How Acupuncture works is a very complex matter and to understand how Acupuncture works it is best to understand the basic mechanisms of pain and physiology in relation to injuries.
Any time there is pain in the body, there are sensory nerves, which are firing; these may or may not be related to a structural problem causing the sensory dysfunction. It is suggested 90-95%[v] of the time with chronic pain; particularly lower back pain there is no major structural reason/cause for the pain (nothing pushing on a nerve, no bulging disc, nothing leaning on a spinal nerve) but the person still has pain!
In most of our minds is the assumption is that if you have pain, there must be a structural reason for it. In other words, there must be some form of structure, being bone, soft tissue, disc or some object actually pushing on the sensory nerve, causing it to continuously fire. This assumption is not always true. So why is the pain still there?
This is because the patient is caught in a sensory motor loop, meaning their body has literally forgotten how to shut the pain down. This is due to a neuropathic problem where the nerve itself is swollen, firing continuously, sending incorrect information to the brain; hence creating a major problem for the patient where they are stuck in a pain cycle.
The second problem involves a survival mechanism that the brain evolved a very long time ago. Let’s take a knee injury as an example. When we bang our knee into something, the brain immediately takes measures to protect it. The brain doesn’t know what happened to the knee, but it assumes a worst-case scenario, that you are losing a lot of blood and thus the injury becomes in your brain life threatening.
What the brain does in this situation is restrict the blood supply going into the knee and the blood return coming out of the knee. This is actually a very intelligent choice. If a venomous snake bit you, reducing blood flow around the knee will lessen the chance that the poison will spread. And if you were cut badly, reducing the blood flow will lessen your chances of bleeding to death.
This phenomenon is known as “guarding”. One of the results of reducing blood flow to the knee is that it becomes stiff and weak. This was a great strategy before the advent of western emergency medicine. Almost everyone would prefer to lose function in his or her knee rather than death. But this isn’t a choice most of us have to make anymore, because when we cut our knee or get bitten by a snake we can go to the hospital and it can save our lives. And the problem is that cutting off blood flow to the knee – while it may have saved our lives in times past – dramatically limits the knee’s ability to heal.
So how does Acupuncture help? Well by inserting needles into the skin at neurovascular nodes we create a series of events within the body;
Firstly it is believed that acupuncture insertion causes “jumps” at the neural threshold on the position nerve pathway, so that the signal can reach the brain. Once the signal reaches the brain a whole series of events occur including vasodilation (increased blood flow), release of enkephalins (the bodies own pain killers), and immune stimulation. However what isn’t quite understood is Acupuncture’s unique ability to stimulate areas that are not being touched by the needle (see above what is an Acupuncture point for more information).
Most pain relief from Acupuncture is very fast. However after needling the pain will come back, the old habits of the nerve chronically firing re-establishes itself. The body, just like the mind, has a hard time breaking bad habits.
But if the patient returns in a couple of days to get another treatment, the neural threshold will be jumped again. And if you keep jumping the neural threshold, eventually the central and peripheral nervous system figure out that it’s better to operate in the non-pain state than in the pain state. The technical term for this is re-establishment of neurological homeostasis.
Once this happens, the brain is no longer receiving pain signals from the knee. It no longer thinks the knee is injured or threatening the survival of the body.