How does Acupuncture work? The physiology behind the mystery.


How does acupuncture work?  What is it doing? These are the questions that I asked when first introduced to Oriental Medicine and  now answer every day as an acupuncturist. Those of us who practice acupuncture in the West have done a disservice to the medicine by only giving the simplistic explanation of “moving Qi,” and then defining Qi as “energy” that travels through invisible “meridians.” Being a skeptic comes naturally to me. I have an inquisitive mind that is not easily dissuaded by simple esoteric explanations OR reductionist Western scientific rationalizations.  However I have found truth in both Western scientific and Eastern philosophical reasonings.  True to my integrative approach of taking the best of eastern medicine and accentuating with the best of western medicine,  I discovered that the poetry of Oriental medicine can not singularly be explained by Daoist philosophy or Western diagnostic imaging.  Instead Oriental medicine is better served by looking at it from both points of view to find the synthesis where they both meet.

In order to keep this to a blog post intended to pique curiosity, as opposed to a dissertation, I will just cut to the chase about the physiological effects that have been documented by western scientific analysis using MRI’s, electrical sensitivity testing and thermography to measure the body’s reactions to acupuncture treatments. Real-time brain imaging studies show acupuncture positively influencing several brain regions including the limbic system, reducing pain and the emotional unpleasantness of pain and other experiences like tinnitus and nausea.

We know that acupuncture has three primary effects:

  1. It relieves pain.
  2. It reduces inflammation.
  3. It restores homeostasis.

Homeostasis refers to the body’s ability to regulate its environment and maintain internal balance with the external world. All diseases involve a disturbance of our body’s natural regulations to achieve homeostasis, and nearly all diseases involve some degree of pain and inflammation. In fact, research over the last several decades suggests that many serious conditions like heart disease previously thought to have other causes are in fact primarily caused by chronic inflammation. If we understand that most diseases are characterized by pain, inflammation and disturbance of homeostasis, we begin to understand why acupuncture can be effective for so many conditions.

There is debate in the acupuncture community about the early translation of the Chinese word Qi as “energy.”  Many of us agree that defining Qi as energy is incomplete. While others will argue that a more correct translation of the word Qi would be “Air.” So then is air flowing through the meridians ?  No.  But oxygen and blood are flowing through the meridians.  So then what are meridians ?  Are they invisible longitudinal lines traversing the body filled with Qi? I would agree with the debate that “meridians” is also an inaccurate translation, and instead would define the Chinese word luo as “vessels”.

Given their detailed description of both vascular and blood circulation, the Chinese undoubtedly discovered the continuous circulation of blood. Within Chinese Medicine, impaired blood flow to any area of the body or internal organs is one of the most important physiological indicators of disease. Western medicine agrees. Impaired blood flow results in pain and dysfunction.  Our vascular system, is an intricate highway that transports oxygen and nutrients to all areas of our bodies while also eliminating cellular waste and sending back deoxygenated blood to the heart. When the smooth flow of blood and oxygen is impaired, tissues are malnourished and discomfort ensues.

With this physiological foundation we can better understand how and why acupuncture works.  Acupuncture effects every major system of the body, including the cardiac, respiratory, gastrointestinal, circulatory, endocrine and immune systems. Several modes of action have been identified for acupuncture. The mechanisms can get quite complex. But ultimately acupuncture is a remarkably simple technique that depends entirely upon one thing: the stimulation of the peripheral nervous system.

The following is a list of mechanisms that have been identified so far:

  • Acupuncture promotes blood flow. This is significant because everything the body needs to heal is in the blood, including oxygen, nutrients we absorb from food, immune substances, hormones, analgesics (painkillers) and anti-inflammatories. Restoring proper blood flow is vital to promoting and maintaining health. Blood flow decreases as we age and can be impacted by trauma, injuries and certain diseases. Acupuncture has been shown to increase blood flow and vasodilation in several regions of the body.
  • Acupuncture stimulates the body’s built-in healing mechanisms. Acupuncture creates “micro traumas” that stimulate the body’s ability to spontaneously heal injuries to the tissue through nervous, immune and endocrine system activation. As the body heals the micro traumas induced by acupuncture, it also heals any surrounding tissue damage left over from old injuries.
  • Acupuncture releases natural painkillers. Needle insertion sends a signal through the nervous system to the brain, where chemicals such as endorphins, norepinephrine and enkephalin are released. Some of these substances are 10-200 times more potent than morphine!
  • Acupuncture reduces both the intensity and perception of chronic pain. It does this by stimulating neurotransmitters in a process called “descending control normalization”, which involves the serotonergic nervous system.
  • Long-term responses and the incremental effect seen during a course of acupuncture treatments results from neuroplasticity in the nervous system. The brain changes as a result of external stimuli, creating a new response.
  • Acupuncture relaxes shortened muscles. This in turn releases pressure on joint structures, tendons and nerves. Vasodilation is then able to restore proper blood flow, providing nourishment to previously deprived tissues, including internal organs.
  • Acupuncture reduces stress. This is perhaps the most important systemic effect of acupuncture. Recent research suggests that acupuncture stimulates the release of oxytocin, a hormone and signaling substance that regulates the parasympathetic nervous system. You’ve probably heard of the “fight-or-flight” response that is governed by the sympathetic nervous system. The parasympathetic nervous system has been called the “rest-and-digest” or “calm-and-connect” system, and in many ways is the opposite of the sympathetic system. Recent research has implicated impaired parasympathetic function in a wide range of autoimmune diseases, including arthritis, lupus, rheumatoid arthritis and inflammatory bowel disease.

As an acupuncture patient, the effects are felt with each treatment which builds upon the last.  One leaves calm and muscles have relaxed as the body seeks to get back to its balanced state of homeostasis. A profound emotional and physical shift occurs and with a series of regular treatments healing of the mind and body can be achieved. For some the physiological explanation quiets their curiosity while others are calmed by the poetry of the Daoist philosophical reasonings.  Acupuncture works regardless of your frame of reference, experience it for yourself. You will Love how you feel!!