How Acupuncture Works

One question that many acupuncture patients are likely to ponder is how does acupuncture work? A reason why this question would come up for acupuncture patients is that acupuncture is so different to conventional medical treatments. Being instructed to take a drug or get surgery are somehow easier for us to comprehend than being told to lie down while someone sticks needles into you.

Taking drugs or having surgery fit comfortably with our notion that the body is composed of parts that function fundamentally due to chemical reactions, what we call the body’s biochemistry. So if there is disease, then correcting the biochemistry with drugs or removing a damaged part seems sensible and logical. But how can we fit the idea of needles as a therapy into this paradigm? Part of the problem here is that some would say that we cannot fit the idea of acupuncture into this paradigm. This is probably the most important reason why the answer to that common question (how does acupuncture work?) is not simple, nor is there a standard scientifically proven answer.

The paradigm problem is probably a good place to start in exploring the terrain of how science explains the mechanism of acupuncture. As mentioned above, Western science looks at the body as being sort of like a large chemical machine. This is referred to as the molecular paradigm. Its domination of our view of living organisms has greatly increased over the last 30 years with the advent of the discipline molecular biology, or its more colloquial term genetic engineering. Everything that is fundamental to the workings of the body arises from the genetic material and imparts its function through molecules associated and chemical reactions.

This is in stark contrast to the traditional East Asian view of the body, which sees the workings of the body from the perspective of its interaction with its surroundings and its internal energetic dynamic. In East Asian medicine (EAM) everything is connected, there is no separation between the body and its environment, between the mind and the body, or the mind and the brain. Everything influences everything else, so emotional and psychological imbalances also influence the physical body and vice versa. A disease cannot be seen only in terms of chemical dysfunctions or problems with isolated parts of the body. A disease, rather, is seen as an imbalance of the whole system, and is treated from that perspective. This is why acupuncturists ask a lot of questions that sometimes seem unrelated to the main problem that the patient is seeking treatment for. They want to get a picture of the whole system.

So in EAM acupuncture works primarily through moving and rebalancing energy. The ancient Chinese devised a very detailed map of the energetic movements in the human body, and the relationship between these movements and corresponding organs of the body. The energetic pathways of the body are called meridians and acupuncture points are located along these energetic pathways. Needling of a point in the pathway activates and balances the movement of energy along the pathway. This energy is called qi.

There are no equivalent concepts or perspectives in Western science or Western medicine. So new concepts for understanding acupuncture have been developed. Basically there are two approaches to understanding how acupuncture works from a Western perspective. The first is to look for changes in the molecular workings of the body in response to acupuncture. That is, fitting acupuncture into the Western scientific molecular paradigm. The second is to try and incorporate the EAM ideas into a Western scientific framework. To ask questions like, what could the ancient Chinese physicians have meant when they talked about energy? How could we best define these concepts using our western scientific knowledge? Perhaps their idea of energy is what we would identify today as electromagnetic phenomena.

These two basic approaches to understanding acupuncture are representative of the two basic categories of theories to explain how acupuncture works from a scientific perspective. In the first category there has been many scientific studies looking at the molecular changes that occur during and following an acupuncture treatment. Most of these studies have been conducted to explore the molecular events associated with pain and its suppression. It is now an accepted scientific fact that acupuncture results in the suppression of pain through causing the production of endorphins and other neurochemicals that are known to block pain signals reaching the brain. These early studies were the beginning of what is now a fundamental theory, the notion that acupuncture works via the nervous system.

More sophisticated studies are being undertaken to explore the acupuncture-nervous system connection. These studies use magnetic resonance imaging (MRI) to identify regions of the brain that are activated following needling of acupuncture points. The idea is that the needling stimulation is transmitted to the brain via the nervous system. The activation of the brain (and associated endocrine system) then mediates a healing response of the diseased region. One interesting feature of these studies is that the function of the acupuncture point according to traditional EAM theory is also being tested. For example, one of the acupuncture points that was studied is located on the little toe and is used in traditional EAM to treat eye conditions. Examination of the brain following needling of this point revealed an activation of the visual cortex, the region of the brain that is involved in eye function. So this study also indirectly verified traditional EAM theory.

The nervous system is not the whole story when it comes to understanding how acupuncture works, although some would have you believe this. This brings us to our second category of theories. These go outside the molecular paradigm. There are several lines of investigation here, some that seek to build a bridge between the energetic and the molecular, and some that lie principally within the energetic framework. The one that is building a bridge between the energetic and molecular is based on the notion that acupuncture first activates its effect through the connective tissue. This is actually thought to be an old idea being originally proposed by ancient practitioners, according to translations of the traditional EAM texts. Perturbation of the connective tissue is thought to activate a mechanical signal, which is then translated into a cellular response and mediation of gene expression. Or more simply, the surrounding cells recognize the pulling of the needle and they respond to this by making new molecules. These new molecules are then able to facilitate healing.

Theories that lie principally within the energetic domain are based on the idea that the body does not only function through the action of molecules and their associated chemical reactions. The body also has a non-molecular mode of functioning. There are a number of possibilities here. The one that is being most actively pursued is the electromagnetic functioning of the body. It is sound scientific reasoning to argue that every molecule and chemical reaction has an associated electromagnetic signature. At the basis of every molecule are the electric forces that hold the atoms and molecules together, and at the heart of chemical reactions are the associated electromagnetic changes that facilitate the reorganization of molecules. All organisms have an electromagnetic field around them and the functioning of certain organs like the brain and heart have synchronized and well characterized electromagnetic cycles. It would seem not too much of a stretch to postulate that the body also functions via such energetic mechanisms. However the role of these in the functioning of the body is not understood or very extensively studied.

It is thought by some that acupuncture works via this electromagnetic mechanism of the body in concert with molecular structures of the body such as the tissues surrounding the nervous system and the connective tissue. These tissues are thought to conduct subatomic particles, such as electrons and protons, thus generating currents and electromagnetic fields. Acupuncture directly affects these currents and fields, and these changes then affect the molecules that are synthesized in the body and their chemical reactions. From this perspective the electromagnetic component of the body is thought to regulate the molecular functioning of the body. This idea has been around for a while but not widely accepted in mainstream science. This represents perhaps one of the most exciting aspects of research into the mechanism of acupuncture. That is, the potential for biology to undergo a paradigm shift through the discoveries that will be made in our ongoing investigations into that old question – how does acupuncture work?

- Belinda Anderson, Lic.Ac., Ph.D.