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Acupressure and Massage News

October 26, 2009 Written by JP       [Font too small?]

Mind-body therapies such acupressure and massage are entering the mainstream of modern medicine. These non-invasive techniques are proving themselves both in controlled scientific studies and in the “eyes” of health care consumers worldwide. Conventional doctors tend to be more open to these treatments because they’re unlikely to do any harm while, at the same time, they provoke positive feelings. This point of view is a bit dismissive but there’s also some logic to it. Any form of therapy that evokes positive sensations and stimulates beneficial chemical, hormonal and immunological changes in the body is likely to do some good. It doesn’t matter whether you believe in the underlying concepts or philosophy that accompanies the treatment itself.

Two newly released studies have implications for those undergoing cancer treatment. A systemic review in the November 2009 issue of Breast Cancer Research and Treatment examines the use of acupoint stimulation as a means of reducing “therapy-related adverse effects”. A total of 26 studies were included in the review. 23 of the trials reported successful outcomes. Acupressure, electro-acupuncture, magnet-assisted acupoint therapy and traditional acupuncture were the modalities utilized in the positive experiments. According to the authors of the summary, the stimulation of a specific acupressure point known as P6 (NeiGuang) appears to reduce chemotherapy related nausea and vomiting. (1)

A Turkish study from September 2009 tested this same acupoint in a group of 34 patients with “gynecologic cancer”. In this case, a wristband that applies consistent pressure to the P6 point was worn by patients undergoing chemotherapy. The addition of the wristband decreased the severity of nausea and reduced the amount of medication (antiemetics) used to control nausea related side effects. A decline in “retching episodes” and vomiting was also established, though to a smaller degree. The concluding remarks of the scientists indicate that “acupressure applied to P6 acupuncture point with wristbands may be effective in reducing chemotherapy related nausea and may decrease the antiemetic use after chemotherapy”. (2)

The reach of acupressure extends far beyond just serving as an adjunct to cancer treatments. For instance, applying 30 minutes of pressure to a pressure point known a SP6 (Sanyinjiao) located just above the ankle may help reduce “the duration and severity of pain of the active phase of labor, cesarean section rates and necessity and amount of oxytocin” (a hormone/medication which induces labor). New evidence also points to a role that acupressure may play in the long term management of type 2 diabetes. A 3 year study recently compared the effects of diet and lifestyle modification in a group of 80 diabetics. Half the group received frequent acupressure therapy (AT) in addition to standard care. The AT diabetics demonstrated lower levels of LDL (“bad”) cholesterol and triglycerides, higher levels of HDL (“good”) cholesterol and exhibited signs of healthier kidney, liver and nerve function. This difference seems to be directly attributable to the effect of acupressure alone or in concert with diet and exercise. (3,4)

Comparison of Depression Score – Aromatherapy Massage vs. Massage
Comparison of Anxiety Score – Aromatherapy Massage vs. Massage
Source: J Korean Acad Nurs. 2008 Aug;38(4):493-502. (link)

Massage can also have a powerful impact on serious conditions such as breast cancer. A recent Swedish study examined the immune function of a group of 30 middle-aged women with breast malignancies. All the women were undergoing radiation therapy at the time of the experiment. Half of the group began a complementary course of “light pressure” massage while the remainder acted as the control group. Blood and saliva samples, blood pressure and heart rate were measured before and after each massage session. The researchers discovered that the massage group maintained better immune function (natural killer cell activity) and showed a reduction in heart rate and systolic blood pressure. (5)

Sometimes scientists set out to study one thing and they end up uncovering something quite unexpected. In October 2009, a paper was presented in the journal Multiple Sclerosis. The intention of the researchers was to test the efficacy of a type of massage known as reflexology on the pain stemming from multiple sclerosis. Reflexology involves the careful manipulation of pressure points on the sides and soles of the feet. In this trial, two types of massage were applied to a group of 73 MS patients. One group received the legitimate form of reflexology, while the others were given non-specific foot massages. Pain measures were taken pre, mid-way and post trial using a scientifically accepted index known as a Visual Analogue Scale (VAS). Much to the researchers’ surprise, both groups exhibited significant reductions in depression, disability, fatigue, pain and spasms. The participants also reported a generalized improvement in their perceived quality of life. (6)

