A question I get a lot is how does Acupuncture work? So I thought I would write a blog about it, explaining how it works. I am training in Western Medical Acupuncture and I have to say getting qualified in it has been invaluable to my practice. I trained with the British Medical Acupuncture Society. Western Medical Acupuncture is being more well know and 47% of GP regularly refer patients for acupuncture. Medical Acupuncture is also in the NICE guidelines and recommended by the NHS for a range of conditions including Headaches, Migraines, Chronic pain including neck, joint, dental and post operative pain.
What is Western Medical Acupuncture?
Western medical acupuncture is an adaptation of Chinese acupuncture and the insertion of fine needles. However it is centred on the most current scientific research available for anatomy, physiology, and pathology. Medical acupuncture works by selecting points in order to stimulate the pathways involved in the nervous system including the transportation and regulation of signals. To perform western medical acupuncture you are required to be a trained healthcare professional that is regulated by a statutory regulatory body. Every acupuncturist will tailor treatment to the individual patients symptoms and neurophysiology and will use a unique combination of the standardised acupuncture and trigger points.
What is the difference between traditional and western medical acupuncture?
While western medical acupuncture is a branch on medical acupuncture it has two main differences that are:
- The concepts of Yin/Yang and the circulation of Qi
- Western medical acupuncture is not considered an alternative medical therapy
Since the 19th century medical practitioners practicing acupuncture in the UK have selected points primarily based on relieving musculoskeletal pain and uses points based around the individual patients maximal tenderness. Western medial acupuncturists do not follow the all the traditional acupuncture points and meridians. The selection of points will be based more on the most effective points to stimulate the nervous system.
How does it work?
Medical acupuncture is centred around the mechanism acting on the neurological and central nervous system. The recognition of acupuncture in the medial world gained validity and accreditation from research produced showing its effects on the release of the body’s natural opioids and its effect on the gate control theory. (Wall & Melzack, 1965) The needles stimulate both the spinal cord and the mechanism of the firing of electrical nerves.
Goddard et al 2010 concluded the mechanism behind the analgesic effect of acupuncture was due to diffuse noxious inhibitory and endogenous opiate mediated pathways in the dorsal horn and trigeminal nuclei. Consequently suggesting a heightened analgesic response to local rather than distant points additionally supported by Smith et al. 2006. My placing needles locally to the area of pain or symptoms it increases the blood supply and releases a range of neuropeptides including hormones such as calcitonin, which is, involved the body’s uptake of calcium and phosphate.
Releases endorphins, serotonin both natural pain killers and reduce the pain messages into the spinal cord where they travel to the brain – detected and reduced pain levels. Acupuncture seems to affect the limbic system of the brain in particular the insula. (Dhond et al 2008) In scientific terms described as activating the descending inhibitory pathways of pain.
What can it treat?
Western medical acupuncture is normally used to treat musculoskeletal problems but is some times used by rheumatology, orthopaedic and pain clinic in the UK. Price & White (2004)
- Temporomandibular pain (Jaw pain
- Minor sporting injuries
- Neck/ back pain
- Arthritic pain
- Muscles strains and spasms
- Shoulder problems
- Knee pain
- Trapped nerve
- Post operative pain
- Tennis and golfers elbow
- Elbow pain
- Nausea (Lee & Done, 2004)
- Pain management (Sun et al 2008)
How is it used in treatment?
Western medical acupuncture is used in conjunction with conventional medical practices. Therefore your practitioner will often take a thorough medical history as well as a physical examination and diagnosis. The needles will then be inserted and continually stimulated throughout treatment to achieve the neuro physiological effects to treat the presenting symptoms. Western medical acupuncture may use additional points that are more associated with traditional Chinese acupuncture. In western medical acupuncture the practitioner will be focused more on the muscles and the amount of stimulation the needles will achieve than the selection of specific points. The duration of acupuncture can vary from anywhere up to 20 to 30 minutes. You can have both manual / normal or electrical acupuncture. There is no specific ‘dose’ for a certain condition and it will be tailored to the individual.
White, A. (2017) Western medical acupuncture: a definition. Acupuncutre in Medicine.
British Acupuncture Council: http://www.acupuncture.org.uk
British Medical Acupuncture Society: http://www.medical-acupuncture.co.uk
Dhond RP, Yeh C, Park K, et al. Acupuncture modulates resting state connectivity in default and sensorimotor brain networks. Pain 2008;136:407–18.
Goddard, G., Karibe, H., McNeill, C., Villafuerte, E. 2002 Acupuncture and Sham Acupuncture Reduce muscle pain in myofascial pain patients. Journal of Orofacial Pain. Pp.71-76
Lee A, Done M. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2004;3:CD003281.
Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965;150:971–9.
Price J, White A. The use of acupuncture and attitudes to regulation among doctors in the UK—a survey. Acupunct Med 2004;22:72–4.
Smith, P., Mosscrop, D., Davies, S., Sloan P., Al-Ani, Z. 2006. The efficiency of acupuncture in the treatment of Temporomandibular joint myofascial pain. Journal of Dentristy. 35. Pp. 259-267
Sun Y, Gan TJ, Dubose JW, et al. Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. Br J Anaesth 2008;101:151–60.