Pain is a common health concern with severe social and economic impact (Xiang, et al., 2017). Acupuncture is widely recognised as powerful and effective alternative non-pharmacological treatment to improve quality of life and to reduce physical, functional and emotional disturbance (Moura, et al., 2022).
Systematic reviews have suggested that acupuncture has also been indicated for acute and chronic pain including toothache, migraines, headaches, lower back pain, cervical pain and osteoarthritic pain, locomotor pain from lumber disk herniation and scapulohumeral periarthritis, tissue and joint injury, muscle pain, muscles fibrositis fibromyalgia and neuralgia pain (Zhang, et al., 2017). Recent research suggested that acupuncture usefully support cancer-related and postoperative pain (Xiang, et al., 2017).
Over 80 systematic reviews were conducted to examine the role of acupuncture in pain relief (Xiang, et al., 2017). Positive results of therapeutic analgesic effect and efficacy on pain relief have been evidently concluded (Xiang, et al., 2017). Most of those systematic reviews and clinical trials have focused on cumulative effectiveness by assessing pain relief outcome after multiple acupuncture treatment sessions (Xiang, et al., 2017). Xiang, et al. (2017) investigated immediate effectiveness of acupuncture on pain relief by taking into consideration psychological impact due to level of expectation from treatment, various type of disease-related pain and potentially wide range of brain networks as the underlying mechanism for therapeutic outcome. It has been found that acupuncture to be more effective in reducing pain compared to analgesic injection intragluteally with analgesic or locally infiltrated with anaesthetic (Xiang, et al., 2017). No significant harm resulted from acupuncture has been found from studies involved in the systematic review although a high risk of bias has been reported implying that there is still lack of evidence regarding this perspective (Xiang, et al., 2017). Neurophysiology associating to acupuncture has been extensively investigated that local blockage at needle-insertion sites impacts on immediate analgesic effect of acupuncture to indicate dependence on intact conduction along the neural pathway, nociceptive pathway and serotonergic pathways (Xiang, et al., 2017). Effect of acupuncture has been found to have duration of onset of 15-30 minutes and duration of analgesic effect of approximately 3 days whereas effect of morphine has been found to have duration of onset of 20 minutes when intravenously injected and 60 minutes when orally administered with the duration of analgesic effect of between 3 to 7 hours (Xiang, et al., 2017). Real acupuncture has been shown greater pain relief than sham acupuncture, non-penetrating sham acupuncture in immediate acute pain reduction (Xiang, et al., 2017).
There is a three-step ladder approach recommended by World Health Organisation for cancer pain relief, however, at least 20-40% of cancer pain has not been effectively managed by application of this approach (Hu, et al., 2016). Additionally, pharmaceutical analgesic medications are highly associated with series of adverse effect to potentially cause more discomfort to those suffering from cancer (Hu, et al., 2016). Acupuncture has been shown to enhance therapeutic outcome on cancer patients in conjunction to pharmaceutical analgesia for higher pain remission rate, shortened pain relief onset time, prolonged analgesic duration and improved quality of life (Hu, et al., 2016). Acupuncture does not cause serious pharmaceutical analgesic therapy associated adverse reactions which including fatigue, constipation, nausea, vomiting, drowsiness and urinary retention (Hu, et al., 2016). Although available evidence is still considered to be insufficient to endorse mast application of routine use of acupuncture to relieve cancer-related pain (Hu, et al., 2016), preliminary impression has been provided to guide for future research in this area of practice.
Jan, et al (2017) has attempted to conduct systematic review on analgesic efficacy of auricular acupuncture in acute emergency settings aiming to further determine the significance of acupuncture’s role in pain management and reduction of use in pharmaceutical analgesic medications in medical emergency situations. It has been found that auricular acupuncture is evidently effective to reduce pain perioperatively either as stand-alone or complementary treatment (Jan, et al, 2017). Also, a quoted improvement of patient satisfaction has been recorded that 62% of respondents indicated to have same treatment again whereas 71% of them indicated as satisfied or very satisfied towards acupuncture treatment (Jan, et al, 2017). Additionally, auricular acupuncture combined with cupping therapy was shown to be therapeutic with remarkable pain severity decrease, pain relief effect increase, pressure pain threshold improvement and physical disability reduction (Moura, et al., 2022). Limitation of clinical significance of this review has been reported due to inadequate evidence-based studies for acupuncture treatment in emergency department (Jan, et al, 2017). However, this has shaped direction to further clinical trials to study the potential benefits for acupuncture use in the Emergencies (Jan, et al, 2017).
Despite limitation on scientific studies, acupuncture is still shown to be recognised as safe and therapeutically effective on a wide range of pain management across multiple clinical settings.
References
Hu, C., Zhang, H., Wu, W., Yu, W., Li, Y., Bai, J., Luo, B., & Li, S. (2016). Acupuncture for Pain Management in Cancer: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2016(1), 1720239–1720239. https://doi.org/10.1155/2016/1720239
Jan, A. L., Aldridge, E. S., Rogers, I. R., Visser, E. J., Bulsara, M. K., & Niemtzow, R. C. (2017). Does Ear Acupuncture Have a Role for Pain Relief in the Emergency Setting? A Systematic Review and Meta-Analysis. Medical Acupuncture, 29(5), 276–289. https://doi.org/10.1089/acu.2017.1237
Moura, C. de C., Chaves, E. de C. L., Nogueira, D. A., Iunes, D. H., Corrêa, H. P., Pereira, G. A., Silvano, H. M., Azevedo, C., Macieira, T. G. R., & Chianca, T. C. M. (2022). Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial. Journal of Traditional and Complementary Medicine, 12(2), 152–161. https://doi.org/10.1016/j.jtcme.2021.07.008
Xiang, A., Cheng, K., Shen, X., Xu, P., & Liu, S. (2017). The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2017(1), 3837194–3837194. https://doi.org/10.1155/2017/3837194
Zhang, Y. J., Cao, H. J., Li, X. L., Yang, X. Y., Lai, B. Y., Yang, G. Y., & Liu, J. P. (2017). Cupping therapy versus acupuncture for pain-related conditions: a systematic review of randomized controlled trials and trial sequential analysis. Chinese Medicine, 12(1), 21–21. https://doi.org/10.1186/s13020-017-0142-0
