Skip to main content
SpringerLink
Log in

Acupuncture Analgesia: A Review of Peripheral and Central Mechanisms

  • Chapter
  • First Online:
Book cover Neuroimaging of Pain

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 279.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education, 2011.

    Google Scholar 

  2. Prevention CfDCa. Injury Prevention & Control: Prescription Drug Overdose—What the Public Needs to Know about the Epidemic 2015 [updated May 5, 2015]. Available from: http://www.cdc.gov/drugoverdose/epidemic/public.html.

  3. Prevention CfDCa. Injury Prevention & Control: Prescription Drug Overdose—Understanding the Epidemic 2015 [April 30, 2015]. Available from: http://www.cdc.gov/drugoverdose/epidemic/index.html.

  4. Sita Ananth M. Complementary alternative medicine survey of hospitals—summary of results. Alexandria, VA: Samueli Institute; 2010. p. 2011.

    Google Scholar 

  5. White A, Ernst E. A brief history of acupuncture. Rheumatology. 2004;43(5):662–3.

    Article  CAS  PubMed  Google Scholar 

  6. Zhang X. Acupuncture: review and analysis of reports on Controlled Clinical Trials World Health Organization; 2003. Available from: http://apps.who.int/medicinedocs/pdf/s4926e/s4926e.pdf.

  7. A standard international acupuncture nomenclature: memorandum from a WHO meeting. Bull World Health Organiz 1990;68(2):165–9.

    Google Scholar 

  8. Asher GN, Jonas DE, Coeytaux RR, Reilly AC, Loh YL, Motsinger-Reif AA, et al. Auriculotherapy for PAIN management: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med. 2010;16(10):1097–108.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Usichenko TI, Lehmann C, Ernst E. Auricular acupuncture for postoperative pain control: a systematic review of randomised clinical trials. Anaesthesia. 2008;63(12):1343–8.

    Article  CAS  PubMed  Google Scholar 

  10. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444–53.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tan JY, Molassiotis A, Wang T, Suen LK. Adverse events of auricular therapy: a systematic review. Evid Based Complement Altern Med eCAM. 2014;2014:506758.

    Google Scholar 

  12. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S. Systematic review of adverse effects: a further step towards modernization of acupuncture in China. Evid Based Complement Altern Med eCAM. 2015;2015:432467.

    Google Scholar 

  13. Janssen PA, Demorest LC, Kelly A, Thiessen P, Abrahams R. Auricular acupuncture for chemically dependent pregnant women: a randomized controlled trial of the NADA protocol. Subst Abuse Treat Prev Policy. 2012;7:48.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cochrane S, Smith CA, Possamai-Inesedy A. Development of a fertility acupuncture protocol: defining an acupuncture treatment protocol to support and treat women experiencing conception delays. J Altern Complement Med. 2011;17(4):329–37.

    Article  PubMed  Google Scholar 

  15. Li X, Hu J, Wang X, Zhang H, Liu J. Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials. Chin Med. 2009;4:4.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Neri I, Airola G, Contu G, Allais G, Facchinetti F, Benedetto C. Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study. J Matern Fetal Neonatal Med (The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet). 2004;15(4):247–52.

    Article  CAS  Google Scholar 

  17. Zhang X, Cao B, Yan N, Liu J, Wang J, Tung VO, et al. Vagus nerve stimulation modulates visceral pain-related affective memory. Behav Brain Res. 2013;236(1):8–15.

    Article  PubMed  Google Scholar 

  18. IASP Taxonomy. Available from: http://www.iasp-pain.org/Taxonomy.

  19. van den Broeke EN, Mouraux A. Enhanced brain responses to C-fiber input in the area of secondary hyperalgesia induced by high-frequency electrical stimulation of the skin. J Neurophysiol. 2014;112(9):2059–66.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Schmid J, Langhorst J, Gass F, Theysohn N, Benson S, Engler H, et al. Placebo analgesia in patients with functional and organic abdominal pain: a fMRI study in IBS, UC and healthy volunteers. Gut. 2015;64(3):418–27.

    Article  PubMed  Google Scholar 

  21. Osaka N, Osaka M, Morishita M, Kondo H, Fukuyama H. A word expressing affective pain activates the anterior cingulate cortex in the human brain: an fMRI study. Behav Brain Res. 2004;153(1):123–7.

    Article  PubMed  Google Scholar 

  22. Garza-Villarreal EA, Jiang Z, Vuust P, Alcauter S, Vase L, Pasaye EH, et al. Music reduces pain and increases resting state fMRI BOLD signal amplitude in the left angular gyrus in fibromyalgia patients. Front Psychol. 2015;6:1051.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gosset N, Dietz N. Unlocking pain: deep brain stimulation might be the key to easing depression and chronic pain. IEEE Pulse. 2015;6(2):16–20.

    Article  PubMed  Google Scholar 

  24. Brain scans indicate that depression can increase pain perception. The Harvard Mental Health Letter from Harvard Medical School. 2009;25(9):7.

    Google Scholar 

  25. Asghar MS, Pereira MP, Werner MU, Martensson J, Larsson HB, Dahl JB. Correction: secondary hyperalgesia phenotypes exhibit differences in brain activation during noxious stimulation. PLoS ONE. 2015;10(5):e0128640.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Asghar MS, Pereira MP, Werner MU, Martensson J, Larsson HB, Dahl JB. Secondary hyperalgesia phenotypes exhibit differences in brain activation during noxious stimulation. PLoS ONE. 2015;10(1):e0114840.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  27. Fischer TZ, Waxman SG. Neuropathic pain in diabetes–evidence for a central mechanism. Nat Rev Neurol. 2010;6(8):462–6.

