Acupuncture, Acustimulation, and Acupressure
Evidence for all types of PC6 (point on wrist) stimulation is mixed, but due to a lack of harm and very few side effects, some women may find these methods helpful.
Overall, research regarding these methods is difficult to assess as there are very few studies, many of which have small sample sizes. Additional research is necessary in larger groups of women to determine safety, effectiveness, tolerance, and benefit in relation to cost.
In women in which these methods worked, symptoms were only slightly relieved, and needed to be used in conjunction with other methods. However, wristbands can be easily used and do not interfere with normal daily function.
Conversely, acupuncture appointments and electrostimulation bands (ReliefBand®) can be expensive (without insurance coverage); further, acupuncture appointments may not be tolerated in women with severe symptoms.
Pressure wristbands (i.e. Sea-Bands®) may be more cost effective and can be easily added to any management regimen.
Women should talk to their HCP if they experience severe NVP symptoms, or symptoms they can no longer control or manage on their own. Women should also talk to their HCP before using any form of acupressure, acupuncture, or acustimulation.
All Source Pregnancy has no affiliation with Sea-Bands® or ReliefBand®.
Background
Acupuncture, acustimulation, and acupressure all involve different types of stimulation to the Nei Guan (PC6) point on the wrist; acupressure also includes many other points on the body. These methods are often studied in post-operative and chemotherapy nausea, as well as Nausea and Vomiting of Pregnancy (NVP).
According to the principles of Traditional Chinese Medicine (TCM) relief of nausea and vomiting is accomplished by stimulation of certain points on the body to restore balance and promote healthy digestive functions.
PC6 is located on the underside of the wrist approximately 3 to 5 cm above the wrist crease, that can be easily felt between two tendons.
Acupressure and electrical stimulation wrist bands have been associated with an improvement in NVP symptoms, but data is very limited. It has been recommended that much large studies/clinical trials are necessary to more adequately determine safety and effectiveness.
However, very few studies reported adverse side effects for any form of PC6 stimulation; however, acupuncture can be associated with lightheadedness, light bruising, or infection. These effects can be avoided through appointments with hygienic practices and licensed acupuncturists.
Acupressure
Acupressure is the application of pressure on specific points on the body to control symptoms.
Pressure may be placed manually or with elastic bands to the inside of the wrists that provide steady pressure with either the fingers (manual) or a small button or disc (band).
Several studies have documented the effectiveness of pressure at the PC6 point for the reduction of nausea (but not vomiting), which some have reported to match vitamin B6 supplementation.
Of note, at least one study indicated acupressure bands were more effective if applied early in the symptom experience, and were less effective if applied later.
However, not all studies have found acupressure effective for NVP management, but due to a lack of side effects and the possibility of its effectiveness for some women, acupressure remains a viable option.
The Hegu point (L14) is another pressure point associated with nausea reduction; the LI4 is located on the back of the hand between the thumb and forefinger. LI4 is often cited as a “forbidden” location during pregnancy, due to possible effects on the uterus that may cause contractions.
However, there is no current evidence that acupuncture or acupressure at L14 or any point can induce miscarriage or the onset of labor. Further, L14 has not been shown to cause harm in pregnant animal studies.
Note: Acupressure on L14 for the reduction of NVP has not been studied regarding effectiveness or safety, and all studies regarding its safety during pregnancy have been very limited in scope and quality.
Acupuncture
Acupuncture involves inserting hair-thin needles into the skin and has been used to treat NVP for thousands of years in TCM. It is assessed that acupuncture can have a positive effect on the gastrointestinal tract or through action on the somatovisceral reflexes through the skin which can relax the autonomic nervous system.
Acupuncture has been less studied than acupressure, but several studies have shown it to be effective at reducing NVP symptoms; however, it is possible that some women may have improved simply with the progression of pregnancy.
Further, additional studies are quite small and of low quality. It is necessary for larger studies to be completed to determine a better understanding of the effect acupuncture may have on NVP symptoms, as well as women’s tolerance for it.
Acustimulation
Acustimulation is the process of stimulation of the PC6 point on the wrist through constant electrostimulation (electrical impulses) over the skin through a wearable device; some studies have found this to be more effective than acupuncture.
Similar to acupressure, evidence is inconsistent regarding the overall effectiveness of acustimulation for the relief of symptoms associated with NVP and Hyperemesis Gravidarum (HG). However, several studies have found it safe and effective for nausea and vomiting, to include the promotion of weight gain in women with HG.
An intradermal thumbtack needle, a needle placed at the PC6 site for 24 hours that can be manually pressed when needed, is currently being studied (as of November 2019) for postoperative nausea. If proven effective, it is possible these results could be extrapolated for NVP and provide an additional option for pregnant women, but more research is necessary.
Action
While evidence for all types of PC6 stimulation is mixed, due to a lack of harm and very few side effects, some women may find these methods helpful.
Acupressure bands can be purchased at local convenience stores for approximately $10; acustimulation bands can vary in price from $100 to $200. (*All Source Pregnancy has no affiliation or financial relationship with either Sea-Bands® or Reliefbands®.)
Note: ReliefBand and Sea-Bands, as medical devices, are both FDA cleared for NVP, but not approved. This means the products are allowed to be marketed for this use (pre-market notification), but the manufacturers did not have to submit detailed efficacy data to the U.S. Food and Drug Administration for approval, only that the devices are substantially equivalent to another product already on the market (read more).
Women should talk to their HCP if they experience severe NVP symptoms, or symptoms they can no longer control or manage on their own. Women should also talk to their HCP before using any form of acupressure, acupuncture, or acustimulation.
Women should also consider sharing their NVP experience below, especially if their experience included using acupressure, acupuncture, or acustimulation to help them mange symptoms. This can help other women learn potential new ways to manage their owns symptoms.
Resources
Effect of acustimulation on nausea and vomiting and on hyperemesis in pregnancy: a systematic review of Western and Chinese literature (BMC Complement Altern Med. 2016)
Meta-analysis of Acustimulation Effects on Nausea and Vomiting in Pregnant Women (Explore (NY). 2006)