O efeito analgésico da acupuntura na dor crônica e sua aplicabilidade no Sistema Único de Saúde: Revisão da literatura.

Abstract

INTRODUCTION. Pain is an experience that is not linearly related to nociceptive input. The processing of nociceptive information and its consequent perception are subject to pro- and anti-nociceptive modulations. Pain receptors drive the painful stimulus to the spinal cord and then to the brain where it is interpreted and transformed into responses. This mechanism has its activity regulated by the pain modulating system, with the participation of substances such as serotonin and endorphins. Chronic pain has high prevalence in the population, with headache and low back pain being determinants of personal and social losses. Although drug treatment is the first choice, it is known that many drugs cause unwanted side effects. 'Alternative' therapies have been increasingly sought to fill these gaps in modern medicine, being acupuncture the best known and most sought after. The entry point for acupuncture in the SUS is the National Policy on Integrative and Complementary Practices (PNPIC). GOAL. Check the effectiveness of acupuncture in pain management. METHODOLOGY. Literature review, with search performed in the "Google Scholar" database, with the keywords: "acupuncture", "analgesia", and “pain". RESULTS AND DISCUSSION. There is a mechanism of neuromodulatory action responsible for the analgesic effect of acupuncture, concentrations of endorphins and dynorphins increase in the cerebrospinal fluid after acupuncture and during the analgesia period. Acupuncture can block painful afference by at least two mechanisms: 1) it inhibits the activity of neurons transmitting pain at the medullary level, according to the mechanism of PIPS (post-synaptic inhibitory potential); 2) inhibits nociceptive afferents according to the gates theory. The stimulation of acupuncture analgesic points activates the hypothalamic-limbic system. Most of the studies that evaluated the ability of electroacupuncture to reduce the consumption of analgesics in pre- and postoperative situations obtained positive results. Acupuncture has also been shown to be an effective alternative to treat lower back pain. Acupuncture can also be used in the management of patients with fibromyalgia, providing pain relief, increasing pain threshold, decreasing morning muscle stiffness and improving sleep quality. CONCLUSION. Acupuncture has been accepted to effectively treat various diseases, particularly chronic pain, and a large body of evidence clearly demonstrates that ACPT analgesia has physiological, anatomical, and neurochemical bases.