Acupuncture mechanisms for clinical long-term effects, a hypothesis

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, ErrorSpinal mechanisms, ErrorSupraspinal mechanisms of anti-stress nature, Cortical, psychological, "placebo" mechanisms. (C) 2002 Elsevier Science B.V. All rights reserved