The word, Acupuncture is derived from Latin meaning "Acu"= surgery or needle, "Puncture"= the act of piercing or perforating the skin with a sharp object.
Acupuncture is medical specialty that uses thin metal needles to stimulate physical structures in the body (Acupuncture points) that help regulate and repair its functions.1,2
The Traditional Chinese Medicine (TCM) concepts of unblocking “Qi” or energy in the "Meridians” is often used to explain how acupuncture works, even though this concept by the Chinese 2,000 years ago has not been proven, the meridians closely match the nerves of the body (with some variations) and energy or Qi inside does correspond the electrical signals generated in the nerves,3 explaining why Traditional Chinese Medicine acupuncture still works despite its explanation not being correct by today's modern science standards4 .
The acupuncture points have been found to be a variety physical structures of the nervous system and soft tissue 6, that can be stimulated by thin metal needles, pressure, electricity, heat and laser,7,8 activating these structures trigger many biological reactions that control or influence the bodies anatomy and physiology.
There have been over 13,000 studies performed in 60 countries understanding how acupuncture works with the number of new acupuncture studies currently twice the number than into new drugs and other conventional mainstream medicine9.
Acupuncture today still suffers from skepticism and doubt from medical professionals and the public in part because of the Traditional Chinese Medicine (TCM) cultural narrative still used to teach "How acupuncture Works" in American and other Acupuncture Schools around the world.10
Acupuncture is proven to work for pain
Safer & more effective than Drugs
Acupuncture has been used for thousands of years by millions of people
Centuries of use can account for some validation to acupuncture's effectiveness, but it is over 60 years of scientific research into how acupuncture really works to treat pain with conclusive evidence that acupuncture is highly effective to treat acute or chronic pain and inflammation.
In 2007 a pragmatic trial in Germany of nearly half a million people treated with evidence-based (medical acupuncture) acupuncture for headache, low back pain, and osteoarthritis reported that 76% cases found acupuncture to be effective to reduce pain11.
Additionaly in 2016 in the USA a two-year retroactive study of over 89,000 patients by American Specialty Health Incorporated Health Services Department found that 93% of patients said that their acupuncturist had been successful in treating their musculoskeletal pain.12
Another study in 2016 a meta-analysis randomized trial of 17,922 patients concluded, “Acupuncture is effective for the treatment of chronic pain” and after a 12 month follow up study, it was found that the beneficial effects of acupuncture still persisted,13,14 studies into the use of opioids by the society of General Medicine show that people were in more pain after 12 months of using the addictive opioid drugs like;15 OxyContin, Roxicodone, Oxecta, Oxaydo, Xtampza, Targiniq, Xartemis and Ercodan.
There are 13 different trials that show acupuncture to be more effective than injection of painkillers for treatment of shoulder impingement, with other studies showing acupuncture with exercise being more effective then NSAIDs, micro-discectomy surgery and low-level laser for lower back pain.16,17
Painful stimulus is felt from activation of pain receptors (nociceptors) inside the tissues of the body, the receptors send pain messages along nerves (C fibers) to a gate at the spinal cord, the message goes through the gate to the spinal cord on to the areas of the brain where it is then felt or registered.
Stimulus to the body with pressure, heat and vibration are also felt at receptors (mechanoreceptors) and they send their messages along different nerves (Ab fibers) to the same gate at the spinal cord as the pain messages (C fibers), the gate has a biological bias to favor the pressure, heat and vibration signals over the pain signals and will close the gate to against the pain signal reducing the amount of pain message getting transmitted into the spinal cord and felt by the brain.
This electrical and chemical mechanism is called Gate control and is why human beings instinctively rub, heat, squeeze an area of pain as it activates our own pain control programs that help to reduce the severity of pain felt, by closing the gate and reducing the pain signals getting to the brain, it is also shown that by activating the pressure receptors (mechano-recpetors) not only reduces pain signals to the brain but it enhances stimulation of natural opioids and further suppression of pain signals in the nervous system by helping activating the descending inhibitory pathway.
