One of the most common conversations I have in clinic with my patients goes like this -
- ‘So how does this acupuncture on my knee actually work’
- ‘Well would you like the traditional explanation or the modern medical explanation?’
Well the modern view looks at how acupuncture affects the nervous system. The nerves should react to a needle and give you that dull tingling associated with acupuncture. When stimulated they send a message to the spinal cord causing a release of dynorphin and enkephalin, (opioid peptides like endorphin). These in turn help the release of various neurotransmitters such as dopamine, serotonine and norepinephrine – and it is these that are thought to interfere with the pain pathways and trigger a general endorphin release in the brain. That might explain the mild euphoria some people feel after a strong acupuncture session. We also see a local improvement in circulation round the needles – an increase in blood and therefore oxygen to painful tissues and this in itself can be very beneficial. A natural pain killer is also released called adenosine which will affect the local tissues. There are several other theories and no-one seems to be 100% sure about the exact physiological mechanism, so hopefully further research will clarify the issue. However from my point of view I can understand how the research explains short term pain relief – immediately after needling, but good acupuncture can give you several days of pain relief after each visit. It’s effects appear accumulative and we aim to extend the period of relief with each visit – most of the pain conditions I see resolve to the point they only need acupuncture once of twice a year if at all.
The traditional Chinese model of pain relief through acupuncture is using the system of Qi flowing in meridians. When you look at a map of these meridians it looks similar to a image of major nerves – long strips that cover the body with branches that interlink. When the Qi runs smoothly we feel light and buoyant. When the Qi gets stuck or slow moving we start to feel pain. A dull achy pain would be the Qi struggling to move freely. A sharp acute pain would indicate the Qi was so impeded that it was affecting the blood and fluids nearby. An acupuncturist will look at the site of pain and where it radiates to and decide which meridians are involved. They then will needle along that meridian and any others that have nearby branches – to give the Qi a kick start in moving on – ‘Go on clear off!’ The dull tingling sensation is visualised as the Qi reaching up and grabbing the needle. Some of the meridians are pretty complicated in their trajectory – and it is for this reason that your acupuncturist sometimes needles a point on the body that appears to be unrelated to the site of pain.
Whichever explanation you prefer, as long as it works – that’s the important thing right! Every Thursday I run a community acupuncture clinic at Exchange Street, Norwich, which provides low cost acupuncture for pain relief. It’s still difficult to get acupuncture on the NHS in Norfolk so this is somewhere in the middle. Yes it’s private still, but you are sharing the treatment space with others - like a ward so the cost is greatly lowered (£15 with GP referral).