Acupuncture mechanisms for clinical long-term effects, a hypothesis

Abstract

In our clinical research, we have drawn the conclusion that meaningful long-term (>6 months) pain relieving effects can be seen in a proportion of patients suffering from nociceptive pain. What are the mechanisms behind this? From the existing experimental data, some important conclusions can be drawn: • A significant proportion 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). • Almost all experimental acupuncture research has been performed with electroacupuncture (EA) in spite of the fact that therapeutic acupuncture (TA) is mostly gentle manual acupuncture (MA). • Most of the experimental human acupuncture pain threshold (PT) research shows only fast and very short-term hypoalgesia, and, very important, PT elevations in humans does not predict clinical outcome. • On the basis of these differences, the effects of acupuncture may be divided into two main components— acupuncture analgesia (AA) and therapeutic acupuncture. A hypothesis on the mechanisms of therapeutic acupuncture will include: Peripheral events that might improve tissue healing effects and local pain relief, Spinal mechanisms, Supraspinal mechanisms of anti-stress nature, Cortical, psychological, “placebo” mechanisms.