Understanding Acupuncture: Origins, Mechanisms, and Modern Scientific Acceptance
- phangngatcmclinic
- May 30
- 10 min read
Let's delve into the origins of acupuncture, how it works, and its recognition in contemporary science.
What is Acupuncture?
Acupuncture is a therapeutic method rooted in Traditional Chinese Medicine (TCM). It involves inserting fine needles into the body, passing through the skin, fascia (connective tissue), muscles, periosteum (bone covering), and near nerves. The placement of these needles is based on traditional Chinese acupuncture points or modern anatomical landmarks, depending on the practitioner's technique. The aim is to stimulate and regulate the body's functions by influencing the meridian system (energy pathways) or the autonomic nervous system.
The Acupuncture Procedure: What to Expect
Physical and Muscular Examination: Your practitioner will assess your body and muscles to identify the most suitable acupuncture points for your specific condition.
Site Cleaning: The area where needles will be inserted is cleaned with alcohol.
Needle Insertion: Specialized, sterile acupuncture needles are inserted into the chosen acupuncture points.
Needle Retention: The needles are typically left in place for 20-30 minutes. You will then have the needles removed. (It's crucial to be in a relaxed position and avoid movement while the needles are in place).
The Ancient Origins of Acupuncture
Acupuncture's history dates back thousands of years, reportedly originating from an accidental discovery during ancient Chinese warfare. It was observed that soldiers hit by arrows sometimes experienced pain relief in other areas of their body when a second arrow struck a different point. This led to experimentation with pressing various points on the body, revealing that this could alleviate pain. Initially, sharpened bones or bamboo were used for acupressure. Through meticulous observation, trial, error, and recording over a long period, these practices evolved into the system of acupuncture points and the specialized needles used today.
Acupuncture Needles?
The needles used in acupuncture are solid, sterile, and disposable (single-use). Their size and length vary depending on the acupuncture point being treated. Used needles are safely destroyed and never reused.
Acupuncture is generally not as painful as an injection because the needles are solid and much thinner than hypodermic needles. Typically, a slight prickling sensation is felt as the needle passes through the skin. Once the needle reaches the acupuncture point, you might experience a sensation of heaviness, numbness, a slight electric jolt, or a dull ache – often described as similar to the feeling when a massage therapist hits the right spot ("De Qi" sensation).
Acupuncture in the Context of Modern Medicine
When Traditional Chinese Medicine, including acupuncture, was first introduced to the United States, it faced skepticism. Western medical practitioners initially struggled to understand concepts like "Qi" (气, vital energy) or meridians (经络). However, as clinical trials demonstrated acupuncture's effectiveness in treating various conditions, interest grew. This prompted research into the mechanisms of acupuncture to explain its effects from a scientific perspective.
What Conditions Can Acupuncture Treat? Is It Effective?
In 2003, the World Health Organization (WHO) acknowledged the efficacy of acupuncture in treating and alleviating various symptoms based on controlled clinical trials. This was detailed in their publication, "Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials." (Link: https://chiro.org/acupuncture/FULL/Acupuncture_WHO_2003.pdf)
Diseases, Symptoms, or Conditions for Which Acupuncture Has Been Proven Effective (through controlled trials):
Adverse reactions to radiotherapy and/or chemotherapy: Reducing side effects of cancer treatments.
Allergic rhinitis (including hay fever): Addressing nasal allergies, sneezing, itchy eyes, nasal congestion, and clear runny nose.
Biliary colic: Acute upper right abdominal pain, possibly with nausea and vomiting, due to gallstones or gallbladder inflammation.
Depression (including depressive neurosis and depression following stroke):
Dysentery, acute bacillary: Severe diarrhea.
Dysmenorrhoea, primary: Menstrual pain without underlying physical pathology (e.g., not caused by cysts).
Epigastralgia, acute (in peptic ulcer, acute and chronic gastritis, and gastrospasm): Pain in the upper abdomen/epigastric region due to stomach inflammation or ulcers.
Facial pain (including craniomandibular disorders):
Headache:
Hypertension, essential: High blood pressure.
Hypotension, primary: Low blood pressure.
Induction of labour: Stimulating childbirth.
Knee pain:
Leukopenia: Low white blood cell count.
