Acupuncture... Ancient Medicine or Sophisticated Neurological Therapy?

"So tell me doc, how does acupuncture work anyway?" This is a question that I get an awful lot as an acupuncturist. I have also written about it in the past from a Traditional Chinese Medical perspective, but there are newer models for the mechanisms at work with acupuncture and other physical medicines that I think need a revisit. Read on and get better acquainted with my thoughts on how this all works.

As acupuncturists we can get very graphic with our detailed descriptions of the meridians, Qi, and the interconnectedness of the energetic organ systems. We will use symbolism adopted from the environment around us like wind, heat, cold, damp or dryness as ways of understanding the pathology in our bodies. I would venture to say that it would be rather foolish in these modern times to believe literally that there is wind blowing around in our bodies. But I will hold firm in the use of this type of symbolism as a tool of defining, understanding, and treating various disharmonies that come up with our health. After all, the system does work for most things. But all this beautiful imagery aside, how does it work? People, including myself, have an innate curiosity to know what mechanism is involved in the insertion of a needle in the hand and the relief of neck pain for example. How that occurs exactly is still a bit uncertain but I would like to offer a very plausible mechanism that I hope will transform the hocus-pocus of acupuncture into something that is easily understood and respected as a valuable and legitimate medical modality.

The first thing to understand about our health is that our brain is everything. Without healthy brain function we could not walk, talk, digest or enjoy our food, appreciate the arts, feel or control our pain, etc. You name it, the brain is everything. Unfortunately in both mainstream and alternative medicines alike we tend to separate the head from the rest of the body. Medicine has ended up getting chopped up into separate systems and rarely, even in alternative medicine, is the whole body, brain included, taken into consideration. This came about from the start of medical thought where all they had was gross anatomy, or what they could see with their eyes. Each system was described and studied as separate concepts and specialists were created in each area. But it was the ancient Chinese that began to really put the pieces together, however archaic their system may seem to some. The Traditional Chinese Medical model does not distinguish between mental, emotional, or physical disharmonies. And they understood that stimulation of points on the hand or foot could have dramatic affects on the head for example. What they did not understand is that by stimulating these points they were actually stimulating pathways in the brain that had positive downstream consequences elsewhere in the body. This has since been shown to be the case in modern brain imaging studies.

The most plausible mechanism for an acupuncture needle that is placed in the hand to create a change elsewhere in the body can be found in small muscle and nerve bundles called golgi tendon receptors. These nerve-like bundles are located in the areas of the tendons and muscles and fire directly into the brain. The primary function of these receptors are to protect the muscle from over strain. For example if you try to lift a very heavy object the golgi receptors will recognize the strain and send a message to your brain to tell the involved muscle to relax. I first learned of these areas many years ago through my Ju-Jitsu training. It came in handy when immobilizing my opponent's limb. Pressure applied directly to the golgi tendon receptor can render an arm powerless. So when inserting an acupuncture needle in a specific area it is plausible that the acupuncturist is stimulating one or many of these golgi tendon receptor areas and stimulating the part of the brain that controls a specific part or system of the body. This gets much more intricate than what I was doing in martial arts. Acupuncture uses combinations of points to create a specific outcome. These patterns of stimulation to particular areas of the body directly stimulate the brain.

The same concept can be applied to any of the physical medicines like chiropractic, massage therapy, aromatherapy, or even music therapy. You will find that one of these modalities will generally work better for certain people. There are certainly the chiropractic loyalists who want to turn everyone they know onto chiropractic because it works so well for them. The same goes for acupuncture and the rest. Each individual has a unique brain/body connection and therefore will respond to different stimuli. This is why certain people will gravitate to the certain modalities. The bottom line here is that it isn't the particular modality that is more valid than the next. It has all to do with the person's unjique brain/body connection that is receiving the treatment.

But what we do know is that the current literature clearly demonstrates dramatic changes in both brain and organ activity with things like acupuncture which can be easily reproduced. We know that the electrical potential across the skin in the area of the acupuncture points is greater than the area adjacent. That means that there is more potential for electrical conductivity at the acupuncture points vs. the areas where no acupuncture points exist. We have seen the immediate stimulation and contraction of the gall bladder for example by the stimulation of a sole acupuncture point on the lateral part of the knee. We have measured increases in the neurotransmitters of the brain from acupuncture and massage. And we can easily see with real time functional MRI imaging that the firing rate of the brain changes immediately with the stimulation of true acupuncture points that is in contrast to sham acupuncture points. That means that the tester is trying to trick the patient with acupuncture points that are not real. The real ones make the appropriate changes in the brain and the fake ones do not.

I personally find this all to be amazing and fascinating. I do very much appreciate the beauty and imagery that Traditional Chinese Medicine has offered me as a tool to understand and treat a vast complexity of different medical disorders. This type of medicine truly is an art form. But the western scientist in me wants to know, like the rest of us, what I am actually doing to help my patients when I perform acupuncture. The answer appears to be really quite simple. Our bodies are not individual systems separate from one another. Our bodies are complex interconnected working systems that support one another and everything is controlled by our brains. By stimulating key points on the body we are directly stimulating the brain which will tend to have an immediate and positive downstream affect on the various systems of our body. Hence a successful and scientifically realistic acupuncture treatment.

A final thought and a little teaser for the next entry would be to pose the question, "Why do physical modalities like acupuncture, chiropractic or massage work better for some people and not others or work better on certain days and not others?" Could it have to do with the health and firing rate of the individual brains perhaps? Look out for my next newsletter for some explanation of this very important concept. But in the mean time keep coming in for acupuncture. Or if you are not currently doing so, go get some acupuncture for crying out loud! Your body and brain alike will be the better for it.