The effectiveness and safety of acupuncture treatment on sciatica: A systematic review and meta-analysis

Han, Kyou-Hwan; Cho, Ki Haeng; Han, Caroline Kim; Cui, Shanqin; Lin, Lily; Baek, Ho-Yu; Kim, Jaejong

doi:10.1016/j.ctim.2022.102872

Cited by 11 publications

(2 citation statements)

References 38 publications

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“…Thought to have therapeutic effects on over 100 kinds of diseases, acupuncture has been most widely studied for its efficacy on pain [2]. Specifically, acupuncture is effective in relieving inflammatory pain [3], neuropathic pain [4,5], and cancer pain [6]. Therefore, acupuncture is recommended by several guidelines as an essential complementary and alternative therapy for pain relief [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The Role of p38 Mitogen-Activated Protein Kinase-Mediated F-Actin in the Acupuncture-Induced Mitigation of Inflammatory Pain in Arthritic Rats

Zhou,

Zhang,

et al. 2024

Brain Sciences

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The analgesic efficacy of acupuncture has been widely recognized. However, the mechanism by which manual acupuncture-generated mechanical stimuli translate into biological signals remains unclear. This study employed a CFA-induced inflammatory pain rat model. Acupuncture intervention was then performed following standardized procedures. Enzyme-linked immunosorbent assay (ELISA) assessed inflammatory cytokines levels, while immunofluorescence and qRT-PCR screened the level of p38 and F-actin expression in the ST36 acupoint area of rats. Results indicated increased inflammatory factors, including IL-1β and TNFα, with reduced paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) in CFA rats compared to unmodeled rats. After acupuncture intervention, the heightened expression level of F-actin and p38 mRNA and the phosphorylation of p38 in the acupoint area was observed alongside decreased inflammatory factors in diseased ankle joints. The application of lifting and thrusting manipulations further enhanced the effect of acupuncture, in which the molecular expression level of muscle and connective tissue increased most significantly, indicating that these two tissues play a major role in the transformation of acupuncture stimulation. Moreover, antagonizing p38 expression hindered acupuncture efficacy, supporting the hypothesis that p38 MAPK-mediated F-actin transduces mechanical signals generated by acupuncture and related manipulation into biological signals.

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Section: Introductionmentioning

confidence: 99%

The Role of p38 Mitogen-Activated Protein Kinase-Mediated F-Actin in the Acupuncture-Induced Mitigation of Inflammatory Pain in Arthritic Rats

Zhou,

Zhang,

et al. 2024

Brain Sciences

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“…The World Health Organization has recommended acupuncture as a non-pharmacologic “first-line therapy” for pain treatment because of its precise analgesic efficacy and high safety ( Kelly and Willis, 2019 ). Although the complex mechanisms underlying acupuncture analgesia remain unclear, there is growing clinical evidence to suggest that acupuncture not only relieves the nociceptive experience of NP but also further modulates the negative emotions and cognitions caused by pain ( Paley et al, 2015 ; Estores et al, 2017 ; Edwards and Shaw, 2021 ; Han et al, 2022 ). Functional brain imaging studies have shown that acupuncture analgesia has region-specific, quantifiable effects on relevant brain structures ( Otti and Noll-Hussong, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Brain nuclei and neural circuits in neuropathic pain and brain modulation mechanisms of acupuncture: a review on animal-based experimental research

Su,

Cai,

Dou

et al. 2023

Front. Neurosci.

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Neuropathic pain (NP) is known to be associated with abnormal changes in specific brain regions, but the complex neural network behind it is vast and complex and lacks a systematic summary. With the help of various animal models of NP, a literature search on NP brain regions and circuits revealed that the related brain nuclei included the periaqueductal gray (PAG), lateral habenula (LHb), medial prefrontal cortex (mPFC), and anterior cingulate cortex (ACC); the related brain circuits included the PAG-LHb and mPFC-ACC. Moreover, acupuncture and injurious information can affect different brain regions and influence brain functions via multiple aspects to play an analgesic role and improve synaptic plasticity by regulating the morphology and structure of brain synapses and the expression of synapse-related proteins; maintain the balance of excitatory and inhibitory neurons by regulating the secretion of glutamate, γ-aminobutyric acid, 5-hydroxytryptamine, and other neurotransmitters and receptors in the brain tissues; inhibit the overactivation of glial cells and reduce the release of pro-inflammatory mediators such as interleukins to reduce neuroinflammation in brain regions; maintain homeostasis of glucose metabolism and regulate the metabolic connections in the brain; and play a role in analgesia through the mediation of signaling pathways and signal transduction molecules. These factors help to deepen the understanding of NP brain circuits and the brain mechanisms of acupuncture analgesia.

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Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk

Tu,

Shi,

Yan

et al. 2024

JAMA Intern Med

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ImportanceSciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce.ObjectiveTo investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk.Design, Settings, and ParticipantsThis was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk. Participants were recruited from March 25, 2021, to September 23, 2021, with a final follow-up through September 22, 2022. Data analyses were performed from December 2022 to March 2023.InterventionsParticipants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded.Main Outcomes and MeasuresThe 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4. Secondary outcomes were adverse events.ResultsA total of 216 patients (mean [SD] age, 51.3 [15.2] years; 147 females [68.1%] and 69 males [31.9%]) were included in the analyses. The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4 (mean difference, −16.0; 95% CI, −21.3 to −10.6; P &lt; .001). The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4 (mean difference, −8.1; 95% CI, −11.1 to −5.1; P &lt; .001). For both VAS and ODI, the between-group difference became apparent starting in week 2 (mean difference, −7.8; 95% CI, −13.0 to −2.5; P = .004 and −5.3; 95% CI, −8.4 to −2.3; P = .001, respectively) and persisted through week 52 (mean difference, −10.8; [95% CI, −16.3 to −5.2; P &lt; .001; and −4.8; 95% CI, −7.8 to −1.7; P = .003, respectively). No serious adverse events occurred.Conclusions and RelevanceThis randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52. Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk.Trial RegistrationChictr.org Identifier: ChiCTR2100044585

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The effectiveness and safety of acupuncture treatment on sciatica: A systematic review and meta-analysis

Cited by 11 publications

References 38 publications

The Role of p38 Mitogen-Activated Protein Kinase-Mediated F-Actin in the Acupuncture-Induced Mitigation of Inflammatory Pain in Arthritic Rats

The Role of p38 Mitogen-Activated Protein Kinase-Mediated F-Actin in the Acupuncture-Induced Mitigation of Inflammatory Pain in Arthritic Rats

Brain nuclei and neural circuits in neuropathic pain and brain modulation mechanisms of acupuncture: a review on animal-based experimental research

Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk

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