Review of modern approaches to the treatment of patients with musculoskeletal disorders and diseases using traditional Chinese medicine (TCM) – acupuncture

Authors

DOI:

https://doi.org/10.63341/ijmmr/1.2025.105

Keywords:

chronic pain, functional state, therapeutic effect, pain syndrome, integrative approach

Abstract

The relevance of the study is due to the substantial spread of diseases of the musculoskeletal system and the need for effective non-drug treatment methods. Its purpose was to analyse scientific data on clinical efficacy, physiological mechanisms of action, and innovative approaches to the use of acupuncture in the treatment of musculoskeletal pathologies. The study was a literature review of scientific publications of 2019-2025 using a comprehensive three-stage methodological approach, which included the analysis of published data on the clinical effectiveness of acupuncture on standardised scales and questionnaires, generalisation of research on neurophysiological mechanisms of action, and systematisation of modern innovative protocols presented in the scientific literature. An analysis of clinical studies showed that the effectiveness of acupuncture varies depending on techniques and nosological forms, with the highest level of evidence for chronic lower back pain and osteoarthritis. After a course of acupuncture (2-3 sessions per week, with a total duration of 4-8 weeks), a decrease in pain intensity on the visual-analogue scale was recorded by 2.87-4.1 points and an improvement in functional indicators by 9.5-20.3%. Based on the generalisation of the data, two theoretical models were formulated: a
triune concept of therapeutic action of acupuncture, which covers physiological (reduction of pain symptoms), functional (restoration of motor activity), and psychoemotional (normalisation of psychological state) components and an integrative model of effectiveness in chronic pain, which includes short-term anaesthesia through neuromodulation, improvement of local microcirculation, and functional restoration of muscle-fascial structures. The examination of neurophysiological mechanisms demonstrated that the therapeutic effect of acupuncture is mediated by activation of the endogenous opioid system, modulation of inflammatory cytokines, and neuroplastic changes in brain networks, which is confirmed by neuroimaging methods. The study also systematised current innovations in acupuncture practice, including optimisation of treatment protocols, group forms of therapy, and telemedicine models. Integrative approaches that combined acupuncture with traditional treatments showed better results in 83% of the analysed studies compared to monocomponent interventions. The results of the study confirm the clinical effectiveness of various acupuncture techniques in diseases of the musculoskeletal system, which is justified by the complex effect on the neurophysiological mechanisms of pain
modulatin and proves the feasibility of including the method in standard therapeutic protocols

Received: 19.02.2025 | Revised: 25.04.2025 | Accepted: 27.05.2025

Author Biography

Yaroslav Mazur, Beauty Medical Centre

Master 08130, 5 Lvivska Str., village Petropavlivska Borshchahivka, Ukraine

References

World Health Organization. Musculoskeletal health [Internet]. 2022 [cited 2025 February 12]. Available from: https://

www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions

Skrypnykov PM, Skrypnikova TP, Lupatsa NA, Raskolupa NV, Ostrovska GY, Titarenko VI, et al. Oral health status

of internally displaced persons. Ukrain Dent Alman. 2023;1:12–6. DOI: 10.31718/2409-0255.1.2023.02

Rademacher A. Complementary medicine: Acupuncture. In: Maziarz RT, Slater SS, editors. Blood and marrow

transplant handbook. Cham: Springer; 2021. P. 747–57. DOI: 10.1007/978-3-030-53626-8_46

Akçalı D, Çevik C. Potential role of acupuncture. In: Özge A, Uludüz D, Karadaş Ö, Bolay H, editors. Peripheral

interventional management in headache. Cham: Springer; 2019. P. 87–95. DOI: 10.1007/978-3-030-10853-3_11

Patel P, Sabia M, Patheja J, Kapoor R, Mathias T, Murtaza T. Acupuncture and its effects on chronic pain. Coop Row

Med J. 2020;2(1):84–97. DOI: 10.31986/ISSN.2578-3343_VOL2ISS1.7

Urits I, Patel M, Putz MF, Monteferrante NR, Nguyen D, An D, et al. Acupuncture and its role in the treatment of

migraine headaches. Neurol Therap. 2020;9:375–94. DOI: 10.1007/S40120-020-00216-1

Iskandarani SE, Deng G. Acupuncture in hematologic malignancies and hematopoietic cell transplantation. Blood

Rev. 2022;56:100985. DOI: 10.1016/J.BLRE.2022.100985

Halámková J, Dymáčková R, Krákorová AD. Acupuncture from the perspective of evidence-based medicine – options

of clinical use based on National Comprehensive Cancer Network (NCCN) guidelines. Klin Onk. 2022;35(2):94–9.