Combining massage with other therapeutic practices is also gaining ground in medical circles. Adding massage to conventional psychotherapy was recently shown to improve depression in prenatal women. A study performed at the University of Miami School of Medicine found that adding 20 minutes of massage therapy to a normal 60 minute session of “Interpersonal Psychotherapy” brought about greater reductions in anxiety, depression and stress hormone levels (cortisol). (7)

The addition of massage therapy to an exercise program can likewise improve the outcome of physiological conditions. A trial just published shows that exercise plus massage can dramatically improve the health of patients with a painful leg condition known as peripheral arterial disease (PAD). Beneficial changes in blood pressure and circulation were noted in the lower extremities of those engaging in this two-pronged treatment protocol. (8)

Acupressure and massage can support physical and psychological wellness by enhancing circulation and immune function, lowering blood pressure, pain, stress hormones, and even prompting the release of endorphins (the brain’s “feel good” chemicals). These types of treatments also connect us in a rather intimate way to another caring individual. Over the course of 60 minutes or so, you’re literally in the hands of a healer whose sole purpose is to help you regain your good health. It’s not often that we can allow ourselves to simply let go and become the center of attention in a genuinely constructive way. I would really love for such mind-body therapies to play a larger role in 21st century medicine. I believe the best way for that to happen is for us, as consumers and patients, to request it. Think of the possibilities – fewer drugs and more massages. Sounds good to me!

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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21 Comments & Updates to “Acupressure and Massage News”

  1. Nina K. Says:

    Morning JP,

    nice nice article. i can highly recommend a regular massage, especially reflexology is very good for different health conditions but some inflammatory conditions don’t tolerate reflexology or get worser. especially for the reflexology you should go to see a good trained therapist.

    Greetings,
    Nina K.

  2. JP Says:

    Good day, Nina.

    Thank you for sharing that piece of advice. I agree 100%. Every situation must be evaluated on a “case-by-case” basis. Choosing a skilled practitioner is vitally important as well. Good reminders! :)

    Be well!

    JP

  3. Oct Says:

    What an excellent article, J.P. … I think both Cro and I would greatly benefit from giving each other foot massages. I will do some reading on proper technique, he is already talented in the proper way to give massage (maybe from his body-building or martial arts years, I just don’t know but I’ll have to ask him).

    Thank you!

  4. JP Says:

    That sounds like a great idea, Oct! :)

    Lately I’ve been giving my wife a special type of foot massage (a modified version of “trigger point therapy”) which has been helping with some soreness she feels in that region.

    Please let me know how it works out for you guys. :)

    Be well!

    JP

  5. Jewel Says:

    My husband has leg cramps and few thread veins. He has tried many over the counter products but of no use. Recently, he has received acupressure massage which relieves his active complaint and relaxes his legs. Thanks for advice.

  6. Nancy Says:

    I suffer with intermittent cramps, pain, and fatigue in my legs due to compromised blood flow to lower extremities. My friend told me to receive acupressure massage to get rid of complaints. I am little bit confused but finally i made my mind to try this. I cant expect better results than that. It works for me….

  7. Nancy Says:

    I suffer with intermittent cramps, pain, and fatigue in my legs due to compromised blood flow to lower extremities. My friend told me to receive acupressure massage to get rid of complaints. I am little bit confused but finally i made my mind to try this. I cant expect better results than that. It works for me….

  8. Jewel Says:

    My husband has leg cramps and few thread veins. He has tried many over the counter products but of no use. Recently, he has received acupressure massage which relieves his active complaint and relaxes his legs. Thanks for advice

  9. Nancy Says:

    I suffer with intermittent cramps, pain, and fatigue in my legs due to compromised blood flow to lower extremities. My friend told me to receive acupressure massage to get rid of complaints. I am little bit confused but finally I made my mind to try this. I can’t expect better results than that. It works for me….

  10. JP Says:

    Thank you for sharing your successful experiences with us, Jewel and Nancy. Much appreciated!

    Be well!

    JP

  11. JP Says:

    Update: Acupressure reduces knee arthritis pain …

    http://www.ncbi.nlm.nih.gov/pubmed/25685487

    J Advanc Res. 2014 Mar;5(2):193-200.

