Acupuncture for Psychological Disorders Caused by Chronic Pain: A Review and Future Directions

Abstract

Accumulating evidence supports an association between chronic pain and psychological disorders, a connection that seems to be bidirectional. Treating both the pain and psychological conditions together is essential for effective treatment outcomes. Acupuncture is a somatosensory-guided mind–body therapy that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. In this review, we discuss the use of acupuncture in some conditions with a high incidence of psychological disorders caused by chronic pain: headache, musculoskeletal pain, low back pain, and cancer pain, focusing on the effect and potential mechanisms of acupuncture. Overall clinical studies indicated that acupuncture might effectively contribute to management of psychological disorders caused by chronic pain. Mechanistic studies showed that acupuncture significantly alleviated such psychological disorders by regulating the activity of amygdala and insula, and regulating functional connectivity of insular and limbic regions/medial prefrontal cortex in humans and the corresponding animal models. In addition, 5-HT in the dorsal raphe nucleus, opioid receptors in the cingulate cortex, and plasma met-enkephalin are involved in acupuncture relief of pain and psychological symptoms. Substantial evidences from animal and human research support a beneficial effect of acupuncture in psychological disorders caused by chronic pain.

Electroacupuncture Ameliorates Chronic Inflammatory Pain-Related Anxiety by Activating PV Interneurons in the Anterior Cingulate Cortex

“…Electroacupuncture (EA) is a treatment method that combines traditional acupuncture with electrical nerve stimulation based on the basic theory of traditional Chinese medicine. Both animal and human studies have shown that EA can significantly improve chronic inflammatory pain and pain-induced disorders ( Lin et al, 2020 ). Our previous studies have demonstrated that EA relieved chronic inflammatory pain and pain-related anxiety by downregulating PKMzeta expression and upregulating the neuropeptide S (NPS)/NPSR system in the anterior cingulate cortex (ACC) ( Du et al, 2017 ; Du et al, 2020 ; Xu et al, 2020 ).…”

Contralateral Acupuncture for the Treatment of Phantom Limb Pain and Phantom Limb Sensation in Oncologic Lower Limb Amputee: A Case Report

“…Acupuncture can improve pain-related mood disorders (Shi et al, 2020) and alleviate retrieval of pain memory (Sun et al, 2015). In a word, acupuncture can manage the multidimensional nature of pain with the capability of restoring homeostasis, (Li et al, 2017;Lin et al, 2020) which seems to be an optimal adjuvant therapy (Tseng et al, 2014). More importantly, this complies with the holistic concept of traditional Chinese medicine, because Chinese medicine believes that the human body is an organic whole.…”

Potential Mechanisms of Acupuncture for Functional Dyspepsia Based on Pathophysiology

“…In conclusion, sham acupuncture could be defined as a useful “inactive” control, so even if acupuncture treatment was not superior to sham acupuncture in some researches, we could not ignore the effect of acupuncture ( Lin et al, 2020 ). Meanwhile, there was no single adequate sham intervention for acupuncture trials and the choice of sham acupuncture should depend on the aims ( Dincer and Linde, 2003 ), such as answering specific questions on the composite influence of the various manipulated variables (location, depth, manipulation, de qi, etc.).…”