Acupuncture-Analgesia-Mediated Alleviation of Central Sensitization

Abstract

Pain can trigger central amplification called central sensitization, which ultimately results in hyperalgesia and/or allodynia. Many reports have showed acupuncture has an analgesic effect. We searched the related article on PubMed database and Cochrane database to discover central sensitization pathway in acupuncture analgesia. We summarized that acupuncture enhances the descending inhibitory effect and modulates the feeling of pain, thus modifying central sensitization. The possible mechanisms underlying the analgesic effects of acupuncture include segmental inhibition and the activation of the endogenous opioid, adrenergic, 5-hydroxytryptamine, and N-methyl-D-aspartic acid, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid/kainate pathways. Moreover, acupuncture can locally reduce the levels of inflammatory mediators. In clinical settings, acupuncture can be used to treat headache, neuropathic pain, low back pain, osteoarthritis, and irritable bowel syndrome. These mechanisms of acupuncture analgesia may be involved in the alleviation of central sensitization.

Electroacupuncture Inhibits the Activity of Astrocytes in Spinal Cord in Rats with Visceral Hypersensitivity by Inhibiting P2Y1 Receptor‐Mediated MAPK/ERK Signaling Pathway

“…EA at body surface acupoints can inhibit visceral injury response at multiple nerve levels with the largest inhibitory effect on spinal dorsal horn [8]. EA can also significantly inhibit the expression of NMDA receptor 1 (NR1) [9] and NR2B receptors [10,11] in the spinal dorsal horn in relieving visceral hypersensitivity [12,13]. In recent years, it has been found that activation of spinal glial cells is a key factor in the occurrence and persistence of visceral hypersensitivity [14].…”

Fire needle plus cupping for acute herpes zoster: study protocol for a randomized controlled trial

“…To our knowledge, so far, this study may be the first clinical trial study that aims to demonstrate the FC effect on AHZ infection with rigorous design and it may also be different from the reference therapy. However, it has gotten our attention that several existing Chinese literatures did report on fire needle and cupping technique to cure for HZ [12][13][14]16] but all of them did not take up a rigorous design trial and are lacking of sufficient evidence to prove FC treatment has a positive effect on AHZ.…”

“…Ancient TCM practitioners also found that the heat provided by fire needles can promote microcirculation in the lesion area through the regulation of cutaneous nerves, and it is particularly beneficial to the absorption of inflammation and metabolites [13]. Furthermore, the high temperature of fire needles can generate an effect that directly kills the microorganisms and achieves antiinflammatory outcomes [14]. Therefore, this trial is aiming along the same line as ancient TCM practitioners and to further provide the fact results in order to validate the analgesic effect on acute herpes zoster (AHZ) treated by trial group A (FC).…”

<p>Evaluating the Characteristics, Reporting and Methodological Quality of Systematic Reviews of Acupuncture for Low Back Pain by Using the Veritas Plot</p>

“…Vickers 34 2012 [13] RCT [19] 10.5 [17] 21.5 [17] 0 [12] Not assessed [16] 15.67 Trigkilidas 35 2010 [10] RCT [19] 4.5 [4] 14 [2] 0 [12] Not assessed [16] 10.50 Machado 36 2009 [8] RCT [19] 7.5 [10] 18.5 [10] 0 [12] Not assessed [16] 12.50 Keller 37 2007 [4] RCT [19] 4 [3] 14.5 [3] 2.5 [17] Not assessed [16] 10.33 Yuan 38 2008 [7] RCT [19] 9 [14] 16.5 [7] 0 [12] Not assessed [16] 12.50 Manheimer 39 2005 [3] RCT [19] 6 [7] 23.5 [18] 0 [12] Not assessed [16] 12.50 Ammendolia 40 2008 [7] RCT [19] 6.5 [8] 15 [4] 0 [12] Not assessed [16]…”

“…7 As a safe and acceptable form of acute analgesia, acupuncture can relieve the symptoms of LBP. [8][9][10] The analgesic mechanism of acupuncture is to stimulate sensory nerve endings, leading to the release of endogenous opioid hormones and other nonopioids in the brain and spinal cord, [11][12][13] which could block the transmission of nerve impulses and thereby relieve pain. 14 In the American College of Physicians guideline, six related SRs and RCTs about acupuncture were included on noninvasive treatments for LBP, the oldest of which was published in 2002.…”