Abstract
Chronic non-oncological nociplastic pain is a prevalent condition worldwide. The non-pharmacological therapeutic pillar is proposed as the first-line treatment, and the development of these tools should be encouraged. The aim of this review is to study the current basic and clinical evidence regarding the mechanisms and usefulness of acupuncture and electroacupuncture in pain relief, improvement in quality of life, and functionality in patients with fibromyalgia, temporomandibular disorder, irritable bowel syndrome, and interstitial cystitis/bladder pain syndrome; and to provide an update on the pathophysiology of nociplastic pain, particularly in the clinical entities under study. A search was conducted for systematic reviews and meta-analyses of controlled clinical trials on acupuncture or electroacupuncture in the four nociplastic pain entities under study. Three biomedical electronic databases were reviewed: PubMed, Cochrane Library, and Lilacs Plus. Out of 124 studies, thirty-nine met the inclusion criteria. A second literature search was performed regarding the pathophysiology of nociplastic pain and the mechanisms through which acupuncture and electroacupuncture could have positive effects on the outcomes studied. A qualitative analysis of the literature obtained from both searches was performed. The evidence found is of low quality but suggests the effectiveness of acupuncture and electroacupuncture on the outcomes and populations studied. There is a correlation between the pathophysiological mechanisms of nociplastic chronic pain and the signaling pathways modulated by acupuncture and electroacupuncture, which could explain their potential benefits in these clinical entities. This review suggests that acupuncture and electroacupuncture could be useful therapeutic tools for both somatic and visceral nociplastic pain. However, higher-quality clinical evidence is needed to confirm their effectiveness and expand their use, thereby strengthening their role as a first-line treatment in non-oncological chronic pain, which is a key component of the non-pharmacological approach.References
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