Effects of Acupuncture on Neuropathic Pain Induced by Spinal Cord Injury: A Systematic Review and Meta-Analysis

Abstract

Introduction. Neuropathic pain is a commonly seen symptom and one of the most intractable comorbidities following spinal cord injury (SCI). Acupuncture has been widely used for neuropathic pain after SCI in clinical settings. There is no systematic review or meta‐analysis evaluating the efficacy of acupuncture in the treatment of SCI-induced neuropathic pain. Thus, this study aimed to conduct a systematic review and meta-analysis to assess the efficacy of acupuncture on SCI-induced neuropathic pain. Methods. Seven databases were comprehensively searched, including PubMed, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Service System (SinoMed), the Wanfang Database, and the Chinese Scientific Journals Database (VIP) from their inception to 30 September 2021. Two independent reviewers evaluated the eligibility of the data retrieved based on the pre-established eligibility criteria and assessed the methodological quality of the included studies using the Cochrane Risk of Bias Tool. The outcome indexes in this study included the visual analogue scale, the numeric rating scale, the present pain intensity, and the pain region index. Sensitivity and subgroup analyses were also performed to specifically evaluate the intervention effects. In addition, publication bias was analyzed. Results. Six randomized controlled trials (145 participants in the experimental groups and 141 participants in the control groups) were identified that evaluated the application of acupuncture for neuropathic pain after SCI and were included in this study. The results of our study revealed that acupuncture had a positive effect on the pain severity (standardized mean difference (SMD): −1.40, 95% confidence interval (CI): −2.23; −0.57), the present pain intensity (MD = −0.61, 95% CIs = −0.98; −0.23), and the pain region index (MD = −3.04, 95% CI = −3.98; −2.11). In addition, sensitivity analyses showed that these results were robust and stable. Subgroup analyses indicated that electroacupuncture (EA) had better effects on SCI-induced neuropathic pain. However, a publication bias was observed. Conclusion. Available evidence appears to suggest that acupuncture may have a role in SCI-induced neuropathic pain management, but this remains to be determined.

Research progress on acupuncture treatment in central nervous system diseases based on NLRP3 inflammasome in animal models

“…Acupuncture is an effective therapeutic method, which has been widely practiced in China for more than 2,000 years. Several systematic reviews and meta-analyses have demonstrated that acupuncture can improve symptoms of CNS disorders, and its anti-inflammatory effects have long been proven (Chen et al, 2022b, He et al, 2022Lin C. J. et al, 2022;Zhou Z. et al, 2022). Exhilaratingly, PROKR2 neurons are indispensable for the anti-inflammatory effect of low-intensity electroacupuncture (EA) through the vagal-adrenal axis, which was once again confirmed by the article published in the authoritative journal NATURE last year (Liu et al, 2021).…”

Electroacupuncture promotes the repair of the damaged spinal cord in mice by mediating neurocan‐perineuronal net

“…Electroacupuncture (EA) is a combination of traditional acupuncture and electric current therapy, as an alternative and complementary strategy, has been widely used in the treatment of SCI with multi‐target therapy in clinical practice 24,25 . Many researchers have proved that EA can not only relieve neuropathological pain after SCI, 26 promote the repair of motor function of injury, 27 but also improve intestinal peristalsis 28 and bladder dysfunction 29 caused by injury. It plays a particular role in the process of neuronal repair post‐SCI 30–32 .…”