Acupuncture

How Does it Work? Toward an Integrative Explanation.acupuncture model

I tell my patients there are two answers: the traditional explanation, and what science has observed thus far. Having worked in integrative medicine settings all of my career, I am neither a pure traditionalist, nor do I believe in replacing traditional medicine philosophy with scientific terminology.  While it is important to seek to elucidate traditional medicine treatments by scientific means, it is also important not to focus on this at the expense of the strengths of the traditional system, which in the case of Chinese medicine is the way of thinking about the individual in context of a multitude of factors both internal and external, and nourishing the individual’s potential to return to balance or homeostasis rather than reducing the person to their disease.

Traditional Chinese medicine explains acupuncture in terms of Qi, or vital energy in the body that controls our metabolic processes, protects us from pathogens, and when in abundance and circulating smoothly, Qi even keeps our emotions in balance. If Qi becomes stagnant or weak, pain and illness can result. Acupuncture seeks to correct imbalances by accessing, boosting and/or re-directing the body’s Qi through stimulation of acupuncture points found throughout the body connected by a network of meridian pathways. Through this network an acupuncture point can influence organs and body parts which may not necessarily be near the treatment site. For example, a point on the gallbladder meridian in the foot can help with one sided headaches (the opposite end of the gallbladder meridian traverses the sides of the head).

Changes in brain activity during acupuncture on MRI

Changes in brain activity during acupuncture on MRI

Perhaps one of the most well known scientific findings is that acupuncture can stimulate the production of endorphins, chemicals that act as natural pain killers and give us a sense of well-being. But acupuncture has much more to offer than simply boosting endorphins. Human and animal studies have shown that acupuncture can help the body to regulate hormones. It helps to regulate the hypothalamic pituitary ovarian axis which influences ovulation and fertility. Specific points have been found to boost white blood cells, an important part of the immune system, while other points can regulate peristalsis, the motion of the intestines. Points on the ear have been found to influence neurotransmitters. Needling acupuncture points can have local effects on chemical changes in tissues that are related to pain sensitivity such as the neurotransmitter adenosine, decrease blood levels of neuro-peptide Y,  a protein linked with the fight or fight stress response. Functional MRIs have found acupuncture point stimulation can decrease brain activity in areas related to pain perception and laser acupuncture can produce similar effects to needles.

Indeed, research has shown that acupuncture points are unique: they have less electrical resistance than other points on the body. This supports a scientific explanation of how acupuncture may work via our body’s electromagnetic or bioenergetic system. Electrical impulses influence our muscles and nerves and send messages to our endocrine system, and affect cellular activity.  Our connective tissue has been found to be a sort of superconductor for such impulses, which may just begin to explain the non-local effects of acupuncture points.  While Western medicine has mostly focused on understanding our bodily processes via chemical and mechanical activity, Chinese medicine has focused on the subtle energies within us and that permeate us from the environment for millenia. Research in both China and the west has found that our bodies emit infrared light, ultrasound, and electromagnetic waves among other energies. Some believe these energies may at least partially explain the concept of Qi.

Studies of people who meditate regularly have shown that we can control many bodily processes through mind-body practices previously thought to be controlled automatically through our autonomic nervous system.  Similarly, modern biofeedback training can help a person influence his/her physiologic processes through breathing, imagery, and other stress reduction techniques bringing about a more balanced, congruent state. Such balancing of the nervous system can also be prompted by acupuncture. It also has been found to reduce sympathetic nervous system activity, also called the fight-or-flight or stress response, an over-activity of which is associated with allergies, heart disease, anxiety, stress, high blood pressure, insomnia, and hot flashes, among other problems.  Combined with the endorphin and neurotransmitter effects, this may explain why people feel so very relaxed during acupuncture. It may be that inducing such a state of balance and well-being changes our threshold for experiencing symptoms and suffering, provides for a buffer against being pulled out of balance or homeostasis, and creates a healing cascade of sorts, rippling throughout our various systems.

Stress can have a multitude of negative effects upon us which manifest in innumerable ways.  Chinese medicine acknowledges that we must treat the person who has the disease, not just the disease.  We all have unique constitutions and vulnerabilities that need to be taken into account when creating a treatment strategy including trying to get rid of a specific symptom. In this way, Chinese medicine treats the whole person, balancing the treatment between addressing the milieu, or context of the problem, with the manifestation (the symptoms).  Not only is this a very comprehensive approach but it is a patient-centered approach that delivers results as good as or better than Western medicine treatments for a great number of conditions.

Chinese medicine has persisted and flourished because of its efficacy, its humanistic approach, and its sophisticated model of how our minds and bodies maintain harmony. While one does not need to “believe” in Qi in order to experience the beneficial effects of acupuncture, Chinese medicine should not merely be reduced to its chemical or even biophysical effects upon us. Such a comprehensive mind-body and patient-centered model has much to offer our current health care system and approach to health and illness.  Focusing too narrowly on disease without nurturing health, encouraging proper function and capitalizing on the body and mind’s innate healing abilities has left us with a modern medical system that is very good at managing acute health crises, but not as successful at dealing with chronic degenerative and stress-related conditions. There is no question; modern medicine serves a very important role in the lives of many but the combination of both approaches will serve us all much better in the long term.

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