Ep. 13: How does acupuncture work? A completely unscientific explanation

Welcome to Notes From Your Acupuncturist, the podcast for anyone who's interested in acupuncture, complementary medicine, holistic, health, and self care. I'm your host, alexa Bradley Hulsey. If you enjoy this show, you can help other people discover it by leaving a rating or a review, by following or subscribing on your favorite podcast listening app, or simply by by telling someone about it. And if you'd like to support this show financially, you can become a paid subscriber on Substackk for just a few dollars a month. Just head over to Substack.com and search Notes From Your acupuncturist or click the link in the show notes. And one more thing before we get started, just a disclaimer that this podcast is for educational purposes only and is not a replacement for medical care from a qualified healthcare provider. Okay, on with the show.

Hello, everyone. Welcome to Notes from Your Acupuncturist. I'm Alexa, and I am so glad you're here. Before we get started, I got to give a big thanks to MCA Amy, who left a five star review on Apple podcasts. Thank you, MCA Amy. Reviews help other listeners find this show and are very appreciated. Today is another solo episode, and it's a follow up to episode twelve, which explains the science behind why acupuncture works. Today is going to be the yin to episode twelve's yang, and I'm going to talk about how acupuncture works from a completely unscientific perspective. It's going to be fun. If you have questions about acupuncture, I would love to hear from you. If you're a Substack subscriber, you can get in touch by commenting on any of my posts or replying to any emails. You can also message me on Facebook or Instagram at Notes From Your ACU or contact me via my website, Notes From Youracupuncturist.com. And if you send me a voice memo, I will play that on the air. 

So on to today's topic. Today I'm talking about how acupuncture works. And like I said in episode twelve, I dove into the scientific research looking at the physiological changes in the body that happen in response to acupuncture. It's really interesting, but it still doesn't fully explain how acupuncture works. So, like, we know that acupuncture increases circulation, and we know it does that by increasing levels of nitric oxide in the local region. But how does acupuncture do that? The questions of how and why acupuncture brings about these physiological changes isn't really answered by research studies. If we really want to understand how acupuncture works, we have to shift our mindset away from a reductive mechanical view of the body and learn a little about acupuncture theory and philosophy. And that's what I'll be talking about today. So, just for fun, I asked an AI tool to explain to me how acupuncture works. And here's what it said. Quote acupuncturists view disease, pain and illness as a result of your chi not flowing as it should. Acupuncture stimulates the flow of qi and brings the body's awareness to an area that's in need of rebalancing the needles send a message and then the body responds. So really the healing comes from within the body. Acupuncture can treat just about anything and it is also a preventive treatment, end quote. And that's actually a pretty good explanation, but it's pretty superficial explanation. I mean, it kind of sounds like exactly the type of explanation an AI bot would write. It answers the question, but not really. I want to dive deeper. So what I'm going to do today is I'm going to look at all those physiological responses I discussed in episode twelve and discuss the traditional Chinese medicine theory explaining why those changes happen. So this is going to be a bit of a first year of acupuncture school episode. Are you ready? Let's go. 

So the first physiological change I talked about in episode twelve is circulation. Multiple research studies show that acupuncture increases blood flow. How does it do this? Well, as we say in Chinese medicine, qi moves the blood. Blood and qi are yin and Yang partners. Blood is substantive, it's nutritive, it's thick and viscous, it doesn't move on its own. It only moves under the influence of the heart muscle. When the heart stops beating, the blood stops flowing. So what makes the heart beat? Chi. Chi is the opposite of blood. It's formless immeasurable and has no structural matrix. But unlike blood, Chi does move. You could even say that it is movement itself and it's what makes us alive. One of my teachers used to say that chi is the difference between a person and a corpse. Chi is what powers all of our body's metabolic processes, including contraction of the heart muscle and the movement of blood through the vessels. Chi is movement, blood is stillness, chi is action, blood is inaction, chi is invisible, blood is material. And as our AI explanation tells us quote, acupuncture stimulates the flow of Chi, end quote. And we use acupuncture needles to direct the flow of Chi and blood to a specific area or in a certain direction. We can harness the power of Chi not only to move the blood, but move it with intention. So acupuncture doesn't just improve circulation generally, it does so with purpose and that's powerful. 

