“How does acupuncture really work?” this is by far the most common question in any acupuncture clinic. However, most clients don’t realize how incredibly difficult it is to answer. There are no simple answers when it comes to explaining how acupuncture works particularly to the science minded individual. Words such as “Qi, meridian, Yin and Yang” permeate conversations with TCM practitioners which add to the mystery (and the hesitation towards) the 3000 year old medicine.
What Exactly are “Meridians” and “Acupuncture Points”?
In Traditional Chinese Medicine (TCM), the body has a number of meridians or “channels” which flows a natural energy force (Qi-pronounced chee). Acupuncture points are distributed on these meridians and are located all over the body. Science has never been able to prove the physical existence of these “channels” but TCM (and many other traditional medicines) continue to declare that these pathways are an integral part of their medicine.
However, in a simple experiment which was designed to verify the existence of these “channels”, a TCM practitioner was instructed to draw a line on a subjects hand where one of these meridians lie. Next, a technician without any experience in TCM or acupuncture was instructed to take an electrical read-out of the line drawn. What they found was that the electrical read-out from the skin had both well defined peaks and valleys indicating areas of high and low electrical resistance. Not so interesting on its own, but each and every electrical peak directly corresponded with an acupuncture point! The test was performed over and over and yielded the same results each time; indicating that certain areas on the body have varying levels of electrical conductivity which just happen to mirror the TCM acupuncture points and channels developed thousands of years ago. Coincidence? Read on before you decide.
Isn’t Acupuncture Just the Placebo Effect?
The possibility of placebo effect has often been the easy answer for sceptics to the question of how acupuncture works. “It’s all in our heads!” they would say. However, an elaborate system of care with over 3000 years of success all resting on the shoulders of a placebo effect seems very unlikely.
Thousands of scientific studies are performed on acupuncture each year. The scientists running these studies are well aware that the placebo effect needs to be controlled or the studies will not be taken seriously. The way to control the placebo effect, in all studies, is to make it impossible for the subjects involved to tell whether they are receiving the “real” acupuncture as opposed to the “fake” acupuncture. The “fake” acupuncture is more commonly known as sham acupuncture and is able to mimic the real acupuncture. If you are unable to tell if you are getting real or sham acupuncture, the placebo effect is not an issue.
Sometimes, studies will perform acupuncture on all subjects but will only use documented acupuncture points in the treatment group and use non-acupuncture points in the control group. This way, both groups will get the acupuncture but only one is getting needled on real acupuncture points which again, nullifies the placebo effect.
Another fact which challenges the placebo effect is that veterinary acupuncture (acupuncture on dogs, cats and race horses is extremely popular today), which has been around just as long as acupuncture on humans, is just as successful. Learning acupuncture is extremely common for veterinarians today and they even have a professional organizations dedicated to it. It is well known that animals are unable to adequately conceptualize this placebo process and therefore could never bring about a placebo response.
What does “Biphasic” Mean?
Acupuncture has the unique ability to be “biphasic”, or as I call it “the great regulator”. For example, in a recent study, researchers studied people with heart rates which were too high, too low and used people with normal heart rates as a control. The same acupuncture point was used on everyone in the study. The group with above average heart rates experienced a decrease (down to a normal level), the group with a lower than average heart rate experienced an increase (up to a normal level) and the final group (control group) with the normal heart rate experienced no change. This same style of study was performed on a number of different health conditions with the same results (i.e. regulating blood pressure). In essence, acupuncture has the ability to regulate bodily systems and put them back to “normal”… “physiological nudge” in the right direction, if you will.
Acupuncture and Pain Management:
When most people think of acupuncture they often think of its use in the realm of pain management. It’s not much of a surprise to people that acupuncture is great for pain but what is the mechanism of action and why does it work so well for this common complaint? The following are a few of the most common conclusions to these questions.
1. The Gate Theory:
One popular mechanism explaining acupuncture’s role in pain management is referred to as the Gate Theory. Simply put, this “gate” controls how much sensory information gets through to our brain. If the “gate” is open, we will feel pain. If the “gate” is closed, pain is diminished. Acupuncture is able to close the “gate” and stop the pain. However, the Gate theory fails to explain why acupuncture is so successful at treating health problems which are not pain related (ie nausea, digestive problems, menstrual issues etc).