    Article  PubMed  Google Scholar 

  28. Rempe T, Wolff S, Riedel C, Baron R, Stroman PW, Jansen O, et al. Spinal fMRI reveals decreased descending inhibition during secondary mechanical hyperalgesia. PLoS ONE. 2014;9(11):e112325.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Kunimoto M. [The peripheral mechanism of physiological pain]. Brain and Nerve = Shinkei kenkyu no shinpo. 2012;64(11):1205–14.

    Google Scholar 

  30. Chang S. The meridian system and mechanism of acupuncture—a comparative review. Part 2: mechanism of acupuncture analgesia. Taiwan J Obstet Gynecol. 2013;52(1):14–24.

    Article  PubMed  Google Scholar 

  31. Hanson P, Schumacker P, Debugne T, Clerin M. Evaluation of somatic and autonomic small fibers neuropathy in diabetes. Am J Phys Med Rehabil Assoc Acad Physiatr. 1992;71(1):44–7.

    Article  CAS  Google Scholar 

  32. Introduction to Pain Pathways and Mechanisms.

    Google Scholar 

  33. Schlereth T, Birklein F. The sympathetic nervous system and pain. NeuroMol Med. 2008;10(3):141–7.

    Article  CAS  Google Scholar 

  34. Abramov R. Lumbar sympathetic treatment in the management of lower limb pain. Curr Pain Headache Rep. 2014;18(4):403.

    Article  PubMed  Google Scholar 

  35. He W, Wang X, Shi H, Shang H, Li L, Jing X, et al. Auricular acupuncture and vagal regulation. Evid Based Complement Altern Med eCAM. 2012;2012:786839.

    Google Scholar 

  36. Usichenko TI, Lehmann C, Ernst E. Auricular acupuncture for postoperative pain control: a systematic review of randomised clinical trials. Anaesthesia. 2008;63(12):1343–8.

    Article  CAS  PubMed  Google Scholar 

  37. Sator-Katzenschlager SM, Michalek-Sauberer A. P-Stim auricular electroacupuncture stimulation device for pain relief. Expert Rev Med Devices. 2007;4(1):23–32.

    Article  PubMed  Google Scholar 

  38. Psychogenic Pain: Cleveland Clinic. Available from: http://my.clevelandclinic.org/services/anesthesiology/pain-management/diseases-conditions/hic-psychogenic-pain.

  39. Kaptchuk TJ. The web that has no weaver. Lincolnwood, Ill.; St. Albans: Contemporary; Verulam [distributor]; 2000.

    Google Scholar 

  40. Wiseman N. Fundamentals of Chinese medicine. Southfield, Michigan: Readings for the Blind; 2007.

    Google Scholar 

  41. Hayano DS. Measuring Qi Energy Available from: http://www.equilibrium-e3.com/images/PDF/Measuring%20Qi%20Energy.pdf.

  42. Hui Lin PD. Overview of the status of Chinese Chi Research International Yan Xin Qigong Association. Available from: http://www.item-bioenergy.com/infocenter/chinesechiresearch.doc.

  43. Traditional Chinese Medicine: Wikipedia. Available from: https://en.wikipedia.org/wiki/Traditional_Chinese_medicine.

  44. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol. 2008;85(4):355–75.

    Article  PubMed  Google Scholar 

  45. Shi R. Pain according to Chinese Medicine San Gabriel, Texas: Rei Shi Acupuncture Clinic. Available from: http://reishiacupuncture.com/page/pain-according-to-chinese-medicine.

  46. Eades W. Ancient Chinese Medicine Meets Modern Anatomy Dissection: Acupuncture Today; 2015. January, 2015, Vol. 16, Issue 01. Available from: http://www.acupuncturetoday.com/mpacms/at/article.php?id=32980.

  47. MacPherson H, Asghar A. Acupuncture needle sensations associated with De Qi: a classification based on experts’ ratings. J Altern Complement Med. 2006;12(7):633–7.

    Article  PubMed  Google Scholar 

  48. Tian DS, Xiong J, Pan Q, Liu F, Wang L, Xu SB, et al. De qi, a threshold of the stimulus intensity, elicits the specific response of acupoints and intrinsic change of human brain to acupuncture. Evid Based Complement Altern Med eCAM. 2014;2014:914878.

    Article  Google Scholar 

  49. Nierhaus T, Pach D, Huang W, Long X, Napadow V, Roll S, et al. Differential cerebral response to somatosensory stimulation of an acupuncture point vs. two non-acupuncture points measured with EEG and fMRI. Front Hum Neurosci. 2015;9:74.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Egot-Lemaire SJP, Ziskin MC. Dielectric properties of human skin at an acupuncture point in the 50–75 GHz frequency range A pilot study. Bioelectromagnetics. 2011;32(5):360–6.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Ahn AC, Wu J, Badger GJ, Hammerschlag R, Langevin HM. Electrical impedance along connective tissue planes associated with acupuncture meridians. BMC Complement Altern Med. 2005;5(1):10.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Leung AY, Park J, Schulteis G, Duann JR, Yaksh T. The electrophysiology of de qi sensations. J Altern Complement Med. 2006;12(8):743–50.