In summary Acupuncture needles into the sensory receptors (mechanoreceptors) near an area of pain sends a strong non-painful message down AB fibers to the spinal cord closing the gate to the pain messages getting to the brain, whilst still strongly stimulating the descending inhibitory pathway18 and activating release of pain killer hormones.
Experiments show that performing acupuncture around the area of pain not only reduce the feeling of pain whilst the needles are in but the effects continue afterwards and with overall pain continuing to stay reduced with consecutive treatments.19
How Acupuncture releases natural painkillers
You already have what you need
Pain is not the cause of disease but a symptom
Pain is not the cause of disease but a symptom, pain is felt in the nervous system and treating pain with medications (natural or pharmaceutical) but not finding out the cause can be dangerous leading to more severe problems. Acute pain is normally from an injury, infection or referred pain and as the tissues/organs heal, the pain should reduce but when pain persists longer than 3 months it is considered chronic.
Studies show people with chronic pain have lower levels of natural pain killing hormones ( endorphins, enkephalinsand dynorphins ) being released by the brain (pituitary gland and brain stem), normally when a person is in pain rubbing the area of pain reduces pain messages to the brain and activates the release natural pain killing chemicals to reduce discomfort, but there are times when this program is not working correctly.
Acupuncture needles placed in sensory nerve pathways in the area of pain not only reduce the pain messages to the brain (gate control) but also stimulate the brain to release endorphins, enkephalins and dynorphins,20 non-opioid neuro-peptides, serotonin,21norepinephrine22 and dopamine23 (part of the descending inhibitory control process) which are biochemicals involved in pain reduction, feelings of well-being also helping with depression, anxiety and insomnia., this process of stimulating the sensory nerve pathways to activate the release of powerful hormones from pituitary gland, brain stem and adrenal gland.
Use of pharmaceutical painkillers like NSAIDS and opioids for pain without treating the cause interferes with the production and release of the brains own painkillers through a process called negative feedback cycle, (this occurs with all hormones in the body including using estrogen and testosterone etc.) the effectiveness of the synthetic/natural painkillers become less effective over time and the body may stop or reduce production its own, leading dependency of medication with escalation to stronger more dangerous drugs at higher dosage, more frequently and with less relief.
It is always important to find out the cause of pain which may include damaged sensory nerves not telling your brain to release painkillers or scar tissue from an old injury that has not healed completely, shortening muscles and tendons that cause misaligned joints, pinching nerves and excessive wear and tear.
Referred pain can be sharp or dull, constant or intermittent, it can restrict movement and cause shooting pain felt in the muscles, joints and skin but it comes from internal dysfunction of organs or glands. The body rarely feels pain in the organs but will refer to the body, examples of refferred pain are in left arm from a heart attack, pain in the lower back from menstrual period or pain in the right shoulder joint/scapula/neck from liver and gall bladder dysfunction.
Organs can refer pain to different areas on the body even if their dysfunction is not severe enough to show up on a blood or imaging tests, the liver may cause pain into the right shoulder but blood tests may not show any changes to liver enzymes or or high cholesterol. Changes to cholesterol or raised liver enzymes usually are associated with some referred pain, but many physicians may not connect the pain in the shoulder/neck to raised cholesterol, in fact two different physicians may be treating them both separately without any connection.
An evidence based trained acupuncture physician can check the functional reflexes (visceral-somatic reflexes) for muscle guarding which indicate organ distress and then by applying pressure or a small electrical charge into the correct reactive acupuncture points will reduce the muscle guarding, it will also reduce pain or improve range of motion of Musculoskeletal area, by treating the organ or gland it will not only stop the pain but it also improves the organ function/disease.
How Acupuncture treats internal disease
Activating the body to heal itself
If an Acupuncturist is not testing the acupuncture points, they are guessing!
