How Acupuncture Works
A Chinese Medicine Explanation
Acupuncture is a way of improving your health by working with chi, the primary force that is the basis of everything in the universe. In our bodies chi flows along mapped pathways called channels, nourishing all of our tissues and internal organs, knitting us together into a cohesive whole. Acupuncture points are locations on these pathways where the chi comes closest to the surface and acupuncture needles are like tiny wires that can be used to tap into its flow. If you look at the literal meaning of the Chinese term for acupuncture point (穴位), it can be translated as a combination of the symbol for cave or hole plus the symbol for position or place. In other words, acupuncture points are locations on the surface that can be used to access the deeper internal workings of the body. Acupuncture points are utilized in three primary ways. One is to use local points to treat pain, connecting the dots along the channel to open blockages and re-establish the flow of chi through the area. Another is to choose points on the channel that passes through a particular internal organ to help address issues in that system. For example, every channel includes a point to reduce inflammation, a point to stop bleeding, and a point to boost function in its associated organ. A third way to use acupuncture points is for emotional balance. There is a huge category of points that are calming. They are found all over the body and they help with things like stress, anxiety, and depression. The general idea with acupuncture is to bring about healing from deep within vs. applying external interventions like surgery or pharmaceutical drugs to manage superficial symptoms. On the most basic level, acupuncture stimulates your body's general natural healing response. The more strategic and accurately it is applied, the more specific the response will be.
Western Medicine and the Concept of Chi
Western medicine has a very hard time understanding how acupuncture works. The primary reason for this is that the theory of Chinese medicine is so different from it, even on the most basic level. For example, there is no equivalent in Western medicine to the concept of chi and its flow along the channels. Although chi is like an energy or a force, it cannot simply be reduced to the electrical conduction of nerve impulses. Although the channels are connective and are found all over the body, they do not correspond one-to-one with any particular anatomical structure, like fascia. Also, the channels chi travels along are not actual anatomical structures but are found in the spaces in between everything where there is the most flow. Still, even though Western medicine has a hard time understanding how acupuncture works, it has a hard time denying that it does, and more and more doctors are referring their patients out for it over time. Below are some of the explanations Western medicine has for how acupuncture works, though they are pretty much limited to its ability to treat pain. Acupuncture has a much broader range of applications that cannot be explained by these theories, including treating conditions like emotional imbalances and internal organ issues, though these ideas certainly are intriguing and show some of its physiological effects.
Acupuncture and the Nervous System
One popular idea is that acupuncture works because of its effect on endorphins, the hormones that reduce pain. According to this theory, acupuncture stimulates the peripheral nerves to send messages to the brain to release endorphins. As the endorphins circulate they bind to the opiate receptors of the nerves, blocking the perception of pain. Levels of endorphins have been measured before and after acupuncture and clinical trials have shown that they rise. Another explanation for how acupuncture works is through its effect on the autonomic nervous system. Most of us are familiar with the symptoms associated with the activation of the sympathetic autonomic nervous system, the fight-or-flight response we have to stress and anxiety: adrenaline release, racing heart, rapid breathing, and tense muscles. In contrast, acupuncture activates its counterpart, the parasympathetic autonomic nervous system, which induces a state of deep relaxation where heart rate and respiration slow way down, muscles relax, and the body focuses on healing, repairing tissues, and replenishing energy reserves.
Acupuncture and the Hypnagogic State
Like the parasympathetic state above, acupuncture also induces what is called the hypnagogic state, the space between being awake and asleep that is very restful and restorative. In this state, we are not quite unconscious but we are very still and the mind is empty. Other types of activities that affect us in similar ways include meditation, yoga, and massage, and people who are familiar with the way those feel say that the experience of acupuncture is similar.
Acupuncture and Blood Flow
In Chinese medicine, pain is thought to be caused in part by a blockage in the flow of blood. Besides pain, other symptoms of a blockage can include tension, spasms, reduced range of motion, and palpable muscle knots. Western medicine also understands that reduced blood flow causes pain. On a very mechanical level, as the muscles tighten, blood flow through the area becomes more and more constricted. If this continues to progress, eventually the circulation gets squeezed off so much that some blood gets stuck in the muscle fibers and starts to clot, local tissues become deprived of oxygen and nutrients, and metabolic waste and toxins accumulate. In Chinese medicine, this is called blood stagnation. By making a small space right in the center of the stagnation, acupuncture can be used to break it up. This has what I call a cascade effect, causing the stagnation to collapse in on itself, re-establishing flow through the area once again. At the bottom of this page, you can see four electron micrograph images showing the dramatic effect acupuncture has on breaking up stagnation.
Acupuncture and Fascia
There is a type of connective tissue in our bodies called fascia. It helps give us structural integrity by wrapping our organs and soft tissues to our skeleton with thin, flat sheets of sticky tissue that are made primarily of collagen. Like muscle fibers, fascia can get bound up, forming trigger points, areas that are tender to the touch. Trigger points are commonly located at the site of acupuncture points, indicating that both systems have identified the same spots as important locations for treating pain. Much like the acupuncture channels, fascia is an interconnected web that is found everywhere in the body. It also has a special property called piezoelectricity, meaning that it can generate an electrical charge. One Western theory of how acupuncture works, then, is that it activates the fascia to conduct electrical signals from one area of the body to another.