How Does Acupuncture Work? Let’s Look Into The Theories

This post was originally published on July 17, 2017 on Ms. Weatherbee (my former interior design blog). 

Last year was a time of great change for me. I left New York City after 13 years, and moved to sunny San Diego to pursue a master's degree in Acupuncture and Chinese Medicine. While this shift might seem random or out of the blue, it's actually something that I had been mulling over for several years. I was growing frustrated with the interior design industry, and yearned to work with people in a more personal, healing manner. I became a certified yoga teacher two years ago, and that experience opened me up to the larger world of alternative medicine and healing.

I had my first acupuncture treatment a little over a year ago, and it completely blew my mind. I had gone through a major breakup and was struggling with deep depression. I literally felt like I was falling apart. I couldn't eat. I couldn't sleep. I couldn't stop crying. I was a hot mess - it was the worst I'd ever felt in my life, and it had been going on for months. Some of my yoga friends swore by acupuncture so I decided to give it a try. I didn't really have high expectations. Mostly I was scared about having needles stuck in me. I assumed at best the treatment would be soothing and relaxing, like a massage. But what happened that day is something I'm still trying to wrap my mind around. It's hard for me to find words to describe that first acupuncture treatment. Right after the treatment I felt relaxed and sleepy, not unlike how I feel after getting a massage. I went home to take a nap, and when I woke up, I knew instantly that something was different. Keep reading for the full story:

I felt a shift that was both incredibly subtle, and deeply profound. On the one hand, nothing had changed. I was still super sad about my breakup, and struggling to figure out the next steps in my life. But somehow everything felt more manageable. The uncontrollable weeping that had plagued me the past few months went away completely. I felt a strange sense of peace and calm. It was almost like my life before was a top spinning out of control, swaying wildly from extreme emotion to extreme emotion. And suddenly I felt more balanced, centered, and in control. My mind was officially blown.

I knew right then and there that I had to figure out what happened to me, even if it took a lifetime. Of course a lot of people were skeptical about my miraculous healing. "Maybe you imagined it." they would say. "Maybe it was the placebo effect". I've definitely questioned myself many times, doubted myself, and wondered if maybe I did imagine the whole thing. But over a year later, I'm certain that what I felt was not just in my imagination. There was a distinct physical sensation that I experienced with acupuncture. It was unlike anything I had ever felt before. I'd describe it as being on some really good drugs - nice, mellow drugs with no side effects. And in fact, that description may not be so off-base. There is evidence that acupuncture activates the endogenous opioid system, stimulating the release of pain-relieving and feel-good neurotransmitters. In other words, it taps into your body's natural pharmacy, giving you the perfect dose of medicine, without all the scary side effects or addictive properties of pharmaceuticals.

Flash forward to a year later, and I'm well into my first year of acupuncture study at Pacific College. I'm learning so much, and loving every minute of the program. But I was actually surprised to learn that even in the acupuncture community, nobody is quite sure exactly how it works. In school we study classical Chinese texts that talk about the flow of qi (vital energy) throughout the body, and the critical balance between the opposing forces of yin and yang. While these esoteric concepts are extremely fascinating, and represent a completely different way of approaching medicine and the body, they don't quite explain how acupuncture works in modern scientific terms. You'll have to dig a little deeper for that.

Modern acupuncture research in the US began around the 1970's, and is continuing to develop. Although there is no one, clear, pervasive theory as to how acupuncture works, we can piece together some ideas by sifting through the research. A 1974 study (Research Group, 1974) revealed that the pain-relieving effects of acupuncture may be transmitted through humoral means (aka through the body fluids). In this study researchers observed pairs of two rabbits. One rabbit received a 30 minute acupuncture treatment, and its cerebrospinal fluid was then infused into a second rabbit. Amazingly, the second rabbit experienced the pain-reducing benefits of acupuncture through the infusion of cerebrospinal fluid. These results indicate that acupuncture has an effect on body chemistry that can be delivered through cerebrospinal fluid.

More specifically, several studies have shown that acupuncture stimulates the release of feel-good hormones called endorphins (Han 2004, Mayer et al. 1977). One study tested the pain threshold of participants by applying electrical stimulation onto a tooth. Participants who received an acupuncture treatment prior to pain stimulation showed an increased tolerance for pain. However, some study participants were also given naloxone - a medication that blocks the effects of endorphins - and they did not experience the same benefits from the acupuncture treatment. This indicates that acupuncture works, in part, by stimulating the release of pain-relieving endorphins.

But other studies show that it's not just through the cerebrospinal fluid that acupuncture works. Currently, there is growing interest in the role that fascia plays in transmitting information throughout the body. Fascia is a connective tissue that can be found everywhere throughout the body, surrounding the muscles, bones, and organs. It is made primarily of interstitial fluid, dissolved nutrients, and fibrous proteins like collagen. Studies have shown that mechanical stimulation of this connective tissue (from an acupuncture needle, for example) is translated into electrochemical signals that affect the way pain is communicated throughout the body (Traverso, 2011). In fact, subtle differences in the way an acupuncture needle is manipulated during insertion can have varying effects on cellular response in the connective tissue (Langevin, 2007).

While these studies give us some clues as to how acupuncture works, they don't provide a comprehensive explanation of how acupuncture can be used to treat such a broad range of conditions ranging from pain and anxiety to asthma, allergies, and irritable bowel syndrome. I look forward to reading more studies as interest in acupuncture, and improvement in research methodology continues to grow.

References
1. Han, J. (2004). Acupuncture and endorphins. Neuroscience Letters,361(1-3), 258-261. doi:10.1016/j.neulet.2003.12.019
2. Jahed Z, Shams H, Mehrbod M, Mofrad MRK. Mechanotransduction pathways linking the extracellular matrix to the nucleus. Int Rev Cell Mol Biol 2014;310:171–220
3. Langevin HM, Bouffard NA, Churchill DL, Badger GJ. Connective tissue fibroblast response to acupuncture: dose dependent effect of bidirectional needle rotation. J Altern Complement Med 2007;13:355–360
4. Langevin HM. What role does fascia play in rheumatic diseases? Rheumatologist. March 1, 2014. Online document at: http://www.the-rheumatologist.org/article/what-role-doesfascia-play-in-rheumatic-diseases/, accessed July, 2017.
5. Mayer DJ, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res 1977;121:368–372
6. Research Group of Acupuncture Anesthesia, P.M.C. The role of some neurotransmitters of brain in finger acupuncture analgesia. Scientia Sinica 1974;117:112– 130.
7. Traverso S. Mechanical signalling in tissues and its possible role in nociception. Theoret Biol Forum. 2011;104:75–84.