Application of Acupuncture in Cervical Spondylotic Radiculopathy: An In-Depth Analysis and Outlook on Pathophysiological Basis and Therapeutic Mechanisms.

Cervical Spondylotic Radiculopathy (CSR) is a debilitating condition caused by nerve root compression from degenerative cervical changes, leading to pain and dysfunction. Acupuncture, a key non-pharmacological treatment, shows significant clinical promise, yet its biological mechanisms are not fully understood. This article analyzes CSR's pathophysiology and acupuncture's therapeutic actions, based on literature published between 2010 and 2025, with a focus on recent key advancements. The review covers CSR's pathology, including mechanical compression, neuro-inflammation (eg, TNF-α), and neural sensitization. It then elucidates acupuncture's mechanisms: central analgesia via endogenous opioids (eg, β-endorphin), downregulation of pro-inflammatory mediators, enhanced local microcirculation, and modulation of oxidative stress. In conclusion, acupuncture intervenes in CSR's pathology through a multi-target neuro-immune-circulatory network. Future high-quality clinical trials and deeper molecular studies are essential to provide robust scientific evidence for its clinical application.