How does Acupuncture Work? Part 1

Patients often ask me how acupuncture works and it’s a really interesting question because depending on who you ask you may get a number of different reasons and explanations. Some words that patients often hear in relation to acupuncture are Qi, energy flow, fascia, nerves, pain relieving chemicals, endorphins and serotonin to name but a few!

I thought I would explain it in my own words, what I think about and the mechanisms I’m trying to utilise when we put those little needles in.

Physiotherapists know that pain is complex and has many factors relating to it, driving it and changing it for better or worse. When we ask our patients about their stress levels, sleep and general well being we are thinking about the whole person and call this a biopsychosocial approach. We are looking at not only the local tissue but beyond it to see how the brain may influence our patients’ symptoms. Once we’ve established some of the driving forces of the individuals’ pain we then consider the different mechanisms of acupuncture to get a very specific recipe of acupuncture points to use for that patient. Here are some of the physiological mechanisms in a nutshell.

1.     Local trauma

Inserting a needle into tissue will cause a microtrauma to it. The bodies natural response is to heal that trauma and so simply the insertion of a needle into the tissue will cause our body to start a healing response. If we have a true tendon problem then putting acupuncture needles close to the tendon can facilitate and enhance the bodies natural healing response.

2.    Spinal effect

This is going to be a little simplified but think of an arctic roll as the spinal cord and cut a slice of it. Now imagine that slice is a level of the spinal cord for example lumbar level 5 (L5). The nerves from L5 supply Glut Max muscles…the buttock. When I insert a needle into Glut Max  an impulse will be sent to the spinal cord at that level, AKA to the slice of arctic roll at L5! That level of the spinal cord is packed with nerves and feedback loops, some of those nerves pass up to the brain. Needling will cause a change in the chemicals released and the transmission of the impulses at that level and dampen down the pain we experience. A very simplified idea is shutting the gate on pain, but there are many mechanisms at play here!

3.    Central effect

Why are they putting those needles in my feet when the problem’s in my neck??? Believe it or not we’re targeting your brain! Acupuncture causes us to release endorphins and other happy hormones in the brain and this helps to calm and relax us, but also has an affect on our experience of pain. The hands and feet are more sensitive and have many more muscles than other areas of the body and so a bigger area of the brain is related to them than other parts of the body. Hence stronger points and more happy hormone’s released if we use these points.

Acupuncture may seem like magic at times and may, by some people, be seen to be a quick fix or considered an alternative therapy. But we can see that the mechanisms that underpin our treatment choices are very scientific, anatomical and physiological in basis. I would love to claim that I have super-powers be mystical and magical and I do love a good scented candle as much as the next person but let us not be confused about how this modality can really help with the pain and function for patients when the treatments are specific for that individual.

So, now you know how acupuncture works BUT the most important question yet to be answered…Do they still make Arctic Rolls? Yep they do, the arctic roll’s popularity slumped in the 90’s but then became popular again in 2008 due to an economic downturn and a need for low cost food! Who knew!!!

A reference for anyone interested in the acupuncture mechanisms https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6431485/