DOI: 10.48095/CCKO202294

Zhu J, Li J, Yang L, Liu S. Acupuncture, from the ancient to the current. Anat Rec. 2021;304(11):2365–71. DOI: 10.1002/

AR.24625

Litscher G. The human touch in acupuncture: A future with artificial intelligence? OBM Integ Com Med.

;10(1):003. DOI: 10.21926/OBM.ICM.2501003

Guideline 00393. Acupuncture [Internet]. 2014 February 7 [cited 2025 February 12]. Available from: https://

guidelines.moz.gov.ua/documents/3256

Tan H, Tumilty S, Chapple C, Huang G, Baxter G. Sensitized-points acupuncture versus routine integrative acupuncture

for chronic low back pain: A randomized-controlled feasibility study. J Back Musc Rehabil. 2025;38(1):101–12.

DOI: 10.1177/10538127241289343

Comachio J, Oliveira CC, Silva IFR, Magalhães MO, Marques AP. Effectiveness of manual and electrical needle

stimulation in acupuncture for chronic nonspecific low back pain: A randomized controlled trial. J Acupun Merid

Stud. 2020;13(3):87–93. DOI: 10.1016/J.JAMS.2020.03.064

Dastjerdi MJ, Azadvari M, Kordafshari G, Zhao B, Adel-Mehraban M, Alipour R, et al. Comparative efficacy of

acupuncture, venesection, and physical therapy on chronic low back pain outcomes: A randomized clinical trial. Ann

Med Surg. 2024;86(5):2729–38. DOI: 10.1097/MS9.0000000000001944

Torres SF, De Macedo ACB, Sakai RY, Bressan GCS, dos Santos MBR, Marques AP. Effect of different frequencies

of electroacupuncture on chronic low back pain in older adults: A triple-фblind, placebo-controlled, randomized

clinical trial. Pain Physic. 2023;26:161–3. DOI: 10.36076/PPJ.2023.26.161

DeBar LL, Justice M, Avins A, Cook A, Eng CM, Herman PM, et al. Acupuncture for chronic low back pain in older

adults: Design and protocol for the BackInAction pragmatic clinical trial. Contemp Clinic Trials. 2023;128:107166.

DOI: 10.1016/J.CCT.2023.107166

Li T, Wang S, Zhang S, Shen X, Song Y, Yang Z, et al. Evaluation of clinical efficacy of silver-needle warm acupuncture

in treating adults with acute low back pain due to lumbosacral disc herniation: Study protocol for a randomized

controlled trial. Trials. 2019;20:470. DOI: 10.1186/S13063-019-3566-2

Lv X, Su Y, Wu C, Gu C, Li J, Wang I. Effects of time-dependent acupuncture on back muscle endurance in women

with chronic nonspecific low back pain: A randomized crossover trial. J Back Muscul Rehabil.2024;38(3):434–52.

DOI: 10.3233/BMR-240213

Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block, et al. 2019 American college of rheumatology/

arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res.

;72(2):149–62. DOI: 10.1002/ACR.24131

Zhu RX, Li X, Yan ZB, Chen C, Zhai W, Zhang HC, et al. Efficacy and safety of acupuncture with moxibustion for

knee osteoarthritis: A meta-analysis of randomized controlled trials. System Rev. 2025;14:15. DOI: 10.1186/S13643-

-02762-X

Li J, Yang J, Wu S, Wang MR, Zhu JM. Effects of acupuncture on rheumatoid arthritis: A systematic review and

meta-analysis. Afr J Tradit Complement Altern Med. 2016;13(2):61–71. DOI: 10.4314/AJTCAM.V13I2.8

Zhang XC, Chen H, Xu WT, Song YY, Gu YH, Ni GX. Acupuncture therapy for fibromyalgia: A systematic review and

meta-analysis of randomized controlled trials. J Pain Res. 2019;12:527–42. DOI: 10.2147/JPR.S186227

Navarro-Santana MJ, Sanchez-Infante J, Fernandez-de-Las-Peñas C, Cleland JA, Martin-Casas P, Plaza-Manzano

G. Effectiveness of dry needling for myofascial trigger points associated with neck pain symptoms: An updated

systematic review and meta-analysis. J Clin Med. 2020;9(10):3300. DOI: 10.3390/JCM9103300

Cavaggioni L, Gilardini L, Redaelli G, Croci M, Capodaglio P, Gobbi M, et al. Effects of a randomized

home-based quality of movement protocol on function, posture and strength in outpatients with obesity. Healthcare.

;9(11):1451. DOI: 10.3390/HEALTHCARE9111451

Chen YJ, Chen CT, Liu JY, Bassi GS, Yang YQ. What is the appropriate acupuncture treatment schedule for chronic pain?

Review and analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2019;2019(1):5281039.

