Four Science Backed Ways Acupuncture Makes You Feel Better
The responses to acupuncture are multifactorial - physiological and psychological factors interplay in a complex manner. The biopsychosocial model provides a practical framework for investigating the complex interplay between acupuncture and clinical outcomes.
Is Acupuncture a Placebo?
For those who are unfamiliar with the literature, it may be easy to assume that acupuncture is just a placebo. It is clear that the placebo response is a big part of why patients feel better, but it is also a within the realm of reasons that patients have a complex biopsychosocial response to acupuncture that INCLUDES but is not LIMITED to placebo.
Evidence Based Acupuncture: is there such a thing?
Evidence based acupuncture is an approach grounded in neuroscience that is based upon a theory that is inline current scientific understanding of how the body works (White 2009). Using occam's razor the insertion of an acupuncture needle is a form of novel stimuli, that functions by sending anti-nociceptive input to the neuroimmune system. Stimulating endogenous opioid release, purinergic signaling and modulation of the endocannabinoid system.
Preferential sites for acupuncture stimulation are associated with areas rich in specialized sensory receptors such as muscle spindles, Golgi tendon organs, ligament receptors, Paciniform and Ruffini’s receptors (joint capsules), deep pressure endings (within muscle belly), and free nerve endings (muscle and fascia).
A Biopsychosocial Approach to Acupuncture
Based off the biopsychosocial model, all of these areas are highly innervated and as a result there are a number of physiological responses that help modulate the experience of pain. An observed favorable outcome may be explained by a number of overlapping mechanism in the periphery, spinal cord, and brain including represented in the image below.
More to Explore
Medical Acupuncture: A Western Scientific Approach, (Second Edition by Filshie, Cummings, and White. 2016)
Oxford Textbook of Musculoskeletal Medicine (Chapter 59 Modern medical acupuncture - Anthony Campbell. 2015)
Chae, Y., Olausson, H. (2017). The role of touch in acupuncture treatment. Acupunct Med.
Chen, L., Michalsen, A. (2017). Management of chronic pain using complementary and integrative medicine. BMJ.
Gerber, L.H., Sikdar, S., Aredo, J.V., Armstrong, K., Rosenberger, W.F., Shao, H., Shah, J.P. (2017). Beneficial Effects of Dry Needling for Treatment of Chronic Myofascial Pain Persist for 6 Weeks After Treatment Completion. PM R.
Hershman, D.L., Unger, J.M., Greenlee, H., ... Crew, K.D. (2018). Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA.
Hu, B., Bai, F., Xiong, L., Wang, Q. (2017). The endocannabinoid system, a novel and key participant in acupuncture's multiple beneficial effects. Neurosci Biobehav Rev.
Ji, R.R., Nackley, A., Huh, Y., Terrando, N., Maixner, W. (2018). Neuroinflammation and Central Sensitization in Chronic and Widespread Pain. Anesthesiology.
Ji, R.R., Chamessian, A., Zhang, Y.Q. (2016). Pain regulation by non-neuronal cells and inflammation. Science.
Kaneko, Y., Kime, R., Furuya, E., Sakamoto, A., & Katsumura, T. (2016). Effects of Acupuncture Stimulation on Muscle Tissue Oxygenation at Different Points. Advances in Experimental Medicine and Biology.
Kaptchuk, T.J. (2002). Acupuncture: theory, efficacy, and practice. Ann Intern Med.
Karatay, S., Okur, S.C., Uzkeser, H., Yildirim, K., Akcay, F. (2018). Effects of Acupuncture Treatment on Fibromyalgia Symptoms, Serotonin, and Substance P Levels: A Randomized Sham and Placebo-Controlled Clinical Trial. Pain Med.
Kim, S., Zhang, X., ... Nackley, A.G. (2018). Acupuncture Resolves Persistent Pain and Neuroinflammation in a Mouse Model of Chronic Overlapping Pain Conditions. J Pain.
Langevin, H.M., Wayne, P.M. (2018). What Is the Point? The Problem with Acupuncture Research That No One Wants to Talk About. J Altern Complement Med.
Langevin, H. M. (2014). Acupuncture, Connective Tissue, and Peripheral Sensory Modulation. Critical Reviews in Eukaryotic Gene Expression.
Liddle, C.E., Harris, R.E. (2018). Cellular Reorganization Plays a Vital Role in Acupuncture Analgesia. Med Acupunct.
Lin, Y-C., Wan, L., Jamison, R.N. (2017). Using integrative medicine in pain management: an evaluation of current evidence. Anesth Analg.
Lundeberg, T., Lund, I., Näslund, J. (2007). Acupuncture--self-appraisal and the reward system. Acupunct Med.
Maeda, Y., Kim, H., Kettner, N., Kim, J., Cina, S., .... Napadow, V. (2017). Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain.
MacPherson, H., Vertosick, E.A., ... Vickers AJ. (2017). The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain.
Mcpartland, J. M., Guy, G. W., & Marzo, V. D. (2014). Care and Feeding of the Endocannabinoid System: A Systematic Review of Potential Clinical Interventions that Upregulate the Endocannabinoid System. PLoS ONE.
Nardini, C., Devescovi, V., Liu, Y., Zhou, X., Lu, Y., Dent, J.E. (2016). Systemic Wound Healing Associated with local sub-Cutaneous Mechanical Stimulation. Sci Rep.
Pavlov, V.A., Tracey, K.J. (2017). Neural regulation of immunity: molecular mechanisms and clinical translation. Nat Neurosci.
Perreault, T., Dunning, J., Butts, R. (2017). The local twitch response during trigger point dry needling: Is it necessary for successful outcomes? J Bodyw Mov Ther.
Robinson, N.G. (2016). Why We Need Minimum Basic Requirements in Science for Acupuncture Education. Medicines (Basel). (OPEN ACCESS)
Salazar, T.E., Richardson, M.R., Beli, E., ... Grant, M.B. (2017). Electroacupuncture Promotes CNS-Dependent Release of Mesenchymal Stem Cells. Stem Cells.
Sawynok, J. (2016). Adenosine receptor targets for pain. Neuroscience.
Tang, Y., Yin, H., Rubini, P., & Illes, P. (2016). Acupuncture-Induced Analgesia: A Neurobiological Basis in Purinergic Signaling. The Neuroscientist.
Tsuchiya, M., Sato, E.F., Inoue, M., Asada, A. (2007). Acupuncture enhances generation of nitric oxide and increases local circulation. Anesth Analg.
Turo, D., Otto, P., Hossain, M., Gebreab, T., Armstrong, K.,... Sikdar, S. (2015). Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain. J Ultrasound Med.
Ulloa, L., Quiroz-Gonzalez, S., Torres-Rosas, R. (2017). Nerve Stimulation: Immunomodulation and Control of Inflammation. Trends Mol Med.
White, A. (2009). Western medical acupuncture: a definition. Acupunct Med.
Yin, C., Buchheit, T.E., Park, J.J. (2017). Acupuncture for chronic pain: an update and critical overview. Curr Opin Anaesthesiol.
Zhang, F., Wu, L., ... Liu, H. (2017). Neurobiological Mechanism of Acupuncture for Relieving Visceral Pain of Gastrointestinal Origin. Gastroenterol Res Pract. (OPEN ACCESS)
Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain. Anesthesiology. (OPEN ACCESS)
Zhang, Z.J., Wang, X.M., McAlonan, G.M. (2012). Neural acupuncture unit: a new concept for interpreting effects and mechanisms of acupuncture. Evid Based Complement Alternat Med.
Zhao, Z.Q. (2008). Neural mechanism underlying acupuncture analgesia. Prog Neurobiol.