# The application of acupuncture in the management of neuropathic orofacial pain: a narrative literature review

## TL;DR

This review explores how acupuncture may help manage neuropathic orofacial pain, highlighting its potential as an integrative treatment despite limited clinical guidelines.

## Contribution

The paper evaluates acupuncture's role in managing neuropathic orofacial pain and emphasizes the need for standardized protocols and further research.

## Key findings

- Acupuncture using local and distal acupoints shows potential in alleviating neuropathic orofacial pain symptoms.
- Current evidence on acupuncture for neuropathic orofacial pain is limited and lacks established clinical guidelines.
- Acupuncture techniques demonstrate safety and efficacy, but their precise mechanisms remain unclear.

## Abstract

Neuropathic orofacial pain (NOP), which includes conditions such as trigeminal
neuralgia, burning mouth syndrome, and temporomandibular disorders, poses a
significant clinical challenge. This difficulty arises primarily from its diverse
pathophysiological mechanisms and the limited efficacy of conventional
treatments. This review highlights recent progress in understanding the
mechanisms underlying NOP while also evaluating the potential of Traditional
Chinese Medicine (TCM), with a particular focus on acupuncture, as an integrative
therapeutic approach. Emerging clinical studies suggest that acupuncture holds
significant potential in alleviating NOP symptoms. Acupuncture effectively
manages NOP by combining local (e.g., TE21 (Erheliao), ST7 (Xiaguan),
SI18 (Quanliao)) and distal (e.g., LI4 (Hegu), PC6 (Neiguan)) acupoints.
Local points relieve pain and improve circulation, while distal points enhance
systemic neuromodulation. This integrative approach optimizes pain regulation and
neuroinflammatory control, making acupuncture a promising NOP treatment. Various
acupuncture techniques and point stimulation methods, whether used independently
or as complementary therapies, have demonstrated both safety and efficacy,
ranging from traditional practices to more modern innovations. However, the
precise mechanisms by which acupuncture exerts its effects in managing NOP remain
unclear and warrant further exploration. While interest in TCM and acupuncture
for musculoskeletal pain has grown considerably, the evidence specifically
addressing NOP remains limited and fragmented. Currently, there are no
established protocols or clear clinical guidelines for the use of acupuncture in
the treatment of NOP. To bridge this gap, future research should adopt a
multidisciplinary approach and implement rigorous experimental designs to deepen
our understanding of acupuncture’s underlying mechanisms. Such efforts could
provide the foundation for developing standardized protocols, ultimately
enhancing acupuncture’s utility as an effective therapeutic option for
individuals coping with NOP.