How Acupuncture Works Part 3: A Biomedical Explanation on How Acupuncture Relieves Pain

• By Dr Luke McPherson (CM) Acupuncturist, Crows Nest

How Acupuncture Works: How acupuncture relieves pain

How Acupuncture works. Acupuncture, has garnered significant attention in the biomedical community for its potential to alleviate pain. Understanding how acupuncture relieves pain through a biomedical lens involves exploring its effects on the nervous system, biochemical pathways, and overall homeostasis.

How Acupuncture Works: The Nervous System and Pain Modulation

The primary mechanism by which acupuncture alleviates pain is through the modulation of the nervous system. Here’s how it works:

1. Stimulation of Nerve Fibres: When acupuncture needles are inserted into the skin, they stimulate sensory nerves, particularly A-delta and C fibers. These nerves send signals to the spinal cord and brain, triggering the release of neurotransmitters .

2. Release of Endorphins: Acupuncture prompts the release of endorphins, the body’s natural painkillers. These endogenous opioids bind to opioid receptors in the brain and spinal cord, reducing pain perception and providing an analgesic effect similar to that of pharmaceutical opioids but without the associated risks .

3. Spinal Gate Control Theory: Acupuncture is believed to activate the "gate control" mechanism in the spinal cord. According to this theory, non-painful input closes the nerve "gates" to painful input, which prevents pain sensation from traveling to the central nervous system. By stimulating specific nerve fibers, acupuncture can effectively "close the gate" on pain signals .

4. Activation of Descending Pain Modulatory Systems: Acupuncture can activate descending inhibitory pathways in the brainstem that modulate pain. This involves the release of serotonin and norepinephrine, which inhibit pain transmission in the spinal cord .

How Acupuncture Works: Biochemical Changes and Inflammatory Response

Acupuncture also induces significant biochemical changes that contribute to pain relief:

1. Anti-Inflammatory Effects: Acupuncture has been shown to reduce inflammation by modulating the activity of pro-inflammatory cytokines and increasing the production of anti-inflammatory cytokines. This helps in conditions where pain is driven by inflammation, such as arthritis .

2. Neurotransmitter and Hormonal Modulation: The practice influences the levels of various neurotransmitters and hormones involved in pain perception. For example, it can increase the levels of adenosine, a neuromodulator with pain-suppressing effects. Additionally, acupuncture can influence the hypothalamus-pituitary-adrenal (HPA) axis, reducing stress-related hormones that exacerbate pain .

How Acupuncture Works: Structural and Functional Brain Changes

Advanced imaging studies have provided insights into how acupuncture affects brain structure and function:

1. Functional MRI (fMRI) Findings: fMRI studies have shown that acupuncture can modulate brain activity in regions associated with pain processing, such as the thalamus, limbic system, and prefrontal cortex. These changes in brain activity correspond with reduced pain perception and improved emotional regulation .

2. Neuroplasticity: Chronic pain often leads to maladaptive changes in the brain, but acupuncture can promote neuroplasticity, helping to restore normal function in pain-related brain areas. This means that regular acupuncture treatment may contribute to long-term pain relief by reconfiguring neural networks .

How Acupuncture Works: Enhancing Overall Homeostasis

Beyond targeting specific pain pathways, acupuncture is thought to enhance overall physiological balance, or homeostasis:

1. Autonomic Nervous System (ANS) Regulation: Acupuncture can influence the balance between the sympathetic and parasympathetic nervous systems. By reducing sympathetic (fight-or-flight) activity and enhancing parasympathetic (rest-and-digest) activity, acupuncture promotes relaxation and reduces stress-related pain .

2. Improvement in Blood Flow: Needle insertion at acupoints can improve local microcirculation, which helps in the delivery of oxygen and nutrients while removing metabolic waste products. Improved blood flow can alleviate pain caused by poor circulation and tissue ischemia .

Acupuncture's ability to relieve pain can be attributed to its multifaceted effects on the nervous system, biochemical pathways, and overall body homeostasis. By stimulating specific acupoints, acupuncture triggers a cascade of biological responses that modulate pain perception, reduce inflammation, and promote neuroplasticity. While traditional explanations of acupuncture's mechanisms are rooted in TCM concepts like qi and meridians, modern biomedical research continues to unveil the complex physiological processes underlying this ancient practice. As our understanding deepens, acupuncture is increasingly being integrated into pain management protocols, offering a valuable complement to conventional medical treatments.

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