Why Does Acupuncture Work?
Acupuncture - how Chinese medicine sees
the body and how it works to help someone heal
Acupuncture is a part of Chinese medicine and Chinese medicine has been part of the world of medicine for over 3,000 years. It had humble beginnings, like so many things, and slowly developed into the fine tuned medical theory that it is today. It has traveled the globe to various countries where branches of it have had their own evolutionary growth throughout history. Overall acupuncture is found to be widely used in 183 different countries with many high quality studies supporting its clinical efficacy.1 Although it has transformed slightly depending on the culture that it has been brought to, the heart of the theory rests in the classic literature, that has a rich history dating back as far as 2,600 years ago, when the Huangdi Neijing was estimated to be written.2 Chinese medicine took a different road than allopathic medicine did. One focal difference includes the importance of reading the pulse, which is a complicated and very important center piece to diagnosis. Chinese medicine follows the diagnostic techniques of inspection (observation), auscultation and olfaction (listening and smelling), interrogation (inquiring or questioning), and palpation (pulse examination), which are all included in the pattern diagnosis of the patient to help determine the best treatment principles.
The body is mapped out with a series of 12 primary channels and 6 extraordinary channels which are pathways of Qi, Blood and fluid circulation in the body. These vital substances in each human being are one of the centerpieces of a patient’s health. Much like is seen in nature, the body’s channels can be equated to waterways. Where water flows, nourishment is possible. The Chinese medical professional works with a patient's channels to open up any blockages in these channels so vital substances are able to flow and nourish the entire body.
When being interviewed by a CM doctor, they often go through a series of what is called the 10 questions. These questions, when answered, can give the practitioner a detailed insight into how the body is functioning. Some questions point to organ function while others point to obstruction or dysfunction within the channel networks. They include questions about sleep, appetite, digestion, body temperature, sweating tendencies, urination and respiration, to name a few. A Chinese medical practitioner is trained to look for signs of pathology in these 10 questions and then investigate further to understand the root of the pathology.
In Chinese medicine, there is the concept of “Ben and Bao” which translates to “Root and Branch”. This means that when a person comes for treatment, sometimes it is important to first treat the consequential symptoms, which are the branches, but ideally the root, or the cause of the symptoms, is addressed. And as these root problems are resolved, the body is brought back into a state of harmony and balance, which is the true focus of Chinese medicine. The idea of balance is seen in the pinnacle Yin and Yang concept. The well recognized symbol of Yin and Yang represent the mutually dependent and interchanging energies of Yin and Yang within themselves. We can see this concept animated in nature and the cosmos. Without darkness there could be no light.
This balance is at the heart of physiology in Chinese medical theory and the focus of a practitioner when treating someone. Although the richness of Chinese medical theory can be hard to grasp, especially for populations that grew up in a more allopathic medical model, some might argue the clinical success of the medicine is proof enough, without need for dissection. However, there has been a huge drive for research to pinpoint the mechanism of action of acupuncture. And research has indeed shown some powerful effects of acupuncture. For example, acupuncture has gained a lot of recognition and acceptance for pain relief in the conventional medical system. Research has shown that the stimulation of a point can create cellular changes at the site of stimulation. When a needle is inserted into the body, there is a micro-trauma that occurs. This recruits the “first responders” in the body, such as dopamine, histamine and endorphins, which are all vasodilators. The vasodilators are able to open up the blood vessels to increase blood flow to the area as well as make space for the larger white blood cells to arrive. This can all help to nourish and heal the tissues and reorganize the tissues. On top of this, if there is tissue or nerves that are being compressed, the expansion and minor swelling that occurs during the healing process can make more space for these structures, reducing the compression and stress on them, which in turn can also help to alleviate pain. An increase in endogenous opioid-containing cells to the site of inflammation have also been found, once again helping induce pain relief. All of this evidence supports the pain relieving power of acupuncture.
There have been hundreds of studies trying to determine the mechanism of action of acupuncture for conditions such as cardiovascular disease, insomnia, depression, irregular menstruation, infertility, stroke and even dermatological conditions like urticaria. Some show more obvious, measurable reasons why acupuncture works, and some have not, but the rich history of Chinese medicine has demonstrated a great amount of success clinically, regardless. There are many times in life we don’t fully understand the reason something works. Long before gravity was defined, the world lived in a subtle recognition of it, and this is similar to Chinese medicine for many. The clinical impact of the science is evident, even though not everyone knows how to put a definitive allopathic name to it.
At the heart of medicine lies the ethical value of doing no harm. Acupuncture, even if not fully understood by western medical practitioners, has without a doubt offered non-invasive, effective care for millions and it is recognized as a treatment option that has very rare adverse effects. This is a huge aspect to consider when seeking treatment. The goal of bringing someone back to balance without causing unnecessary harm is not always easily found in the conventional medical model. Treatments can be quite invasive and the side effect profile of operations and medications can be very profound. Chinese medicine, with its deep investigatory methods, is often able to understand the body and its physiology and pathology, without being intrusive to the body. Offering a low harm model of health care is valuable to the world at large. If someone can achieve health care with little to no adverse effects, then it appears the medicine has followed the no harm model of care, and placed the patient at the center, which is to me most important.
Teresa Thissen, OMD
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