Acupuncture has the ability to treat the symptoms of many diseases and even reverse the process of some diseases but experiments and studies show that it is crucial to locate the correct “active” acupuncture points on each individual for it to successfully treat gynecological, digestive, immune and stress related conditions.24,25,26
Nerves entering/exiting the spinal cord going to and from the internal organs (Enteric nervous system) have branches that connect to the nerves that go to the arms, legs and torso (Peripheral nervous system).27 When there is even mild dysfunction of the internal organ, electrical distress signals are sent across to the nerves going to the torso, arm or legs, various acupuncture points (neuro-vascular nodes) become inflamed, painful to touch and have higher electrical resistance, this process is called neurogenic inflammation.28
Experiments demonstrate this process, Rats with high blood pressure, ulcerated colitis, and gastric ulcers were injected with blue dye and the active acupuncture points (neurovascular nodes) went blue from the dilation of capillaries at the points, but not all the same acupuncture points along the nerve that connected to the internal organ showed inflammation (went blue) for the same disease. Areas that were not acupuncture points showed no inflammation nor did acupuncture points on different nerve pathways not connected to the diseased organs.
Needling the reactive/inflamed acupuncture points did change the symptoms but also reversed the diseases, needling the non-reactive points (point didn’t become inflamed or go blue) on the diseased organ nerve pathway had no effects.
These experiments demonstrate that successful treatment of internal disease depends on the acupuncture physician correctly finding and needling only the reactive acupuncture points on each individual.29,30
How Acupuncture reduces inflammation
Without the side effects
Inflammation is not a cause of disease but a symptom
Inflammation is the bodies response to something causing harm, like trauma, infection or toxins and it is the bodies attempt to heal itself, excessive or prolonged inflammation should be treated, but inflammation is not the cause of a disease. Treating the inflammation without finding out and treating the reason may lead to further more serious issues but acupuncture offers safe and effective treatments without the side effects of anti-inflammatory meds.
When Acupuncture needles are placed into structures like mechanoreceptors, the pressure of the needle cause the release biochemicals A.T.P, G.A.B.A, and adenosine, these bio-chemicals trigger local biological reactions involved in the reduction of inflammation plus other physiological reactions that control local tissue metabilism.31,32,
Experiments on Rats with induced bone cancer showed acupuncture significantly decreased the levels of chemicals responsible for persistent pain and thermal hyperalgesia (inflammation),33 there has been many other experiments that can support acupuncture's effect to release local bio-chemicals involved in pain and inflammation control.34,35
Human studies measuring the anti-inflammatory bio-chemical adenosine in tissues before, during and after acupuncture and it was found that levels increased dramatically during and after the acupuncture but only if the needle was put into the correct reactive acupuncture point location.36,37
Further experiments in rats subjected to persistent inflammation in the hip were treated with acupuncture, there was a significant reduction of pain, swelling (edema) plus their injuries were observed to repair, unlike the rats with the same injuries for the same period of time that did not receive acupuncture.38
How Acupuncture balances hormones and reduces stress
Make and regulate your hormones not replace them
Acpuncture can't change what stresses you but it can change how you react to it
Studies show acupuncture into active neuro-vascular branches (distal acupuncture points) can cause an increase in a persons resistance before triggerring the stress hormone response by the hypothalamus-pituitary-adrenal axis which is also responsible for the regulation of many hormones in the body39.40.41. Acupuncture can be seen on Magnetic Resonate Imagining (MRI), to effect function of the brian stem, amygdala, hypothalamus and other structures that control our anatomy and physiology.42
Other experiments show that acupuncture effects the hypothalamus-pituitary-adrenal axis to regulate stress hormones like cortisol (increases blood sugar and weight gain), adrenaline (causes fear, anxiety and anger), and aldosterone (causes high blood pressure and fluid retention) through balancing hormone levels to normal levels and repeated acupuncture shows to increase a person’s tolerance to stress and reduce many sypmtoms of stress like anxiety, insomnia, depression, and menopuause.
