Pain Chronobiology and Epigenetic Regulation Nutrition, Nutraceuticals, Acupuncture

The biopsychosocial model allows an evaluation of different parameters involved in chronic pain. There may, however, be simple non-iatrogenic strategies based on the physiology that can improve treatment outcome. Non-drug strategies as nutrition, neutraceuticals and acupuncture in addition to drugs take a special place in the management of critical situations were conservative treatment failed. A therapeutic algorithm integrating chronobiology and the epigenetics factors considering the inter individual variability has been used for several years. The applied chronobiology also uses acupuncture strategies that associate the extraordinary vessels regulation, individualized points focussing on the typology of each, system regulator points, trigger points, auriculotherapy. Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. Both principles of classic acupuncture and the latest scientific explanation of the underlying mechanisms explained above show that acupuncture involves central and peripheral mechanisms. Treating intestinal mucosa and microbiome involved to chronicity and drug response seems to be one of the points of the enhancing effect. This report analyses the published reports illustrating the basis of the multimodal model reasoning, which are retrieved and discussed in light of explaining the findings in clinical practice.