    Article  PubMed  Google Scholar 

  53. Zhu L, Li C, Yang B, Ji C, Li W. The effect of neonatal capsaicin on acupuncture analgesia–to evaluate the role of C fibers in acupuncture analgesia. Zhen ci yan jiu = Acupuncture research [Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 1990;15(4):285–91.

    Google Scholar 

  54. Cao X. Scientific bases of acupuncture analgesia. Acupunct Electrother Res. 2002;27(1):1–14.

    Article  PubMed  Google Scholar 

  55. Li AH, Zhang JM, Xie YK. Human acupuncture points mapped in rats are associated with excitable muscle/skin-nerve complexes with enriched nerve endings. Brain Res. 2004;1012(1–2):154–9.

    Article  CAS  PubMed  Google Scholar 

  56. Helms J. The basic, clinical, and speculative science of acupuncture. In: Helms J, editor. Acupuncture energetics a clinical approach for physicians. Berkeley: Medical Acupuncture Publishers; 1995. p. 19–43.

    Google Scholar 

  57. Fuiyu Yip L. Tendinomuscular pain treatment with acupuncture. Available from: http://acupuncture-n-herbs.com/tendinomuscular-treatment-for-pain.

  58. Leung A, Khadivi B, Duann JR, Cho ZH, Yaksh T. The effect of Ting point (tendinomuscular meridians) electroacupuncture on thermal pain: a model for studying the neuronal mechanism of acupuncture analgesia. J Altern Complement Med. 2005;11(4):653–61.

    Article  PubMed  Google Scholar 

  59. Langevin HM, Churchill DL, Cipolla MJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. FASEB J: Official Publication of the Federation of American Societies for Experimental Biology. 2001;15(12):2275–82.

    Article  CAS  Google Scholar 

  60. Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, et al. Evidence of connective tissue involvement in acupuncture. FASEB J: Official Publication of the Federation of American Societies for Experimental Biology. 2002;16(8):872–4.

    CAS  Google Scholar 

  61. Yu Bai JW, Jin-peng Wu, et al. Review of evidence suggesting that the fascia network could be the anatomical basis for acupoints and meridians in the human body. Evid-Based Complement Altern Med. 2011.

    Google Scholar 

  62. Finando S, Finando D. Qi, acupuncture, and the fascia: a reconsideration of the fundamental principles of acupuncture. J Altern Complement Med. 2012;18(9):880–6.

    Article  PubMed  Google Scholar 

  63. Guo F, Song W, Jiang T, Liu L, Wang F, Zhong H, et al. Electroacupuncture pretreatment inhibits NADPH oxidase-mediated oxidative stress in diabetic mice with cerebral ischemia. Brain Res. 2014;1573:84–91.

    Article  CAS  PubMed  Google Scholar 

  64. Bing Z, Villanueva L, Le Bars D. Acupuncture and diffuse noxious inhibitory controls: naloxone-reversible depression of activities of trigeminal convergent neurons. Neuroscience. 1990;37(3):809–18.

    Article  CAS  PubMed  Google Scholar 

  65. Chung WY, Zhang HQ, Zhang SP. Peripheral muscarinic receptors mediate the anti-inflammatory effects of auricular acupuncture. Chin Med. 2011;6(1):3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Mattson MP. Glutamate and neurotrophic factors in neuronal plasticity and disease. Ann NY Acad Sci. 2008;1144:97–112.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Zhou W, Fu LW, Guo ZL, Longhurst JC. Role of glutamate in the rostral ventrolateral medulla in acupuncture-related modulation of visceral reflex sympathoexcitation. Am J Physiol Heart Circ Physiol. 2007;292(4):H1868–75.

    Article  CAS  PubMed  Google Scholar 

  68. Guo Z, Zhang L, Wu Y, Li M, Yang X, He Z, et al. The role of glutamate transporter-1 in the acquisition of brain ischaemic tolerance in rats induced by electro-acupuncture pre-treatment. Brain Inj. 2015;29(3):396–402.

    Article  PubMed  Google Scholar 

  69. Yang J, Liu WY, Song CY, Lin BC. Through central arginine vasopressin, not oxytocin and endogenous opiate peptides, glutamate sodium induces hypothalamic paraventricular nucleus enhancing acupuncture analgesia in the rat. Neurosci Res. 2006;54(1):49–56.

    Article  CAS  PubMed  Google Scholar 

  70. Enna SJ, McCarson KE. The role of GABA in the mediation and perception of pain. Adv Pharmacol. 2006;54:1–27.

    Article  CAS  PubMed  Google Scholar 

  71. Xu Q, Yang JW, Cao Y, Zhang LW, Zeng XH, Li F, et al. Acupuncture improves locomotor function by enhancing GABA receptor expression in transient focal cerebral ischemia rats. Neurosci Lett. 2015;588:88–94.

    Article  CAS  PubMed  Google Scholar 

  72. McLennan H, Gilfillan K, Heap Y. Some pharmacological observations on the analgesia induced by acupuncture in rabbits. Pain. 1977;3(3):229–38.

