NEUROPHYSIOLOGICAL EFFECTS OF ACUPUNCTURE ANALGESIA IN INDIVIDUALS WITH CHRONIC PAIN

Abstract

Introduction: Chronic pain, a highly prevalent condition sustained by neurophysiological, emotional, and social alterations, remains a clinical challenge due to the limitations of exclusively pharmacological treatments. In this context, the use of non-pharmacological strategies has increased, including acupuncture, which is recognized for modulating endogenous analgesic mechanisms.

Objective: To analyze the neurophysiological mechanisms of acupuncture-induced analgesia and the evidence supporting its effectiveness in individuals with chronic pain.

Methodology: A narrative review conducted according to SANRA criteria, carried out in the PubMed, PEDro, Web of Science, and LILACS databases, using the descriptors “Acupuncture,” “Chronic Pain,” and “Acupuncture Analgesia.” After screening, 46 studies were included.

Theoretical framework: Acupuncture modulates peripheral, spinal, and supraspinal pathways through the release of endogenous opioids, serotonin, and noradrenaline, strengthening the descending inhibitory system and reducing central sensitization. Neuroimaging evidence demonstrates functional reorganization of structures such as the anterior cingulate cortex, insula, thalamus, and prefrontal cortex, as well as adjustments in default mode and salience networks. Comparative trials indicate greater specificity of true acupuncture compared to sham acupuncture, particularly in connectivity between the periaqueductal gray matter, serotonergic nuclei, and pain-modulating regions, with effects observed mainly between 4 and 12 sessions.

Final considerations: The evidence indicates that acupuncture exerts consistent analgesic effects supported by integrated neurophysiological mechanisms, contributing safely and effectively to the interdisciplinary management of chronic pain.

DOI: https://doi.org/10.56238/sevened2026.008-034