Low back pain:
Malposition of fetus, correction of:
Morning sickness:
Nausea and vomiting:
Neck pain:
Pain in dentistry (including dental pain and temporomandibular dysfunction):
Periarthritis of shoulder: Shoulder pain (e.g., frozen shoulder).
Postoperative pain: Pain after surgery.
Renal colic: Kidney stone pain.
Rheumatoid arthritis: Joint pain from rheumatoid arthritis.
Sciatica: Hip pain, numbness, or radiating pain down the leg due to sciatic nerve compression.
Sprain: Ankle sprains and other joint sprains.
Stroke:
Tennis elbow: Outer arm pain.
Diseases, Symptoms, or Conditions for Which the Therapeutic Effect of Acupuncture Has Been Shown but Further Proof is Needed:
Abdominal pain (in acute gastroenteritis or due to gastrointestinal spasm)
Acne vulgaris
Alcohol dependence and detoxification
Bell’s palsy (facial paralysis)
Bronchial asthma
Cancer pain (reducing pain from cancer)
Cardiac neurosis (panic attacks, palpitations, fatigue, abdominal discomfort triggered by stress, anxiety, or fear)
Cholecystitis, chronic, with acute exacerbation (gallbladder inflammation)
Cholelithiasis (gallstones)
Competition stress syndrome
Craniocerebral injury, closed (brain injury)
Diabetes mellitus, non-insulin-dependent
Earache
Epidemic hemorrhagic fever
Epistaxis, simple (nosebleeds without generalized or local disease)
Eye pain due to subconjunctival injection
Female infertility
Facial spasm (muscle twitching in the face)
Female urethral syndrome (urinary tract infection symptoms in women)
Fibromyalgia and fasciitis (chronic muscle and connective tissue pain)
Gastrokinetic disturbance (stomach motility issues)
Gouty arthritis (joint pain from gout)
Hepatitis B virus carrier status
Herpes zoster (shingles)
Hyperlipaemia (high blood lipids)
Hypo-ovarianism (underactive ovaries)
Insomnia (difficulty sleeping)
Labour pain
Lactation, deficiency (insufficient breast milk production)
Male sexual dysfunction, non-organic
Ménière disease (inner ear disorder causing vertigo)
Neuralgia, post-herpetic (nerve pain after shingles)
Neurodermatitis (nerve-related skin inflammation)
Obesity
Opium, cocaine, and heroin dependence (reducing withdrawal symptoms)
Osteoarthritis (degenerative joint disease)
Pain due to endoscopic examination (reducing pain from procedures like gastroscopy)
Pain in thromboangiitis obliterans (pain from blocked peripheral blood vessels)
Polycystic ovary syndrome (PCOS) (Stein–Leventhal syndrome)
Post extubation in children (laryngeal and vocal cord swelling after intubation in children)
Postoperative convalescence (enhancing recovery after surgery)
Premenstrual syndrome (PMS)
Prostatitis, chronic (chronic inflammation of the prostate)
Pruritus (itching)
Radicular and pseudoradicular pain syndrome (radiating nerve pain, e.g., lower back pain radiating to the leg, neck pain radiating to the arm)
Raynaud syndrome, primary (pale, cold hands and feet due to cold exposure)
Recurrent lower urinary tract infection
Reflex sympathetic dystrophy (severe pain due to sympathetic nervous system dysfunction)
Retention of urine, traumatic (inability to urinate after trauma)
Schizophrenia
Sialism, drug-induced (excessive salivation)
Sjögren syndrome (autoimmune disorder causing dry eyes and mouth)
Sore throat (including tonsillitis)
Spine pain, acute
Stiff neck (difficulty bending the neck, pain/tightness at the back of the neck)
Temporomandibular joint dysfunction (TMJ issues, difficulty opening/closing mouth or moving jaw)
Tietze syndrome (chest pain during breathing due to costal cartilage inflammation)
Tobacco dependence (reducing withdrawal symptoms from quitting smoking)
Tourette syndrome (involuntary muscle tics or vocalizations)
Ulcerative colitis, chronic (chronic inflammation of the large intestine, severe diarrhea, abdominal cramping, possible fever)
Urolithiasis (urinary tract stones)
Vascular dementia (dementia resulting from cerebrovascular disease)
Whooping cough (pertussis) (persistent coughing fits followed by a "whooping" sound on inhalation)
Diseases, Symptoms, or Conditions for Which Acupuncture May Be a Worthwhile Option (especially when conventional treatments are challenging), based on individual controlled trials reporting some therapeutic effects:
Chloasma (skin discoloration, melasma)
Choroidopathy, central serous (fluid buildup under the retina, causing distorted or smaller vision)