    Article  CAS  PubMed  Google Scholar 

  73. Pomeranz B, Nguyen P. Intrathecal diazepam suppresses nociceptive reflexes and potentiates electroacupuncture effects in pentobarbital-anesthetized rats. Neurosci Lett. 1987;77(3):316–20.

    Article  CAS  PubMed  Google Scholar 

  74. ZHU Lixia YY, MO Xiaorong, JI Changfu. The important role of activation of GABA_B receptors in acupuncture analgesia. Acupunct Res. 2002.

    Google Scholar 

  75. Sommer C. Serotonin in pain and analgesia: actions in the periphery. Mol Neurobiol. 2004;30(2):117–25.

    Article  CAS  PubMed  Google Scholar 

  76. Takagi J, Yonehara N. Serotonin receptor subtypes involved in modulation of electrical acupuncture. Jpn J Pharmacol. 1998;78(4):511–4.

    Article  CAS  PubMed  Google Scholar 

  77. Kim SK, Park JH, Bae SJ, Kim JH, Hwang BG, Min BI, et al. Effects of electroacupuncture on cold allodynia in a rat model of neuropathic pain: mediation by spinal adrenergic and serotonergic receptors. Exp Neurol. 2005;195(2):430–6.

    Article  CAS  PubMed  Google Scholar 

  78. Hu WB, Wu ZJ, Wang KM. Progress of researches on involvement of serotonin in the central nervous system in acupuncture analgesia and other effects. Zhen ci yan jiu = Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 2012;37(3):247–51.

    Google Scholar 

  79. Bravo-Hernandez M, Cervantes-Duran C, Pineda-Farias JB, Barragan-Iglesias P, Lopez-Sanchez P, Granados-Soto V. Role of peripheral and spinal 5-HT(3) receptors in development and maintenance of formalin-induced long-term secondary allodynia and hyperalgesia. Pharmacol Biochem Behav. 2012;101(2):246–57.

    Article  CAS  PubMed  Google Scholar 

  80. Liu X, Zhu B, Zhang SX. Relationship between electroacupuncture analgesia and descending pain inhibitory mechanism of nucleus raphe magnus. Pain. 1986;24(3):383–96.

    Article  CAS  PubMed  Google Scholar 

  81. Treister R, Pud D, Eisenberg E. The dopamine agonist apomorphine enhances conditioned pain modulation in healthy humans. Neurosci Lett. 2013;548:115–9.

    Article  CAS  PubMed  Google Scholar 

  82. Potvin S, Grignon S, Marchand S. Human evidence of a supra-spinal modulating role of dopamine on pain perception. Synapse. 2009;63(5):390–402.

    Article  CAS  PubMed  Google Scholar 

  83. Millan MJ. Descending control of pain. Prog Neurobiol. 2002;66(6):355–474.

    Article  CAS  PubMed  Google Scholar 

  84. Jarcho JM, Mayer EA, Jiang ZK, Feier NA, London ED. Pain, affective symptoms, and cognitive deficits in patients with cerebral dopamine dysfunction. Pain. 2012;153(4):744–54.

    Article  CAS  PubMed  Google Scholar 

  85. Wood PB. Role of central dopamine in pain and analgesia. Expert Rev Neurother. 2008;8(5):781–97.

    Article  CAS  PubMed  Google Scholar 

  86. Jaaskelainen SK, Lindholm P, Valmunen T, Pesonen U, Taiminen T, Virtanen A, et al. Variation in the dopamine D2 receptor gene plays a key role in human pain and its modulation by transcranial magnetic stimulation. Pain. 2014;155(10):2180–7.

    Article  CAS  PubMed  Google Scholar 

  87. Wang HH, Xu SF. Effect of D1 and D2 dopamine receptor antagonists on acupuncture analgesia. Sheng li xue bao: [Acta Physiologica Sinica]. 1993;45(1):61–8.

    CAS  Google Scholar 

  88. Dai JL, Xu SF. The attenuation effect of chlorpromazine on electro-acupuncture analgesia: involvement of dopamine system. Acupunct Electrother Res. 1991;16(3–4):101–9.

    Article  CAS  PubMed  Google Scholar 

  89. Liu XY, Zhou HF, Pan YL, Liang XB, Niu DB, Xue B, et al. Electro-acupuncture stimulation protects dopaminergic neurons from inflammation-mediated damage in medial forebrain bundle-transected rats. Exp Neurol. 2004;189(1):189–96.

    Article  CAS  PubMed  Google Scholar 

  90. Gao X, Xin BM, Zhu CB, Wu GC, Xu SF. Effect of intrathecal injection of dopamine receptor agonists/antagonists on pain and acupuncture analgesia in rats. Sheng li xue bao: [Acta Physiologica Sinica]. 1998;50(1):43–8.

    CAS  Google Scholar 

  91. Wang HH, Zhu YH, Xu SF. The potentiation effect of haloperidol on the binding of etorphine to brain membranes in acupuncture analgesia. Sheng li xue bao: [Acta Physiologica Sinica]. 1994;46(4):313–9.

    CAS  Google Scholar 

  92. Leung L. Neurophysiological basis of acupuncture-induced analgesia—an updated review. J Acupunct Meridian Stud. 2012;5(6):261–70.

    Article  PubMed  Google Scholar 

  93. Zhang Y, Qu H, Zhou Y, Wang Y, Zhang D, Yang X, et al. The involvement of norepinephrine in pain modulation in the nucleus accumbens of morphine-dependent rats. Neurosci Lett. 2015;585:6–11.