Another area I discussed in episode twelve is inflammation. Lots of research out there shows that acupuncture reduces inflammation. So what does that actually mean? So in Chinese medicine, one of the ways that we think about disease is whether a pathogen affects the exterior or the interior of the body. Diseases that affect the exterior of the body are going to produce symptoms that are more superficial. So an external disease is going to affect the skin, the muscles, the tendons and the joints. Interior diseases are going to affect the internal organ systems and you can have inflammation anywhere on this spectrum from exterior to interior. In general, in Chinese medicine we think of inflammation as a condition of too much heat in the body, whether it's concentrated in a specific area like arthritic joints or if it's more systemic, say, in the case of something like an autoimmune disease that affects multiple areas of the body. And the word inflammation comes from the Latin word inflammare, which means to set on fire. So, Chinese medicine theory is right in line with biomedical understanding of inflammation. And the five cardinal signs of inflammation, which are pain, swelling, redness, heat, and loss of function, are also signs of heat in Chinese medicine. So starting with the most superficial level of the body, the skin inflammation will manifest as rashes, acne, and things like rosacea, where the skin is really red and feels warm to the touch. And our approach with acupuncture is to clear the heat. We might do this with an acupuncture technique or certain points that we select or maybe with herbs or with foods that are cooling in nature. Now, moving a little deeper to the muscles and tendons and joints. We often categorize inflammation here as what we call painful obstruction syndrome or B syndrome, and that's Bib syndrome. In Chinese medicine, this is considered still a relatively superficial level of disease because the organ systems are not affected. So base syndrome usually involves a combination of what we think of as exterior pathogenic factors. These are influences from outside of the body that have penetrated through the skin and are now lodged in the musculoskeletal level. These pathogenic factors can be wind, dampness, heat, or cold. And they can literally invade from the surrounding environment like getting a stiff neck when you've been outside in the cold. Or they can arise from an injury or from trauma. So when we're treating B syndrome or painful obstruction syndrome with acupuncture, we're using the needles to move the Chi and also to clear out these pathogenic factors. And when we clear out the pathogenic factors, the symptoms of inflammation, the redness and the swelling, the heat, et cetera, those symptoms will resolve. Often what happens with the musculoskeletal system is a combination of stagnation and inflammation. When a joint or muscle has an injury, then the Chi becomes stagnant in that area. Over time, stagnation causes heat to accumulate. Now, it's interesting how we treat this because cold counteracts heat, which is why you want to apply ice to an acute injury, like a sprained ankle. It's to quickly reduce that inflammation. But cold causes the flow of Chi to slow down, so it causes more stagnation, which then leads to more inflammation. This is why an acupuncturist will almost never recommend applying ice to sore joints and muscles unless it's an acute injury because cold will cause more problems in the long run. But we also need to reduce the heat. So it's kind of a delicate balancing act. But that's what Chinese medicine is really good at, which is why it's so effective for pain. So now, moving deeper to the organ level. When there's inflammation internally, it's almost always due to excess heat. We often see this in the digestive system. So things like acid reflux, gastric ulcers, inflammatory bowel disease, ulcerative colitis, things like that, these are all conditions in which there's inflammation somewhere in the digestive tract. In a Chinese medicine, we see that as excess heat in the digestive system. And we use cooling herbs to counteract the heat. Or we select acupuncture points that help to clear that heat. We also see this in infectious diseases. When an infection causes a fever, that's a sign of heat. And again, we use cooling treatment techniques to counteract that heat. So, in a nutshell, acupuncture reduces inflammation by clearing heat, and we can do that at any level of the body. When I'm treating a patient who has inflammation somewhere in the body, I'll generally use a couple of points that have sort of general heat clearing properties, and then I'll add other points to target the specific area where the inflammation is occurring. So if one patient has arthritis in their knees and another has psoriasis on their scalp, I'll use some of the same heat clearing points on both patients, and then I'll add others to focus and direct that heat clearing action. This is one of the things I love about acupuncture. We have hundreds of points to choose from, so our treatments are tailored for whatever is happening with that patient in that moment. Okay? 