Acupuncture and Menopause
A randomized clinical trial published in 2016 from Wake Forest School of Medicine and Duke Medical University in North Carolina of several hundred women with menopausal symptoms including at least 4 hot flushes a day show acupuncture showed a significant decrease in severity and duration of hot flushing in only 3 treatments, with 8 treatments needed to give maximum effect.
The effects of acupuncture in this trial also included: reduced depressive symptoms, lowered anxiety, feeling less stressed, improved health-related quality of life, and improved sleep quality, benefits of the trial were still maintained even after 6 months without any further treatment43.
This presents acupuncture to be an effective and safe alternative to the treatment of menopause mitigating the cancer risks of Hormone Replacement Therapy (even bio-identical hormones pose risk) in the treatment of menopause.
Acupuncture and Poly-cystic Ovarian Syndrome
Various Studies into Acupuncture for Obesity with Poly-cystic ovarian syndrome show that acupuncture is very successful to reduce symptoms and also reverses the condition, one study published in 2016 in Obesity Science and Practice; show how 5 weeks of Electro-acupuncture on overweight women aged 18 to 35 can reduce the HbA1c involved in diabetes, and reduce androgen levels from poly-cystic ovarian syndrome44.
In another Scandinavia study in 2000, women 24-40 years of age were given 10-14 acupuncture treatments with poly-cystic ovarian syndrome found significant improvements in regulation of ovulation, lower body-mass index, waist to hip circumference, lower testosterone concentrations and improved insulin concentrations45.
How Acupuncture heals scar tissue
The original stem cell therapy
Is that old injury still effecting you?
Chronic pain can occur in areas of injury which fail to heal fully leaving behind scar tissue and damaged nerves that continue to transmit pain signals long after injury, scar tissue and adhesion's also shortens muscles and tendons causing the misalignment of joints and pinched nerves.
It can take months and even years for a the shortening of muscles and tendons to begin to cause pain in a joint and the joints effected may not be were the scar tissue is, for example a injured right knee may cause the body to compensate by putting more weight on left leg and hip and over time the extra stress on the left leg and hip causes the hip joint (also the sacroiliac joint) to misaligned and cause more wear and tear and eventually pain then arthritis. The process may take 7 to 10 years after the right knee injury and often the person has been diagnosed with one leg shorter than the other or it is genetic or you carry your bag on the left side.
X-Rays and other imaging only show the bones/vertebrae that are bulging or pinching nerves, they don’t show the tight/shortened muscles, tendons and ligaments that are actually causing it, and it is often not considered because scar tissue and adhesions cannot be seen on any imaging tests including x-ray, ultra-sound, MRI or C-T scan, they can only be diagnosed with surgery or by a trained physician who knows how to feel for them and with testing the range of motion of joints.
Shortened muscles and tendons from scar tissue (or just tight muscles) from old injuries are often the unknown or undiagnosed by many Doctors who only focus on the bones, many joint problems from inflammation, pinched nerves, bulged discs, ruptured disc and degenerative conditions like osteoarthritis46require continuous adjustments, medications and eventually surgery because the cause is often never treated.
Establish research shows how acupuncture initiates the repair and regeneration of soft tissue (muscle, tendon, ligament, fascia, nerves, blood vessels) through activating the body’s own ability to repair damaged tissue (the healing cascade) and the attraction of stem cells to the area of injury.47,48,49,50,51
The use of ice to treat pain and inflammation works fast and is effective to reduce pain and inflammation becasue it freezes the nerves and tissues, this can damage sensory nerve receptors which can malfunction the body pain control program (gate control and decending inhibitory control) leading to chronic pain, additionally it interrupt the body ability to heal (healing cascade) leading to formation of scar tissue, muscle knots and reduced soft tissue strength.
Ice appears to accelerate healing but in fact it slows it down and can even stop complete healing52,53 and damage nerve receptors reducing pain signals giving impression the area is healed leading to reinjury.
