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 two primary ways. One is to use local points to treat pain, connecting the dots along the pathway to re-establish the flow of chi through the area. The other is to choose points on the pathway that passes through a particular internal organ to help address functional issues in that system. The general idea is to stimulate healing from within vs. applying external interventions like surgery or pharmaceutical drugs to manage superficial symptoms. In the most basic way, as the introduction of a foreign object, acupuncture stimulates your body's general natural healing response. The more strategic and accurate acupuncture 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 the nerves, blood vessels, or connective tissue like fascia. Chi and the channels it flows on are much more fundamental than any western anatomical concept. I think of them as more like the energetic blueprint upon which all of the structures in the body are laid out, including the nerves, blood vessels, connective tissues, bones, digestive tract, and everything else. Also, the channels chi travels along are not actual anatomical structures but are found in the spaces in between the structures of the body, 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 and Chinese medicine have 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 their physiological effects.

Acupuncture and the Nervous System
One popular idea is that acupuncture works because of its effect on endorphins. According to this theory, acupuncture stimulates the peripheral nerves to send messages to the brain to release endorphins. As they circulate they bind to the body's opiate receptors, blocking pain pathways in the brain. 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 parasympathetic nervous system. Most of us are familiar with the symptoms associated with the activation of the sympathetic 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 nervous system, which induces a state of deep relaxation in which the heart rate and respiration slow way down, and the body focuses on healing, repair, and replenishing energy reserves. Acupuncture also induces what is called the hypnogogic state, the space between being awake and asleep that is very restful and restorative, when 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 by a blockage of the flow of chi and blood in the channels. Besides pain, other symptoms of blockages can include tension, spasms, reduced range of motion, and palpable muscle knots. As the muscles tighten, the 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. In Chinese medicine, this is called blood stagnation or blood stasis and is what causes pain and makes the tissue feel hard and dense. When this occurs the local tissues become deprived of oxygen and nutrients and metabolic waste and toxins will start to accumulate, which also causes pain. By making a small space right in the densest center of a knot, acupuncture can be used to release tension and break up blood stagnation. This has what I call a cascade effect, causing the knot to collapse in on itself from the inside out, re-establishing blood flow through the area once again.
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 is made primarily of collagen. Like muscle fibers, fascia can get bound up, forming what are called trigger points, spots in the tissues 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 theory of how acupuncture works, then, is that it activates the fascia to conduct electrical signals from one area of the body to another.
