How Acupuncture Works
Despite how common acupuncture has become, how it works remains a mystery to many people, including those who receive it. And understandably so. While acupuncture itself is mainstream, its mechanisms remain less so. In this article we’ll dive into the science behind this ancient medicine.
A LIGHT SWITCH FOR THE NERVOUS SYSTEM
We can learn a lot about how acupuncture works by looking at where acupuncture points lie in relationship to major anatomical structures. Traditional Chinese Medicine defines specific lines along the body as meridians. These meridians largely reflect the major pathways of the peripheral nervous system. The acupuncture points themselves are found along these pathways, typically at the junction of major nerves. Research¹ shows that when an acupuncture point is needled and stimulated, it activates the surrounding peripheral nerves.
Peripheral nerves are important because they communicate information about the outside world to the brain via the spinal cord. The brain can then send chemical instructions back to the body about how to maintain physiological balance. Sometimes this balance gets thrown out of whack from things like illness, injury and stress. Acupuncture can tap directly into this chemical messaging system between body and brain to help restore physiological balance.
How do we know for certain that the nervous system is activated during acupuncture? The sensations felt around the needle – heaviness, distension, warmth, pulsating, dullness, aching, migrating, traveling – are actually physical manifestations of peripheral nerve stimulation. If you feel these sensations during treatment, it means nerve pathways are being activated!
HEALING NEUROCHEMICAL RELEASE
The magic of acupuncture isn’t stimulation of the nerves themselves, but what happens as a result. When an acupuncture needle stimulates surrounding nerves, the body responds by releasing neurochemicals. These neurochemicals have been shown to instigate various aspects of the body’s innate healing process.¹ This healing neurochemical release occurs both locally where the needle is placed, as well as distally in the spinal cord and brain.
Chemicals released locally at the site of the acupuncture point have been shown to decrease pain, reduce inflammation, stimulate healing, fight infections and increase circulation.² Neuroscience researcher and acupuncturist Dr. Michael Corradino has termed this phenomenon “healing neurochemical soup,”² giving context for why acupuncture is so effective for addressing things like injuries, inflammation, infections and pain.
Chemicals released distally in the spinal cord and brain have similar analgesic, anti-inflammatory and circulation-enhancing effects. In fact, the pain-relieving chemical release that can occur during acupuncture can be so powerful that it has been used as an adjunctive therapy to reduce the amount of anesthesia needed during open heart surgery in integrative care settings in China.³⁻⁵ As striking as it may seem, acupuncture has been used for perioperative purposes since 1958.⁶ It wasn’t until 1971 when the appendix of a man named James Reston was under threat of rupture did the Western World first became aware of acupuncture’s potential. During a trip to Beijing, the New York Times Journalist and Pulitzer Prize Winner underwent an emergency appendectomy and received acupuncture to successfully manage his postoperative pain. His op-ed, “Now, About My Operation in Peking,” ignited the curiosity of the West and contributed to our culture’s conception of acupuncture as pain-relieving medicine.
While acupuncture is rightfully touted for its pain-relieving abilities, this is just one of its many effects. In addition to stimulating the release of pain-relieving, anti-inflammatory and circulatory chemicals, acupuncture can mobilize a slew of other neurochemicals that have downstream, regulatory impacts. This helps explain why acupuncture has shown clinical benefit for a wide variety of conditions from mood-related concerns like anxiety and depression,⁷⁻¹⁰ to various internal conditions such as immune-related disorders,¹¹⁻¹⁴ reproductive health-related issues,¹⁵⁻¹⁸ neurological conditions,¹⁹⁻²¹ gastrointestinal disorders²² and more.
Take, for example, the use of acupuncture for fertility support. While exact mechanisms remain to be fully elucidated, acupuncture has been shown to help with certain fertility challenges because of its broad, regulatory effects on the endocrine and reproductive systems. Acupuncture has been clinically shown to modulate stress and reproductive hormone levels, improve endometrial receptivity, support regular ovulation and improve sperm and ovum viability.¹⁵,¹⁶,²³,²⁴ Acupuncture’s success in treating infertility and other internal conditions lies in its ability to tackle an issue from many angles by influencing multiple physiological systems.
THE X-FACTOR
Thanks to science, the link between acupuncture and the body’s response is now more fully understood. But maybe one of the most remarkable things about acupuncture is that once a needle is placed, the exact details of the healing response are left up to the body. This is the X-Factor of acupuncture. While much of acupuncture’s effectiveness is contingent on point selection and technique, the minutia of the response is always left up to the body. In this way, acupuncture works with mind and body, supporting them in doing what they are designed to do – rebalance, heal and thrive.
