Journal ArticleDOI
Acupuncture mechanisms for clinically relevant long-term effects--reconsideration and a hypothesis
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It is drawn that clinically relevant long-term pain relieving effects of acupuncture (>6 months) can be seen in a proportion of patients with nociceptive pain and the mechanisms behind such effects are considered in this paper.Abstract:
From the author's direct involvement in clinical research, the conclusion has been drawn that clinically relevant long-term pain relieving effects of acupuncture (>6 months) can be seen in a proportion of patients with nociceptive pain. The mechanisms behind such effects are considered in this paper. From the existing experimental data some important conclusions can be drawn: 1. Much of the animal research only represents short-term hypoalgesia probably induced by the mechanisms behind stress-induced analgesia (SIA) and the activation of diffuse noxious inhibitory control (DNIC). 2. Almost all experimental acupuncture research has been performed with electro-acupuncture (EA) even though therapeutic acupuncture is mostly gentle manual acupuncture (MA). 3. Most of the experimental human acupuncture pain threshold (PT) research shows only fast and very short-term hypoalgesia, and, importantly, PT elevation in humans does not predict the clinical outcome. 4. The effects of acupuncture may be divided into two main components--acupuncture analgesia and therapeutic acupuncture. A hypothesis on the mechanisms of therapeutic acupuncture will include: 1. Peripheral events that might improve tissue healing and give rise to local pain relief through axon reflexes, the release of neuropeptides with trophic effects, dichotomising nerve fibres and local endorphins. 2. Spinal mechanisms, for example, gate-control, long-term depression, propriospinal inhibition and the balance between long-term depression and long-term potentiation. 3. Supraspinal mechanisms through the descending pain inhibitory system, DNIC, the sympathetic nervous system and the HPA-axis. Is oxytocin also involved in the long-term effects? 4. Cortical, psychological, "placebo" mechanisms from counselling, reassurance and anxiety reduction.read more
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Acupuncture for tension-type headache.
TL;DR: It is concluded that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches with small but statistically significant benefits of acupuncture over sham.
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Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials.
TL;DR: The findings cast doubt on the validity of traditional acupuncture theories about point locations and indications, and the theoretical basis for traditional acupuncture practice needs to be re-evaluated.
References
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Journal ArticleDOI
Acupuncture- from Empiricism to Science: Functional Background to Acupuncture Effects in Pain and Disease
S. Andersson,T. Lundeberg +1 more
TL;DR: Experimental and clinical evidence suggest that acupuncture may affect the sympathetic system via mechanisms at the hypothalamic and brainstem levels, and that the hypothalamus beta-endorphinergic system has inhibitory effects on the vasomotorcenter, VMC.
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The neurobiology of pain.
TL;DR: Another approach could be single molecules with dual drug actions, that encompass targets where additive or synergistic effects of different mechanisms may enable pain relief without major adverse effects.
Journal ArticleDOI
Learning and memory in pain pathways
TL;DR: Key aspects of synaptic plasticity in general are summarized and related changes at nociceptive synapses are described to discuss the potential relevance of these mechanisms for the development, the prevention and the treatment of chronic pain.
Journal ArticleDOI
Differentiation of delta and mu opiate receptor localizations by light microscopic autoradiography
TL;DR: It is proposed that mu and delta receptors are respectively the physiologic receptors for [Met]- and [Leu]enkephalin neurons.