Acupuncture
What is acupuncture?
Acupuncture is the insertion of ultra-thin, sterile, disposable needles make of surgical stainless steel, in order to elicit therapeutic responses for a wide variety of health and wellness issues. The metal of the needles is ionized and thus has antibiotic properties, and acupuncture is known to be incredibly safe, resulting in excellent, replicable results without side effects.
How does acupuncture work?
Over the decades, numerous theories from a Western biomedical perspective have arisen to attempt to understand and articulate the origins of acupuncture and its mechanisms of action (how it works). More contemporary research focuses intensely on how acupuncture affects and modulates the nervous system, especially given that 309 acupuncture points fall on or alongside key nerves and nerve plexuses, and 286 on major blood vessels (Chan 1984, Williams 1989).
Early Chinese research demonstrates that acupuncture generates nerve action potentials away from the acupuncture points being treated. This means that therapeutic effects are created throughout the body away from the site of needle insertion. The most promising research suggests that acupuncture has such wide-ranging and powerful effects because it modulates the nervous system and effects the brain. The brain is responsible for commanding each cell in the body through electrical and chemical messaging, and thus any modality that effects it will have downstream effects on other systems and cells.
How Acupuncture affects the body at different Levels
A more detailed description of how acupuncture affects the body at different levels can be found below, but in short, the most profound effect of acupuncture is that it reduces inflammation, as well as:
Some Research Meta-analyses
The brain both directly manufactures and causes the creation of endogenous (internal) chemicals, which modern pharmaceutical treatments seek to recreate. So, by affecting the brain with acupuncture, we can influence and alter all the body’s systems bioelectrically and biochemically, affecting such functions as blood flow, hormones, and other aspects of physiology. Further research on acupuncture has been done worldwide.
Please find research studies and meta-analyses for download and review under the Download Research tab at the top of this site.
What happens when an acupuncture needle is inserted?
When a needle is inserted and a sensation is elicited, the signal travels along afferent or sensory fibers to the relevant nerve plexus, and from that plexus to its spinal nerve root(s) (dorsal horn where neuropeptides are released), from the spine to the thalamus (incoming sensory center and pain interpretation) and hypothalamus in the brain, as well as the periaquaductal grey (PAG) in the midbrain (otherwise known as the pain station of the body). Some effects from this stimulation include down regulating all pain signaling in the nervous system, as well as affecting the hypothalamic-pituitary-adrenal axis (HPA) which regulates the hormonal system, our stress levels, and immunity.
How often should I get treated?
Generally speaking, modern research demonstrates that the neuropeptides released via acupuncture metabolize and break down within 3-5 days, such that being treated with acupuncture 2-3x/week (especially in the acute stage) will maintain the effects of acupuncture consistently throughout a whole week. Also, getting treated more frequently, especially in the beginning, has a compounding effect and leads to better and quicker results.
Once a condition moves from an acute stage to a stabilized or maintenance stage, treatment is not needed as frequently.
At first office visit, each patient will receive an individualized, recommended treatment plan based on their diagnosis and the practitioner's clinical experience.
Effects of Acupuncture at Different Levels of the Body:
Local Effect
Insertion of acupuncture needle in a local area stimulates small nociceptive nerve fibers in skin and muscle (A-delta and C fibers) whose job it is to transmit information and signals to the central nervous system. Traditional Chinese medicine calls this “qi”. The fact that the patient feels some sensation such as heaviness, dullness, or an ache, means the neural transmission has traveled to and terminated in the brain. Also at the local level, acupuncture stimulation causes a nerve axon reflex and the release of neuropeptides in the local network such as: calcitonin gene related peptide (strongest endogenous vasodilator that is responsible for growth of new blood vessels), Nerve Growth Factor (NGF), histamine, white blood cells to fight infections, red blood cells, glutamate for tissue repair, serotonin from mast cells, prostaglandins, and substance P. This biochemical soup results in local damage healing, including rehabilitation of the local nerves. Because a nerve axon reflex is approximately 25mm in diameter, local injury may require more than one needle depending on size of the injury. Local effects have a stronger effect on patients with a history of acupuncture, and after needle removal the blood circulation normalizes (important in stroke/CVA and bells palsy).