    Effectiveness of acupressure versus isometric exercise on pain, stiffness, and physical function in knee osteoarthritis female patients.

    Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability in older adults. Conservative non-pharmacological strategies, particularly exercise, are recommended by clinical guidelines for its management. The aim of this study was to assess the effectiveness of acupressure versus isometric exercise on pain, stiffness, and physical function in knee OA female patients. This quasi experimental study was conducted at the inpatient and outpatient sections at Al-kasr Al-Aini hospital, Cairo University. It involved three groups of 30 patients each: isometric exercise, acupressure, and control. Data were collected by an interview form and the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scale. The study revealed high initial scores of pain, stiffness, and impaired physical functioning. After the intervention, pain decreased in the two intervention groups compared to the control group (p < 0.001), while the scores of stiffness and impaired physical function were significantly lower in the isometric group (p < 0.001) compared to the other two groups. The decrease in the total WOMAC score was sharper in the two study groups compared to the control group. In multiple linear regression, the duration of illness was a positive predictor of WOMAC score, whereas the intervention is associated with a reduction in the score. In conclusion, isometric exercise and acupressure provide an improvement of pain, stiffness, and physical function in patients with knee OA. Since isometric exercise leads to more improvement of stiffness and physical function, while acupressure acts better on pain, a combination of both is recommended. The findings need further confirmation through a randomized clinical trial.

    Be well!

    JP

  12. JP Says:

    Update: Acupressure supports healthier breast milk production …

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325417/

    Iran J Nurs Midwifery Res. 2015 Jan-Feb;20(1):7-11.

    Effect of acupressure on milk volume of breastfeeding mothers referring to selected health care centers in Tehran.

    BACKGROUND: Breast milk is the main food source for infants’ growth and development. Insufficient milk is one of the obstacles to the adequate use of this substance. One of the treatments to help this issue is acupressure. Therefore, the present study was designed to determine the effect of acupressure on maternal milk volume.

    MATERIALS AND METHODS: This study is a randomized clinical trial in which 60 breastfeeding mothers complaining of hypogalactia and meeting the inclusion criteria were studied. In addition to providing routine education, bilateral acupressure was performed for 12 consequentia l days on the acupoints of SI1, LI4, and GB21 in the intervention group, as three sessions per week with each session conducted 2-5 times. The control group received only routine education. In both groups, breast milk volume before intervention and 2 and 4 weeks after intervention was evaluated by an electric pump. Data were analyzed by descriptive and inferential statistical analysis through SPSS.

    RESULTS: The t-test showed no significant difference in the mean volume of milk in the two groups (P = 0.543). Mean volumes of milk before and 2 and 4 weeks after the intervention were 10.5 (8.3), 33 (13.44), and 36.2 (12.8), respectively, in the acupressure group and 9.5 (7.7), 17.7 (9.4), 18 (9.5), respectively, in the control group. Analysis of variance (ANOVA) test showed a significant difference in the mean volume of milk at 2 and 4 weeks after the intervention (P < 0.001).

    CONCLUSIONS: Both acupressure and general education methods were effective on the milk volume of breastfeeding mothers. Acupressure method was more effective than the other method. Therefore, application of acupressure as a method of alternative medicine to increase breastfeeding is suggested.

    Be well!

    JP

  13. JP Says:

    Update: Lavender oil massage reduces menstrual pain …

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325408/

    Iran J Nurs Midwifery Res. 2015 Jan-Feb;20(1):156-60.

    The effect of aromatherapy massage with lavender oil on severity of primary dysmenorrhea in Arsanjan students.

    BACKGROUND: Presently, using complementary therapy such as lavender oil has specific application in medicine. The purpose of this study was to investigate the effect of aromatherapy massage on the severity of primary dysmenorrhea in nursing and midwifery students of Islamic Azad University of Arsanjan, Iran.

    MATERIALS AND METHODS: This study was performed using clinical trial method on 80 eligible students whose level of pain was measured by visual analogue scale (VAS) before the intervention. Each participant, in the first days of menstruation, randomly received two types of massage with lavender and placebo oil in two consecutive cycles of menstruation. Their level of pain was measured before and 30 min after the intervention. In this study, each group was considered as their self-control group in the next cycle. The data were analyzed by SPSS software.