1. Li YW, Li W, Wang ST, et al. The autonomic nervous system: A potential link to the efficacy of acupuncture. Front Neurosci. 2022;16:1038945. doi:10.3389/fnins.2022.1038945
2. Corradino MD. Neuropuncture: A Clinical Handbook of Neuroscience Acupuncture. 2nd ed. Singing Dragon; 2017.
3. Qiu M, Li C, Sun T, Ruan Q. Effect of perioperative acupuncture-assisted general anesthesia on the anesthetic dosage required in adult surgical patients: a network meta-analysis of randomized controlled trials. Front Med (Lausanne). 2023;10:1133585. doi:10.3389/fmed.2023.1133585
4. Asmussen S, Przkora R, Maybauer DM, et al. Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care. J Intensive Care Med. Aug 2019;34(8):652-661. doi:10.1177/0885066617708558
5. Zhou J, Chi H, Cheng TO, et al. Acupuncture anesthesia for open heart surgery in contemporary China. Int J Cardiol. Jul 1 2011;150(1):12-6. doi:10.1016/j.ijcard.2011.04.002
6. Litscher G, Simonis H, Kröll W. Anesthesia and Acupuncture. World Journal of Anesthesiology 2015;4(1):1-4. doi:10.5313/wja.v4.i1.1
7. Armour M, Smith CA, Wang LQ, et al. Acupuncture for Depression: A Systematic Review and Meta-Analysis. J Clin Med. Jul 31 2019;8(8)doi:10.3390/jcm8081140
8. Yang XY, Yang NB, Huang FF, Ren S, Li ZJ. Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. Ann Gen Psychiatry. Jan 30 2021;20(1):9. doi:10.1186/s12991-021-00327-5
9. Sniezek DP, Siddiqui IJ. Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review. Med Acupunct. Jun 2013;25(3):164-172. doi:10.1089/acu.2012.0900
10. Zhao FY, Fu QQ, Kennedy GA, Conduit R, Zhang WJ, Zheng Z. Acupuncture as an Independent or Adjuvant Management to Standard Care for Perimenopausal Depression: A Systematic Review and Meta-Analysis. Front Psychiatry. 2021;12:666988. doi:10.3389/fpsyt.2021.666988
11. Li N, Guo Y, Gong Y, et al. The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. J Inflamm Res. 2021;14:7191-7224. doi:10.2147/JIR.S341581
12. He M, Qin W, Qin Z, Zhao C. Acupuncture for allergic rhinitis: a systematic review and meta-analysis. Eur J Med Res. Apr 25 2022;27(1):58. doi:10.1186/s40001-022-00682-3
13. Feng S, Han M, Fan Y, et al. Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. Jan-Feb 2015;29(1):57-62. doi:10.2500/ajra.2015.29.4116
14. Wang M, Liu W, Ge J, Liu S. The immunomodulatory mechanisms for acupuncture practice. Front Immunol. 2023;14:1147718. doi:10.3389/fimmu.2023.1147718
15. Mo J, Zhang Y, Jin N, Zhou Y. Effectiveness of traditional Chinese medicine formulas combined with acupuncture in the treatment of ovulation dysfunction infertility: A systematic review and meta-analysis. Medicine (Baltimore). Jul 7 2023;102(27):e34310. doi:10.1097/MD.0000000000034310
16. Wang X, Wang Y, Wei S, et al. An Overview of Systematic Reviews of Acupuncture for Infertile Women Undergoing in vitro Fertilization and Embryo Transfer. Front Public Health. 2021;9:651811. doi:10.3389/fpubh.2021.651811
17. Xu Y, Zhao W, Li T, Zhao Y, Bu H, Song S. Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis. PLoS One. 2017;12(10):e0186616. doi:10.1371/journal.pone.0186616
18. Woo HL, Ji HR, Pak YK, et al. The efficacy and safety of acupuncture in women with primary dysmenorrhea: A systematic review and meta-analysis. Medicine (Baltimore). Jun 2018;97(23):e11007. doi:10.1097/MD.0000000000011007
19. Wu P, Mills E, Moher D, Seely D. Acupuncture in poststroke rehabilitation: a systematic review and meta-analysis of randomized trials. Stroke. Apr 2010;41(4):e171-9. doi:10.1161/STROKEAHA.109.573576
20. Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). Jan 2017;96(3):e5836. doi:10.1097/MD.0000000000005836
21. Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database Syst Rev. Jan 21 2009;(1):CD007587. doi:10.1002/14651858.CD007587
22. Wang XY, Wang H, Guan YY, Cai RL, Shen GM. Acupuncture for functional gastrointestinal disorders: A systematic review and meta-analysis. J Gastroenterol Hepatol. Nov 2021;36(11):3015-3026. doi:10.1111/jgh.15645
23. Zhong Y, Zeng F, Liu W, Ma J, Guan Y, Song Y. Acupuncture in improving endometrial receptivity: a systematic review and meta-analysis. BMC Complement Altern Med. Mar 13 2019;19(1):61. doi:10.1186/s12906-019-2472-1
24. Feng J, He H, Wang Y, et al. The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review. Front Endocrinol (Lausanne). 2022;13:1009537. doi:10.3389/fendo.2022.1009537