Colour blindness
Deafness
Hypophrenia (unexplained sadness or depression)
Irritable bowel syndrome (IBS)
Neuropathic bladder in spinal cord injury (bladder dysfunction, e.g., urinary incontinence, due to spinal cord injury)
Pulmonary heart disease, chronic (lung and respiratory diseases)
Small airway obstruction
Diseases, Symptoms, or Conditions for Which Acupuncture May Be Tried Provided the Practitioner Has Special Modern Medical Knowledge and Adequate Monitoring Equipment:
Breathlessness in chronic obstructive pulmonary disease (COPD)
Coma
Convulsions in infants
Coronary heart disease (angina pectoris)
Diarrhea in infants and young children
Encephalitis, viral, in children, late stage (brain inflammation due to viral infection in children)
Paralysis, progressive bulbar and pseudobulbar (muscle weakness, degeneration of motor neurons)
The Scientific Mechanisms of Acupuncture: How Does It Work?
Simplified Explanation:
Acupuncture stimulates physiological mechanisms that help the body regain balance between the somatic (voluntary) and autonomic (involuntary) nervous systems. It works by activating reflex pathways. This is done by sending somatic sensory signals (specifically pain sensations) at a subthreshold level (a level of pain that the brain doesn't consciously register as painful). However, the responding signals can vary depending on the acupuncture point and stimulation method, affecting sensation, motor function, autonomic responses, and hormonal release.
Detailed Explanation:
Pain Reduction:
Acupuncture is widely used for pain management. When the body is injured, nerves transmit pain signals to the spinal cord, releasing a pain neurotransmitter called Substance P, which then travels to the brain. When an acupuncture needle is inserted through the skin and various tissue layers to reach a muscle, a crucial, often overlooked layer is the fascia. Fascia is connective tissue composed of collagen, located beneath the skin, enveloping and separating muscles, nerves, blood vessels, and internal organs. On the surface of the fascia are tiny openings containing a "triad" of a nerve, a venule (small vein), and an arteriole (small artery). Pain often occurs when this triad is compressed or overly surrounded by collagen. Medical research has found that when collagen around the triad is loosened, pain significantly decreases. Furthermore, acupuncture stimulates the release of endorphins, which inhibit Substance P in the spinal cord, thereby reducing the transmission of pain signals to the brain. A study in Germany found an 82% overlap between the locations of these fascial triads and the 361 classical acupuncture points, providing further evidence supporting acupuncture's efficacy.
Health Promotion:
Beyond pain relief, acupuncture can also promote overall health. Stimulating the triad with acupuncture needles leads to the release of Substance P into mast cells. These mast cells then release histamine, heparin, and neurokinins. These substances influence blood pressure, inflammation, anxiety, mood, and cellular recovery. They stimulate surrounding cells and transmit nerve impulses through the spinal cord to the brain, eliciting responses via the sympathetic and parasympathetic nervous systems.
Sympathetic Nervous System: Controls a "fight-or-flight" response, preparing the body for danger or emergencies. This includes increasing glucose levels for energy, raising heart rate, and reducing digestive system activity to prepare the body for exertion.
Parasympathetic Nervous System: Controls "rest-and-digest" functions, conserving energy and managing the baseline activity of internal organs and blood vessels. It prepares the body for relaxation and digestion, increasing stomach acid secretion, reducing heart rate, or increasing intestinal motility.
Acupuncture: Pros and Cons
Advantages:
Reduces reliance on chemical medications by stimulating the body's own healing mechanisms.
Can precisely target the root cause of pain.
Disadvantages:
Patients with a significant fear of needles may need to prepare themselves mentally.
Mild soreness or bruising may occur at the needle sites for 2-3 days post-treatment.
For widespread pain, cupping therapy might be recommended in conjunction with acupuncture due to the small size of the needles.
