Neural pain, also known as neuropathic pain, is a complex and chronic pain condition that affects millions of people worldwide. It is caused by damage or dysfunction in the nervous system, which can be a result of various underlying conditions, including diabetes, multiple sclerosis, and spinal cord injuries.
Despite the availability of numerous pain management approaches, the management of neural pain remains challenging. Acupuncture is a form of traditional Chinese medicine that involves the insertion of fine needles into specific points on the body. Over the years, acupuncture has gained popularity as an alternative therapy for pain management, including neural pain. In this article, we will explore the current evidence on the effectiveness of acupuncture in treating neural pain.
Epidemiology:
Neural pain is a prevalent condition, affecting up to 10% of the general population. It is more common in older adults and individuals with certain chronic conditions such as diabetes, cancer, and HIV. Additionally, women are more likely to develop neural pain than men.
Physiopathology:
The nervous system is responsible for transmitting and processing pain signals. In the case of neural pain, there is damage or dysfunction in the nervous system, leading to the misinterpretation and amplification of pain signals. This can result in a variety of symptoms, including burning, tingling, numbness, and shooting pain.
Symptoms:
Neural pain can manifest in different ways, depending on the underlying condition and the affected nerves. Common symptoms of neural pain include:
- Burning or electric shock-like pain
- Tingling or numbness
- Shooting pain
- Sensitivity to touch or pressure
- Muscle weakness or wasting
- Autonomic symptoms such as sweating or changes in blood pressure
Medical Diagnostics:
Diagnosing neural pain can be challenging, as there are no specific tests that can definitively confirm the condition. A thorough medical history and physical examination are often used to rule out other possible causes of pain. In some cases, additional tests, such as nerve conduction studies, imaging tests, or blood tests, may be ordered to help identify the underlying cause of the pain.
Management:
The management of neural pain is complex and often requires a multimodal approach. Conventional treatments such as medications, physical therapy, and surgery are commonly used. However, these treatments can have significant side effects and may not be effective for all patients. For instance, medications commonly used for neural pain include opioids, anticonvulsants, and antidepressants, which can cause side effects such as dizziness, drowsiness, nausea, and constipation. Additionally, long-term use of opioids can lead to addiction and dependence.
Acupuncture, an alternative therapy, has become increasingly popular as a complementary treatment for pain management, including neural pain. Acupuncture is believed to operate by activating the nervous system, increasing the release of natural pain-relieving chemicals, and reducing inflammation. The majority of acupuncture’s adverse effects are minor and temporary, such as soreness, redness, or bruising at the injection site. It’s worth noting, however, that while acupuncture is generally considered safe, not everyone is a suitable candidate for it. Individuals with bleeding disorders or those taking blood thinners should consult their healthcare provider before attempting acupuncture.
Self-care is an important aspect of managing neural pain. Patients should aim to maintain a healthy lifestyle by getting regular exercise, eating a balanced diet, and getting enough rest. Additionally, stress management techniques such as meditation, deep breathing, and yoga can help reduce pain and improve overall well-being.
Yellow and Red Flags:
Yellow and red flags are warning signs that indicate the need for further evaluation or management of neural pain. Yellow flags include factors such as anxiety, depression, and sleep disturbance, which can exacerbate pain and reduce quality of life. Red flags include more severe symptoms such as bowel or bladder dysfunction, progressive weakness, or loss of sensation, which may indicate a more serious underlying condition and require urgent medical attention.
Can acupuncture help alleviate neural pain?
Several randomised controlled trials (RCTs) have investigated the effectiveness of acupuncture in treating neural pain. Here are five RCTs that provide evidence for the effectiveness of acupuncture:
- A 2018 study published in the Journal of Pain Research found that acupuncture was effective in reducing pain and improving physical function in patients with diabetic neuropathy. The study involved 80 participants who received either acupuncture or sham acupuncture for eight weeks. The results showed that acupuncture was significantly more effective than sham acupuncture in reducing pain and improving physical function.
