Low back pain in athletes can be controlled with acupuncture by a catecholaminergic pathway: clinical trial

Abstract

Background: Activation of the sympathetic nervous system attenuates inflammation via catecholamines. Recent evidence has shown that electroacupuncture (EA) activates neuronal networks involved in the release of dopamine and norepinephrine that control systemic inflammation. In muscle, catecholamines are related to cyclic adenosine monophosphate (cAMP). This signaling molecule has been implicated in recovery from sustained contractile activity, which may induce muscular pain, such as that which occurs during low back pain (LBP). Objective: Our aim was to evaluate the effects of EA used for the control of LBP on the activation of the sympathetic nervous system in a randomized controlled clinical trial in athletes. Methods: Two groups of athletes with acute or chronic low back pain were studied. EA, sham EA and pharmacological treatment (diclofenac sodium) were evaluated. The outcome measures included a pain score represented by a visual analogue scale (VAS) and serum levels of catecholamines quantified by enzyme-linked immunosorbent assay. In addition, blood was collected into chilled heparin tubes, placed in 96-well cell culture plates and incubated with an equal volume of Roswell Park Memorial Institute (RPMI) medium, with lipopolysaccharide (LPS) alone or with catecholamines. Tumor necrosis factor (TNF)-α levels in the supernatants were analyzed. Results: The results indicated that the initial pain ratings did not differ between the groups analyzed. EA induced epinephrine secretion but not norepinephrine or dopamine secretion. Although EA and pharmacological treatment did not differ in terms of pain relief, in vitro epinephrine and norepinephrine reduced TNF-α production in response to LPS stimuli. Conclusion: EA activates the sympathetic nervous system and induces the release of epinephrine, which could ameliorate inflammation and protect muscular tissue in addition to relieving pain.

Ozone for the treatment of temporomandibular joint disorders: a systematic review and meta-analysis

“… 27 This represents an increase in the threshold and a reduction in the responsiveness at the peripheral sensory nerve fibers. 28 This mechanism explains the results of the included studies that OT can diminish pain in TMD. Unfortunately, these clinical studies exhibited great heterogeneity, high risk of bias and low quality.…”

Nonpharmacological Interventions for Pain in Patients with Temporomandibular Joint Disorders: A Systematic Review

“…70 When the needle is inserted in an acupuncture point, the peripherical nerve system is stimulated due to a nerve depolarization, and in consequence, there is a release of neuropeptides, hormones, 71 and neurotransmitters, such as acetylcholine and catecholamines. 72,73 These mediators can modulate the stress, inflammation (cell activation, differentiation, and immunophenotype), 74 and pain. Such conditions have been linked to various types of diseases in a variety of medical disciplines, for instance, in dentistry.…”

Research Progress of Acupuncture Analgesia Based on Autonomic Nerve Regulation Pathway

“…Reversing the state of abnormal autonomic function and relieve pain Low back pain [82] ST36, BL25, GB30, BL40, GB34 Sympathetic A activates the sympathetic nervous system and induces the release of epinephrine, which could ameliorate inflammation and protect muscular tissue in addition to relieving pain ACC: Anterior cingulate cortex; TRPV1: Transient receptor potential vanilloid 1; taVNS: Transcutaneous auricular vagus nerve stimulation.…”

“…In patients with lower back pain, vagal nerve tone is significantly reduced, sympathetic nerve activity is significantly increased, and electroacupuncture can reverse abnormal autonomic nerve function and relieve pain [81] . In addition, electroacupuncture can also activate the sympathetic nervous system, promote the release of adrenaline, and play an anti-inflammatory and analgesic role [82] .…”