How Does Acupuncture Work?

Acupuncture works, according to the classical TCM view, by restoring balance to the body's system. In TCM, "meridians," or channels of energy, flow throughout the body. By stimulating points along these meridians, the entire meridian is affected, including whatever parts of the body the meridian flows through.

The Western medical model describes the body quite differently from the TCM model. The Western view is "mechanistic." This means that the body is seen as a complicated machine made up of parts that work together. The parts are organized into numerous systems, including the skeletal system, the muscle system, the digestive system, the endocrine system, and so on. Speaking very broadly, mainstream Western medicine will address a patient's condition by targeting the appropriate system, locating the part within the system that is malfunctioning, and then using chemical (medicine) or mechanical (surgical) means to attempt to repair the part. There is nothing inherently wrong with this mechanistic approach (it is tremendously powerful for dealing with trauma, like broken bones, for instance), but it is only one way of looking at the human organism.

In TCM, by contrast, the body is organized according to the energies of the human being. The life force energy has two main aspects, negative and positive ("yin" and "yang"). Energy is also expressed in terms of five "elements": metal, fire, wood, earth, and water. The body is said to be made up of various "organs": spleen, liver, bladder, etc. But these are not the same as the physical organs we know by those names. They are energy complexes that we associate with those physical organs. With a knowledge of how all these energies interrelate, and of hundreds of specific acupuncture points, a doctor of TCM will manipulate energy blockages and imbalances to bring harmony to the patient's entire system.

You do not need to "believe in" acupuncture and TCM for it to work. Western research has proved that needles work whether or not the patient believes they will.

So, according to the Western medical science view, how does acupuncture work? Many possibilities have been suggested. Some of them appear to be valid, at least partly. However, none of them adequately explain the wide-ranging, long-lasting effects of acupuncture.

One theory is that we have certain nerves that will feel pain, and other nerves that block the feeling of pain. The pain-blocker nerves are usually in use, keeping us from feeling pain every time we touch something. Certain things will override the pain-blocker nerves, and then the pain-feeling nerves can jump into action. This is a very simplified recap of what is known as the "gate theory" of pain. Looking at acupuncture from the point of view of the gate theory, acupuncture needles stimulate the pain-blocker nerves so that they once again do their job of keeping the pain-feeling nerves inactive. One problem with this explanation is that it doesn't explain the long-term benefits of pain relief from acupuncture.

Another theory is that acupuncture needles hurt so much that your body is distracted from the pain that you were feeling in the first place. This explanation also doesn't explain acupuncture's long-term benefits. Another problem is that acupuncture needles really don't hurt. An acupuncture needle is a fraction of the thickness of a human hair. In many cases, the needle causes no sensation whatsoever. Most of the time, when you do feel the needle entering your skin, it's a tiny pinprick sensation that's over nearly as soon as it begins. It doesn't feel anywhere near as painful as, for instance, the needle used to draw a blood sample (which is itself not very painful, and not for long.) Could such a tiny hint of a sensation produce the "counter-pain" that blocks the chronic pain that acupuncture can help? Perhaps, but this theory does not seem to explain acupuncture's effects entirely, either.

Still another theory is that the acupuncture needles stimulate endorphins, your body's natural pain-relief substance. Research supports that this is at least a partial explanation for some of the benefits of acupuncture. Patients given anti-morphine drugs were resistant to the pain-relieving effects of certain types of acupuncture.

None of these three theories explain how acupuncture helps when it comes to conditions that aren't about chronic pain, like bronchitis, asthma, efforts to stop smoking, or the nausea caused by chemotherapy,

Will Western science ever have a full explanation for acupuncture? Will there ever be a way to talk about the effects of TCM that's not about "energies" and "elements"? It's hard to say. In the meantime, it is interesting and useful to learn about the different ways that Western science considers TCM, and the ways in which TCM and mainstream doctors have found to work together, complementing each other's knowledge and skills for the benefit of you, the patient.

For more information:

• The Institute for Traditional Medicine gives a good description of how acupuncture works, in both classical Chinese and modern terms.