Pain is an unpleasant sensation that can significantly affect our quality of life. Most pains involve one or more of the following pain mechanisms: peripheral sensitization, central sensitization, and pain processing in the brain. Acupuncture effectively targets these mechanisms to alleviate pain.
There were 826 clinical studies about treating pain with acupuncture alone in the year of 2022, not including animal experiments, non-English and non-pain related studies. (Li ZQ, 2024).
Peripheral Sensitization
Pain starts at the site of injury or inflammation, where damaged tissues generate pain signals transmitted through peripheral nerves to the spinal cord and brain. Acupuncture directly addresses this by reducing inflammation and promoting blood circulation (Inoue, 2008) at the site of injury or inflammation. Needle insertion stimulates nerve fibers, releasing natural painkillers like endorphins and neurotransmitters, reducing pain signal transmission from the injury site to the spinal cord.
Central Sensitization
When pain signals from peripheral nerves are frequent or intense, they cause the spinal cord and central nervous system to become overly responsive, leading to heightened pain sensitivity and even causing non-painful stimuli to be perceived as painful. Acupuncture helps regulate central sensitization by reducing neuroinflammation and inhibiting excessive neuron activity (inactivation of glial cells) in the spinal cord (Gim, 2011), reducing overall pain sensitivity, and normalizing pain processing pathways.
Abnormal Pain Processing in the Brain
This involves how the brain interprets pain signals, involving various regions responsible for emotions, cognition, and stress responses. Acupuncture influences brain regions involved in pain perception and emotional regulation by promoting the release of serotonin (Saliha Karatay, 2018), a neurotransmitter that enhances mood and pain inhibition. This effect is similar to how physicians use antidepressant medications to treat chronic pain (e.g., lower back pain, fibromyalgia) by increasing serotonin levels. Additionally, studies show that acupuncture alters brain activity in pain networks (Zyloney, 2010), reducing pain sensation and emotional distress.
Although some pain can arise from the abnormal processing of pain signals without any clear evidence of tissue damage, most pains start with peripheral sensitization. If pain is left untreated, it may escalate, leading to sensitization at the spinal cord and abnormal processing in the brain, which becomes harder to treat. Early pain management is thus crucial in preventing further complications.
References
Gim, G. J. (2011). Electroacupuncture attenuates mechanical and warm allodynia through suppression of spinal glial activation in a rat model of neuropathic pain. Brain Res. Bull., 86: 403-411.
Inoue, M. H. (2008). Acupuncture treatment for low back pain and lower limb symptoms — the relation between acupuncture or electroacupuncture stimulation and sciatic nerve blood flow. Evid. Based Complement. Alternat. Med., 5: 133-143.
Li ZQ, W. X. (2024). Global trends of acupuncture clinical research on analgesia from 2010 to 2023: a bibliometric and visualization analysis. Front Neurol., 15:1368988.
Saliha Karatay, S. C. (2018). Effects of Acupuncture Treatment on Fibromyalgia Symptoms, Serotonin, and Substance P Levels: A Randomized Sham and Placebo-Controlled Clinical Trial. Pain Medicine, 19(3), 615–628.
Zyloney, C. K. (2010). Imaging the functional connectivity of the Periaqueductal Gray during genuine and sham electroacupuncture treatment. Mol. Pain., 6: 80.
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