A long-standing patient of mine showed me a leaflet some time ago from a local hospital that stated that no one really understood how acupuncture worked; needless to say, I strongly disagreed with the leaflet. The language of traditional acupuncture shouldn’t in my view be a barrier to understanding, nor does it describe anything you can’t understand in your own terms. I have therefore written this post as an attempt to explain in simple terms for anyone interested, how acupuncture works.

There are a couple of ways I find easiest to explain the mechanism of acupuncture; I will describe acupuncture first in very general terms, then in terms of the use of distal points, then needling to affect the channels.

In general terms

Our bodies have the natural capacity to heal. Acupuncture points are in areas which when needled safely, you can stimulate without causing any long-term damage. These are often spaces between physical structures like muscles, tendons, and bones (although not exclusively; it can be useful to needle muscles to release them).

When you put a needle in, your body recognises damage being done to local tissue, and reacts in the same way it would if you sustained a minor injury. However, unlike with a genuine injury, when you remove the acupuncture needle, the wound seals up and leaves no discernible mark or effect. So applied appropriately acupuncture stimulates your body to produce pain killers and chemicals that heal the area, reducing pain, stimulating circulation, and easing or resolving the problem.

Distal points

When it comes to using distal points, or points that are not in the vicinity of the issue being treated, my most common justification for this is the tissue is in some way inflamed. You can imagine, in most situations if you put a needle into inflamed tissue, it will only make your body’s reaction worse. This is why for me palpation of the area and the channels around it is such an important part of deciding where to place the acupuncture needles. If you suffer from migraines for example, my first thought would be to stimulate areas at a distance from the headache, often points in the feet or hands; this reduces the degree of stimulation around your head, relieving pain and often getting rid of it altogether. There are of course times when it’s appropriate to use points in the vicinity of the pain, and this is where you would come back to palpation and finding out what the nature of the pain is. In a very general sense the more acute and intense it is, the more likely I would be to stimulate areas a long way from it; dull aches caused by poor circulation by contrast might respond more to local stimulation, to stimulate greater flow through the area.

Channel needling

There are other mechanisms that one can also learn to use. When acupuncture is applied, an acupuncturist can elicit a couple of different reactions: to get your body to grip the needle, or to bounce it back out.

When you know what a gripped needle feels like, with sufficient experience and practice, you can move qi along channels, that is you can raise or lower, move qi along limbs and so on. This is useful when there is something stuck in an area and you want to pull it in a direction. The channel description can be useful here, because rather than just putting a needle in perpendicular to the surface of the body, you are likely to needle at an angle, to allow you to pull or push up or down the channel. We are talking about causing a train of a few cells to shift along and push or drag cells behind them. This sensation of travelling can be felt by the practitioner and is another way of helping to spread qi that has got stuck. (Qi not being any mystical presence but some physical blockage; of course we should always seek to understand what has produced this blockage as best as possible).

Ah-shi / trigger point needling

Thumbs are blunt, and needles can be very useful to get into and release tight areas of muscle which massage can’t get to. This can be direct, as in needling into a knot (which shouldn’t be painful with the right technique and placement). This opens up an area which has become so tight it’s closed firm. It can also mean using the second physical mechanism mentioned above; if one taps the surface of a tight muscle with an acupuncture needle, the muscle spasms to bounce the needle away. This can act as a reset for the muscle, contracting then relaxing.

There are techniques that seem different to these principles, but which can be viewed through the same lens. Auricular acupuncture for example is a very finely tuned method of stimulating areas of the brain by using points in the ears. The method of finding active points relies on finding points in the ear that show electrical sensitivity, but the ultimate stimulation still works in my view via minor damage stimulating a reaction in a broader system.

It's worth bearing in mind that it would be possible to overstimulate someone in a weakened state, so even though my explanation is simple enough in itself, you cannot practice acupuncture without being mindful of the context for the patient, and this may require taking a wide range of factors into account. If someone is in a weakened state, they may not have the resources to heal themselves, and one might need to focus on using very few points or even on massage, dietary therapy or herbs rather than acupuncture.

As with many things, you can describe them and how they work before you are able to do them with any finesse. The skills I’m describing may sound simple, but the sensitivity required to do them needs many hours of practice; this is the reason why it’s so important to seek a qualified practitioner if you wish to have any acupuncture treatment.

As with any of my posts, if what I’ve written raises any questions, by all means use my contact form to get in touch.

How does acupuncture work?

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