    Article  CAS  PubMed  Google Scholar 

  94. Ono H, Nakamura A, Kanbara T, Minami K, Shinohara S, Sakaguchi G, et al. Effect of the norepinephrine transporter (NET) Effect of the norepinephrine transporter (NET) Effect of the norepinephrine transporter (NET) inhibition on mu-opioid receptor (MOR)-induced anti-nociception in a bone cancer pain model. J Pharmacol Sci. 2014;125(3):264–73.

    Article  CAS  PubMed  Google Scholar 

  95. Cao J, Zhou MQ, Wu SB, Wang KM, Zhou YP, Wang YL, et al. Effects of acupuncture on expression of norepinephrine transporter mRNA in the cervical sympathetic ganglion and beta1-AR mRNA in the heart in cerebral-cardiac syndrome rats. Zhen ci yan jiu = Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 2011;36(4):252–7.

    Google Scholar 

  96. Wang H, Jiang J, Can X. Changes of norepinephrine release in rat’s nucleus reticularis paragigantocellularis lateralis in acupuncture analgesia. Zhen ci yan jiu = Acupuncture research/[Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 1994;19(1):20–5.

    Google Scholar 

  97. Hackel D, Stolz A, Mousa SA, Brack A, Rittner HL. Recruitment of opioid peptide-containing neutrophils is independent of formyl peptide receptors. J Neuroimmunol. 2011;230(1–2):65–73.

    Article  CAS  PubMed  Google Scholar 

  98. Mayer DJ, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res. 1977;121(2):368–72.

    Article  CAS  PubMed  Google Scholar 

  99. Brissett DI, Whistler JL, van Rijn RM. Contribution of mu and delta opioid receptors to the pharmacological profile of kappa opioid receptor subtypes. Eur J Pain. 2012;16(3):327–37.

    Article  CAS  PubMed  Google Scholar 

  100. Wang Y, Gehringer R, Mousa SA, Hackel D, Brack A, Rittner HL. CXCL10 controls inflammatory pain via opioid peptide-containing macrophages in electroacupuncture. PLoS ONE. 2014;9(4):e94696.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  101. Nezhentsev M, Aleksandrov S. Effect of naloxone on the antipyretic action of acupuncture. Pharmacology. 1993;46(5):289–93.

    Article  CAS  PubMed  Google Scholar 

  102. Wang Y, Zhang Y, Wang W, Cao Y, Han JS. Effects of synchronous or asynchronous electroacupuncture stimulation with low versus high frequency on spinal opioid release and tail flick nociception. Exp Neurol. 2005;192(1):156–62.

    Article  CAS  PubMed  Google Scholar 

  103. Fearon AM, Twin J, Dahlstrom JE, Cook JL, Cormick W, Smith PN, et al. Increased substance P expression in the trochanteric bursa of patients with greater trochanteric pain syndrome. Rheumatol Int. 2014;34(10):1441–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Teodoro FC, Tronco Junior MF, Zampronio AR, Martini AC, Rae GA, Chichorro JG. Peripheral substance P and neurokinin-1 receptors have a role in inflammatory and neuropathic orofacial pain models. Neuropeptides. 2013;47(3):199–206.

    Google Scholar 

  105. Parenti C, Arico G, Ronsisvalle G, Scoto GM. Supraspinal injection of Substance P attenuates allodynia and hyperalgesia in a rat model of inflammatory pain. Peptides. 2012;34(2):412–8.

    Article  CAS  PubMed  Google Scholar 

  106. Ebner K, Singewald N. The role of substance P in stress and anxiety responses. Amino Acids. 2006;31(3):251–72.

    Article  CAS  PubMed  Google Scholar 

  107. Lee HJ, Lee JH, Lee EO, Kim KH, Kim SH, Lee KS, et al. Substance P and beta-endorphin mediate electro-acupuncture induced analgesia in mouse cancer pain model. J Exp Clin Cancer Res CR. 2009;28:102.

    Article  PubMed  CAS  Google Scholar 

  108. Ma XP, Tan LY, Yang Y, Wu HG, Jiang B, Liu HR, et al. Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome. World J Gastroenterol WJG. 2009;15(41):5211–7.

    Article  CAS  PubMed  Google Scholar 

  109. Mackey S. Mechanisms of inflammatory pain: therapeutic implications. J Clin Rheumatol Pract Reports Rheum musculoskelet Dis. 2004;10(3 Suppl):S5–11.

    Google Scholar 

  110. Ji RR. Peripheral and central mechanisms of inflammatory pain, with emphasis on MAP kinases. Curr Drug Targets Inflamm Allergy. 2004;3(3):299–303.

    Article  CAS  PubMed  Google Scholar 

  111. Lin JG, Chen WL. Acupuncture analgesia: a review of its mechanisms of actions. Am J Chin Med. 2008;36(4):635–45.

    Article  CAS  PubMed  Google Scholar 

  112. Nager AL, Kobylecka M, Pham PK, Johnson L, Gold JI. Effects of acupuncture on pain and inflammation in pediatric emergency department patients with acute appendicitis: a pilot study. J Altern Complement Med. 2015;21(5):269–72.

    Article  PubMed  Google Scholar 

  113. Cao L, Zhang XL, Gao YS, Jiang Y. Needle acupuncture for osteoarthritis of the knee. A systematic review and updated meta-analysis. Saudi Med J. 2012;33(5):526–32.

