How Does Acupuncture Work to Reduce Pain?

And thrilled to announce a second location at Live Well Chiropractic, Pilates & Acupuncture in Mid-City LA!

I am thrilled to add a second location in the Mid-City area of Los Angeles at Matt Gloin’s wonderful Live Well Chiropractic & Pilates Center at 5553 W. Pico Blvd. It is so nice to have a presence nearer to my West Adams home, and a joy to work with Matt, whom I’ve known for years. I’m also thrilled to be able to teach a little Pilates again! I owned my Pilates studio from 1996-2006, after which I started my acupuncture clinic within the walls of In & Up Pilates. I love working collaboratively, so I am looking forward to working at a place where patients can receive chiropractic care, acupuncture, microneedling, Pilates, and massage all under one roof.

I’ll still be at my Los Feliz office on Mondays and Fridays and at Live Well on Tue/Wed/Thu. Weekend appointments can be accommodated at either location for urgent cases. You can use the link below to schedule your appointment, or existing patients can text me.

One of the questions I’m asked most frequently is “How does acupuncture work to reduce pain?” The 5000 year-old tradition of Asian medicine has its own terminology to explain the beneficial effects of acupuncture, but modern people desire modern explanations.

Unfortunately, up to 75% of all clinical trials are funded by corporate sponsors — largely pharmaceutical companies — with enormous financial stakes in the tested products. Additionally, the scientists who conduct clinical trials are often compensated by Big Pharma. Therefore, studies into therapies, devices, and procedures that cannot be patented for profit by Big Pharma and the scientific community are rarely funded.

Sometimes things make us sick though we don’t know why. Bacterium Yersinia killed millions before we knew what caused The Black Plague— or even that bacteria was ‘a thing.” And sometimes therapies — like acupuncture — work for thousands of years before we have a scientific explanation.

BUT we do have some recent research that sheds light on the mechanisms which make acupuncture therapy an effective means of pain management.

According to Sandberg et al in the European Journal of Applied Physiology, “Ultrasound and optical imaging techniques have found that blood flow is elevated locally where the needle is inserted, with graded increases when the needle is inserted deeper and manually stimulated,” thus demonstrating that acupuncture improves circulation. Additionally, studies show that acupuncture can produce local pain reduction via the release of neurotransmitters such as adenosine — which can act as a central nervous system depressant and analgesic — at the site of needling.

Neuroscientist Maiken Nedergaard of the University of Rochester Medical Center lightly anesthetized mice to get them to hold still, then needled an acupuncture point on the lower leg and sampled the fluid around the needle. She found a 24-fold rise in adenosine, which seemed promising.

Adenosine release may explain the effectiveness of local points, yet many effective acupuncture points are “distal points,” or points located a distance away from the pain point. How might that be explained?

Acupuncture needles penetrate into the fascia, which is the thin casing of connective tissue surrounding every muscle fiber, muscle body, nerve, blood vessel, and organ. It is like a giant interconnected web holding everything in place, but it also has its own nerves, making it as sensitive as skin. It is composed of several layers with fluid in between, and ideally stretches with movement. But injury, immobility, and/or repetitive movements can cause fascia to become sticky, creating adhesions and rendering it less mobile thus reducing mobility. Its connection to the nervous system, and ultimately brain function, can lead to pain when fascia is unhealthy. But this connection also allows a route for acupuncture needles to act upon the interconnected fascia system to reduce pain and inflammation both locally and distally. Chen et al demonstrated the effectiveness of lower leg acupoints on neck and shoulder pain.

There are several mechanisms by which acupuncture works for pain relief. These include local response at the needling site, suppression of signaling at the spinal level, and the release of endogenous opioids. Neuro-imaging studies demonstrate that acupuncture also produces analgesia by modulating specific brain networks involved in sensory, affective, and cognitive processing. Acupuncture also seems to modulate autonomic nervous system pathways, allowing it to not only manage pain symptoms but potentially target the sources that drive pain, such as inflammation.

(Acupuncture’s effect on the autonomic nervous system also make it a good treatment option for those with digestive, mood, and sleep issues. We can discuss that in more detail in a future post.)

MRI studies on brain response to acupuncture stimulation found that needle stimulation can impact activity in many emotion and cognitive processing brain areas – not just brain areas that respond to touch. And Positron Emission Tomography (PET) imaging studies have noted how acupuncture increases binding of endorphin receptors in emotion processing areas of the brain, enhancing modulation of the brain’s own “endogenous” opioids.

An analysis of data from 20 studies (6,376 participants) of people with painful conditions (back pain, osteoarthritis, neck pain, or headaches) showed that the beneficial effects of acupuncture continued for a year after the end of treatment for all conditions except neck pain.

In conclusion, acupuncture can be a great tool for treating both acute and chronic pain. I also go over therapeutic exercises with every pain patient so they can maximize their results.

To your health,

Melissa