Background

Auriculotherapy applies the principles of to specific points on the ear. It is a treatment modality where the specific malfunctioning organ or a systemic illness can be treated by application of a laser and/or (transcutaneous electrical nerve stimulation) unit to a correlating part of the external ear.

The point on the ear is located according to a somatotopic map, where each part of the auricle, or external ear, corresponds with a part of the body. The most popular somatotopic map is the "inverted fetus" image, where the organs correspond to the superimposed image of an upside-down person. However, at least four other maps exist to locate and treat maladies of the body. Practitioners may use the somatotopic map to correct imbalances or disease in nearly any part of the body, including chronic health conditions and diseases.
Auriculotherapy was discovered by Dr. Paul Nogier in the 1950s, a French practitioner who treated sciatica by cauterizing, or destroying by burning, searing, or scarring, an area of the ear.

Dr. Nogier's success with this treatment led him to investigate the insertion of acupuncture needles into the ear as a treatment for pain. Proponents believe that auriculotherapy works because many of the nerve endings in the ear connect to hormonal parts of the brain and organs within the body.

Auriculotherapy is most popularly used to treat substance abuse and chronic pain. Some hospitals offer auriculotherapy for post-operative pain management. Some detox centers provide auriculotherapy for the treatment of drug addiction.

Auriculotherapy can and should be used to maintain health and promote recovery from almost any condition. Uses of auriculotherapy based on tradition or theory include addiction, adrenal disorders, analgesia, chronic pain, high blood pressure, inflammation, musculoskeletal disorders, pain, relaxation, sciatica, stress, and swelling. Advocates claim that because of the wide range of point functions and locations on the ear, auriculotherapy has a promising future alongside conventional Western treatment of nearly every condition. Despite its claimed uses, there are currently no available high quality trials confirming its efficacy.

Auriculotherapy applies the principles of to specific points on the ear. It is a treatment modality where the specific malfunctioning organ or a systemic illness can be treated by application of a laser and/or (transcutaneous electrical nerve stimulation) unit to a correlating part of the external ear.

The point on the ear is located according to a somatotopic map, where each part of the auricle, or external ear, corresponds with a part of the body. The most popular somatotopic map is the "inverted fetus" image, where the organs correspond to the superimposed image of an upside-down person. However, at least four other maps exist to locate and treat maladies of the body. Practitioners may use the somatotopic map to correct imbalances or disease in nearly any part of the body, including chronic health conditions and diseases.
Auriculotherapy was discovered by Dr. Paul Nogier in the 1950s, a French practitioner who treated sciatica by cauterizing, or destroying by burning, searing, or scarring, an area of the ear. Dr. Nogier's success with this treatment led him to investigate the insertion of acupuncture needles into the ear as a treatment for pain. Proponents believe that auriculotherapy works because many of the nerve endings in the ear connect to hormonal parts of the brain and organs within the body.
Auriculotherapy is most popularly used to treat substance abuse and chronic pain. Some hospitals offer auriculotherapy for post-operative pain management. Some detox centers provide auriculotherapy for the treatment of drug addiction.

Proponents claim that auriculotherapy can and should be used to maintain health and promote recovery from almost any condition. Uses of auriculotherapy based on tradition or theory include addiction, adrenal disorders, analgesia, chronic pain, high blood pressure, inflammation, musculoskeletal disorders, pain, relaxation, sciatica, stress, and swelling. Advocates claim that because of the wide range of point functions and locations on the ear, auriculotherapy has a promising future alongside conventional Western treatment of nearly every condition. Despite its claimed uses, there are currently no available high quality trials confirming its efficacy.

Technique

During a typical treatment, the practitioner, called an auriculotherapist, takes the complete medical history of the patient. The practitioner often examines the ear for slight variations in coloring, flaking skin, large veins, and other topical irregularities. The ear may also be palpated with the finger or special instruments for patient sensitivity. Treatment focuses on the presenting concern. Sessions may be as brief as 10 minutes or may last as long as an hour. The duration of the therapy varies according to the response of the patient to treatment and the severity of their condition.

A treatment may occur in an individual or group setting. The treatment is usually relatively painless, and some patients fall asleep during treatment.

Auriculotherapy is often combined with somatic acupuncture because of the synergy between the two treatment systems.

Auriculotherapists perform this therapy with a variety of tools, including TENS unit, a laser, press balls, or a magnet. Though a TENS unit involves the insertion of needles into the ear, the needles are not similar to those used for acupuncture. However, both of these practices might use the electrical current of the TENS unit to enhance stimulation of a point. Practitioners might also treat the patient's prescribed ear points with a laser, where the ray of a laser focuses on a particular point on the ear. Or, magnets or press balls may be taped to the auricle with medical tape. Press balls are small seeds, which are typically held against the ear.

