Controlling neuropathic pain remains one of the most complex challenges in chronic pain management. Characterized by sensations ranging from tingling and burning to stabbing pain, this type of suffering results from an injury or dysfunction of the nervous system. Based on controlled scientific studies, acupuncture has proven to be a promising therapeutic approach, capable of modulating altered nerve signals and providing relief to those living with this particularly debilitating condition.
Definition and Main Causes
Neuropathic pain arises from damage or disease affecting the somatosensory nervous system, both peripheral and central. Unlike nociceptive pain, which signals tissue damage, neuropathic pain results from nerve injury and may persist even after the original lesion has healed, as the damaged nerves continue to send nociceptive signals to the brain’s sensory areas.
The most common causes include diabetes (which can damage peripheral nerves, leading to diabetic neuropathy), viral infections such as herpes zoster (which can cause postherpetic neuralgia), spinal cord injuries, multiple sclerosis, and certain chemotherapies. Although each condition has its own characteristics, all share altered neurobiological mechanisms that perpetuate pain.
Difference Between Neuropathic and Muscular Pain
While muscular or nociceptive pain is a normal response to tissue injury and tends to improve with healing, neuropathic pain persists independently of visible damage. It manifests with specific symptoms: intense burning, electric shocks, hypersensitivity to touch or even mild pain stimuli (allodynia), and pain disproportionate to the stimulus (hyperalgesia).
Muscular pain generally responds well to common painkillers, whereas neuropathic pain often requires specific medications such as anticonvulsants or antidepressants, which act on altered nerve mechanisms. This distinction is crucial for selecting the correct therapeutic approach.
How Acupuncture Modulates Nerve Signals
Acupuncture has a strong analgesic effect, acting at various levels of the nervous system to counter neuropathic pain. At the peripheral level, stimulation of acupoints activates segmental nerve fibers that can inhibit pain signal transmission (according to the gate control theory). At the spinal and cerebral levels, acupuncture promotes the release of neurotransmitters and endogenous opioids that modulate pain perception.
Recent research has shown that acupuncture can also influence neuroplasticity — the nervous system’s ability to reorganize itself in response to peripheral stimuli. This is particularly relevant in neuropathic pain, where neural circuits are hyperactive; stimulation of acupuncture points may help normalize these altered circuits.
Scientific Evidence and Clinical Studies
Over the past decades, numerous studies have highlighted the efficacy of acupuncture in treating neuropathic pain. Randomized controlled trials have shown significant reductions in pain intensity and improved quality of life compared to control groups.
A systematic review published in international medical journals reported that acupuncture produces benefits comparable to conventional drugs, with the advantage of better safety and fewer side effects. However, researchers emphasize the need for further studies to standardize treatment protocols and fully understand the mechanisms involved.
Reducing Chronic Pain
Diabetic neuropathy affects about 50% of people with long-term diabetes, causing burning pain, tingling, and numbness — mainly in the lower limbs. Acupuncture has demonstrated the ability to significantly reduce these symptoms and improve patients’ quality of life.
Needles are placed both in local points along the affected limbs and in distal points influencing the central nervous system. This combined strategy optimizes therapeutic response, with many patients reporting a reduced need for pain medication after regular acupuncture sessions.
Improving Peripheral Sensitivity
Beyond pain control, acupuncture can improve peripheral nerve function. Controlled studies have documented partial recovery of tactile and thermal sensitivity in diabetic patients treated with acupuncture, likely due to improved peripheral blood flow and reduced oxidative stress, which damages nerve fibers.
This functional improvement is crucial to preventing complications such as foot ulcers and falls, common among patients with advanced neuropathy who have lost sensation in their feet.
Controlling Persistent Pain After Shingles
Postherpetic neuralgia is a painful complication that can follow an episode of shingles, characterized by severe burning pain along the affected nerve. This condition can become chronic and last for months or even years, often resisting conventional treatments.
Acupuncture has proven particularly effective in managing this condition, as demonstrated by studies showing significant pain reduction when treatment begins early. Stimulating specific acupuncture points along the affected dermatome and in distal areas helps desensitize overactive nerves and reduce persistent neurogenic inflammation.
Improving Quality of Life
Postherpetic neuropathic pain profoundly affects quality of life, interfering with sleep, mood, and daily activities. In addition to its analgesic effects, acupuncture benefits sleep and the emotional component of pain, reducing anxiety and depression often associated with chronic pain conditions.
Patients treated with acupuncture report a greater ability to engage in social and recreational activities, gradually regaining autonomy lost due to persistent pain.
Peripheral neurotoxicity — a frequent side effect of cancer treatments — represents a major challenge in oncology. It affects 30–40% of patients, sometimes persisting for months after therapy and severely impairing quality of life.
Scientific Evidence and Clinical Studies
Many substances have been tested as neuroprotectors against drug-induced nerve damage, but results remain inconclusive. According to ASCO (American Society of Clinical Oncology) guidelines, there is currently no proven drug prevention for CIPN, while some medications show limited benefits during ongoing neuropathy.
Several studies have found that the best outcomes are achieved when acupuncture is included in an integrated medicine protocol. NCCN (National Comprehensive Cancer Network) guidelines recommend acupuncture among non-pharmacological treatments for CIPN, with a level 2A evidence rating (weak recommendation, high-quality evidence).
Integrative and Non-Invasive Approach
Acupuncture is a safe and well-tolerated therapy, especially valuable for patients with contraindications or intolerance to neuropathic medications. The absence of major side effects makes it suitable even for elderly patients or those with multiple comorbidities.
Its non-invasive nature and ability to act on multiple aspects of neuropathic pain make it an ideal complementary approach within integrated chronic pain management programs.
Complementarity with Pharmacological Therapies
Acupuncture does not replace conventional medical treatments but enhances their effectiveness. Studies show that combining acupuncture with medication achieves better pain control and often allows for lower drug dosages, minimizing side effects.
This therapeutic synergy provides patients with a personalized care path that respects individual needs and preferences, improving treatment adherence and long-term outcomes.
Is acupuncture useful for neuropathic pain?
Yes. Multiple studies show that acupuncture can reduce the intensity of neuropathic pain by modulating nociceptive signaling along neural pathways.
In which nerve-pain conditions is it used?
Primarily in diabetic neuropathy and postherpetic neuralgia, but also in other forms of chronic nerve pain—particularly CIPN, chemotherapy-induced peripheral neuropathy.
How does acupuncture act on the nervous system?
It stimulates specific body points that influence signal transmission along nociceptive pathways, thereby reducing the perception of pain.
Can it replace analgesic medications?
Not always. However, within an integrated treatment plan it can reduce medication use and enhance therapeutic effects.