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

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 (<i>e.g.</i>, TE21 (Erheliao), ST7 (Xiaguan), SI18 (Quanliao)) and distal (<i>e.g.</i>, 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.