Preparing for Your Acupuncture Session
Eat a light meal 1-2 hours before your appointment. Acupuncture on an empty stomach, or when overly full or fatigued, can increase the risk of dizziness or lightheadedness ("needle sickness").
Try to relax and get adequate sleep the night before your session.
Wear loose, comfortable clothing that isn't too tight. (Don't worry, clinics often provide gowns if needed).
Inform your practitioner about all your symptoms and health conditions, not just the primary reason for your visit. TCM views the body holistically, so accurate and complete information aids diagnosis.
Important Precautions for Acupuncture
Be cautious or inform your practitioner if you:
Are overly fatigued, hungry, or too full.
Have a heart condition, severe anxiety, an extreme fear of needles, or difficulty controlling yourself. It's advisable to have a companion present during treatment.
Have a pacemaker (cardiac pacemaker implantation). Always inform your practitioner before every session.
Are pregnant.
Have cancer (certain points may be contraindicated or require caution).
Contraindications: When Acupuncture Should Be Avoided
Acupuncture is contraindicated if you:
Have an open, infected wound in the area to be treated.
Have a bleeding disorder affecting blood clotting.
Have taken the following medications within the last 14 days (always consult your doctor and acupuncturist):
Anticoagulants (blood thinners)
Thrombolytic drugs (rtPA)
LMWH (Low Molecular Weight Heparin, e.g., Fraxiparin & Clexan)
Pradaxa (Dabigatran)
Xarelto (Rivaroxaban)
Eliquis (Apixaban)
Lixiana (Edoxaban)
Orfarin (Warfarin)
Heparin
Post-Acupuncture: What to Expect and Aftercare
You can typically resume daily activities immediately after acupuncture; no specific recovery period is needed. Some individuals may experience bruising at the needle sites, soreness, or a mild fever for 2-3 days.
Post-Acupuncture Recommendations:
Rest well for another day. Avoid strenuous work or excessive exercise immediately after treatment.
Avoid showering or bathing for 2 hours after acupuncture or cupping.
If you experience the following common post-treatment reactions, they usually resolve within 72 hours. If discomfort is significant:
Fever/Soreness: You can take standard pain relievers or fever reducers.
Swelling/Bruising: Apply a cold compress for the first 24 hours, followed by a warm compress.
How Many Acupuncture Sessions Are Needed? How Often?
For general aches and pains, an initial course of 3-5 continuous sessions is often recommended to observe changes and the duration of treatment effects.
The frequency of acupuncture during the initial phase is typically 1-2 times per week, depending on the condition and the patient's physical state. The interval between sessions can then be gradually extended based on individual progress.
Is Acupuncture Dangerous? What Are the Potential Side Effects?
Acupuncture is a safe treatment method with no severe side effects when performed correctly according to established principles by a licensed medical doctor or a licensed Traditional Chinese Medicine practitioner.
However, if the practitioner is not careful, or if the person performing the treatment lacks proper knowledge of acupuncture principles, complications such as a punctured lung (pneumothorax), bent or broken needles, or miscarriage (in pregnant women) can occur, as sometimes reported in the news or online forums.
Where Should You Get Acupuncture? Choosing a Qualified Practitioner
At a minimum, choose a licensed medical facility. The practitioner must hold a valid license to practice legally, which helps prevent potential risks.
At Phangnga Clinic, we limit the number of patients per day to ensure ample time for thorough examination, history taking, and treatment, and to prevent our TCM doctors from being overworked. Our team of TCM doctors has extensive treatment experience and regularly undergoes further training and knowledge updates.
P.S. In Thailand, don't forget to check the photo and official stamp on the blue practitioner's license (Sor.Por.6 form). Ensure the person treating you is the same individual pictured on the license. (Every practitioner in a clinic must have their own blue license)
References
Malaiwet, Sawai (Paisarn Malaphan). Tamra Thaeng Khem Rom Ya (Textbook of Acupuncture and Moxibustion). Bangkok: Sookaphap Jai, 2010.
Ratanavijitrasilp, Adul (Clinical Professor Dr.). Fang Khem Kap Dulyaphap (Acupuncture and Balance). Bangkok, 2021.
Wanawibool, Witit. Prawat Kan Phaet Chin (History of Chinese Medicine). 4th ed. Bangkok: Mor Chao Baan, 2008.
