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Mechanisms of Action of Acupuncture and How It Works in Healing

Acupuncture functions as an independent healing modality today, but it originated from Traditional Chinese Medicine (TCM), which views health as harmony both within the body, and between the body and the universe. In TCM, this concept is personified by the yin and yang symbol, which shows the duality and the interconnectedness of all life. With acupuncture: “the needle is ‘yang’ in its sharp, metallic, focused, and intrusive form [and] the body is ‘yin,’ comparatively soft, organic, expansive and complex” (Micozzi, 2015).  In TCM, practitioners seek to balance a patient’s energy force, known as “chi,” in order to bring harmony to the body and subsequently health to the person. When measuring and manipulating chi, TCM doctors will seek to influence the energy meridians of the body with acupuncture. Just as lakes and streams carry water to nurture the earth, so too do tributaries of energy carry our life force throughout our body. Over five thousand years ago, the Chinese were the first to record these subtle energies that flow within us, and named them meridians. Sometimes, dams or debris can clog up the waterways and energetic healing such as acupuncture can clear these obstacles so the energy can flow again and our energetic bodies can reach homeostasis.

The basis by which acupuncture works has a long and detailed history in Asian cultures, but it is only just beginning to be understood by Western medicine. In TCM, meridians are “energy pathways for chi, the true foundation of the traditional Chinese system…chi is the force that animates and informs everything” (Dale, 2009). There are twelve major meridians which connect to a specific organ and organ system. Knowledge of these energy meridians has been known in Asian cultures for thousands of years, but modern science is just starting to be able to translate their existence into biomedical data necessary for allopathic understanding: “mapping meridians thermographically (measuring heat, electronically, and radioactively with modern technology, studies and applications of these amazing streams of energy are closing the gap between Eastern and Western thought” (Dale. 2009). This can be seen in studies such as “Biophotonics in the infrared spectral range reveal acupuncture meridian structure of the body” (Schlebusch et al., 2005) and “Appearance of human meridian-like structure and acupoints and its time correlation by infrared thermal imaging” (Yang et al., 2007).

While there is robust literature to support the efficacy of this modality, the mechanisms of actions (MOA) are only just being investigated. Additionally, “it is clear that acupuncture effects are the consequence not of a single physiological process, but rather of a complex and dynamic of local tissue, vascular, and CNS-mediated neuroendocrine events” (Micozzi, 2015). Mallory et al. notes “there are a variety of theories that explain physiological effects, including altered brain chemistry by the increased release of endogenous opioids and neurotransmitters, which occur with acupuncture…[and] acupuncture has been shown to have a number of immunomodulatory properties.” While the exact MOA are not yet know, it is clear that lab samples drawn from patients before and after treatment have shown that endogenous opioid peptides are present in both humans and animals after treatment, which elevate mood and lessen pain (Hosobuchi et al., 1979)(Mayer et al., 1977). The parts of the brain that are the most stimulated are the “nuclei accumbens, amygdala, habenula and periaquaductal grey which are the strategic sites for endogenous opioids to exert their analgesic effect. These brain areas are also of extreme importance for the realization of morphine analgesia” (Zhou et al., 1981). Furthermore, “Acupuncture has been demonstrated to enhance endogenous opiates, such as dynorphin, endorphin, encephalin, and release corticosteroids, relieving pain and enhancing the healing process” (Patil et al., 2006). Because of aucpuncture’s success in treating pain, it is commonly used for pain management but has also been shown to be clinically beneficial for anxiety, post-operative nausea and vomiting, hot flashes, and neuropathy (Mallory et al., 2016) to name a few.

Ongoing scientific inquiry continues to concretely demonstrate the science of acupuncture, but in the meantime, millions of people continue to benefit from its effects as a stand-alone treatment or in conjunction with other healing modalities.

References

Dale, C. (2009). The subtle body: An encyclopedia of your energetic anatomy. Boulder, CO: Sounds True, Inc.

Hosobuchi, Y., Rossier, J., Bloom, F. E., & Guillemin, R. (1979). Stimulation of human periaqueductal gray for pain relief increases immunoreactive beta-endorphin in ventricular fluid. Science (New York, N.Y.), 203(4377), 279–281. https://doi.org/10.1126/science.83674

Mayer, D. J., Price, D. D., & Rafii, A. (1977). Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain research, 121(2), 368–372. https://doi.org/10.1016/0006-8993(77)90161-5

Mallory, M. J., Do, A., Bublitz, S. E., Veleber, S. J., Bauer, B. A., & Bhagra, A. (2016). Puncturing the myths of acupuncture. Journal of integrative medicine, 14(5), 311–314. https://doi.org/10.1016/S2095-4964(16)60269-8

Micozzi, M. (2015). 5th edition. Fundamentals of Complementary and Integrative Medicine, St. Louis, Missouri: Elsevier.

Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. https://doi.org/10.1007/s11916-016-0552-1

Schlebusch, K. P., Maric-Oehler, W., & Popp, F. A. (2005). Biophotonics in the infrared spectral range reveal acupuncture meridian structure of the body. Journal of alternative and complementary medicine (New York, N.Y.), 11(1), 171–173. https://doi.org/10.1089/acm.2005.11.171

Yang, H. Q., Xie, S. S., Hu, X. L., Chen, L., & Li, H. (2007). Appearance of human meridian-like structure and acupoints and its time correlation by infrared thermal imaging. The American journal of Chinese medicine, 35(2), 231–240. https://doi.org/10.1142/S0192415X07004771

Zhou, Z. F., Du, M. Y., Wu, W. Y., Jiang, Y., & Han, J. S. (1981). Effect of intracerebral microinjection of naloxone on acupuncture- and morphine-analgesia in the rabbit. Scientia Sinica, 24(8), 1166–1178.

About the author: Mary Genevieve Carty, MS, MHEd holds Masters degrees in Complementary and Integrative Health as well as Higher Education and is currently a doctoral student in Health Science at George Washington University’s College of Medicine and Health Science.  She is passionate about holistic health and wellness, and has additional training in teaching, Reiki, and Tapping/ Emotional Freedom Technique. Her research interests include resiliency, psychoneuroimmunology, neuroplastic pain, placebo/ nocebo effect, and bioenergy therapies.  The views she expresses are her own, and do not reflect any affiliation.

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Medically reviewed by Dr. Stephen Matta, DO, MBA CAQSM and Mary Anne Matta, MS, MA, LAC

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