DOI: 10.1155/2019/5281039

Zou X, Yang J, Lin L, Qi L, Wang Y, Yan S, et al. Optimization and implementation of clinical trial of acupuncture:

Reflection on the successful case of acupuncture for postprandial distress syndrome. Chin Acupunct Moxibus.

;41(11):1276–80. DOI: 10.13703/J.0255-2930.20201109-0005

Ginnerup-Nielsen E, Christensen R, Bliddal H, Henriksen M. Effect of research participation versus usual clinical care

in patients with rheumatic and musculoskeletal disorders: A prospective cohort study. RMD Open. 2023;9:e003414.

DOI: 10.1136/RMDOPEN-2023-003414

Chan SC, Engkasan JP. Does acupuncture improve pain and function in people with hip osteoarthritis? A cochrane

review summary with commentary. Intern J Rheum Diseas. 2020;23(12):1741–3. DOI: 10.1111/1756-185X.13948

Epstein AS, Liou KT, Romero SAD, Baser RE, Wong G, Xiao H, et al. Acupuncture versus massage for pain in patients

living with advanced cancer: The IMPACT randomized clinical trial. AMA Netw Open. 2023;6(11):e2342482.

DOI: 10.1001/JAMANETWORKOPEN.2023.42482

Trinh K, Belski N, Zhou F, Kuhad A, Luk D, Youn E. The efficacy of acupuncture on foot and ankle for pain intensity,

functional status, and general quality of life in adults: A systematic review. Med Acupunct. 2021;33(6). DOI: 10.1089/

ACU.2021.0006

Lu M, Sharmin S, Tao Y, Xia X, Yang G, Cong Y, et al. Effectiveness of acupuncture in treating patients with pain

and mental health concerns: The results of the Alberta Complementary Health Integration Project. Front Neurol.

;15:1366685. DOI:10.3389/FNEUR.2024.1366685

Tang CT, Sookochoff M, Rhea L, Carrier J, Prather H, Guan L. An audit of structure-based medical acupuncture

by a single provider in patients with musculoskeletal pain using PROMIS scores as the outcome. Acupunct Med.

;41(1):48–54. DOI: 10.1177/09645284221118589

Lyu Z, Guo Y, Gong Y, Fan W, Dou B, Li N, et al. The role of neuroglial crosstalk and synaptic plasticity-mediated

central sensitization in acupuncture Analgesia. Neural Plastic. 2021;2021(1):8881557. DOI: 10.1155/2021/8881557

Zhou M, Zhang Q, Huo M, Song H, Chang H, Cao J, et al. The mechanistic basis for the effects of electroacupuncture

on neuropathic pain within the central nervous system. Biomed Pharm. 2023;161:114516. DOI: 10.1016/J.

BIOPHA.2023.114516

Hsiao IH, Liao HY, Lin YW. Optogenetic modulation of electroacupuncture analgesia in a mouse inflammatory pain

model. Scient Rep. 2022;12:90167. DOI: 10.1038/S41598-022-12771-8

Gao Y, Wang J, Han Y, Liu J. Κ-opioid receptor is involved in electroacupuncture analgesia via inhibition of spinal

microglial Toll-like receptor 4 in neuropathic pain rats. Acupunct Res. 2022;47(2):95–100. DOI: 10.13702/J.1000-

201112

Ding SS, Xu Y, Zhang YY, Chen JZ, Hong SH. An hypothesis for CXCL1/CXCR2 signaling regulating neutrophilderived opioid peptides involved in acupuncture for inflammatory pain. Evid Based Complement Alternat Med.

;2021(1):6671195. DOI: 10.1155/2021/6671195

Ma X, Chen W, Yang NN, Wang L, Hao XW, Tan C, et al. Potential mechanisms of acupuncture for neuropathic pain

based on somatosensory system. Front Neurosci. 2022;16:940343. DOI: 10.3389/FNINS.2022.940343

Qi M, Wang Y, Zhang Y, Feng Y, Liu B. Potential neural mechanisms of acupuncture therapy on migraine: A systematic

review and activation likelihood estimation meta-analysis update. Quantit Imag Med Surg. 2025;15(2):1653–68.

DOI: 10.21037/QIMS-24-916

Saha DK, Bohsali A, Saha R, Hajjar I, Calhoun VD. Neuromark PET: A multivariate method for estimating

whole brain fMRI guided intrinsic networks and connectomes from fMRI and PET data. bioRxiv. 2025.

DOI: 10.1101/2024.01.10.575131

Lv Q, Xu G, Pan Y, Liu T, Liu X, Miao L, et al. Effect of acupuncture on neuroplasticity of stroke patients with motor

dysfunction: A meta-analysis of fMRI studies. Neural Plastic. 2021;2021(1):8841720. DOI: 10.1155/2021/8841720

Madsen SS, Hvidsten S, Andersen TL. Functional FDG-PET: Measurement of task related neural activity in

humans – a compartment model approach and comparison to fMRI. Diagnostics. 2023;13(19):3121. DOI: 10.3390/

DIAGNOSTICS13193121

Liu Z, Wen C, Zhang S. Stimulated oxygen transport in tissue by magnetic needle acupuncture. bioRxiv. 2021.

