One of the most common questions I get from new patients is “How does acupuncture work?”
It’s a simple question, but simple isn’t always easy. Acupuncture is a complicated medicine, with layers of historical and poetic metaphor to explain complex physiological responses. For so small of a question, the answer is huge.
But I live for questions like this. I used to be a linguistics major and linguistics isn’t the study of a wide variety of languages, it’s the study of how languages work. Linguists study how this group of words or vocabulary evolved differently than this group, even though they are talking about the same thing. I may not be a linguistics major anymore, but this philosophy has carried itself forward into my practice.
My hope for this blog post is to give you an understanding of this big idea – how acupuncture works – in the vocabulary you use every day. While I may have been trained to think in terms of qi, blood, yin and yang, acupuncture works through blood flow, hormone cascades, muscle release and more.
So, if you’re ready, let’s dive in.
The concept behind acupuncture is simple
Acupuncture is the process of moving qi and blood through the insertion of single use, sterile needles into acupuncture points. While the concept is simple, choosing the points through pattern diagnosis, selecting the type of needle, the technique to insert (and remove) the needle is more complicated.
But I promised to talk about this in Western terms so let’s revisit qi and blood.
What is qi?
You have probably heard qi defined as energy, but it’s a bit more than that. In fact, if you look up qi in the Oxford English to Chinese dictionary you won’t see energy listed anywhere. Qi is less of a definite thing and more a modifier to describe an effervescent quality. Carbonated water is “qi water.” Electricity is qi, but so is the light from the bulb it turns on. Nutrients from your food are qi. Oxygen in the air you breathe is qi. Your constitution, attitude and overall drive are your qi.
So, depending on the context, qi might mean something’s energy. But it might mean its function. Or that it’s light, bright or ethereal.
What is blood?
If qi is light, moving and yang in quality, blood is dense, static and yin. Blood is your physical blood, but it’s also the dense parts of your body – the physical parts of food that are broken down and converted into stored calories (fat) or muscle.
Blood nourishes the body. Qi makes it function.
What is an acupuncture point?
An acupuncture point, or acupoint, is an area about 1 centimeter wide usually found near a neuromuscular bundle (a group of blood vessels and nerves), a trigger point or a motor point. If an acupoint is located by palpation or touch, and determined by the tenderness in the local area it is an ashi point, or a painful point. Many of these coincide with classical points.
Acupuncture works on many levels
Acupuncture is part of a much broader type of medicine, often referred to as Traditional Chinese Medicine or Traditional East Asian Medicine. Because acupuncture was designed to treat conditions ranging from pain to hormone imbalance, acupuncture must work on many different physiological levels.
I’ve broken it down to six categories:
• Nervous system
• Endocrine system
• Musculoskeletal system
• Parasympathetic/Sympathetic balance
• The unknown
Acupuncture works through the circulatory system
Our circulatory systems are the means by which nutrients get to where they need to go and waste gets removed. By gently impacting the flow of blood to an area we can take advantage of this system. Most acupuncture points (up to 95%!) are located near a “neurovascular bundle” – a bundle of blood vessels and nerves.
By creating a microtrauma, we trigger the body’s acute inflammatory response which brings new blood and oxygen to an area, while washing away the metabolic wastes that are naturally produced by the body, but that may be hanging around longer than is necessary.
Acupuncture works through the nervous system
This same microtrauma can impact the nervous system. By stimulating the nerve to fire, acupuncture can help with stroke recovery, peripheral neuropathy, and other nervous system disorders.
By stimulating the nerves, we can also impact sensations of pain. Because stimulating the nervous system triggers it to stimulate the endocrine system, and…
Acupuncture works through the endocrine system
Your endocrine system is your hormonal system. The microtrauma at the acupuncture point sends a signal to your brain. Your hypothalamus, the part of the brain that bridges the nervous and endocrine system, starts what’s called a “hormonal cascade” – a chain of hormone releases.
In the case of pain, the hypothalamus triggers the body to release enkephalins, compounds produced by our bodies that bind to our body’s opioid receptors.
But these cascades impact other functions of our body – reproduction, digestion, sleep – everything is ultimately regulated by the endocrine system. Our nervous system may be the boss of the body, but a nerve impulse travels about 100 meters per second and is over in a flash. The endocrine system does the long-term work; hormones can circulate in our blood stream for much longer than a nerve impulse is present AND can impact the production (or reduction) of other hormones.
Acupuncture works through the musculoskeletal system
Another way that acupuncture can have a local (nearby) or a long-reaching effect is through fascia. Fascia is the white connective tissue that is wrapped around every muscle cell, bundle, muscle and muscle group. Fascia is what connects one part of your body to another. If you were able to take a picture of yourself and photoshop out everything but the fascia, there would be a white you-shape of fascia standing there.
