Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system

Abstract

Neuropathic pain, caused by a lesion or disease of the somatosensory system, is common and distressing. In view of the high human and economic burden, more effective treatment strategies were urgently needed. Acupuncture has been increasingly used as an adjuvant or complementary therapy for neuropathic pain. Although the therapeutic effects of acupuncture have been demonstrated in various high-quality randomized controlled trials, there is significant heterogeneity in the underlying mechanisms. This review aimed to summarize the potential mechanisms of acupuncture on neuropathic pain based on the somatosensory system, and guided for future both foundational and clinical studies. Here, we argued that acupuncture may have the potential to inhibit neuronal activity caused by neuropathic pain, through reducing the activation of pain-related ion channels and suppressing glial cells (including microglia and astrocytes) to release inflammatory cytokines, chemokines, amongst others. Meanwhile, acupuncture as a non-pharmacologic treatment, may have potential to activate descending pain control system via increasing the level of spinal or brain 5-hydroxytryptamine (5-HT), norepinephrine (NE), and opioid peptides. And the types of endogenously opioid peptides was influenced by electroacupuncture-frequency. The cumulative evidence demonstrated that acupuncture provided an alternative or adjunctive therapy for neuropathic pain.

A Comprehensive Overview of the Neural Mechanisms of Light Therapy

“…In clinical practice, the common approaches to treating chronic pain include opioid analgesic medication [ 26 ], cognitive behavioral therapy [ 27 , 28 ], meditation, and acupuncture [ 29 , 30 ]. However, these approaches have various limitations.…”

Acupuncture for neuropathic pain: focusing on the sympathetic nerve system

“…Acupuncture may inhibit neuronal activity caused by neuropathic pain by reducing pain-related ion channel and protein kinase activation. In addition, EA reduced the release of inflammatory factors such as tumor necrosis factor α and interleukin-1β, suppressing the neuronal excitability and inflammatory response [71] . Acupuncture as a non-pharmacological treatment has the potential to activate the descending pain control system by increasing the levels of spinal or brain 5-hydroxytryptamine, and opioid peptides [110] .…”

“…Possible mechanisms for the regulation of sympathetic nerves by acupuncture to relieve neuropathic pain Acupuncture as an alternative therapy has been widely used for the treatment of neuropathic pain such as peripheral neuropathic pain, prosopalgia, and postherpetic neuralgia [70][71][72] . Acupuncture has a benign effect on the ANS regulating function [20,[73][74] .…”

Bibliometric Analysis of Acupuncture Therapy for Cancer Pain Over the Past 10 Years

“…96 Acupuncture, as a early form and foundation of peripheral stimulation, 97,98 provide an alternative or adjunctive therapy for neuropathic pain via increasing the level of spinal or brain 5-hydroxytryptamine (5-HT), norepinephrine (NE), and opioid peptides. 99 Acupuncture are beneficial and cost-effective approaches for easing peripheral neuropathic pain and hence can be considered for peripheral neuropathic pain management. 100 A study showed that acupuncture resulted in significant improvement in CIPN symptoms compared with usual care.…”