DOI: 10.1101/2021.02.01.426016.

Yu WL, Park JY, Park HJ, Kim SN. Changes of local microenvironment and systemic immunity after acupuncture

stimulation during inflammation: A literature review of animal studies. Front Neurol. 2022;13:1086195. DOI: 10.3389/

FNEUR.2022.1086195

Perdrizet JA, Shiau DS, Xie H. The serological response in dogs inoculated with canine distemper virus vaccine at the

acupuncture point governing vessel-14: A randomized controlled trial. Vaccine. 2019;37(13):1889–96. DOI: 10.1016/J.

VACCINE.2018.10.076

Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels

and targets and is not limited to “driving the vagus-adrenal axis”. J Integrat Med. 2023;21(4):320–3. DOI: 10.1016/J.

JOIM.2023.06.001

Hwang YC, Lee IS, Ryu Y, Lee MS, Chae Y. Exploring traditional acupuncture point selection patterns for

pain control: Data mining of randomised controlled clinical trials. Acupunct Med. 2020;39(9):184–91.

DOI: 10.1177/0964528420926173

Mao JJ, Liou KT, Baser RE, Bao T, Panageas KS, Romero SAD, et al. Effectiveness of electroacupuncture or auricular

acupuncture vs usual care for chronic musculoskeletal pain among cancer survivors: The PEACE randomized clinical

trial. JAMA Oncol. 2021;7(5):750–7. DOI: 10.1001/JAMAONCOL.2021.0310

Bao T, Zhi WI, Baser RE, Li QS, Weitzman M, Gillespie EF, et al. Electro-acupuncture versus battle field auricular

acupuncture in breast cancer survivors with chronic musculoskeletal pain: Subgroup analysis of a randomized clinical

trial. Breast Cancer Res Treat. 2023;202:287–95. DOI: 10.1007/S10549-023-07072-1

Hung YC, Lin PY, Chiu HE, Huang PY, Hu WL. The effectiveness of laser acupuncture for treatment of musculoskeletal

pain: A meta-analysis of randomized controlled studies. J Pain Res. 2021;14:1707–19. DOI: 10.2147/JPR.S308876

Pugazhendi S, Rajamani P, Daniel A, Pugazhendi K. Non-invasive complementary therapies in managing

musculoskeletal pains and in preventing surgery. Intern J Therap Massag Bodyw. 2020;13(2):9–18. DOI: 10.3822/

IJTMB.V13I2.493

Dilaveri CA, Croghan IT, Mallory MJ, Dion LJ, Fischer KM, Schroeder DR, et al. Massage compared with massage

plus acupuncture for breast cancer patients undergoing reconstructive surgery. J Altern Compl Med. 2020;26(7).

DOI: 10.1089/ACM.2019.0479

Ha D, Kim S, Baek Y, Won J, Nam S, Shin J, et al. Current research trends in randomized controlled trials investigating

the combined effect of Korean medicine and western medicine treatment. J Acupunct Res, 37(1):13–8. DOI: 10.13045/

JAR.2019.00318

McKee MD, Nielsen A, Anderson B, Chuang E, Connolly M, Gao Q, et al. Individual vs. group delivery of acupuncture

therapy for chronic musculoskeletal pain in urban primary care – a randomized trial. J Gen Intern Med. 2020;35:1227–

DOI: 10.1007/S11606-019-05583-6

Ribagin S, Grozeva A, Popova G. Generalized net model of telerehabilitation program for patients with socially

significant diseases. In: Sotirov SS, Pencheva T, Kacprzyk J, Atanassov KT, Sotirova E, Staneva G, editors. Contemporary

methods in bioinformatics and biomedicine and their applications. Cham: Springer; 2022. P. 91–9. DOI: 10.1007/978-

-030-96638-6_10

Jiang YB, Guan L, Li Y, Shu M, Cui BC, Huang ZY. Efficacy analysis of acupuncture and rehabilitation for traumatic

spinal cord injury. Medicine. 2025;104(2):e41245. DOI: 10.1097/MD.0000000000041245

Downloads

Published

2026-04-23

How to Cite

Mazur, Y. (2026). Review of modern approaches to the treatment of patients with musculoskeletal disorders and diseases using traditional Chinese medicine (TCM) – acupuncture. International Journal of Medicine and Medical Research, 11(1), 105–120. https://doi.org/10.63341/ijmmr/1.2025.105