2. Acupuncture Releases our Natural Pain Killers:
Many scientific studies have shown that acupuncture initiates the release of our body’s natural pain killers or endogenous opioids; also commonly known as endorphins. Dr. Bruce Pomeranz, at the University of Toronto, has researched this area extensively and is world renowned for his discoveries.
3. Decrease Inflammation and Swelling:
Acupuncture has the unique ability to minimize swelling and inflammation. It is thought that acupuncture is able to control the release of many different types of neurotransmitters which influence pain and swelling. This mechanism is most likely hormone related.
4. Relax Muscles and Stops Spasms:
Injured muscles want to protect themselves and they do this by tightening or spasming (self-defense mechanism). This causes pain. Acupuncture is able to relax the muscles and effectively decrease the tension and spasms. Pain is therefore reduced.
5. Increases Circulation to Injured Area
With the insertion of an acupuncture needle, the body immediately recognizes it as a foreign object. This sets off a chain reaction which primarily involves an increase in blood flow to the injured area. This increased blood flow brings along with it more oxygen, nutrients and immune related cells which ultimately hasten recovery time.
Much more research is needed to adequately explain acupuncture’s role in pain management. The bottom line is that it works safely and naturally without any side-effects.
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Acupuncture meets the fMRI:
At this point, most people are convinced that acupuncture can help deal with pain. Stick a needle where it hurts most and be done with it, right? Well, there is much more to acupuncture than that. Traditional acupuncture often uses points which are far away from the affected area (distal points). For example, there is a common acupuncture point for stomach disorders on the shin and an important acupuncture point on the hand for headaches. Every traditional acupuncture treatment involves these distal points. Many people have a hard time with this concept but if you understand TCM meridian theory, it makes perfect sense. However, we now have very interesting scientific evidence which proves that these “traditional” acupuncture points do indeed exhibit a therapeutic effect.
This compelling evidence which illustrates traditional Chinese acupuncture’s effect on the body involves recent research with functional Magnetic Resonance Imaging (fMRI). Functional MRI’s are slightly different than regular MRI in that they allow researchers to view brain activity while the brain is experiencing a stimulus, in real time. For example, if you were to play music for someone in an fMRI, the hearing centres of the brain (sides of the brain) will actually light up on the fMRI screen. Likewise, if you were to flash a light in the eyes, the visual cortex (back of the brain) will light up.
The lead researcher in this case, Dr. LH Cho, (a professor of radiation physics who also happens to be co-inventor of the PET scan and a major pioneer of MRI technology) was experiencing back pain. After having successful acupuncture treatments, he decided that he would like to do some of his own experiments on how acupuncture works. Since he experienced traditional acupuncture, he had points on his lower legs for his back pain. Dr. Cho thought it would be interesting to see what happens in the brain when these “distal” acupuncture points were stimulated. They decided to experiment on a traditional point which commonly treats eye disorders (the acupuncture point literally translates to Bright Light) and resides on the lateral ankle. To everyone’s amazement, the visual cortex of the brain lit up during acupuncture stimulation! They tried a similar experiment with a point on the lower leg that treats ear problems and low and behold, the hearing centres of the brain lit up! Again and again, the same unbelievable results.
How does a point on the foot stimulate the brains visual cortex? Where are the direct pathways from the ankle to the brain? What is the mechanism of this action? For one, it means that traditional acupuncture points influence the related areas of the brain despite their precarious location. To the TCM practitioner, this experiment seemingly validates the meridian system (there are no other known pathways to explain this phenomenon). Science does not accept things it cannot see, so it is hard to convince people (scientists especially) that the meridian theory could be real. So in the end, they decided that it must be some unknown system which was sending the signal.
Interestingly enough, the Quantum physics community is coming up with some interesting answers which validate a lot of TCM theories and related questions about the workings of this Chinese energy known as “Qi”.
What it all Means:
In the end, all of the research is a major plus for acupuncture and TCM in general. The fact that people are studying how it works should be enough of an indicator that something is indeed happening.
The National Institutes of Health (NIH) released the following statement after the NIH consensus conference on acupuncture in 1997. “There is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and to encourage further studies of its physiological and clinical value” JAMA 280, 1518-1524, 1998.
There are no clear cut answers as to why acupuncture works unless you give the TCM philosophies a chance. These teachings, which have evolved over 5 millennia, beautifully describe a completely different way of looking at health and the human body. These sound theories use nature to describe change in the body by viewing the body as a microcosm to our environment. TCM is truly a poetic medicine and is well worth the time investigating.
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