As Kendall states, “Research so far shows that the true concepts of Chinese medicine operate under known physiological principles, involving the complex organization of the neural, vascular, endocrine, visceral and somatic systems, sustained by the circulation of nutrients, vital substances and oxygen from vital air.”
In fact, the ancient Chinese physicians were the first to discover blood circulation, internal organ systems, somatovisceral relationships and the organization of the cardiovascular, immune, and musculoskeletal system.
Kendall goes on to say, “One of the truly unique discoveries of the Chinese was their recognition that those neurovascular nodes (acupoints) located on the body (soma), associated with superficial vessel branching and related nerves, could reflect disease conditions in the internal organs (viscera). Body-organ or somatovisceral relationships were established by the Chinese through correlating the location of body pain with observed problems in particular organs.”
It is important to note that the effects that follow provide a framework as to how acupuncture works and are far more general and broad spectrum in nature than the detailed effects described for each point or a specific combination of points in our Chinese Medical textbooks- which link specific points and point combinations to certain patterns and functions that the Chinese observed for thousands of years and modern research is only beginning to look at and understand. For example, our textbooks relay that PC 6 is a comprehensive point in the treatment of cardiac pain, palpitations, tight chest, epilepsy, insomnia, irritability and other mental disorders but often only appears in the research as an effective point for nausea, vomiting and pain in wrist region. This is one of many examples where more research is needed to catch up with and make sense of what we already know clinically. It is also important to note that an Acupuncturist would not just prescribe a point or point combination based on symptoms alone. One would have to look at the whole person (their body, mind and life) through thorough inquiry and evaluation of genetic, environmental, physiological, mental, emotional and psychosocial factors as they go on to identify the root, the manifestations and the relevant patterns in order to come up with a precise and effective treatment plan.
So let’s dive in.
Every time a needle is inserted into and punctures the skin at the site of an acupoint, a microtrauma is created and a signal is sent throughout the entire body. This microtrauma generates a local and systemic effect as well as a central and peripheral nervous system response, activating complex defense mechanisms involving tissue reactions, blood vessels, sensory nerves, somatovisceral pathways, the brain and endocrine glands as a cascade of chemical mediators, analgesics, immune substances, hormones and neurotransmitters are released into the bloodstream.
Researchers have found that acupuncture points, or superficial nodes, form where collateral branches of deeper distribution blood vessels supply the body surface, which involve afferent and efferent neural properties (Kendall). The acupoints contain a significantly higher concentration of mast cells, fine lymphatics, blood capillaries, venules, and converging arterioles, along with sympathetic nerves supplying the vessels, nerve bundles, nerve plexuses, and free nerve endings (Kendall). This makes acupoints extremely reactive to the needle insertion.
We now know that acupuncture through the activation of these systems increases vasodilation, promotes blood flow, relaxes the muscles, reduces pain, relieves stress, decreases inflammation and restores homeostasis. If we understand that a disturbance of homeostasis and more specifically these functions are at the physiological root of pathological disease and disorder, we begin to understand how acupuncture can play an important role in the healing process and be a beneficial part of the solution. In this next section, we will delve into and explore how acupuncture elicits these responses in the body. It is also important to point out that these effects work synergistically.
- Acupuncture increases vasodilation and promotes blood flow. When the tissue is injured via needle insertion, mast cells help to increase the initial vasodilation phase by releasing histamine, heparin and kinin protease. This keeps the blood from clotting and acts as an anticoagulant. It is also important to point out that the blood carries everything the body needs to heal including nutrients, analgesics, anti inflammatories, immune substances and other chemical mediators.
- Acupuncture relieves stress by promoting parasympathetic function, or the “calm and connect” mode, while decreasing sympathetic function, or the “fight or flight” response through the release of opioid peptides (enkaphalins, endorphins, and dynorphins), serotonin (5HT), neurohypophysial hormones (oxytocin and vasopressin)- as seen recently in research studying acupuncture analgesia. The effects of acupuncture become even more clear when we look at the link between stress related disorders and inflammation.
- Acupuncture relaxes muscles through vasodilation and the other effects listed primarily as an adaptive response to work the needle out of the body subsequently repairing the surrounding tissues.
- Acupuncture reduces pain through the activation of the immune system and the peripheral and central nervous system. More specifically, acupuncture relieves pain through the endogenous opioid system. By inserting a needle into the skin, opioid peptides (enkaphalins, endorphins and dynorphins) are released into the bloodstream. These peptides immediately reduce and in many cases stop pain by attaching to local and systemic pain receptor sites. It is this same mechanism, the release of opioid peptides, that has also been shown to increase pleasure, and decrease anxiety, depression, and gastrointestinal discomfort 1. When we experience pain, two types of nerves are involved, sensory (nocioceptive) and position (proprioceptive). These nerves register pain by quickly relaying information to the spine and onto the neurons in the spinothalamic tract. This information is then transmitted up the spinal cord to the midbrain. There are two different types of sensory nerves involved in the acupuncture response, A-Delta Fibers (acute pain) and C-Fibers (chronic pain). If all goes well, acupuncture will remind the body what it is like to function without pain. It is also important to note that if the nerves are damaged, acupuncture will not be able to help.
- Acupuncture decreases inflammation through a cascade of chemical mediators released into the blood including prostaglandins, leukotrienes and substance P.
- Acupuncture restores homeostasis intrinsically via the effects stated above.
In conclusion, Acupuncture and Chinese Medicine meet the three scientific standards Claude Bernard set in 1865 as a tried and true form of healthcare. He stated that medicine must have an experimental base derived from anatomical and physiological studies, disease must be described in terms of physiological mechanisms and manifestations, and medicine must have a clinical practice essential to restoring or normalizing physiological function.
I would also like to make mention of the interaction and exchange between the patient and healthcare provider. I am not going to explore this relationship here in this article, but we now know scientifically, and many of us know intuitively, that this is an incredibly important part of the healing experience and journey back to health and happiness. I will however definitely be exploring this topic in the future.
I know that when I sit down with my own patients, allow them to tell their story and give them a place in which they are heard, something special happens, as tears flow and transformation begins. Although Acupuncture may not be as mystical as you once thought, I hope you are able to appreciate the innate beauty of this powerful system and your body’s ability to heal itself given the right conditions, tools, and treatment- and find reverence in that.
Recently, I have also started to bring community acupuncture to different locations, particularly in the Orlando area, and include dry needling, as an additional therapeutic approach. Along with the power of needle therapy, community has been well documented to heal.
Finally, I hope this article has provided insight and equipped you with a basic understanding of Acupuncture and Chinese Medicine, as well as opened your eyes to an alternative option that you and your loved ones can now choose with confidence to heal and be well.