It amuses me how often I am asked “So.. how does acupuncture work?” while someone is lying on my treatment couch with needles in for the first time (book yours here). Its mechanisms aren’t fully understood as yet to be honest, but I will try to explain what they know about how acupuncture works as best as I can, showing the evidence from a bio-medical model on the effects on the body. As well as using the lens of TEAM (Traditional East Asian Medicine) where they use very different, ancient language that I feel makes it much easier to understand the complexities of our bodies, as well as accounting for the bits we don’t YET understand using the bio-medical model.
Acupuncture activates and regulates Homeostasis (Wu Wei)
From a very simplistic East Asian point of view I generally describe acupuncture as a communication, reminding the body of its true harmony and breaking its old habits. We (accredited acupuncturists) describe the body as a constantly adapting energy flow (homeostasis in allopathic terms), which we can affect via acupuncture points. I do not treat symptoms in isolation: they are part of a whole being, and as such I need to treat that whole being, their location and description are of more importance to me than the orthodox diagnosis.
Traditional East Asian Medicine(TEAM), as I understand it, is a very poetic, logical way to explain the many, many processes that occur within our bodies in a relatively simple way, whilst not getting lost in the myriad of hormones, neurotransmitters, genomes etc that are required to explain a function in bio-medical terms. We attribute the functioning of the body to organs, who communicate and control each other to ensure our bodies work as best as they can: in a cyclical fashion.
I truly believe in the power of acupuncture, having experienced it 1st hand and also witnessed changes in the many hundreds of patients I have worked with since graduating in 2007. The gold standard for testing any medicine in the scientific world is a ‘double blind’: unfortunately (and it is the case for many therapies) this is very difficult to achieve in acupuncture, as I have to know what I am treating to treat it (therefore I am not blind) and creating a control is near to impossible as one can’t not be needled! Asghar et al established that the body responded to even superficial needling when looking at fMRIs, suggesting even sham needling does have an impact. I believe that as science advances and we develop more sophisticated ways of examining the body, the energy field I work with will be demonstrable.
Acupuncture comes under much scrutiny, as it should, studies that look at conditions are often flawed (as previously discussed) and there is ALWAYS a call for more.
Advances in technology have meant that the ability to understand anatomy from a TEAM perspective is growing and thus provides a different way to examine acupuncture.
Scientific Studies that examine how acupuncture works
Research thus far has looked at acupuncture in a few ways, examining responses of certain acupuncture points, exploring the effects on different systems of the body. Using fMRi technology, examining electrical variations and advances in understanding embryological development have all aided in demonstrating and understanding how acupuncture works. . It is worth mentioning that the mechanisms of WHY sticking a needle somewhere has such a systemic response is still not really understood (at time of writing 2021) but they can show that it DOES – and WHAT systems and mechanisms it influences.
Kawakita et al (2014) examined the many ways acupuncture has been shown to affect the way the body communicates: it activates the vagus nerve; balances the menoamine neurotransmitters including dopamine; increases ACTH, serotonin, noradredaline and has been shown to affect the amygdala (the part of the brain associated with memory and emotions).
The location of acupuncture points are very precise, a study by Bradman (07) showed a local increase in vasodilation and an increase in blood flow, therefore enhancing local healing. Ahn et al (08) found that:
“Five out of nine points studies showed positive association between acupuncture points and lower electrical resistance and impedance, while 7 out of 9 meridian studies showed positive association between acupuncture meridians and lower electrical impedance and higher capacitance.”
Which may explain why certain points have certain actions for example the wonderful Pericardium 6 has been shown to not only decrease heart rate but causes an increase in the high-frequency HRV index of cardiac vagal modulation.
More fascinating that this , for me, is the results of brain FMRis that showed a direct link between the activation of areas of the brain with acupuncture points that we ascribe certain tasks to. For example:
“Acupuncture point Gall Bladder (GB)37 (Guangming), located on the lower leg, is indicated for the treatment of vision related disorders within the TCM system. The name of the point, Guangming, is translated as bright light and indicates the acupoint’s use in the treatment of visual disorders. It is categorized as a Luo-connecting point and has the TCM functions of regulating the liver and clearing vision. The point is indicated for the treatment of hyperopia (farsightedness), myopia (nearsightedness), night blindness, and eye pain. The research demonstrates that GB37 increases neural responses in the occipital cortex. The researchers add that it was “discovered that modulations in vision-related cortex (BA18/19) were responsive to the specificity of GB37….” This connection between fMRI findings and TCM indications confirms the specificity of GB37 for the treatment of visual disorders.”
All of these show what happens physiologically during an acupuncture treatment, what none of these explain is HOW and I believe this is where our ever advancing understanding of embryo development may help. Dr Keown has written and lectured extensively on this subject and his book explains in amazing detail where the links can be found. He discusses ‘systems theory’ that understands that the whole is greater than the sum of its parts. He goes on to explain that communication between these parts are of utmost importance, creating embryological organising centres (morphostats) which are found in concentration at same areas as acupuncture points, thus the points have the most potential to create change. I have found it to be a truly fascinating book, and hope it is the beginning of a greater understanding of the human body, and of course, of the mechanisms of acupuncture.
How does Acupuncture work – no one knows for sure!
The sbort answer is that no one really knows for sure, what can be sure of is that acupuncture influences our neurotranmitters, our pain receptors, our inflammatory markers and our nervous system in general, helping to get out body’s back to that perfect balance that it wants: homeostasis, or Wu Wei in TEAM terms. I have enjoyed doing the research for this blog, and whilst I have not written it to be a journal paper I have included the references I used for those who want to do more study themselves. I hope that with this greater insight more people will trust that popping pills is not always the answer and that acupuncture can, and does, have the potential to have a hugely varied impact on your health: if you let it!
- Keown, D, (2014) The Spark In The Machine: How the Science of Acupunture Explains the Mysteries of Western Medicine, Singing Dragon.
- Ahn AC1, Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM, Langevin HM. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics. 2008 May;29(4):245-56. doi: 10.1002/bem.20403.
- Asghar, A.U.R, Green, G., Lythgoe, M.F., Lewith, G, MacPherson, H.., Acupuncture needling sensation: The neural correlates of deqi using fMRI. Brain Research, Volume 1315, Issue null, Pages 111-118
- Choi, E.M., Jiang, F., Longhurst, J.C., Samueli, S., Point specificity in acupuncture. Chinese Medicine 2012, 7:4 doi:10.1186/1749-8546-7-4.
- Bradnam, L. (2007) A proposed clinical reasoning model for Western acupuncture. Journal of the Acupuncture Association of Chartered Physiotherapists. 21-30
- Kawakita, K., and Okada, K., (2014) Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders? Biopsychosoc Med. 2014; 8: 4.