Auriculotherapists may also practice bleeding, which is removing a couple drops of blood at certain points of the ear, or electroacupuncture, which is sending small electric currents through the ear or the body, to treat a variety of conditions.

Auriculotherapists must be licensed health care providers, such as an acupuncturist or chiropractor, to put needles into the ear. However, any individual may practice auriculotherapy with lasers, tape magnets, or press balls.

Theory/evidence

Whereas the acupuncture diagnostic and treatment system focuses on paths of energy running through the body, auriculotherapy focuses on connections between the ear, the affected organ(s), and the central nervous system. While ear acupuncture uses needles without an electrical current, auriculotherapy uses a TENS unit or a laser.

The exact mechanism of auriculotherapy's action is unclear, and the efficacy of this therapy is controversial. However, a 1980 study partially designed by contemporary auriculotherapy expert Terry Olsen and published in the journal Pain found a significant correlation between the "inverted fetus" somatotopic map and localized musculoskeletal pain. Auriculotherapy is currently under investigation to treat pain and neurological disturbances.

The capability of reflex points on the external ear to alter neuromuscular and neuropathic disorders has been attributed to the descending pain inhibitory pathways of the central nervous system. The inverted fetus perspective of the somatotopic arrangement of auricular acupuncture points was first described in the 1950s by Dr. Paul Nogier of France, and has received scientific support from double-blind studies examining auricular diagnosis of musculoskeletal and of coronary disorders. Acupuncture points on the ear and on the body have lower levels of electrical skin resistance than surrounding tissue. These electrodermal differences are apparently related to autonomic control of blood vessels rather than increased sweat gland activity. The heightened tenderness of reactive acupuncture points may be explained by the accumulation of noxious, subdermal substances. Electrical stimulation of specific points on the external ear leads to site-specific neural responses in different regions of the brain. Behavioral analgesia produced by auricular acupuncture can be blocked by the opiate antagonist naloxone, indicating the role of endorphinergic systems in understanding the underlying mechanisms of auriculotherapy. The anatomical structures and electrical application of the auricle are described as they relate to the localization of master points, musculoskeletal points, internal organ points, and neuroendocrine points.

The scientific community has not reached a consensus on the efficacy of auriculotherapy. Most trials of this practice are of poor design quality; the results are often difficult to analyze. Based on one randomized, controlled trial, auriculotherapy appears to have no effect for the treatment of cervical myofascial pain. In this study, somatic acupuncture was used together with auriculotherapy, and although both somatic acupuncture alone and the combined technique had positive effects in reducing pain, there was no significant difference between the two groups, indicating that auriculotherapy did not have any strong additive effects.
A study that tested auriculotherapy as an aid for smoking cessation found that after two months of treatment, 15 people (38.5%) had stopped completely and 24 people had reduced their smoking by more than half. Details of this study are unclear, and more research is needed to confirm these findings.

Safety

Caution is advised in pregnant women. Acupuncture somatotopic systems strictly prohibit the needling of some points in pregnant women, because they theoretically move vital essences and might induce a miscarriage.
Some patients may become lightheaded during treatment.


Bibliography
Auriculotherapy.com. www.auriculotherapy.com. Last accessed May 30, 2006.
Auriculotherapy Training Institute. www.auriculotherapy.org. Last accessed October 4, 2007.
Ceccherelli F, Tortora P, Nassimbeni C, et al. The therapeutic efficacy of somatic acupuncture is not increased by auriculotherapy: a randomized, blind control study in cervical myofascial pain. Complement Ther Med. 2006 Mar;14(1):47-52.
Electrotherapy Association. www.electrotherapy.com. Last accessed October 4, 2007.
King CE, Clelland JA, Knowles CJ, et al. Effect of helium-neon laser auriculotherapy on experimental pain threshold. Phys Ther. 1990 Jan;70(1):24-30.
Oleson T. Auriculotherapy stimulation for neuro-rehabilitation. NeuroRehabilitation. 2002;17(1):49-62.
Oleson TD, Kroening RJ, Bresler DE. An experimental evaluation of auricular diagnosis: the somatotopic mapping or musculoskeletal pain at ear acupuncture points. Pain. 1980 Apr;8(2):217-29
Oleson, T. Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture. London: Churchill Livingstone. 2002.