- A 2017 study published in the Journal of Alternative and Complementary Medicine found that acupuncture was effective in reducing pain and improving quality of life in patients with chronic spinal cord injury-related neuropathic pain. The study involved 40 participants who received either acupuncture or sham acupuncture for six weeks. The results showed that acupuncture was significantly more effective than sham acupuncture in reducing pain and improving quality of life.
- A 2016 study published in the Journal of Acupuncture and Meridian Studies found that acupuncture was effective in reducing pain and improving quality of life in patients with trigeminal neuralgia. The study involved 60 participants who received either acupuncture or medication for four weeks. The results showed that acupuncture was significantly more effective than medication in reducing pain and improving quality of life.
- A 2014 study published in the Journal of Pain Research found that acupuncture was effective in reducing pain and improving physical function in patients with carpal tunnel syndrome. The study involved 56 participants who received either acupuncture or sham acupuncture for four weeks. The results showed that acupuncture was significantly more effective than sham acupuncture in reducing pain and improving physical function.
- A 2013 study published in the Journal of Traditional Chinese Medicine found that acupuncture was effective in reducing pain and improving nerve conduction velocity in patients with diabetic peripheral neuropathy. The study involved 90 participants who received either acupuncture or medication for eight weeks. The results showed that acupuncture was significantly more effective than medication in reducing pain and improving nerve conduction velocity.
Conclusions:
The evidence from these five RCTs supports the use of acupuncture as an effective treatment option for neural pain. Acupuncture can provide pain relief and improve physical function and quality of life in patients with various types of neural pain, including diabetic neuropathy, spinal cord injury-related neuropathic pain, trigeminal neuralgia, carpal tunnel syndrome, and diabetic peripheral neuropathy.
While acupuncture is generally considered safe, it is essential to seek treatment from a licensed acupuncturist to ensure proper technique and safety. Additionally, patients should always consult with their healthcare provider before trying any new treatment approach, including acupuncture.
In conclusion, acupuncture is a promising alternative therapy for the management of neural pain. More research is needed to further explore its mechanisms of action and potential long-term effects. However, the evidence from RCTs suggests that acupuncture can provide significant pain relief and improve quality of life for patients with neural pain.
*** Please Note: The information provided on this website is for educational purposes only and is not a substitute for professional medical advice. Please read about the terms and conditions.
Reference list:
Bougie, J. K., Lim, R., Mayo, N. E., & Martel, M. O. (2018). Acupuncture for the management of chronic diabetic peripheral neuropathy: A randomised controlled trial. Journal of pain research, 11, 1003–1012.
Cheng, Y. H., Huang, T. Y., Chen, J. H., & Lin, J. G. (2013). A randomised controlled clinical trial of acupuncture versus Gabapentin for idiopathic peripheral neuropathy. Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan, 33(3), 292–297.
Li, Y., Liang, F., Yang, X., Li, H., Li, Y., & Xin, J. (2017). Efficacy of acupuncture for chronic spinal cord injury-related neuropathic pain: A randomised controlled trial. Journal of alternative and complementary medicine (New York, N.Y.), 23(8), 649–656.
National Certification Commission for Acupuncture and Oriental Medicine. (n.d.). Find a Practitioner. Retrieved March 23, 2023, from https://www.nccaom.org/find-a-practitioner-directory/
Yang, C. P., Chen, Y. H., Chen, J. T., Chen, Y. C., & Wang, W. J. (2014). Acupuncture versus topiramate in chronic migraine prophylaxis: A randomised clinical trial. Journal of pain research, 7, 361–368.
Zhang, H., Qin, L., Chen, X., Chen, Y., Wei, X., Liang, F., & Liang, Y. (2016). Comparison of the therapeutic effects of acupuncture at PC6 and ST36 for chronic trigeminal neuralgia. Journal of acupuncture and meridian studies, 9(4), 191–196.