Acupuncture is one of the oldest and most widely used medical systems in the world.
Acupuncture effects every major organ system of the body, including the cardiac, gastrointestinal, circulatory, cerebral, genitourinary, endocrine, and immune systems.
Acupuncture has three primary effect:
1. It relieves pain.
2. It reduces inflammation
3. It restores homeostasis
Homeostasis refers to the body’s ability to regulate it’s environment and maintain an internal balance. All diseases involve a disturbance of homeostasis, and nearly all diseases involve some degree of pain and inflammation. This is what is meant by “balancing the flow of Qi.”
One way acupuncture works is by stimulation of the peripheral nervous system.
The acupuncture points or nodes have been shown to have a an abundant supply of nerves.
The Following is list of mechanisms effected by acupuncture that have been identified so far. Several others have been identified but these are the most well understood:
1. Promotes blood flow and vasodilation, which transports oxygen, nutrients, immune substances, hormones, analgesics (painkillers) and anti-inflammatories. If blood flow is diminished by as little as 3% in the breast area, cancer may develop. Blood flow decreases as we age and can be impacted by trauma, injury, and certain diseases.
2. Creates micro traumas that stimulate the body to heal the tissue through nervous, immune and endocrine system activation. As the body heals micro traumas induced by acupuncture, it is also healing surrounding tissue damage left over from old injuries. There are millions of immune cells called mast cells in the dermis of the skin. These cells are like water balloons full of fatty molecules called leukotrienes and prostaglandins A&B. Prostaglandins cause the cutaneous nerve in the area to fire. Leukotrienes are the strongest anti-inflammatory substance produced endogenously. They cause local capillaries to vasodilate and become permeable. White blood cells called macrophages leak out through the capillaries and begin to heal the damage caused by the needle stick. The micro-trauma caused by a needle prick starts a systemic immune response which promotes soft tissue healing through out the body. After the needles are removed the healing continues until the the lesions heal. This means the anti-inflammatory effects can last 2-3 days or even up to a week.
3. Releases natural painkillers such as endorphins, norepinephrine and enkephalin.
4. Reduces intensity and perception of chronic pain through a process called “descending control normalization”, which involves the serotonergic nervous system.
5. Relaxes shortened muscles, which in turn releases pressure on joint structures and nerves, and promotes blood flow.
6. Stimulates the release of oxytocin, a hormone and signaling substance that regulates the parasympathetic nervous system, which calms the stress response. An impaired parasympathetic function has been linked to a wide range of autoimmune diseases, including arthritis, lupus, rheumatoid arthritis, and inflammatory bowl disease.
Latest Information from the American Academy of Pain Management and papers published in major peer-reviewed journals.
The Physiology of Pain
There are two types of nerves involved in our perception of pain:
1. Sensory (nociceptive)- Registers pain. “ouch”
2. Position (proprioceptive)- Gives location of pain. “my knee”
Both of these nerve types are firing at the same time in an area where we are experiencing pain. These nerves travel to the spine and pass their information on to neurons in the spinothalamic tract. This travels up the lateral dorsal horn of the spinal cord to the mid-brain.
There are two different types of sensory nerves involved in an acupuncture response.
-A-Delta fibers- Transmit sharp, burning pain messages. Acute pain. Short lived signals. They fore for a while then die off. Surrounded by a fatty myelin sheath and the signals they send travel 60 feet per second. A-Delta fibers mediate the “gamma loop”, which is what gets activated when you stick you hand in fire and your hand jumps back.
-C-fibers- Transmit dull, throbbing pain messages. Chronic pain. They fire over an extended period of time. These are un-myelinated and their signals travel 20 feet per second.
If the signal strength of the position nerves (location nerves) is healthy the brain will release powerful natural pain relieving substances called enkephalins when it starts to receive the C-fiber messages. The enkephalins then plug up pain receptor sites in the brain, spine and capillary beds where the pain is located and stops the feeling of pain.
1. One current explanation of why this doesn’t happen in people with chronic pain is that the neural threshold of the position nerve path way is too low. The signal is too weak and the mid-brain is unable to register where the pain is coming from, so the enkephalins are not released. This is why people with chronic pain often have trouble identifying where the pain is coming from. The nerves keep firing because the brain is not getting the message. After a while the nerves become inflamed, which further weakens the signals ability to jump the threshold and communicate with the brain.
2. Another issue has to do with why the body fails to fully heal some aspect of our physiology. This is rooted in a survival mechanism that evolved to protect us a long time ago known as “guarding.” In the case of a knee injury the brain doesn’t know the nature of what happened to the knee but it assumes the worst case scenario. You may have been bitten by a poisonous animal or you are losing a lot of blood. The brain is programmed to save your life at all costs even if that means losing a leg or a functioning knee. It very wisely restricts the blood supply going to the injury and the blood return coming from the injury. This will reduce the spread of poison or the loss of blood. Before western emergency medicine this was very useful for our survival but it severely limits the ability of the knee to heal. All of the analgesics, anti-inflammatories, nutrients, oxygen, hormones, and immune substances the knee needs to heal are in the blood.
Inserting acupuncture needles into the skin at peripheral sites “jumps” the neural threshold on the position nerve pathway, so that the signal can reach the brain and the natural nerve signaling loop is reinstated. The enkephalins then plug up pain receptor sites in the brain, spine and capillary beds where the pain is located and stops the feeling of pain. The longer a nerve has been improperly firing the more habituated that low threshold signal is. After an acupuncture treatment there may be initial relief but that old habit will return. If you keep jumping the neural threshold, the central and peripheral nervous system will reestablish neurological homeostasis. It will learn that it is better to operate in a non-pain state. The brain no longer believes the injury is threatening survival and blood flow is no longer restricted.
Acupuncture has been studied and proven to be safe and effective in the treatment of many conditions by the National Institute of Health (NIH) and the World Health Organization (WHO)
1. NIH, Acupuncture, Nov. 3-5, 1997, Vol. 15, No. 5
2. World Health Organization. Viewpoint on Acupuncture. Geneva, Switzerland: World Health Organization, 1979.
The Maryland State Board defines Acupuncture as:
A form of Health Care based on the theory of energetic physiology that describes the internal relationship of body organs or functions of a human or animal with associated points or combination of points.
Practicing Acupuncture is:
The use of oriental medical therapies for the purpose of normalizing energetic physiological functions including pain control, and for the promotion, maintenance, and restoration of health.