Redefining pain and mental health management in cervical spondylosis: Electroacupuncture as a neuroinflammatory modulator and multimodal therapeutic innovation

Abstract

This editorial examines the constraints and novel approaches to management of cervical spondylosis patients with generalized anxiety disorder. Cervical spondylosis is a prevalent degenerative illness that often coexists with generalized anxiety disorder, which can cause pain and diminishing functional capacity. The loop of pain, anxiety, and inflammation diminishes the effectiveness of standard medications and rehabilitation, resulting from the interaction of neuroinflammation, central sensitization, and maladaptive pain processing. Electroacupuncture (EA), integrating traditional acupuncture with low-frequency electrical stimulation, has the capacity to modify pain and inflammatory pathways. EA stimulates the release of endogenous opioids, regulates cytokines such as interleukin (IL)-6 and tumor necrosis factor-alpha, and increases anti-inflammatory markers including IL-10 and transforming growth factor-β. It also augments motor and sensory functions, alleviates inflammation, and rehabilitates cognitive processes. Throughout an eight-week trial, a recent study showed that EA significantly reduced back pain, disability, and anxiety, while simultaneously decreasing inflammatory biomarkers, indicating strong connections between symptom relief and biochemical improvement. EA alleviates the pain-anxiety loop, enhancing its use as an adjunct therapy by targeting inflammation. EA is a multimodal strategy that improves quality of life, reduces reliance on pharmaceuticals, corresponds with mechanism-based therapy, and is clinically safe. Moreover, its advantageous safety profile yields socioeconomic benefits by lowering healthcare costs, enabling workforce reintegration, and improving access to adjunct medicines. This editorial advocates for the incorporation of EA into clinical practice to optimize treatment outcomes, enhance quality of life in certain patient populations, and improve symptom management.

Keywords: Cervical spondylosis; Generalized anxiety disorder; Electroacupuncture; Neuroinflammation; Pain-anxiety-inflammation cycle; Central sensitization; Endogenous opioids; Cytokines; Multimodal therapy; Socioeconomic impact

Core Tip: Cervical spondylosis is frequently comorbid with generalized anxiety disorder, creating a loop of pain-anxiety-inflammation that complicates therapy. This editorial proposes electroacupuncture (EA) as a possible treatment that can reduce pain, anxiety, and functional impairment in chronic stress patients with generalized anxiety disorder by influencing neural inflammation and the release of endogenous opioids. EA aids in regulating inflammatory signals and restoring brain function, complementing conventional therapy. Due to its superior safety profile and potential cost savings, EA offers a novel, evidence-based approach to enhance quality of life, decrease medication usage, and alleviate both physical and mental symptoms in these patients.