How Does Acupuncture Work?

East and West

Acupuncture can be understood within the context of variable cultural languages. It has been in continuous use for millennia in Asia. About 25 years after the introduction of acupuncture to mainstream America, the National Institutes of Health (NIH) Consensus Development Conference in 1997 declared there is clear evidence that acupuncture is an effective modality.

Acupuncture points for Qi in the back

How does acupuncture work according to Chinese medicine?

Acupuncture is based on the assumption that Qi (pronounced chee) courses through the body just as rivers flow across the earth. A lattice of channels forms a web of Qi that unites all parts of the body. Within this model, acupuncture works by regulating the movement of Qi, and this Qi is responsible for the circulation of blood. So by restoring the healthy circulation of Qi, there is a healthy circulation of blood. Blood is responsible for delivering oxygen and nutrients to each and every cell. Blood also carries away metabolic debris. So acupuncture affects us globally both by activating the delivery system that distributes the food, and by encouraging the hauling away of waste. Acupuncture supports healthy cellular nutrition and detoxification.

Every Organ Network has a corresponding set of channels. The acupuncture points are located in small depressions in the skin called “men” or gates, at which points the channels come closest to the surface. In ancient times, when cities were fortified by walls, gates were opened and closed to keep harm away. With acupuncture, the gates of the body are opened and closed to adjust the circulation in the channels and expel noxious influences from them.

Translating this into modern language, acupuncture improves microcirculation; acupuncture regulates immunity, respiration, temperature, pressure, hormonal secretion and sensitivity, neuromuscular coordination, and the manufacture of blood cells. Acupuncture also stimulates the central nervous system, activating mechanisms of repair and regeneration. Acupuncture provides a tune-up to the organs and tissues of the body and enhances a dynamic equilibrium.

How does modern Western science explain how acupuncture works?

Since the early 1970s, neurophysiologist Bruce Pomeranz has studied the effectiveness of acupuncture for pain, nerve regeneration, and cutaneous wound healing.  He demonstrated that acupuncture relieved chronic pain in 55% to 85% of patients, compared to a 30% relief of pain by placebo, evidence that acupuncture is as effective as many potent drugs.

Bruce Pomeranz comments, “It should be apparent that we know more about acupuncture analgesia than about many chemical drugs in routine use.  For example, we know very little about the mechanisms of most anesthetic gases but still use them regularly.”

Woman Heart Side - acupuncture points

Acupuncture analgesia is initiated by the stimulation of small afferent sensory nerve fibers embedded in musculature that send impulses to the spinal cord to affect three centers: the spinal cord, midbrain, and hypothalamic-pituitary. When these centers are activated, neurotransmitters release endorphins, enkephalins, monoamines, and cortisol to block pain messages. Needles placed near the pain site, either on an acupoint or at a tender spot, activate segmental circuits to the spinal cord in addition to all three centers. In practice, both local and distal needling enhances the overall analgesic effect.

Acupuncture does not have the undesirable side effects of nausea, constipation, fatigue, dulled consciousness, or toxicity associated with pharmaceutical pain medications.

There is reliable, compelling data for the effectiveness of acupuncture for problems other than pain as well. The NIH Consensus Panel on Acupuncture in 1997 concluded, “there is clear evidence that needle acupuncture is efficacious for adult postoperative and chemotherapy nausea and vomiting.”

The Chinese experience with the use of acupuncture analgesia as an adjunct or alternative during surgery reveals that, in addition to effectively inhibiting the pain response, acupuncture also maintains normal blood pressure, visceral reflexes, preserves gut motility, and body temperature, while noticeably reducing the risk of hemorrhage, accelerating wound repair, and shortening postoperative recovery time.

(This information and more can be found in Stux G., B. Pomeranz, B. Berman Basics of Acupuncture, Springer-Verlag, 2003; and Pomeranz, B., “Acupuncture Analgesia,” in G. Stux and R. Hammerschlag (eds), Clinical Acupuncture: Scientific Basis, Springer-Verlag, 2001.)

Initially researcher thought acupuncture was full of beans

More than 25 years ago, neurophysiologist Bruce Pomeranz set out to disprove the validity of acupuncture, claiming, “I thought it was full of beans because my mentor, Patrick Wall, said acupuncture was just placebo, a distraction. He had traveled to China to investigate it, and he knows more about pain than I will ever know, so who was I to argue?

Acupuncture points - front view

But a Chinese student of mine working in my lab studied acupuncture on anesthetized animals. If it was placebo, then it should not have worked, because for placebos you need consciousness. That it also worked on infants had me wondering as well. So we did these experiments on anesthetized animals where there was no placebo going on, and we got acupuncture to block the pain pathways.” Pomeranz's theory was that acupuncture analgesia is achieved by peripheral nerve stimulation that directs the brain to release endorphins, which in turn block pain pathways in the brain.  Over the decades since 1976, he has accumulated 16 distinct lines of evidence, that is, 16 different types of experiments based on 16 diverse hypotheses, and all ended up supporting what he had tried to disprove. He concluded that there is more evidence in favor of the acupuncture-endorphin hypothesis than there is for 95% of conventional medicine.

History of acupuncture practice in the West

Acupuncture has been in continuous use in Asia for at least 2,300 years. References to it can be traced back to the 1700s in Germany, Holland, and England.  In 1755, the Dutch physician Gerhard van Swieten speculated that acupuncture triggered neurological phenomena, and its use was pain relief. Louis Berlioz wrote a book on acupuncture in France in 1816, and another Frenchman, George Soulie de Morant, wrote a major compendium in the early part of the 20th century.  In 1892 William Osler of the Johns Hopkins School of Medicine described the use of acupuncture for low back pain in a book circulated in the United States.  And Chinese-born traditional physicians provided acupuncture for the Chinese laborers building the railroads in the West, with evidence of herbal pharmacies in Idaho in the early part of the 20th century. Acupuncture entered mainstream consciousness in the United States in 1971, following then-President Nixon's lifting of the Bamboo Curtain.

FDA Recognizes Acupuncture Needles

In 1973 the US Food and Drug Administration (FDA) classified acupuncture needles as experimental, and the American Medical Association echoed that this modality should be restricted to use by physicians in research protocols. Yet schools of acupuncture were formed, and state licensing initiatives were undertaken in the mid-1970s. In states such as Nevada and California, acupuncturists were licensed as primary care providers by 1976.

“Acupuncture is simple, and often works. It has few side effects or complications, and the cost is low. For these reasons, it can be a good choice for some problems.”

—American Cancer Society

In 1980 a Texas judge ruled on limiting the practice of acupuncture to physicians, stating that acupuncture “is no more experimental as a mode of medical treatment than is the Chinese language as a mode of communication. What is experimental is not acupuncture, but Westerners' understanding of it and their ability to use it properly.” Acupuncture needles were reclassified as safe and effective more than 20 years after the FDA conducted their initial review. There is now growing cooperation and collaboration between the established conventional medical community and those who practice Chinese medicine.

Chinese Medicine

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