    PubMed  Google Scholar 

  114. Wang C, de Pablo P, Chen X, Schmid C, McAlindon T. Acupuncture for pain relief in patients with rheumatoid arthritis: a systematic review. Arthritis Rheum. 2008;59(9):1249–56.

    Article  PubMed  Google Scholar 

  115. Levine JD, Gordon NC, Bornstein JC, Fields HL. Role of pain in placebo analgesia. Proc Natl Acad Sci USA. 1979;76(7):3528–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  116. Atlas LY, Wager TD. A meta-analysis of brain mechanisms of placebo analgesia: consistent findings and unanswered questions. Handb Exp Pharmacol. 2014;225:37–69.

    Article  PubMed  Google Scholar 

  117. Kam-Hansen S, Jakubowski M, Kelley JM, Kirsch I, Hoaglin DC, Kaptchuk TJ, et al. Altered placebo and drug labeling changes the outcome of episodic migraine attacks. Sci Transl Med. 2014;6(218):218ra5.

    Google Scholar 

  118. Vase L, Vollert J, Finnerup NB, Miao X, Atkinson G, Marshall S, et al. Predictors of the placebo analgesia response in randomized controlled trials of chronic pain: a meta-analysis of the individual data from nine industrially sponsored trials. Pain. 2015;156(9):1795–802.

    Article  CAS  PubMed  Google Scholar 

  119. Le Bars D, Dickenson AH, Besson JM. Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain. 1979;6(3):283–304.

    Article  PubMed  Google Scholar 

  120. Xiong J, Liu F, Zhang MM, Wang W, Huang GY. De-qi, not psychological factors, determines the therapeutic efficacy of acupuncture treatment for primary dysmenorrhea. Chin J Integr Med. 2012;18(1):7–15.

    Article  PubMed  Google Scholar 

  121. Chiu YH, Silman AJ, Macfarlane GJ, Ray D, Gupta A, Dickens C, et al. Poor sleep and depression are independently associated with a reduced pain threshold. Results of a population based study. Pain. 2005;115(3):316–21.

    Article  CAS  PubMed  Google Scholar 

  122. Wang XJ, Wang LL. A mechanism of endogenous opioid peptides for rapid onset of acupuncture effect in treatment of depression. Zhong xi yi jie he xue bao = J Chin Integr Med. 2010;8(11):1014–7.

    Article  Google Scholar 

  123. Bohren Y, Tessier LH, Megat S, Petitjean H, Hugel S, Daniel D, et al. Antidepressants suppress neuropathic pain by a peripheral beta2-adrenoceptor mediated anti-TNFalpha mechanism. Neurobiol Dis. 2013;60:39–50.

    Article  CAS  PubMed  Google Scholar 

  124. Lazzeri L, Vannuccini S, Orlandini C, Luisi S, Zupi E, Nappi RE, et al. Surgical treatment affects perceived stress differently in women with endometriosis: correlation with severity of pain. Fertil Steril. 2015;103(2):433–8.

    Article  PubMed  Google Scholar 

  125. Eshkevari L, Permaul E, Mulroney SE. Acupuncture blocks cold stress-induced increases in the hypothalamus-pituitary-adrenal axis in the rat. J Endocrinol. 2013;217(1):95–104.

    Article  CAS  PubMed  Google Scholar 

  126. Kong JT, Schnyer RN, Johnson KA, Mackey S. Understanding central mechanisms of acupuncture analgesia using dynamic quantitative sensory testing: a review. Evid Based Complement Altern Med eCAM. 2013;2013:187182.

    Google Scholar 

  127. Olesen SS, van Goor H, Bouwense SA, Wilder-Smith OH, Drewes AM. Reliability of static and dynamic quantitative sensory testing in patients with painful chronic pancreatitis. Reg Anesth Pain Med. 2012;37(5):530–6.

    Article  PubMed  Google Scholar 

  128. Arendt-Nielsen L, Yarnitsky D. Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J Pain: Official Journal of the American Pain Society. 2009;10(6):556–72.

    Article  Google Scholar 

  129. Zheng Z, Feng SJ, Costa C, Li CG, Lu D, Xue CC. Acupuncture analgesia for temporal summation of experimental pain: a randomised controlled study. Eur J Pain. 2010;14(7):725–31.

    Article  PubMed  Google Scholar 

  130. Tobbackx Y, Meeus M, Wauters L, De Vilder P, Roose J, Verhaeghe T, et al. Does acupuncture activate endogenous analgesia in chronic whiplash-associated disorders? A randomized crossover trial. Eur J Pain. 2013;17(2):279–89.

    Article  CAS  PubMed  Google Scholar 

  131. Le Bars D, Villanueva L, Bouhassira D, Willer JC. Diffuse noxious inhibitory controls (DNIC) in animals and in man. Patologicheskaia fiziologiia i eksperimental’naia terapiia. 1992;4:55–65.

    Google Scholar 

  132. Pud D, Granovsky Y, Yarnitsky D. The methodology of experimentally induced diffuse noxious inhibitory control (DNIC)-like effect in humans. Pain. 2009;144(1–2):16–9.

