How does acupuncture work?

To the typical Westerner, acupuncture may seem rather esoteric and unscientific. It doesn’t help that acupuncture is mostly explained with ancient Chinese metaphorical language and imagery. We typically hear about energy meridians that traverse the body through which energy (Qi) travels. Acupuncture points are described as areas where stuck energy can be unblocked, like turning on a light switch. The basic premise of Chinese medicine is that where Qi and blood are moving, disease can’t take hold.

After reading this, do you feel like you understand acupuncture any better than before? I know I don’t. I do get an inkling that there is truth in these statements, but the concepts are truly vague. You might wonder how I ever got through acupuncture school with these heretical assertions! 

Well, I did make it through school. I trusted that 3,000 years of positive results meant that there was a lot of truth to be found in the ancient Chinese medical texts, and that they just had to be interpreted through a lens of modern anatomy and physiology. Luckily, there are scholars who have dedicated their lives to truly understanding the ancient texts and making them not only more accessible, but more applicable for Western Chinese medicine practitioners like me. Here is a distillation for you, my clients.

In his book The Dao of Chinese Medicine, Understanding an Ancient Healing Art, author Donald Kendall discusses various interpretations of Chinese medicine throughout history, then adds his two cents. He prefers to translate Qi as vital air, AKA oxygen. He believes that blood carries oxygen through the vessels (another name for meridians). In other words, acupuncture theory relates to the circulatory system.

I’m currently in the midst of taking a 55-hour course on Neuro-Meridian Integrative Acupuncture taught by Poney Chiang. Chiang offers a slightly different interpretation of what the ancients are describing. He believes that the nerve pathways relate directly to the meridian system. He shows how each acupuncture point directly targets a specific structure, such as a nerve trunk, a nerve branch, or a nerve’s entry point into a muscle. He believes that each point has its own very specific function, which is never repeated by another point. Therefore, in-depth knowledge of each point, including its precise location and intended action, allows the acupuncturist to achieve specific results with acupuncture treatment.

Interestingly, these two interpretations of the Chinese medicine texts are actually quite similar. Nerves supply stimulation to the blood vessels. The nerves and the blood vessels often travel together, forming neurovascular bundles. Therefore, when you insert an acupuncture needle, you are often stimulating a neurovascular bundle of nerves and blood vessels.

Each needle that is inserted into the body triggers a cascade of physiological events. As Kendall puts it, “Needling therapy activates complex defensive mechanisms in the body, involving the immune system, tissue reactions, blood vessels, sensory nerves, somatovisceral pathways, autonomic nervous system, central nervous system, brain, and endocrine glands.”

Ultimately, acupuncture increases blood flow to organs and tissues, it stimulates atrophied muscles, and it releases overly tightened muscles. Acupuncture also exerts a more systemic effect, via the nerve pathways, to regulate the nervous system. 

The remarkable thing about the ancient Chinese medicine practitioners is that they determined exactly where all of these important, tucked-away anatomical structures are in the body and how to access them with an acupuncture needle. To acknowledge the correlation of acupuncture points with our modern understanding of anatomy and physiology is to acknowledge that acupuncture is grounded in science. This makes it much easier for our modern brains to grasp.