Acupuncture can be helpful in postoperative care after back surgery or joint replacement, specifically for patients interested in or recommended for non-pharmacologic pain management.
Acute pain resulting from surgical trauma can present significant challenges by delaying the ability of patients to move about and begin to perform rehabilitation exercises that are important to help reduce the development of scar tissue, improve range of motion, and increase the chances for a successful recovery. In addition, patients who undergo spinal and joint replacement surgery are at greater risk for developing a deep vein thrombosis and their risk may increase if pain continues to limit physical movement after surgery.
While opioid medication are typically effective to reduce pain, they also can cause unwanted side effects like nausea, vomiting, dizziness, sedation, pruritus, constipation, and urinary retention. These can further delay recovery and lead to a decreased sense of satisfaction with the surgical procedure by the patient.
Acupuncture can offer an alternative to opioids and is commonly uses for pain management. It can provide a safe and effective non-pharmacologic option to manage acute postoperative pain. Several related systemic reviews of randomized controlled trials have been conducted on this subject and found acupuncture to be effective in reducing post-surgical pain intensity and lead to a lower incidence of opioid-related side effects when used alongside conventional interventions for pain. Citations for these reviews are included at the end of this article. One meta-analysis specifically summarizes the effectiveness of acupuncture treatment for pain reduction after back surgery.
Further studies have shown the pain modulating effects of acupuncture to be due to its ability to augment the peripheral and central nervous system to inhibit pain-signaling pathways and increase the threshold for pain tolerance. Acupuncture has been recognized to trigger the release of specific neuropeptides including beta-endorphins, enkephalins, and dynorphins to elicit a self-healing response and create analgesia.
When being used for surgical pain, acupuncture has been found to be especially helpful when received within 24 hours before surgery as well as within the first week after surgery. Additionally, acupuncture can address pain or debility that may occur during and after the rehabilitation phase and can be useful in a multi-modal approach for patients experiencing lowered signs of progress with standard care alone.
Acupuncture for Postoperative Pain Research Citations
Systemic Reviews and Meta-analyses
Liu X.L., Tan J.Y., Molassiotis A., Suen L.K., Shi Y. (2015). Acupuncture-point stimulation for postoperative
 pain control: A systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary and Alternative Medicine, 2015;2015:657809. http://doi.org/10.1155/2015/657809
Sun Y., Gan T.J., Dubose J.W., Habib A.S. (2008). Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. British Journal of Anaesthesia, 101(2):151-160. http://doi.org/10.1093/bja/aen146
Wu M.S., Chen K.H., Chen I.F., Huang S.K., Tzeng P.C., Yeh M.L., Lee F.P., Lin J.G., Chen C. (2016). The efficacy of acupuncture in post-operative pain management: A systematic review and meta-analysis. PloS One, 11(3). http://doi.org/10.1371/journal.pone.0150367
Acupuncture Mechanism of Action Studies
Mayor D. (2013). An exploratory review of the electroacupuncture literature: clinical applications and endorphin mechanisms. Acupuncture in Medicine, 31(4):409-15. s
Wang J.Q., Mao L., Han J.S. (1992). Antinociceptive effects induced by electroacupuncture and transcutaneous electrical nerve stimulation in the rat. Int J Neurosci. 1992; 65: 117–129.
Zhao Z.Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, Aug;85(4):355-75. http://doi.org/10.1016/j.pneurobio.2008.05.004