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

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 modulation and proves the feasibility of including the method in standard therapeutic protocols