How Does Acupuncture Work?


© 2014 C.P. Negri, OMD, NMD

 Traditional Oriental medicine contains a practice known in the West as acupuncture.  Chinese medical theories developed long ago that involve a mapped out system of pathways in the body (called meridians) through which an internal life force is supposed to flow.  Stimulation of points on the skin along these pathways—by inserting needles, or by other means—is supposed to influence the flow of this energy, and have an influence on health.

Scientists and physicians all over the world have recognized for decades that stimulating these points creates physiological reactions.  There has been a large amount of scientific documentation of these effects and the evidence is growing all the time.  We now have some very clear views as to why acupuncture at a particular spot produces the results that it does.

A number of these reflexes that are activated by needles (or by heat, electrical stimulation, laser, or pressure) travel along longitudinal pathways contained within the spinal cord.  Because these effects are predictable, it appears that the mechanism is the meridian, as it has been illustrated on acupuncture charts for hundreds of years.

But really, acupuncture works to activate physiological processes by way of neural signaling.  It does not move an invisible energy around through invisible channels, in the sense of the traditional model.  My argument with my profession is that it is still embracing that traditional model.

Close observation of what we would now call “stimulus / response” patterns led the ancient Chinese to make an association between the surface of the skin and reflex responses.  However, there was much they did not yet know about anatomy and physiology.

Now we have a tremendous amount of medical knowledge to draw from, and acupuncture has been rigorously studied.  The bioelectric nature of acupuncture points has been explained by neural features[1],[2],[3]. The points have been revealed as concentrations of skin-nerve-muscle connections that are easily excited.  The role of the nervous system in all this has been extensively researched[4],[5],[6],[7],[8] 95% of all established acu-points have been found to have nerve trunks or large nerve branches within the 1.0 cm surrounding the center of the point[9].  The body of evidence that acupuncture is working through the (already understood) workings of the nervous system is overwhelming.  But it does not end there.

While this would seem to suggest that there are purely “electrical” characteristics involved, it is clearly seen that many of acupuncture’s effects are chemical in nature as well.  Stimulation of the points can tap into “the body’s drugstore”, in which neurotransmitters and hormones create the beneficial results, rather than such metaphysical concepts as “nourishing Yin”, or “dispelling dampness”.

The acupuncture effect is an afferent signal created at the site of a point, which travels from there to the spinal cord.  From there, the central nervous system may send efferent signals back out to the site, or loop into visceral nerves associated with organic functions, or activate the release of opioid chemicals in the dorsal horn of the spinal cord (which blocks pain), or affect higher centers in the cerebellum and brain stem, leading to the regulation of hormones and the modulation of brain functions.  It may do all of the above, depending on the combination of points used.

My own experience and knowledge of distantly related therapies (like Bowen Therapy and Neuromuscular Therapy) leads me to agree with researchers who feel there is also a connective tissue mechanism involved in the acupuncture effect[10],[11].  Neural modulation is known to occur from stretching of the fascia and collagen fibers.  So it does not specifically take a needle to produce all the acupuncture effects.

The scientific reality of acupuncture is known.  It is not an “energy medicine”, but a way of activating specific neural systems, and affecting physiological pathways.  There is no question that it can both restore and maintain health.  My personal feeling is that we should use it without relying on 17th Century concepts and terminology.  American medical personnel were slow to recognize the validity of acupuncture for exactly this reason.  Now that the science is there, no one can argue that it doesn’t work.  But we should agree on why it works.

[1] Croley TE and Carlson M., Histology of the acupuncture point. American Journal of Acupuncture. 1991;19:247- 253.
[2] Ionescu-Tirgoviste C. Anatomic and functional particularities of the skin areas used in acupuncture. American Journal of Acupuncture. 1975;3:199-206.
[3] Still J. Acupuncture treatment of thoracolumbar disc disease: a study of 35 cases. Com panion Animal Practice. 1988A;2:19-24.
[4] Gunn CC, Ditchburn FG, King MH, and Renwick GJ., Acupuncture loci: a proposal for their classification according to their relationship to known neural structures. American Journal of Chinese Medicine. 1976;4:183- 195.
[5] Fu H. What is the material base of acupuncture? The nerves! Medical Hypotheses. 2000;54:358-359.
[6] Dung HC. Anatomical features contributing to the formation of acupuncture points. American Journal of Acupuncture. 1984; 12:139-143.
[7] Wong JY. A Manual of Neuro-Anatomical Acupuncture, Volume I and Vol. II. Toronto: The Toronto Pain and Stress Clinic, Inc., 1999, 2001.
[8] Matsumoto T and Lyu B. Anatomical comparison between acupuncture and nerve block. The American Surgeon. 1975;41:11-16.
[9] Shaozong C. Modern acupuncture theory and its clinical application. (Chapter 5 The Morphologic Relationship between Points and Nerves). International Journal of Clinical Acupuncture. 2001;121(2):149-158.
[10] Langevin HM, Churchill DL, and Cipolla MJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. The FASEB Journal. 2001; 15:2275-2282.
[11] Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, and Krag MH. Evidence of connective tissue involvement in acupuncture. The FASEB Journal. (April 10, 2002)