Efficacy and Mechanisms of Acupuncture and Electroacupuncture for Peripheral Neuropathy: A Narrative Review of Studies Using Nerve Conduction Testing

Growing evidence suggests that acupuncture and electroacupuncture are effective in alleviating the numbness, pain, paresthesia, and other symptoms commonly seen in idiopathic, diabetic, and chemotherapy-induced peripheral neuropathy (PN). While the mechanisms causing the peripheral nerve damage underlying these symptoms differ, the symptoms are similar, and no effective condition/disease-modifying therapies currently exist. Nerve-conduction studies (NCS) provide the clearest feasible evidence of peripheral nerve fidelity and are the most widely used electrodiagnostic tool. Studies utilizing NCS as their primary outcome provide the best opportunity for testing a therapy’s capacity to improve compromised nerve functioning. A growing body of research utilizing NCS as the primary outcome has been testing acupuncture’s capacity to improve nerve functioning in common types of PN. But do these studies demonstrate that acupuncture improves functional nerve damage or facilitates neuroregeneration, and if so, what mechanisms might account for this? This narrative review examines the potential mechanisms. The research shows consistent evidence of improvements in nerve conduction velocities and action potential in sensory and motor nerves, with a pattern of these occurring alongside improvement in patient-reported symptoms. Although the strength of current evidence is limited by a small number of studies, additional studies with NCS as the primary outcome not yet published were found in our search. Suggestions for improving future research are offered. These findings support the use of acupuncture as a noninvasive treatment for PN. Further research is necessary to investigate acupuncture/EA as a possible disease-modifying treatment option.