Acupuncture analgesia: A review of peripheral and central mechanisms

Abstract

Acupuncture is an ancient needling modality within Traditional Chinese Medicine used for chronic pain management. Western biophysical and Chinese meridian theory views of pain differ, and so do their respective management practices. The reversible effect of naloxone on the acupuncture induced analgesia is well known. Research has also shown correlations between acupuncture and its effect on the peripheral nerve endings, connective tissue, neurotransmitters, and inflammatory mediators. Centrally, studies with functional imaging and dynamic quantitative sensory testing substantiate the modulatory role of acupuncture in the "wind-up" phenomenon of spinal wide dynamic range neurons and different brain areas related to pain perception and modulation. Despite this increased understanding in the mechanisms and the analgesic efficacy of acupuncture, controversy continues to evolve around the issues of placebo effect and its potential therapeutic role in the main stream medicine.