Mechanisms of Acupuncture-Electroacupuncture on Persistent Pain

Anesthesiology, 2014 · DOI: 10.1097/ALN.0000000000000101 · Published: February 1, 2014

Alternative Medicine Neurology Pain Management

Simple Explanation

Electroacupuncture, a form of acupuncture using electrical stimulation, has shown promise in preclinical studies for alleviating persistent pain arising from tissue injury, nerve damage, cancer, and visceral issues. It appears to work by activating the nervous system differently depending on whether the body is in a healthy state or experiencing pain. The pain-relieving effects of electroacupuncture are believed to stem from the release of various bioactive chemicals that act on peripheral, spinal, and supraspinal mechanisms. These chemicals include opioids (like endorphins), serotonin, and norepinephrine, which help to reduce inflammation and desensitize pain receptors. Combining electroacupuncture with low doses of conventional pain medications may offer a more effective approach to pain management. This combined approach could potentially reduce the side effects associated with higher doses of traditional pharmaceuticals.

Study Duration

Not specified

Participants

Animal models (rats and mice)

Evidence Level

Review of preclinical investigations

Key Findings

1
Electroacupuncture alleviates both sensory and affective dimensions of inflammatory pain, suggesting it not only reduces the physical sensation of pain but also the emotional distress associated with it.
2
Electroacupuncture inhibits inflammatory and neuropathic pain more effectively at lower frequencies (2–10 Hz) compared to higher frequencies (100 Hz), indicating that the frequency of stimulation is a crucial parameter for its effectiveness.
3
Electroacupuncture-induced endogenous opioids in the rostral anterior cingulate cortex may suppress NMDAR functions, which play an important role in electroacupuncture inhibition of the affective dimension of pain.

Research Summary

Electroacupuncture has been shown to significantly alleviate inflammatory, neuropathic, cancer, and visceral pain in animal models, suggesting its potential as a therapeutic intervention for various types of persistent pain. The mechanisms of electroacupuncture involve a complex interplay of bioactive molecules, including opioids, serotonin, norepinephrine, and cytokines, acting at peripheral, spinal, and supraspinal levels to modulate pain pathways. Electroacupuncture demonstrates potential for integration with conventional pain management strategies, as it can enhance the effects of pain medications and potentially reduce the required dosages, minimizing adverse effects.

Practical Implications

Integrative Pain Management

Electroacupuncture can be integrated into comprehensive pain management plans, complementing conventional treatments to improve patient outcomes.

Personalized Treatment Strategies

Tailoring electroacupuncture parameters, such as frequency, based on the type of pain and individual patient characteristics may optimize therapeutic effects.

Reduced Reliance on Pharmaceuticals

The ability of electroacupuncture to enhance the efficacy of pain medications may lead to reduced reliance on high doses of pharmaceuticals, minimizing side effects and improving quality of life.

Study Limitations

1
Brain mechanisms underpinning electroacupuncture analgesia are less studied than are peripheral and spinal mechanisms.
2
Female rats have been seldom used in electroacupuncture analgesia studies.
3
Peripheral mechanisms of electroacupuncture inhibition of neuropathic pain and the mechanisms of electroacupuncture inhibition of cancer pain are not well studied.

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