Have you been interested in trying Acupuncture, but don’t understand how it works? For many years, the west dismissed Acupuncture as pseudoscience that had no medical value and any positive experience as placebo. Acupuncture has since emerged into mainstream medicine and is used for a wide variety of conditions and disorders. There are many theories proposed as to the exact physiological mechanisms behind acupuncture’s efficacy. As evidence based research and controlled studies steadily increase, so too have some of the mechanisms of acupuncture become clearer. There are three main effects that have been found: it restores homeostasis, it reduces inflammation, and it relieves pain. Dive deeper into the science and evidence with me as I breakdown the 5 main acupuncture mechanisms.
1. Neurotransmitter & Endorphin Theory
Acupuncture needle insertion stimulates the release of specific neurotransmitters, such as serotonin, norepinephrine & GABA, and endogenous opioids, such as endorphins and enkephalins. It has been proposed that the release of these neurotransmitters and endogenous opioids lead to the analgesic, pain reducing, mood improving qualities often experienced during acupuncture sessions. Studies have shown that the use of low frequency electro-acupuncture leads to an increased release of endorphins and enkephalins that act to block our perception of pain and relieve stress (1).
2. Gate Control Theory
Acupuncture regulates our pain physiology system. We have two types of pain receptors (A- fibers & C- fibers) that carry pain signals to our spinal cord and central nervous system. Needle stimulation may inhibit the transmission of pain signals from A- fibers during acupuncture treatment. The basis of this theory is rooted in competition of pain signaling to the brain. Therefore, when acupuncture activates receptors at a distal point on the body, these other pain- signaling mechanisms are “gated out” and unable to elicit a pain response (2).
3. Circulatory/Blood Chemistry Theory
Acupuncture affects the circulatory system by dilating the blood vessels through nitric oxide release, ultimately increasing blood flow and oxygenation to local tissues and muscles. The insertion of needles creates a “micro-trauma” to the body that increases the amount and migration of white blood cells to the area that helps improve immune function, removes metabolic waste, and reduces inflammation in the local area. As blood flow is increased, more nutrients and inflammatory mediators are circulating which leads to a faster healing response time after injury (3).
4. Growth Control Theory
It is believed that acupuncture points have a high correlation to areas on the body known as organizing centers that form during our embryonic (fetal) development. Further, it has been shown that acu-points are areas where there is a high level of electrical conductivity as opposed to adjacent tissue. So, by stimulating acupuncture points, we are regulating this growth control system of the body that is responsible for cellular and tissue growth and regeneration (4).
5. Connective Tissue Model
While the previous theories represented biological models of acupuncture, this theory presents a biomechanical mechanism of acupuncture. This model looks at the interaction between the muscles, connective tissue, and fascia and the acupuncture needle. By stimulating what are known as trigger points (taut bands of connective tissue) or the muscle spindle (innervation into muscle belly), acupuncture can release these tight bands of tissue and re-establish proprioceptive communication between the muscle and the central nervous system (brain). When the strands of fascia wrap around the needle, leading to what’s called tissue-needle coupling, the body elicits a response to allow these areas to relax (5,6).
Citation
Ma SX. Neurobiology of Acupuncture: Toward CAM. Evid Based Complement Alternat Med. 2004;1(1):41-47. doi:10.1093/ecam/neh0
Jurgen. Lang-Lasting Analgesia following TENS and Acupuncture: Spinal Mechanisms beyond Gate Control. Proceedings oi the 9th World Congress on Pain, Progress in Pain Research and Management, Vol. 16
Song-Yi Kim, Seorim Min, Hyangsook Lee, Soyeon Cheon, Xiuyu Zhang, Ji-Yeun Park, Taek-Jin Song, Hi-Joon Park, "Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review", Evidence-Based Complementary and Alternative Medicine, vol. 2016, Article ID 9874207, 11 pages, 2016. https://doi.org/10.1155/2016/9874207
Shang C. Electrophysiology of growth control and acupuncture. Life Sci. 2001 Feb 9;68(12):1333-42. doi: 10.1016/s0024-3205(00)01032-8. PMID: 11388686.
Langevin, Helene M et al. “Connective tissue fibroblast response to acupuncture: dose-dependent effect of bidirectional needle rotation.” Journal of alternative and complementary medicine (New York, N.Y.) vol. 13,3 (2007): 355-60. doi:10.1089/acm.2007.6351
Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002;269(6):257-265. doi:10.1002/ar.10185
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