Adding 25hz of microcurrent of electrical stimulation to needles leads to generation of ATP and further cellular healing.
Effects of Acupuncture
Different Levels of the Body
Spinal Segment Effects
The nerves that supply different parts of our bodies all travel to the central nervous system, which is made up of the spinal column and the brain. Various levels of the spine (ex. C-7, T-5, L-2, S-1) are the mid-station for communication between body and the brain, and the location where both somatic (skin, muscle) and visceral (organs) afferent nerve fibers all converge into one tract. When we stimulate a relevant segment of the spine with acupuncture, we affect all skin (dermatome), muscles (myotome), bones (sclerotome), and organs (viscerotome) that are innervated by that level’s spinal nerve root. In the same way that visceral problems can manifest in skin, muscles, etc, likewise we can stimulate skin or muscle with acupuncture in order to influence internal organs of the same spinal innervation. In addition to affecting all organs and structures innervated by that spinal segment in alignment with Hilton’s Law, when we apply acupuncture there is also a local release of neuropeptides in the dorsal horn of the spinal column.
Neurochemical Activity Affecting the Brain
Neurochemical activity mediates information up to the brain, especially sensory information. Acupuncture stimulation of a spinal segment results in release of 3 main neuropeptides in the dorsal horn of the spinal cord: serotonin (which down-regulates signaling in the nervous system), noradrenaline, and enkephalin/dynorphins (endogenous opioids that modify and down-regulate pain signaling to the brain). Acupuncture to release these chemicals will disrupt dysfunctional autonomic reflexes including in viscera, causing relaxation and a return to homeostasis. Acupuncture therefore has both orthopedic and visceral applications.
Stimulates Relevant Brain Receptors
Stimulation at relevant areas with electrical acupuncture leads to the release of the following opioids: beta-endorphins (most common), dynorphins, and enkephalin, which effects mu (most common), kappa, and delta receptors. We can attune electrical acupuncture to specific receptors using specific electrical frequencies, and can activate prescribed areas of the brain that are responsible for pain interpretation and experience, such as the periaquaductal grey (PAG). The PAG in the midbrain is the pain station of the brain and can be targeted with electrical acupuncture frequencies, and thus is the primary control center for descending pain modulation. It is activated by beta-endorphins that are released by the hypothalamus and the arcuate nucleus, where some of A-delta afferent fibers terminate when stimulated by acupuncture.
Neuromuscular Junction Effects:
The neuromuscular junction is the area in the body where neurons interact with muscles. Acupuncture here can re-sets myospasms and therefore release muscles from static tension. It also stimulates internal healing mechanisms through the release of local neuropeptides and re-establishing homeostasis of the muscles.
Endogenous Opioid Circuit
Another neurophysiological mechanism of acupuncture is that it stimulates the body to produce more of its own natural pain reducing chemicals. Our body's own pain reducing function operates by releasing chemicals called endogenous (“originating inside”) opioids which attach to receptors and therefore inhibit the transmission of pain signals.
Exogenous Opiates
Exogenous (“originating outside”) opioids--such as opioid medications-- lead to abnormal messaging and physical changes as a result of neuroplasticity. This leads to higher tolerance of opioid medications and the potential for addiction. We can rehabilitate opiate patients by stimulating the endogenous opioid circuit, which activates nerve cells normally with natural neurotransmitters. Research on acupuncture and addressing the opioid crisis can be found under the research downloads tab above.
CNS Effects
CNS Effects
Neuromuscular junction effects: the neuromuscular junction is the area in the body where neurons interact with muscles. Acupuncture here can re-sets myospasms and therefore release muscles from static tension. It also stimulates internal healing mechanisms through the release of local neuropeptides and re-establishing homeostasis of the muscles.Also, the release of opioid peptides naturally enhances gene expression so that more of those endogenous opioids are manufactured and stored at that terminal. Next time that nerve is stimulated, more natural peptides will be released thus improving holistic pain control and lessening the need for opiate medications.