    RESULTS: A significant decrease in VAS score after lavender massage was detected in comparison with placebo massage. There was a statistically significant difference between VAS scores after and before placebo massage. In addition, statistically the effect of lavender massage on the severity of primary dysmenorrhea was higher than that of placebo massage (P < 0.001).

    CONCLUSIONS: Findings of this study showed that lavender oil massage decreases primary dysmenorrhea and it can be used as an effective herbal drug.

    Be well!

    JP

  14. JP Says:

    Udpate 04/17/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387643/

    Iran J Nurs Midwifery Res. 2015 Mar-Apr;20(2):200-4.

    Comparing the effects of reflexology and relaxation on fatigue in women with multiple sclerosis.

    BACKGROUND: Fatigue is the most common and highly disabling symptom of multiple sclerosis (MS) that has negative effects on employment, the process of socialization, compliance with the disease, and other factors effective on activities of daily living. The usage of complementary and alternative medicine methods in MS patients is higher than in the general population. However, there is no scientific evidence to support their effectiveness. Therefore, this study aimed to compare the effects of reflexology and relaxation on fatigue in women with MS.

    MATERIALS AND METHODS: This study is a single-blinded randomized clinical trial that was done on 75 patients with MS who referred to the MS Clinic of Ayatollah Kashani Hospital (Isfahan, Iran). After simple non-random sampling, participants were randomly assigned by minimization method to three groups: Reflexology, relaxation, and control groups (25 patients in each group). In the experimental groups, the interventions foot reflexology and relaxation (Jacobson and Benson) were performed for 4 weeks, twice a week for 40 min in each session, and the control group received care and routine medical treatment as directed by a physician. Data were collected through a questionnaire and the fatigue severity scale before, immediately after, and 2 months after interventions from all three groups. Data analysis was performed by SPSS version 18 using descriptive and inferential statistical methods.

    RESULTS: Findings obtained from analysis of variance (ANOVA) showed that there was no significant difference in the mean fatigue severity scores in the pre-interventions between the three groups (P > 0.05), but there was significant difference immediately after and 2 months after interventions between the three groups (P < 0.05). Findings obtained from repeated measures (ANOVA) showed that there was significant difference in the mean fatigue severity scores during different times between the three groups (P < 0.05), while this difference was not significant in the control group (P > 0.05). Furthermore, least significant difference post-hoc test revealed that the mean scores of fatigue severity immediately after intervention was lower in the reflexology group than in the other two groups and were lower in the relaxation group than in the control group; 2 months after interventions, the mean scores of fatigue severity were lower in the reflexology group than in the other two groups, but there was no significant difference between the two groups of relaxation and control (P > 0.05).

    CONCLUSIONS: It seems that both interventions were effective in reducing fatigue, but the effects of reflexology on reducing fatigue were more than those of relaxation. Hence, as these two methods are effective and affordable techniques, they can be recommended.

    Be well!

    JP

  15. JP Says:

    Update 05/18/15:

    http://www.ctcpjournal.com/article/S1744-3881%2815%2900041-9/abstract

    Complementary Therapies in Clinical Practice – May 11, 2015

    A Pilot Randomised Controlled Trial (RCT) investigating the effectiveness of reflexology for managing pregnancy low back and pelvic pain

    Many pregnant women with LBPP use pain medications to manage this pain, much of which is self-prescribed and potentially harmful. Therefore, there is a need to find effective nonpharmacological treatments for the condition. Reflexology has previously been shown to help nonspecific low back pain. Therefore; a pilot RCT was conducted investigating reflexology in the management of pregnancy-LBPP. 90 primiparous women were randomised to either usual care, a reflexology or footbath intervention. Primary outcome measures were; the Pain Visual Analogue Scale (VAS). 64 women completed the RCT; retention rates for the reflexology group were 80%, usual care group 83.33% and footbath group 50%. The reflexology group demonstrated a Clinically Important Change (CIC) in pain frequency (1.64cm). Results indicate it is feasible to conduct an RCT in this area, although a footbath is an unsuitable sham treatment. Reflexology may help manage pregnancy-LBPP; however a fully powered trial is needed to confirm this.

