[Acupuncture in pain therapy: current concepts]

Abstract

Acupuncture is a technique that was originally developed in ancient Chinese culture. One of the most important areas of use is in pain treatment. Many scientific publications have tried to prove the efficacy of acupuncture and have tried to determine the possible mechanisms of action. It has been shown that stimulation by acupuncture, mechanically or electrically, stimulates certain endocrine control mechanisms, which cause the release of morphine like substances. These endocrine controls are not only stimulated by acupuncture, but also are activated by other pain fighting techniques that utilize peripheral stimulation. Even if experimental studies could prove the effects of acupuncture, it is still difficult for scientists to accept the Chinese theory. Until now, nobody could determine the exact nature of the points and circles of acupuncture. The precise location of the points does not seem to be a requirement for the analgesic effects. The analysis of referred pain made it possible to confirm the anatomical and functional bases of acupuncture points and circles. Many authors have found good external agreement between points of pain and acupuncture points and have found agreement between the Chinese circles and radicular and pseudoradicular pain areas. With respect to the interpretation of the results of controlled clinical studies, it was difficult to determine the criteria for placebo. The criteria used depends on which acupuncture model is used. In the traditional model, any use of the needle at a different point from the Chinese point is called placebo. In the neurophysiological model, it seems that the method of stimulation, mechanical or electrical, makes the difference. This hypothesis has been confirmed by analysing all past clinical studies.(ABSTRACT TRUNCATED AT 250 WORDS)