Efficacy of auriculotherapy in reducing pain: a comprehensive literature review

Introduction This review examines the efficacy of auriculotherapy in reducing pain across acute and chronic contexts, focusing on pain intensity scores, analgesic requirements, and safety profiles. Methods A comprehensive, English-language literature search was conducted across PubMed, b-On, Web of Science, Scopus, and SciELO using Boolean combinations of terms related to auriculotherapy, chronic and acute pain, and randomized trials (searches first run March 2026, re-run June 2026). Eligibility was defined a priori using a PICOS framework. From 280 initially identified records, 13 studies were included after duplicate removal and eligibility screening, and findings were synthesized narratively by pain type given substantial heterogeneity across designs. Methodological quality was assessed using the Cochrane risk-of-bias tool for the seven included primary RCTs and AMSTAR-2 for the five included systematic reviews/meta-analyses. Results Auriculotherapy significantly reduced acute postoperative pain, with meta-analyzed Visual Analog Scale (VAS) reductions of −0.44 (95% CI: −0.72 to −0.17) at 24 h and an analgesic-requirement standardized mean difference of −0.88 (95% CI: −1.29 to −0.46). For chronic back pain, standardized mean differences ranged from −0.65 to −0.85. In migraine, VAS decreased by −0.65 (95% CI: −0.86 to −0.43) with attack frequency reduced by an MD of −0.49 (95% CI: −0.59 to −0.40). Cancer pain studies reported 36% VAS reductions at 2 months. Adverse events were minimal, limited to mild local reactions in less than 5%–8% of cases, with no serious events reported. Discussion Auriculotherapy demonstrates moderate, consistent efficacy across pain types, likely mediated through autonomic modulation and endorphin release via somatotopic ear projections. A dose–response pattern emerged, with multiple sessions (2–3 weekly over 4–8 weeks) yielding sustained effects. Stronger benefits were observed in orthopedic perioperative settings and with needle-retention protocols. It concludes that auriculotherapy is a safe, viable non-pharmacological adjunct for pain management, while calling for large, diverse, standardized RCTs with longer follow-up and objective biomarker measures to strengthen the evidence base. Because these findings derive from a narrative synthesis of a heterogeneous mix of primary trials, they should be interpreted as indicative rather than definitive, particularly given the diversity of study designs and predominantly Asian/perioperative populations represented.