How does acupuncture work?

There is no simple answer to this question. Chinese medicine has elegant and complex explanations about how acupuncture works. To understand it properly, it is necessary to understand concepts and terminology that don’t always fit comfortably with a biomedical understanding of human biology. For example, the concept of Qi, which has no equivalent in western thought.

Biomedical research has begun to investigate how acupuncture works from the western point of view, and has suggested some theories based on the neurology of pain. None of them yet explain the effects of acupuncture adequately, but research that looks at a combination of psychology, neurology and immunology may be beginning to understand the wide-ranging benefits acupuncture can deliver.

Biomedical modelWhat's it like having treatment?

Acupuncture works by stimulating certain sensitive and reactive places on the body. These sensitive areas are known as acupuncture points, and are thought to link to nerve junctions in other parts of the body. When needles are inserted into these points, the body releases natural pain killing substances, known as endorphins. Endorphins enter into the nerve pathways of the brain and spinal cord and help to relieve pain in the corresponding part of the body. For example, acupuncture needles are inserted into the tender areas of muscle in the neck and shoulders to treat headaches.

The release of other substances, such as serotonin, the ‘feel-good’ hormone, as a result of acupuncture stimulation, may explain the sense of well-being that many patients experience as a result of treatment. Functional neuro-imaging or brain scanning of people receiving acupuncture, shows  complex reactions in the central nervous system (Esch et al 2004), and further research in this area may help our understanding of the ‘holistic’ effects of acupuncture.

Chinese medical theory model

Qi is seen as flowing through  channels in the body, just like blood flows though the blood vessels. When the Qi flows freely, the body is healthy, and we feel well. If Qi stops flowing freely, or stagnates, we start to notice stiffness, pain or a compromise of function in the area of the stagnation. If the area of stagnation is not resolved or moved, the problem is likely to get worse or affect other systems in the body. For example, chronic tension in the shoulders can lead to headaches.

Qi is commonly translated as ‘life force’ or ‘energy’. However, this interpretation is somewhat simplistic. The term ‘Qi’ is used extensively in the classic Chinese medical texts and throughout East Asian philosophy. It refers to natural phenomena and their relationship with one another. Rather than being a physical ‘thing’, Qi describes (or provides a framework for describing) the activities and movements that make up  relationships in the natural world. Birch and Felt (1999) propose that Qi is a ‘generative matrix in which all things interact with all other things through the exchange of information’. Supposing that nature is observably ordered, Qi provides a useful construct for describing and predicting behaviour and events. Chinese medical theory describes the functions of the human body and mind in terms of Qi, and it is using ‘Qi’ that acupuncturists aim to treat their patients.

An important part of acupuncture treatment aims to restore the flow of Qi to or from an area by hand with qistimulating acupuncture points. Once the stagnated area is moved, the problems resolve. This theory applies as much to internal problems such as irritable bowel syndrome (IBS) or menstrual problems, as it does to painful conditions such as chronic muscular tension.

Beyond the flow of Qi, there are a range of further complications described in the Chinese medical model. A person can become unbalanced in temperature, body fluids or emotions. Chinese medicine does not differentiate between mind and body, seeing the two as inextricably intertwined, so emotional problems and physical conditions may both come into play. For example, a person with depression may often suffer from associated physical pains, or someone with painful osteoarthritis of the knee may become depressed as a result of their impaired mobility.

A professional acupucturist has extensive training so they can diagnose the underlying causes of the problems their patients present, and focus on treating the individual, rather than the disease. This may be why patients often report that they experience a sense of increased well-being with acupuncture, (Cassidy CM, Emad MC.1997) and that their general health improves with treatment, not just the main problem.



Esch T, Guarna M, Bianchi E, Zhu W, Stefano GB. (2004) Commonalities in the central nervous system’s involvement with complementary medical therapies: limbic morphinergic processes . Med Sci Monit, 10(6): MS6-17

Birch S.J., Felt R.L. (1999)  How does acupuncture work? (in)Understanding Acupuncture. Churchill Livingstone.

Cassidy CM, Emad MC.(1997) What patients say about Chinese medicine. (in) Contemporary Chinese Medicine and Acupuncture.(1997) Churchill Livingstone