MD, CAc, Consulting Physician, Department of Holistic Medicine,BMCRC, Vatsala Hospital,Tulsi Das Marg, Lucknow, UP, India.
Rajeev Rastogi, MSc, BNYS, Assistant Director (Naturopathy), Central Council for Research in Yoga and Naturopathy, Department of AYUSH, Ministry of Health, Government of India, New Delhi, India.
Ranjana Rastogi, MD, Head, Department of Obstetrics and Gynecology, State Ayurvedic College and Hospital, Lucknow, India.

The shoulder is one of the most versatile but also most unstable and vulnerable joints of the body. It is vulnerable to a variety of injuries, of which rotator cuff injuries predominate. These require specific tissue-targeted therapy to heal the point injuries. Conventional physiotherapy has been found to be limited in its efficacy as it offers superficial physical measures that cannot reach the traumatized tissue. Acupuncture, by virtue of its mode of application, can reach deeper in the traumatized tissue and offer substantial pain relief along with rapid healing of the trauma through ways that are yet to be fully understood. Acupuncture therapy for the management of rotator cuff injury seems to be the most productive way to reduce the intervention time and improve the net outcome, as observed in the case studied.
Key words: acupuncture, rotator cuff, macrotrauma, tendon sheath.

Linda M. Rapson, MD, CAFCI, Rapson Pain and Acupuncture Clinic, Toronto; Consultant, Acupuncture Program, Toronto Rehabilitation Institute Lyndhurst Centre, Toronto, ON.
Robert Banner, MD, CCFP, FRCP(C), Dip AAPM/CAPM, Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, ON.

Acupuncture, an ancient form of medicine that originated in China several thousand years ago, has been used by Canadian physicians since the 1970s. Research on the neurophysiology of acupuncture analgesia supports the theory that it is mediated primarily via the selective release in the central nervous system of neuropeptides. Evidence of its anti-inflammatory effects is emerging. Meta-analyses of randomized controlled trials provide evidence for acupuncture’s effectiveness in treating back pain, neck pain, and osteoarthritis. Applications of electroacupuncture using transcutaneous electrical nerve stimulation can provide good pain relief via home treatment and make management of cancer pain using acupuncture knowledge realistic.
Key words: acupuncture, pain, TENS, endorphin, anti-inflammation.

Mary Xiumei Wu, MD, TCM (China), MSc, Dipl OM, RAc, President, Toronto School of Traditional Chinese Medicine, Toronto, ON.

Traditional Chinese medicine (TCM) is a distinct and comprehensive medical system deeply rooted in Chinese philosophy. It is composed of fundamental theory, unique diagnostic methods, and a variety of treatment modalities primarily including acupuncture, Chinese herbal medicine, tuina massage, and taiji qigong. Traditional Chinese medicine has a wide range of clinical applications encompassing health promotion, disease prevention, and treatment and may be used for pain management either as an alternative or complement to allopathic medicine. An advantage of TCM is that it improves the patient’s general health in addition to controlling pain; therefore, it usually provides long-lasting effects and results in the relief of other accompanying symptoms such as fatigue, poor circulation, anxiety, depression, and insomnia, which are common comorbidities of pain in older adults.
Key words: traditional Chinese medicine (TCM), acupuncture, herbal medicine, tuina massage, taiji qigong, chronic pain.

Sanjeev Rastogi, MD, CAc, Consulting Physician and Lecturer, Government Ayurvedic College and Hospital, Handia, Allahabad, India.
Rajieev Rastogi, MBSc, BNYS, Assistant Director (Naturopathy), Central Council for Research in Yoga and Naturopathy, New Delhi, India.

Acute low back pain (ALBP) is a common condition that results in huge economic losses in the form of treatment and absenteeism (direct monitary loss for incurring the treatment and indirect monitary loss resulting from absence). It responds well to conservative therapy, but it often takes a period of between one and three months before improvement is seen. Acupuncture has its effect in pain reduction in various musculoskeletal conditions including ALBP. As is observed in the present case, this technique can reduce the recovery period in these patients and, thus, can improve the net outcome.
Key words: acute low back pain, acupuncture, conservative management, recovery period, analgesia.

Aileen Burford-Mason, PhD, President, Holistic Health Research Foundation of Canada, Toronto, ON.
Trish Dryden RMT, MEd, Coordinator of Massage Therapy Research and Development, School of Applied Arts and Health Sciences, Centennial College, Scarborough, ON.
Merrijoy Kelner, PhD, Professor Emerita, Institute for Life Course and Aging, University of Toronto, Toronto, ON.
Paul Richard Saunders, PhD, ND, DHANP, Professor of Materia Medica, Canadian College of Naturopathic Medicine, North York, ON.
Mark Ware, MD, MRCP(UK), MSc, Assistant Professor, Departments of Anesthesia and Family Medicine, McGill University, Montreal, QC.

Complementary and Alternative Medicine (CAM) is defined as a group of diverse medical and health care practices, products, and systems that are not presently considered part of conventional medicine but are increasingly being used. For older patients already receiving multiple drugs, such practices are attractive as nonpharmacological approaches to pain management. This review highlights several CAM therapies, including acupuncture treatment, massage therapy, and several natural health products supported by recent research.
Key words: pain, acupuncture, massage, Devil’s claw, glucosamine.