Acupuncture needles can stimulate changes either in the muscle belly itself, for a local effect, or in the fascia. This can cause changes along an entire limb, your back, or even from the heels of your feet to the back of your neck. This is because of anatomy trains, or bands of fascia running from one part of the body to another. Anatomy trains are musculoskeletal channels that allow acupuncturists to choose points to treat muscles that are in spasm and may be too difficult to treat directly.
Acupuncturists can also stimulate trigger points and motor points. Trigger points are pockets of metabolic waste that when irritated, cause pain elsewhere. Most trigger point referral patterns seem to follow acupuncture channel pathways or pairings. Motor points are points that, when stimulated, cause a muscle to contract.
Being able to directly impact fascial pathways, trigger points and motor points allows acupuncturists to help pain all over the body.
Acupuncture works by helping you relax
This function is part nervous system and part endocrine system, but the impact is different than when we try to work directly with those systems above.
Your sympathetic nervous system, or your fight/flight response is your stress response. This is the part of your nervous system that tells your body it needs to be prepared for battle. It pumps out cortisol and adrenaline, restricts blood flow to all but the most essential organs (which means the reproductive organs are left out of the loop), negatively impacts digestion, sleep and a whole slew of other healthy things our body needs to do to rebuild including heal.
Your parasympathetic nervous system is your “rest and digest” response. Your body sends out the all-clear and blood flow increases to gonads, digestive system, “non-essential” organs that help our bodies function well. We sleep better, our stool becomes easier and more comfortable to pass and our fertility increases.
Many Westerners are “sympathetic dominant”. Because of our lifestyles we’ve trained our bodies to think that we need to constantly fight bears and run from tigers (when really, it’s just due dates and paperwork, usually).
We get out of sympathetic dominance by relaxing, but for most people it’s hard – our relaxation muscle needs work because it’s been underutilized for so long.
Acupuncture is a way to trick the body into learning to relax again. The hormone cascades and nervous system firings tell your body that there is no bear or tiger trying to eat you. That it’s ok to work on that inflammation, that tender shoulder, the bad digestion and maybe, tonight, it will be ok to sleep.
Acupuncture works for…reasons, I guess
The thing with acupuncture is that the whole is more than the sum of the parts. Modern science is amazing, but it hasn’t advanced enough to understand the concepts behind many things we use or experience every day.
For instance, modern medicine doesn’t understand the exact mechanics of triggering labor. Labor may be triggered by the deterioration of telomeres in the amniotic fluid, but we don’t know for sure.
Another example is SSRIs. We don’t know the mechanics of how they work but they are one of the most prescribed medications for anxiety and depression in the West.
We don’t know all the mechanics of how acupuncture works. But study after study is showing that it helps with pain, addiction, mental health issues and yes, issues relating to pregnancy and motherhood. Many people dump this unknown quantity into a bucket labeled “energy medicine.” Maybe that’s fair. Maybe there is a purely energetic component to Traditional Chinese Medicine.
But I hold out hope that one day, TCM and Modern Medicine will advance to the point that we can understand why a tender point on someone’s leg can help with frozen shoulder on the opposite side. Or why certain points can be used adaptively – used to treat opposite problems in the exact way a patient needs.
So, to sum it up. Acupuncture works by stimulating blood flow to an area, bringing nutrients and oxygen and washing away waste. It works by stimulating the nervous system, reducing symptoms of numbness and tingling by reminding the body of appropriate pathways. Acupuncture can stimulate the endocrine system and help the body re-adjust to more balanced hormonal flow. It works by inducing states of deep relaxation, allowing the body’s stress response to take a break and let the body heal. And acupuncture works for reasons we haven’t been able to explain yet.
But we know that acupuncture works. If it sounds like something you want to try, schedule an appointment today. Because acupuncture can work for you too, however it works.
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Resources and links
How to talk to your acupuncturist: Acupuncture 101
Disclaimer: I am an acupuncturist in the state of Minnesota, and the information falls within my scope of practice in my state. However, unless I have directed you here as your homework I am probably not your acupuncturist. The information in this post is for general purposes only and does not constitute medical advice. As always, check with your own acupuncturist or primary care provider before making any lifestyle changes. This post does not create a patient-practitioner relationship and I am not liable for any losses or damages resulting or relating to the content in this post.
Jessica Gustafson is a licensed acupuncturist in St Paul, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul as well as doing home visits in the Twin Cities area. Check out the services page for more information!
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