How Does Acupuncture Work? BioMedical insights into underlying physiological mechanisms of acupuncture.

April 30, 2019

 

 

 

From an Eastern perspective acupuncture works for restoring balance & flow. Disease is caused by the disruption of Qi (energy) and/or blood flow in the body. Acupuncture restores the balance and the flow of Qi (energy) and blood. 

 

Biomedicinal research into how and why acupuncture is effective for many differing conditions gives us many insights and hypothesis about how acupuncture works.Some of the strongest evidence demonstrates that acupuncture works through the neurohormonal pathways; meaning specific points stimulate nerves to induce specific physiological responses that help balance the body. Biomedical research into acupuncture demonstrates acupunctures effect on following body systems: nervous, endocrine, immune, cardiovascular, and digestive. Acupuncture can help improve sleep, improve digestive function, resolves pain, and enhance an overall sense of wellbeing. 

 

Clinical studies have shown benefits for a wide range of conditions from infertility to insomnia, depression and anxiety to musculoskeletal pain, from nausea to leukopenia, from Sjogren’s syndrome to gout.  See a list of conditions acupuncture has been found to be useful for at the end of this blog.

 

The most simple way of understanding how acupuncture works:

  1. Acupuncture relieves pain by releasing the body's natural analgesic response and modulating the nervous system.

  2. Acupuncture reduces inflammation.

  3. Acupuncture restores homeostasis. 

Going deeper:

  • About 95% of acupuncture points are within 1.0 cm of a major nerve. Acupuncture’s first effect is by stimulating the peripheral nervous system which then has a cascade effect throughout the rest of the body’s systems. 

  • Acupuncture restores balance to the neuroendocrine system by modulating the hypothalmic-pituitary-adrenal axis (HPA). 

  • Acupuncture promotes blood flow. Proper blood flow is vital in maintaining health and preventing disease and pain. Acupuncture increase local adenosine levels up to 24%: adenosine is an analgesic and a vasodilator as well as having a sedative effect on the nervous system. Most people either fall asleep or feel deeply relaxed and peaceful during the resting phase of acupuncture. 

  • Acupuncture reduces inflammation by modulating the immune system response by inhibiting pro-inflammatory cytokines while activating anti-inflammatory cytokines. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781596/) Acupuncture has also been found to decrease inflammatory sepsis in the emerging field of research into neuroimmune pathways. 

  • (https://www.scientificamerican.com/article/can-acupuncture-curb-killer-immune-reactions) 

  • Acupuncture release natural pain killers: endorphins, norepinephrine, enkephalins. (Acupuncture vs intravenous morphine in the management of acute pain in the Emergency Department: https://www.ncbi.nlm.nih.gov/pubmed/27475042)

  • Acupuncture decrease the intensity and perception of chronic pain through a process called ‘descending control normalization’ in the serotonergic nervous system. 

  • Acupuncture also relieves pain by relaxing contracted muscles which benefits joints structures and surrounding nerves.

  • Acupuncture reduces stress while enhancing resilience. (http://time.com/3966005/acupuncture-anxiety-stress/). Acupuncture has been shown to lower cortisol levels via the Hypothalamus-Pituitary-Adrenal Axis (HPAA). Acupuncture also increases the release of oxytocin, which regulates and stimulates the parasympathetic nervous system, the ‘rest, digest & restore’ nervous system while sedating the sympathetic nervous systems, the ‘fight or flight or freeze’ nervous system. 

Case-controlled clinical studies have shown that acupuncture has been an effective treatment for the following diseases, symptoms or conditions:

 

  • Allergic rhinitis (including hay fever)

  • Biliary colic

  • Depression (including depressive neurosis and depression following stroke)

  • Dysentery, acute bacillary

  • Dysmenorrhoea, primary

  • Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm)

  • Facial pain (including craniomandibular disorders)

  • Headache

  • Hypertension, essential

  • Hypotension, primary

  • Induction of labor

  • Knee pain

  • Leukopenia

  • Low back pain

  • Malposition of fetus, correction

  • Morning sickness

  • Nausea and vomiting

  • Neck pain

  • Pain in dentistry (including dental pain and temporomandibular dysfunction)

  • Periarthritis of shoulder

  • Postoperative pain

  • Renal colic

  • Rheumatoid arthritis

  • Sciatica

  • Sprain

  • Stroke

  • Tennis elbow

 

The following diseases, symptoms or conditions also have evidence to support the therapeutic use of acupuncture:

 

  • Abdominal pain (in acute gastroenteritis or due to gastrointestinal spasm)

  • Acne vulgaris

  • Alcohol dependence and detoxification

  • Bell’s palsy

  • Bronchial asthma

  • Cancer pain

  • Cardiac neurosis

  • Cholecystitis, chronic, with acute exacerbation

  • Cholelithiasis

  • Competition stress syndrome

  • Craniocerebral injury, closed

  • Diabetes mellitus, non-insulin-dependent

  • Earache

  • Epidemic haemorrhagic fever

  • Epistaxis, simple (without generalized or local disease)

  • Eye pain due to subconjunctival injection

  • Female infertility

  • Facial spasm

  • Female urethral syndrome

  • Fibromyalgia and fasciitis

  • Gastrokinetic disturbance

  • Gouty arthritis

  • Hepatitis B virus carrier status

  • Herpes zoster (human (alpha) herpesvirus 3)

  • Hyperlipaemia

  • Hypo-ovarianism

  • Insomnia

  • Labour pain

  • Lactation, deficiency

  • Male sexual dysfunction, non-organic

  • Ménière disease

  • Neuralgia, post-herpetic

  • Neurodermatitis

  • Obesity

  • Opium, cocaine and heroin dependence

  • Osteoarthritis

  • Pain due to endoscopic examination

  • Pain in thromboangiitis obliterans

  • Polycystic ovary syndrome (Stein-Leventhal syndrome)

  • Post-extubation in children

  • Postoperative convalescence

  • Premenstrual syndrome

  • Prostatitis, chronic

  • Pruritus

  • Radicular and pseudoradicular pain syndrome

  • Raynaud syndrome, primary

  • Recurrent lower urinary-tract infection

  • Reflex sympathetic dystrophy

  • Retention of urine, traumatic

  • Schizophrenia

  • Sialism, drug-induced (excessive salivation)

  • Sjögren syndrome

  • Sore throat (including tonsillitis)

  • Spine pain, acute

  • Stiff neck

  • Temporomandibular joint dysfunction

  • Tietze syndrome

  • Tobacco dependence

  • Tourette syndrome

  • Ulcerative colitis, chronic

  • Urolithiasis

  • Vascular dementia

  • Whooping cough (pertussis)

 

(List Resource: http://cim.ucsd.edu/clinical-care/acupuncture.shtml)

 

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