How Acupuncture Works

By Lifang Xie, LAc

image collage of acupuncture needles, treatment session and lecture

Although it is an ancient Chinese healing practice, acupuncture has found broad acceptance in the Western world for many conditions. Here, our experts answer some basic questions about this valued treatment.

What is acupuncture?

Acupuncture began in ancient China. Records of its use date back 2,000 years, but some authorities claim that it has been practiced in China for some 4,000 years. Sharpened stones and bones that date from about 6000 BCE have been interpreted as instruments for acupuncture treatment to open and drain abscesses.

Today, however, acupuncture is safe, precise and scientific. During an acupuncture treatment, fine needles are applied to specific parts of the body, called acupuncture points or acupoints. The needles are inserted through the muscles or other subcutaneous layers of tissue below the skin. According to traditional medical theory, acupuncture stimulates the flow of Qi (pronounced chi), which is defined in Chinese medicine as a life force that circulates through channels in the body called meridians.

Acupoints are presumed to be physiologically linked with organs and systems in the body and, according to traditional Chinese medicine, reflect the status or health of those organs or systems. Under this theory, stimulating specific acupoints may facilitate changes in the organ or system and reduce disease symptoms. Acupuncture stimulation is given either right on the acupoint or a nearby affected area (called an ashi point) for the treatment of local symptoms, such as knee pain, while the placement of needles away from ashi points is used to treat systemic abnormalities.

How popular is acupuncture?

During the past 40 years, acupuncture has become more popular, evolving into one of the most utilized forms of complementary integrative medicine interventions in the United States. More than 10 million acupuncture treatments are administered annually in the U.S., according to New York University Langone Medical Center.[1] Its rise in popularity, particularly in the West, can be attributed in part to its effectiveness for pain relief and in part to scientific studies that have begun to prove its effectiveness.  In fact, insurers including Medicare, Medi-Cal, and private insurers have started to cover acupuncture services for various indications.

What health conditions can acupuncture treat?

Acupuncture can be used to treat a number of conditions. According to a 1998 report from the World Health Organization,[2] published controlled clinical trials have determined the practice is effective for such common conditions as:

  • Adverse reactions to radiotherapy and/or chemotherapy
  • Allergic rhinitis, such as hay fever
  • Depression
  • Hypertension
  • Knee pain
  • Low back pain
  • Nausea and vomiting
  • Neck pain
  • Post-operative pain
  • Peri-arthritis of the shoulder
  • Rheumatoid arthritis
  • Sprains
  • Stroke[3]

How does acupuncture reduce pain?

Acupuncture has been shown in scientific research to help alleviate several types of pain, including pain from menstrual cramps, pain from passing a gallstone, knee pain, facial pain, headache, sciatica, neck pain, jaw or dental pain, postoperative pain, kidney pain, tennis elbow and several types of intestinal pain conditions.

The treatment is thought to work to reduce pain by stimulating the function of nerve cells and reducing inflammation in the body, which is often the source of pain. Acupuncture might also relieve pain by suppressing some types of pain receptors on cells and boosting production of brain chemicals that enhance well-being, such as endorphins, which are brain neurotransmitters that act as natural opioids.[4] Other research shows acupuncture may change the concentrations of many naturally occurring substances that influence pain, such as serotonin, prostaglandins and the stress hormone cortisol.[5]

How does acupuncture work?

In addition to the mechanisms associated with pain relief, scientific research, including NIH-funded research done at SSIHI, has shown that acupuncture treatment can promote functional recovery by stimulating Schwann cell proliferation,[6] nerve growth factor secretion, increased brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF) expression levels, as well modulating endogenous opioids in the brain.[7],[8] It has also been indicated by scientific studies that acupuncture treatment may exert its anti-inflammatory effects via attenuating the production of inflammatory cytokines, such as IL 1β, IL-6, IL-8, and NFκB, and increasing the production of anti-inflammatory cytokines, such as IL-10, which are key to proper immune system function.[9] Acupuncture may also reduce inflammation by activating the vagus nerve, which is a major pathway that sends signals from the brain throughout the body.[10]


References

[1] NYU Langone Medical Center. Acupuncture

[2] WHO Traditional Medicine Strategy 2014-2013

[3] Li, et al., Pain Research and Management Volume 2020, Article ID 3825617; Zhao, et al., JAMA Intern Med. 2019;179(10):1388-1397

[4] Zhang, et al., Chin Med. 2020 Feb 4;15:13

[5] Xu, et al., Evid Based Complement Alternat Med. 2020; 2020: 8630368;  Mayer et al., 1977, Brain Res. 121, 368–372; Lee et al., Evid Based Complement Alternat Med. 2019 May 2;2019:1304152

[6] Hu et al., Neural Regen Res. 2018 Mar; 13(3): 477–483. Wenjin, Cell Mol Neurobiol. 2011;31:459–467.; Liu, J Neuropathol Exp Neurol. 2013;72:697–707.; Zhao, Neural Regen Res. 2013;8:1974–1984.; Chang, J Acupunct Meridian Stud. 2013;6:89–97

[7] Pagani, et al., Brain Res. 2006 May 30;1092(1):198-206; Zhang, et al., J Ethnopharmacol. 2015 Aug 22;172:124-32; Kim et al., Sci Rep. 2018 Feb 1;8(1):2044

[8] Fu LW, Tjen-A-Looi SC, Barvarz S, Guo ZL, Malik S. Role of opioid receptors in modulation of P2X receptor-mediated cardiac sympathoexcitatory reflex response. Sci Rep. 2019;9(1):17224.

[9] Baek, et al., Brain Res. 2005;1057(1–2):181–185.; Li, et al., Altern Ther Health Med. 2015;21(4):26–34.; Tian, et al., World J Gastroenterol. 2003;9(5):1028–1033.; Gondim, et al., Can J Physiol Pharmacol. 2012;90(4):395–405; Da Silva, et al., Mol Neurobiol. 2015 Feb; 51(1): 19–31. da Silva, et al., Evid Based Complement Alternat Med. 2011; 2011: 217946; Dai, et al., Evidence-Based Complementary and Alternative Medicine Volume 2019, Article ID 8413576

[10] Song, et al., Anesthesiology. 2012;116(2):406–414.; Liu, et al, Neurosci Lett. 2004;366(2):215–219.; Fang, et al., Sci Rep. 2017; 7:39801.; Hu, et al., Acupunct Electrother Res. 1993;18(2):117–124