    Be well!

    JP

  16. JP Says:

    Updated 07/15/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26170519

    Iran J Med Sci. 2015 Jul;40(4):328-34.

    The Effect of Acupressure on Sleep Quality in Menopausal Women: A Randomized Control Trial.

    BACKGROUND: One of the common problems in menopausal women is sleep disorder. Traditional Chinese acupressure is a noninvasive and safe technique. Menopausal women can easily learn the technique and a self-care method to manage their sleep disorder. This study was carried out to evaluate the effectiveness of acupressure on sleep quality of postmenopausal women in Mashhad during 2009.

    METHODS: This double blind, randomized clinical trial was performed on 120 qualified menopausal women at the age of 41-65 years. Their sleep quality was measured according to the Pittsburgh Sleep Quality Index (PSQI). Participants were randomly assigned to an acupressure group (n=37), a sham acupressure group (n=36) and a control group (n=32) by two time randomized method (systematic and simple randomized). These interventions were carried out for four consecutive weeks. The participants in the acupressure and sham acupressure groups learned to carry out the acupressure technique as a self-care at home with simultaneous massage techniques that were to be performed 2 hours before sleep, whereas only conversation was used in the control group. The data were analyzed by the SPSS software version 17.

    RESULTS: The results indicated significant differences in total PSQI scores among the three groups (P<0.001). Tukey’s test revealed that there were significant differences between the acupressure group and the control group (P<0.001), the acupressure group and sham acupressure group (P<0.001), and the sham acupressure and the control group (P<0.001).

    CONCLUSION: Acupressure can be used as a complementary treatment to relieve sleep disorders in menopausal women; and is offered as an efficient method to manage sleep quality.

    Be well!

    JP

  17. JP Says:

    Updated 08/28/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26311485

    J Child Health Care. 2015 Aug 26.

    The effects of massage therapy on physical growth and gastrointestinal function in premature infants: A pilot study.

    To promote the growth and development of premature infants, effective and tender care is required in neonatal intensive care units (NICUs). The purpose of this study was to test the potential effects of massage therapy on increasing physical growth and promoting gastrointestinal function in premature infants. Twenty subjects were divided into two groups in the NICU of one general hospital located in South Korea. The experimental group (n = 10) were given massage therapy and the control group (n = 10) received routine care. Massage therapy was performed twice daily for 14 days, for 15 minutes per session. In the physical growth, height and chest circumference were significantly increased in the experimental group. In assessing gastrointestinal function, frequency of pre-feed gastric residual was significantly decreased and numbers of bowel movements were significantly increased in the experimental group. This study showed massage therapy has the potential effects on increasing physical growth and gastrointestinal function in premature infants. The massage in the NICU might be utilized as a part of developmental care, but more research needs to be done. NICU nurses need to be trained in massage therapy techniques to provide more effective clinical care for premature infants.

    Be well!

    JP

  18. JP Says:

    Updated 02/23/16:

    http://www.jams-kpi.com/article/S2005-2901%2815%2900218-6/fulltext

    J Acupunct Meridian Stud. 2016 Feb;9(1):11-5.

    Acupressure on Self-Reported Sleep Quality During Pregnancy.

    The aim of this study was to investigate the short-term effect of acupression at the H7 point on sleep quality during pregnancy. After oral consent had been obtained, the midwife invited the women claiming to have poor sleep quality and anxiety symptoms to complete the Pittsburgh Sleep Quality Index questionnaire and the State-Trait Anxiety Inventory-1. Then, the same midwife, previously trained by an expert acupuncturist (I.N.), advised the women to put on the wrist overnight compression H7 Insomnia Control half an hour before going to bed and to take it off upon awakening, for 10 consecutive days and thereafter every odd day (active group). Women refusing to wear the device for low compliance toward acupression were considered as the control group. After 2 weeks, a second questionnaire evaluation was completed. In the active, but not in the control, group, a significant improvement of sleep quality was observed after H7 device application. The study suggests that H7 acupression applied for 2 weeks improves sleep quality in pregnant women. This preliminary result should serve to stimulate further studies on the long-term effects of acupression.