    Article  PubMed  Google Scholar 

  133. Schliessbach J, van der Klift E, Siegenthaler A, Arendt-Nielsen L, Curatolo M, Streitberger K. Does acupuncture needling induce analgesic effects comparable to diffuse noxious inhibitory controls? Evid Based Complement Altern Med eCAM. 2012;2012:785613.

    Article  Google Scholar 

  134. Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, Moore CI, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Hum Brain Mapp. 2000;9(1):13–25.

    Article  CAS  PubMed  Google Scholar 

  135. Liu WC, Feldman SC, Cook DB, Hung DL, Xu T, Kalnin AJ, et al. fMRI study of acupuncture-induced periaqueductal gray activity in humans. NeuroReport. 2004;15(12):1937–40.

    Article  PubMed  Google Scholar 

  136. Yoo SS, Teh EK, Blinder RA, Jolesz FA. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. NeuroImage. 2004;22(2):932–40.

    Article  PubMed  Google Scholar 

  137. Jeun SS, Kim JS, Kim BS, Park SD, Lim EC, Choi GS, et al. Acupuncture stimulation for motor cortex activities: a 3T fMRI study. Am J Chin Med. 2005;33(4):573–8.

    Article  PubMed  Google Scholar 

  138. Qin W, Tian J, Bai L, Pan X, Yang L, Chen P, et al. FMRI connectivity analysis of acupuncture effects on an amygdala-associated brain network. Mol Pain. 2008;4:55.

    Article  PubMed  PubMed Central  Google Scholar 

  139. Chen Y, Wang Y, Yin Q. The role of paraventricular nucleus of hypothalamus in acupuncture analgesia in rats. Zhen ci yan jiu = Acupuncture Research [Zhongguo yi xue ke xue yuan Yi xue qing bao yan jiu suo bian ji]. 1991;16(1):32–8.

    Google Scholar 

  140. Napadow V, Dhond RP, Purdon P, Kettner N, Makris N, Kwong KK, et al. Correlating acupuncture FMRI in the human brainstem with heart rate variability. Conference proceedings: annual international conference of the IEEE engineering in medicine and biology society IEEE engineering in medicine and biology society annual conference. 2005;5:4496–9.

    Google Scholar 

  141. Vargas CA, Helms Medical I. Medical acupuncture for physicians: a pocket clinical reference guide. Berkeley, California: Medical Acupuncture Publishers; 2004.

    Google Scholar 

  142. Shukla S, Torossian A, Duann JR, Leung A. The analgesic effect of electroacupuncture on acute thermal pain perception—a central neural correlate study with fMRI. Mol Pain. 2011;7:45.

    Article  PubMed  PubMed Central  Google Scholar 

  143. The Eight Influential Points. Available from: http://www.acupuncture.com/education/theory/eightpts.htm.

  144. Leung A, Zhao Y, Shukla S. The effect of acupuncture needle combination on central pain processing—an fMRI study. Mol Pain. 2014;10:23.

    PubMed  PubMed Central  Google Scholar 

  145. Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KK. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Hum Brain Mapp. 2005;24(3):193–205.

    Article  PubMed  Google Scholar 

  146. Li L, Liu H, Li YZ, Xu JY, Shan BC, Gong D, et al. The human brain response to acupuncture on same-meridian acupoints: evidence from an fMRI study. J Altern Complement Med. 2008;14(6):673–8.

    Article  CAS  PubMed  Google Scholar 

  147. Bai L, Tian J, Zhong C, Xue T, You Y, Liu Z, et al. Acupuncture modulates temporal neural responses in wide brain networks: evidence from fMRI study. Molecular Pain. 2010;6:73.

    PubMed  PubMed Central  Google Scholar 

  148. Usichenko TI, Wesolowski T, Lotze M. Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers. Brain Imaging Behav. 2015;9(2):236–44.

    Article  PubMed  Google Scholar 

  149. Huang W, Pach D, Napadow V, Park K, Long X, Neumann J, et al. Characterizing acupuncture stimuli using brain imaging with FMRI—a systematic review and meta-analysis of the literature. PLoS ONE. 2012;7(4):e32960.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  150. Tracey KJ. The inflammatory reflex. Nature. 2002;420(6917):853–9.

    Article  CAS  PubMed  Google Scholar 

  151. Xudong G. Clinical study on analgesia for biliary colic with ear acupuncture at point Erzhong. Am J Acupunct. 1993;21(3):237–9.

    Google Scholar 

  152. Arai YC, Sakakima Y, Kawanishi J, Nishihara M, Ito A, Tawada Y, et al. Auricular acupuncture at the “shenmen” and “point zero” points induced parasympathetic activation. Evid Based Complement Altern Med eCAM. 2013;2013:945063.

    Google Scholar 

  153. La Marca R, Nedeljkovic M, Yuan L, Maercker A, Elhert U. Effects of auricular electrical stimulation on vagal activity in healthy men: evidence from a three-armed randomized trial. Clinical Sci (London, England: 1979). 2010;118(8):537–46.

    Google Scholar 

  154. Sator-Katzenschlager SM, Michalek-Sauberer A. P-Stim (TM) auricular electroacupuncture stimulation device for pain relief. Expert Rev Med Devices. 2007;4(1):23–32.

    Article  PubMed  Google Scholar 

  155. Najafi S, Halstead-Kenny J. Applying auricular electroacupuncture device (P-STIM) for chronic lumbar radiculopathy. Am J Phys Med Rehabil. 2014:a33-a.