How Acupuncture reduces muscle tension and knots
Muscles move bones
Trigger points and muscle tension
Muscle tension causing pain, misalignment of joints and reduced energy can come from stress, toxins, repetitive strain, fatigue, injury, cold or referred pain and over time the muscle tension can develop into muscle knots or trigger points. Trigger points are a bundle of muscle fibers that have contracted into spasm and can form calcification inside the fibers making it feel like a hard ball in muscle.
The position and movement of a joint or vertebrae is completely is determined by the muscle, tendons and ligaments that connect and hold it into position,bones cannot move themselves and if two bones (vertebrata/joints) are out of alignment, it is because muscles, tendons or ligaments are pulling it out.
Acupuncture is able to reduce muscle tightness and tension by stimulating neural structures called muscles called muscle spindles and Golgi organs in the tendons that control their contraction and relaxation. Acupuncture needle directly into the muscle spindles and Golgi organs then a low level electrical current (electro-acupuncture) is introduced causes the muscle or tendon to contract and relax, resetting the tissue back to normal resting state.
This is similar process to TENS stimulation that goes on to the surface of the skin but with electro-acupuncture a much smaller current is used directly into the neural structure (hardware) that holds the program (software) that controls the tension of muscles.
10. Essentials of Chinese Acupuncture Beijing, Shanghai and Nanjing College of TCM. Beijing: Foreign Language Press, 1980.
11. Weidenhammer W, Streng A, Linde K, Hoppe A, Melchart D. Acupuncture for chronic pain within the research program of German Health Insurance Funds–basic results from an observational study. Complementary therapies in medicine. 2007;15(4):238-46. https://pubmed.ncbi.nlm.nih.gov/18054725/
12. American Specialty Health Incorporated Health Services Department. (2016). Acupuncture: Does Acupuncture Provided Within a Managed Care Setting Meet Patient Expectations and Quality Outcomes? 1–12.
14. MacPherson, H., Vertosick, E. A., Foster, N. E., Lewith, G., Linde, K., Sherman, K. J., et al. (2016). The persistence of the effects of acupuncture after a course of treatment. Pain, 1–22. https://doi.org/10.1097/j.pain.0000000000000747
15. Krebs EE. Effectiveness of opioid therapy vs. non-opioid medication therapy for chronic back & osteoarthritis pain over 12 months. annual meeting, Society for General Internal Medicine, Washington DC 2017. https://pubmed.ncbi.nlm.nih.gov/29509867/
19. Acupuncture analgesia for temporal summation of experimental pain: a randomized controlled study. Zheng Z, Feng SJ, Costa Cd, Li CG, Lu D, Xue CC. 2010 Aug;14(7):725-31. doi: 10.1016/j.ejpain.2009.11.006. Epub 2009 Dec 31., Eur J Pain. https://www.ncbi.nlm.nih.gov/pubmed/20045360
20. Harris, R. E., Zubieta, J.-K., Scott, D. J., Napadow, V., Gracely, R. H., & Clauw, D. J. (2009). Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on μ-opioid receptors (MORs). Neuro Image, 47(3), 1077–1085. https://doi.org/10.1016/j.neuroimage.2009.05.083
21. Electroacupuncture inhibition of hyperalgesia in an inflammatory pain rat model: involvement of distinct spinal serotonin and norepinephrine receptor subtypes. Y. Zhang, 1,2,† R. X. Zhang, M. Zhang, X. Y. Shen A. Li, J. Xin, K. Ren, B. M. Berman, M. Tan. https://pubmed.ncbi.nlm.nih.gov/22628394/
22. Involvement of central opioidergic and nonopioidergic neuroendocrine systems in the suppressive effect of acupuncture on delayed-type hypersensitivity in mice. Kasahara T, Amemiya M, International Journal of Immunological pharmacology, 1993 https://www.ncbi.nlm.nih.gov/pubmed/8365824
23. Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review. Jiang-Ti Kong, Rosa N. Schnyer, Kevin A. Johnson, and Sean Mackey. 2013 Evidence Based Complimentary Alternative Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666367/#B13
24. Do changes in electrical resistance of acupuncture points reflect menstrual pain? A comparative study in healthy volunteers and primary Dysmenorrhea patients. Yan-Fen She, Liang-Xiao Ma, Cong-Hui Qi, Yan-Xia Wang, Ling Tang, Chun-Hua Li, Hong-Wen Yuan, Yu-Qi Liu, Jia-Shan Song and Jiang Zhu. https://www.hindawi.com/journals/ecam/2014/836026/
26. The Study of Dynamic Characteristic of Acupoints Based on the Primary Dysmenorrhea Patients with the Tenderness Reflection on Diji (SP 8). Sheng Chen, Yanhuan Miao, Yinan Nan, Yanping Wang, Qi Zhao, Enhui He, Yini Sun, and Jiping Zhao. Volume 2015, Evidence-Based Complementary and Alternative Medicine. https://www.hindawi.com/journals/ecam/2015/158012/
29. Distribution of the activated acupoints after acute gastric mucosal injury in the rat. Cheng, B., Shi, H., Ji, C.F., Li, J.H., Chen, S.L., Jing, X.H. Volume 35, Issue 3, June 2010, Zhen ci yan jiu, pp. 193-197. https://pubmed.ncbi.nlm.nih.gov/20848894/
30. Observation of pain-sensitive points along the meridians in patients with gastric ulcer or gastritis. H. Ben, L. Li, P.J. Rong, Z.G. Jin, J.L. Zhang, Y.H. Li, 2012, Evid Based Complement Altern Med. https://www.hindawi.com/journals/ecam/2012/130802/
32. Influence of electro-acupuncture on the release of substance P and the potential evoked by tooth pulp stimulation in the trigeminal nucleus caudalis of the rabbit. Yonehara N, Sawada T, Matsuura H, Inoki R. 1992 Neuroscience Letters. https://www.ncbi.nlm.nih.gov/pubmed/1383896.
33. Electroacupuncture attenuates bone cancer pain and inhibits spinal interleukin-1β expression in a rat model. hang RX, Li A, Liu B, et al. 2007 Anesthesia and Analgesia. https://pubmed.ncbi.nlm.nih.gov/17959986/
37. Electro-acupuncture attenuates behavioral hyperalgesia and selectively reduces spinal Fos protein expression in rats with persistent inflammation. Lao L, Zhang G, Ren K. 2001 Journal of Pain. https://www.ncbi.nlm.nih.gov/pubmed/14622832
44. Changes in HbA1c and circulating and adipose tissue androgen levels in overweight-obese women with polycystic ovary syndrome in response to electroacupuncture Steiner-Victorin NCBI, PubMed.gov, 2016 https://pubmed.ncbi.nlm.nih.gov/30013603/
45. Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.Steiner-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO. s.l. : Acta Obstetrics Gynecological Scandinavia., 2000 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192539/
47. The use of acupuncture-like electrical stimulation for wound healing of lesions unresponsive to conventional treatment. Sumano H, Mateos G.. 1999, American Journal of Acupuncture ;27(1-2):5-14. https://pubmed.ncbi.nlm.nih.gov/10513093/
48. Experimental research on the effect of electro-acupuncture on reparative processes]. Di Bernardo N, Crisafulli A, Gemelli F, Ferlazzo F, Cucinotta E, Foti A. 1980 Minerva Med. https://pubmed.ncbi.nlm.nih.gov/7231749/
49.Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechano-transduction-based mechanism. Jun, J Cell. 2006, a journal of Cellular Physiology. https://pubmed.ncbi.nlm.nih.gov/16511830/
51.Observations on clinical therapeutic effect in treating soft tissue injuries by acupuncture, with pain threshold and electromyography as parameters. Yuan CX, Xing JH, Yan CY. 1989;9(1):40- https://pubmed.ncbi.nlm.nih.gov/2761282/