    Be well!

    JP

  19. JP Says:

    Updated 06/27/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27327537

    Res Nurs Health. 2016 Jun 21.

    The Effects of Acupressure Training on Sleep Quality and Cognitive Function of Older Adults: A 1-Year Randomized Controlled Trial.

    We explored the effects of acupressure training on older adults’ sleep quality and cognitive function. Ninety older adults with impaired sleep quality were selected from screened volunteers and randomly divided into equal control and experimental groups; 82 completed the 1-year follow-up. Participants in the control group were given instructions on sleep health, while those in the experimental group received sleep health instructions plus individual and small group acupressure training sessions and support to practice the intervention on their own each day. All participants were assessed by trained assistants blind to study group allocation using Chinese versions of the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Mini-Mental State Examination, and four subscales from the revised Chinese version of the Wechsler Memory Scale, at baseline and at 3, 6, and 12 months. Repeated measures analysis of variance showed that acupressure training improved older adults’ sleep quality and cognitive function, but the mediating effect of sleep on the relationship between acupressure training and cognitive function was not supported. Given the ease, simplicity, and safety of acupressure training observed with community-dwelling older adults in China, attempts should be made to replicate these preliminary positive findings with larger samples.

    Be well!

    JP

  20. JP Says:

    Updated 12/12/16:

    https://www.ncbi.nlm.nih.gov/pubmed/27903827

    West J Nurs Res. 2016 Nov 30.

    Effects of Auricular Acupressure on Constipation in Patients With Breast Cancer Receiving Chemotherapy: A Randomized Control Trial.

    The purpose was to examine the effects of auricular acupressure to relieve constipation in patients with breast cancer who were undergoing chemotherapy. Participants were 52 patients with breast cancer receiving chemotherapy at E University Hospital, Seoul, Korea, randomized into two groups of equal size. For the experimental group, auricular acupressure was applied to seven auricular acupoints for 6 weeks using vaccaria seeds, whereas the control group received the usual care. Constipation-assessment scores of the experimental group were significantly lower compared with the control group (p < .001). Stool-form scores of the experimental group were significantly higher compared with the control group (p = .003). Patient Assessment of Constipation-Quality of Life scores of the experimental group were significantly lower compared with the control group (p < .001). Auricular acupressure was effective at relieving constipation in patients with breast cancer receiving chemotherapy. Auricular acupressure was also a safe and acceptable nursing intervention.

    Be well!

    JP

  21. JP Says:

    Updated 04/25/17:

    http://www.complementarytherapiesinmedicine.com/article/S0965-2299(17)30120-6/abstract

    Complement Ther Med. 2017 Apr;31:65-70.

    The effect of applying pressure to the LIV3 and LI4 on the symptoms of premenstrual syndrome: A randomized clinical trial.

    OBJECTIVE: To evaluate the effect of simple acupressure protocol in LIV3, LI4 and placebo points on the quality of life (QOL) in women with premenstrual syndrome (PMS).

    METHOD: This paper reports a randomized, single blinded clinical trial. 97 participants (students in of Hormozgan University of Medical Sciences, Iran) with PMS were allocated to three groups to receive 20min acupressure on different acupoints for 14days before menstruation for three consecutive menstrual cycles (training and then two cycles self applied acupressure). The acupoints were LIV3 and LI4; one group received acupressure at a placebo point. Each participant completed the PSST scale (to determine PMS severity), HADS scale (for depression and anxiety), and quality of life SF12.

    RESULTS: The number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group (p<0.04). Moreover, depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the placebo group (p<0.05).Analyzing the score of SF12 fields in the second and third cycles showed a significant difference in all dimensions between the intervention and placebo groups. There was no significant difference between LIV3 and LI4 acupressure groups in decrease of PMS symptoms, anxiety and depression and improving SF12scores (p<0.05).

    CONCLUSION: Performing the simple acupressure protocol at LIV3 and LI4 is an effective method to decrease the severity of PMS symptoms, anxiety and depression, and to improve the QOL. Pressure at LIV3 and LI4 appears to be equally effective.

    Be well!

    JP

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