How Medical Acupuncture works - a Mechanisms Review

There are five physiological mechanisms which can be used to explain how medical acupuncture works. Each can be used for a different purpose which is why anyone using medical acupuncture must be able to make a conventional medical diagnosis and have an understanding of the underlying pathology to be effective when using a medical acupuncture approach.

The different mechanisms require variations in the treatment technique and so this needs to be tailored to the individual patient.

This blog will discuss the first of the five mechanisms, the local effects:

The local effects refers to the ability of acupuncture to activate specific sensory nerve fibres in the skin and muscle. Needling near the sensory nerve endings sets off action potentials (nerve impulses) which spread around and along with the local network of nerve fibres – this is called an axon reflex. 

acupuncture 2277444 640 1Various substances are released as a result including adenosine and calcitonin gene-related peptide (CGRP) both of which cause local blood vessels to dilate, causing an increase in local blood flow. The blood flow is also increased in the deeper tissues, which encourages tissue healing. Adenosine also has a mild local pain-relieving effect, while CGRP may also promote healing and repair.

More recent research has shown the acupuncture needle stimulus to trigger the release of myokines within the muscle tissue, mainly when electrical stimulation is applied (electro-acupuncture). Myokines help reduce muscle atrophy, improve muscle mass and promote muscle healing. 

Lastly, the mechanical stimulus of the needle may help disrupt the dysfunctional motor endplate, which has been proposed to be the driver of muscular myofascial trigger point activity. In combination with the other local effects described above, the disruption may assist with the deactivation of sensitive and pain referring trigger points (aka muscle ‘knots’). When medical acupuncture is used to treat trigger points, it is often referred to as Dry Needling.

Summary: Acupuncture promotes local healing in the tissues and can be used to deactivate trigger points.

By Simon Coghlan MSc, BScPhysio, DipMedAc

References:

White A, Cummings M. Filshie J. An introduction to western medical acupuncture. Churchill Livingstone; 2008.

Campbell A. Acupuncture in practice: beyond points and meridians. Butterworth-Heinemann, Oxford; 2001.

Baldry PE.  Acupuncture, trigger points and musculoskeletal pain. 3rd ed. Edinburgh: Elsevier Churchill Livingstone; 2005.

Andersson S, Lundeberg T. Acupuncture - from empiricism to science: functional background to acupuncture effects in pain and disease. Medical Hypotheses 1995; 45(3):271-281

Simons DG, Travell JG, Simons PT. Travell & Simons’ myofascial pain & dysfunction. The trigger point manual. Volume 1. Upper Half of Body. 2nd ed. Baltimore: Williams & Wilkins; 1999.

Lund I, Lundeberg T. Are minimal, superficial or sham acupuncture procedures acceptable as inert or placebo controls? Acupunct Med. 2006;24(1):13-15.   

Bowsher D. Mechanisms of acupuncture. In: Filshie J, White A, editors. Medical acupuncture- a western scientific approach. 1st ed. Edinburgh: Churchill Livingstone; 1998.p.69-82.

Staud R, Price DD. Mechanisms of acupuncture analgesia for clinical and experimental pain. Expert Rev Neurother 2006;6:661–7.

Sandberg M, Lundeberg T, Lindberg LG, et al. Effects of acupuncture on skin and muscle blood flow in healthy subjects. Eur J Appl Physiol 2003;90:114–9.

Fernández-de-las-Peñas C, Dommerholt J. International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: a Delphi study. Pain Medicine. 2018 Jan 1;19(1):142-50.

 

Image by Ryan Hoyme from Pixabay 

How Medical Acupuncture works - A Mechanisms Revie...
Treating Runner's Knee with Dry Needling