    Google Scholar 

  156. Holzer A, Leitgeb U, Spacek A, Wenzl R, Herkner H, Kettner S. Auricular acupuncture for postoperative pain after gynecological surgery: a randomized controlled trail. Minerva Anestesiol. 2011;77(3):298–304.

    CAS  PubMed  Google Scholar 

  157. Sator-Katzenschlager SM, Wolfler MM, Kozek-Langenecker SA, Sator K, Sator PG, Li B, et al. Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. Hum Reprod. 2006;21(8):2114–20.

    Article  PubMed  Google Scholar 

  158. Likar R, Jabarzadeh H, Kager I, Trampitsch E, Breschan C, Szeles J. Electrical point stimulation (P-STIM) via ear acupuncture: a randomized, double-blind, controlled pilot study in patients undergoing laparoscopic nephrctomyX. Schmerz (Berlin, Germany) [Internet]. 2007; 21(2):154–9. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/702/CN-00586702/frame.html, http://link.springer.com/article/10.1007%2Fs00482-006-0519-y.

  159. Kager H, Likar R, Jabarzadeh H, Sittl R, Breschan C, Szeles J. Electrical punctual stimulation (P-STIM) with ear acupuncture following tonsillectomy, a randomised, controlled pilot study. Acute Pain. 2009;11(3–4):101–6.

    Article  Google Scholar 

  160. Kong KH, Ng WW. Treatment of chronic pain with an auricular acupuncture device (P-Stim) in Singapore. Acupunct Med (Journal of the British Medical Acupuncture Society). 2009;27(4):187–8.

    Article  Google Scholar 

  161. Goertz CM, Niemtzow R, Burns SM, Fritts MJ, Crawford CC, Jonas WB. Auricular acupuncture in the treatment of acute pain syndromes: a pilot study. Mil Med. 2006;171(10):1010–4.

    Article  PubMed  Google Scholar 

  162. Niemtzow RC. Battlefield acupuncture. J Acupunct Assoc Chart Physiother. 2010:55–9.

    Google Scholar 

  163. Pickett H. Battlefield acupuncture. J Chin Med. 2011;96:14–7.

    Google Scholar 

  164. Niemtzow RC, Litscher G, Burns SM, Helms JM. Battlefield acupuncture: update. Med Acupunct. 2009;21(1):43–6.

    Article  Google Scholar 

  165. Plunkett A, Turabi A, Wilkinson I. Battlefield analgesia: a brief review of current trends and concepts in the treatment of pain in US military casualties from the conflicts in Iraq and Afghanistan. Pain Manag. 2012;2(3):231–8.

    Article  PubMed  Google Scholar 

  166. Soliman N. Pain: an evidence-based approach through the auricular acupuncture microsystem. Med Acupunct. 2008;20(4):263–7.

    Article  Google Scholar 

  167. Napadow V, Edwards RR, Cahalan CM, Mensing G, Greenbaum S, Valovska A, et al. Evoked pain analgesia in chronic pelvic pain patients using respiratory-gated auricular vagal afferent nerve stimulation. Pain Med. 2012;13(6):777–89.

    Article  PubMed  PubMed Central  Google Scholar 

  168. Laqua R, Leutzow B, Wendt M, Usichenko T. Transcutaneous vagal nerve stimulation may elicit anti- and pro-nociceptive effects under experimentally-induced pain—a crossover placebo-controlled investigation. Auton Neurosci Basic & Clinic. 2014;185:120–2.

    Article  Google Scholar 

  169. Ceccherelli F, Manani G, Ambrosio F, Angel A, Valenti S, Facco E, et al. Influence of acupuncture on the postoperative complications following ketamine anesthesia. The importance of manual stimulation of point R and shen menn. Acupunct Electrother Res. 1981;6(4):255–64.

    Article  CAS  PubMed  Google Scholar 

  170. Bai L, Yan H, Li L, Qin W, Chen P, Liu P, et al. Neural specificity of acupuncture stimulation at pericardium 6: evidence from an FMRI study. J Magn Reson Imaging JMRI. 2010;31(1):71–7.

    Article  PubMed  Google Scholar 

  171. Chong PS, Cros DP. Technology literature review: quantitative sensory testing. Muscle Nerve. 2004;29(5):734–47.

    Article  PubMed  Google Scholar 

  172. Beissner F, Henke C. Methodological problems in FMRI studies on acupuncture: a critical review with special emphasis on visual and auditory cortex activations. Evid Based Complement Altern Med eCAM. 2011;2011:607637.

    Google Scholar 

  173. Langevin HM, Wayne PM, Macpherson H, Schnyer R, Milley RM, Napadow V, et al. Paradoxes in acupuncture research: strategies for moving forward. Evid Based Complement Altern Med eCAM. 2011;2011:180805.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of California in San Diego (UCSD), La Jolla, USA

    Mikiko Murakami & Albert Leung

Authors
  1. Mikiko Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Albert Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Albert Leung .

Editor information

Editors and Affiliations

  1. University of Cagliari, Cagliari, Italy

    Luca Saba

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Murakami, M., Leung, A. (2017). Acupuncture Analgesia: A Review of Peripheral and Central Mechanisms. In: Saba, L. (eds) Neuroimaging of Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-48046-6_17

Download citation

Publish with us

Policies and ethics

Search

Navigation