Pain resulting from surgical trauma is a significant challenge for healthcare providers. Opioid analgesics are commonly used to treat postoperative pain, but these drugs are also associated with a number of undesirable side effects. Additionally, in 2015, the U.S. Department of Health and Human Resources issued a statement of an endemic Opioid Crisis, whereby opiate medications were shown to be wildly over-prescribed and overused, leading to widespread chemical addiction. Research is showing that acupuncture can effectively stimulate the production of the body’s own “endogenous opioids” as well as natural anti-inflammatory compounds. Acupuncture facilitates better usage of the body’s own natural chemistry to relieve pain, and creates the potential for similar or, in some cases, benefits superior to synthetic drugs - without the risks of addiction or side effects.

Acupuncture and Related Techniques for Postoperative Pain: a Systematic Review of Randomized Controlled Trials

A meta-analysis of 15 studies meeting rigorous standards, including a sample size of 1,166 patients, concludes that acupuncture reduces “postoperative pain intensity.” The research was conducted by investigators in the Department of Anesthesiology at the Duke University Medical Center, and subsequently published in the British Journal of Anaesthesia. This independent meta-analysis demonstrates that acupuncture results in a significant reduction of opioid drug use for the management of postoperative pain. Acupuncture resulted in an average of 21% – 29% less opioid medication use and a significant reduction of pain intensity levels.

Sun, Yanxia, Tong Joo Gan, J. W. Dubose, and A. S. Habib. "Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials." British Journal of Anaesthesia 101, no. 2 (2008): 151-160.

The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis

Thirteen studies carefully selected, including 682 patients total, were systematically reviewed and analyzed to evaluate the effectiveness of acupuncture and acupuncture-related techniques in treating postoperative pain. The meta-analysis found that patients treated with acupuncture or related techniques had less pain and used less opioid analgesics on Day 1 after surgery compared with those treated with control (P < 0.001).

Wu M-S, Chen K-H, Chen I-F, Huang SK, Tzeng P-C, Yeh M-L, et al. (2016) The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLoS ONE 11(3): e0150367. doi:10.1371/journal.pone.0150367

Mechanisms of Acupuncture-Electroacupuncture on Persistent Pain

A variety of animal models have been used to study the effect and mechanisms of electroacupuncture on persistent pain. This review synthesizes and analyzes 206 studies to give an overall picture of how electroacupuncture alleviates pain through peripheral and central mechanisms of the body, and to show that a number of bioactive chemicals are involved in electroacupuncture inhibition of pain. The review found that electroacupuncture blocks pain by activating a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms. These include opioids, which desensitize peripheral nociceptors and reduce proinflammatory cytokines peripherally and in the spinal cord, and serotonin and norepinephrine, which decrease spinal N-methyl-D-aspartate receptor subunit GluN1 phosphorylation.

Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology. 2014;120(2):482-503.

Neural Mechanism Underlying Acupuncture Analgesia

Acupuncture has been accepted by the World Health Organization to effectively treat acute and chronic pain by inserting needles into the specific "acupuncture points" (acupoints) on the patient's body. During the last decades, our understanding of how the brain processes acupuncture analgesia has undergone considerable development. This review reveals that diverse signal molecules contribute to mediating acupuncture analgesia, such as opioid peptides (mu-, delta- and kappa-receptors), glutamate (NMDA and AMPA/KA receptors), 5-hydroxytryptamine, and cholecystokinin octapeptide. Among these, the opioid peptides and their receptors in Arc-PAG-NRM-spinal dorsal horn pathway play a pivotal role in mediating acupuncture analgesia.

Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Progress in neurobiology. 2008;85(4):355-75.

Acupuncture Helping Reduce Use of Pain Killers in Army

“Brig. Gen. Norvell V. Coots, deputy commanding general of the U.S. Army Medical Command and assistant surgeon general for force projection, testified… at a hearing of the Senate Veterans Affairs Committee about overmedication concerns. In 2011, 26 percent of all service members were prescribed at least one type of opioid medication, Coots said. That number was brought down to 24 percent [in 2013], Coots continued, partly due to the use of… acupuncture. The Army has had a large upswing in the use of [acupuncture] in the past few years, Coots said, and its use has been written into the Army's Comprehensive Pain Management Campaign.”

Sheftick, Gary. "Acupuncture Helping Reduce Use of Pain Killers in Army." Www.army.mil. U.S. Army News Service, 2 May 2014. Web. 25 Jan. 2017.

Acupuncture for Chronic Pain: Individual Patient Data Meta-Analysis

This landmark meta-analysis was conducted using data from 29 of 31 eligible randomized controlled trials (RCTs), with a total of 17,922 patients analyzed. It was undertaken to determine the effect sizes of acupuncture for 4 chronic pain conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain, and to reduce some of the common disparities found in acupuncture trial reporting standards. After exclusion of an outlying set of 2 RCTs that strongly favored acupuncture, the effect sizes were similar across pain conditions. Patients receiving acupuncture had less pain, with scores that were 0.23 (95% CI, 0.13-0.33), 0.16 (95% CI, 0.07-0.25), and 0.15 (95% CI, 0.07-0.24) SDs lower than sham controls for back and neck pain, osteoarthritis, and chronic headache, respectively; the effect sizes in comparison to no-acupuncture controls were 0.55 (95% CI, 0.51-0.58), 0.57 (95% CI, 0.50-0.64), and 0.42 (95% CI, 0.37-0.46) SDs.

Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of internal medicine. 2012;172(19):1444-53.

Comparative Clinical Effectiveness of Management Strategies for Sciatica: Systematic Review and Network Meta-Analyses

A recent systematic review and network meta-analyses of 21 different interventions for sciatica found that acupuncture produced significantly better outcomes for global effect and pain reduction than all other therapies (including opioid analgesia), except a Cytokine-modulating procedure still in experimental stages.

Lewis RA, Williams NH, Sutton AJ, Burton K, Din NU, Matar HE, et al. Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. The spine journal : official journal of the North American Spine Society. 2015;15(6):1461-77.