Now, another physiological response I talked about in episode twelve is the nervous system response to acupuncture. And in particular, acupuncture has been shown to have a modulating effect on the autonomic nervous system. It helps take your body out of a sympathetic fight or flight or freeze response and into parasympathetic or rest and digest mode. So here's how we think about that in Chinese medicine terms. It actually goes back to the most fundamental concept in Chinese medicine, is what we learn on day one of acupuncture school, which is drum roll yin and Yang. Okay, so Yin and Yang are opposites. They're interdependent, one transforms into the other. And these opposing forces manifest everywhere in our bodies and in nature and in the universe. And everything we do with acupuncture and in Chinese medicine can be viewed through the lens of Yin and Yang. What I talked about earlier with Qi and blood, qi is Yang and blood is Yin because Qi is active and energetic, and blood is substantive and inert. Or I talked about the pathogenic factors of B syndrome. Cold is Yin because it stagnates and stiffens. While heat is young. It's fiery and dynamic. And so it is with the autonomic nervous system. When the sympathetic system is dominant, your heart rate increases, your pupils dilate, your mouth becomes dry, your digestive system goes on pause, your airways loosen to take in more air. And all of this is to ready you to respond to an attack. You're on edge prepared for fight or flight, and everything feels heightened. This is a young state of being. On the other hand, when the parasympathetic system is dominant, your heart rate slows, your pupils constrict, digestive system fires back up again, and you're no longer on edge because your body senses that there's no imminent threat and you can relax. This is a Yin state of being. Our bodies are very good at getting into sympathetic mode. This is how our ancestors survived. So we've evolved to respond to external threats. But sometimes the body is a little too good at getting into sympathetic mode. Now, it's great to be able to respond to threats, of course, but many of our body systems, like digestion, just don't really function all that well in sympathetic mode, because we divert all of our resources to staying alive in that moment. And modern life is full of stimuli that our body perceives as an existential threat but isn't really a threat. We know intellectually that our life isn't in danger at all moments, but we have so many stressors coming at us at all times that our nervous system can't really sort out what's a threat and what isn't. So everything gets treated as a threat, and our bodies stay in a prolonged state of sympathetic nervous system dominance. When that happens, when the body stays in this prolonged sympathetic mode, which is a Yang state, what happens is that the Yang starts to consume the Yin, and so it gets harder and harder for the Yin to stay at a sufficient level to balance out the Yang. And Yang just becomes more and more dominant, and the body ends up being in a state of prolonged excess yang and deficient Yin, which is ultimately just a state of disharmony and imbalance. Acupuncture brings yin and Yang into balance. That's really the ultimate goal with acupuncture and any other modality of Chinese medicine balance Yin and Yang. And, yes, acupuncture stimulates neurotransmitters and modulates hormone levels and does all those things that we talked about. But ultimately, what it really does is bring Yin and Yang into balance. So that's the nervous system. 

Now let's talk about endorphins and just a quick refresher. Endorphins are naturally occurring chemicals in the brain that act as pain relievers and mood elevators. They are released in response to certain stimuli, such as exercise or stress, and are responsible for producing feelings of euphoria and well being. Acupuncture has been shown to stimulate the release of endorphins, which may explain why it is effective in treating pain and depression. Okay, so I want to focus on these two big things that endorphins do. They lift the mood and relieve pain. So how exactly does acupuncture do that? Once again, it gets back to acupuncture's action to move the chi. So I talked about chi earlier, but let's talk about it a little more, because there's one thing acupuncturists love talking about. It's Qi. And once again, I asked my AI Bot friend to tell me what is Qi? And here is what it said. Quote in traditional Chinese medicine, qi is the vital energy that flows through the body's meridians or energy pathways. It is considered the animating force behind all living things and is responsible for the body's various processes and functions. Acupuncture is believed to stimulate the flow of Qi and bring balance to the body's energy systems. End quote. And I think my AI Bot friend is getting a little smarter because this is quite a good description of Chi. The only area where I disagree is when it says acupuncture is believed to stimulate the flow of Chi. I would correct that to say acupuncture does stimulate the flow of Chi. I mean, that's the whole point of sticking a needle in someone. It's a therapeutic intervention and not a belief system. But chi can't really be measured. Therefore we can't prove that acupuncture does anything to Chi or that Chi even exists anyway. Semantics. But in a nutshell, acupuncture stimulates the flow of Qi, which is the vital energy that flows through the body's meridians. So back to endorphins, they naturally lift the mood. And when the mood is low or depressed we think of this as the Chi sinking. There's often fatigue, malaise, mental fog and a feeling of heaviness associated with depression or just a sedated mood. And all of these are signs that the chi somewhere is stuck and sinking. And what we call the pure Chi is not rising to the head. So we use acupuncture to lift the Chi and encourage the pure Chi, or the clear Chi to rise to the head. I'll give you an example. I once treated a patient who was suffering from severe depression and she had some various very obvious signs of this sinking chi. And the most obvious sign was that she could barely hold her eyes open. And when she first came in, I actually thought she was visually impaired because her eyes were barely open. So I did treatments on her to lift the chi, to lift out of that sinking state where it was so heavy that the eyelids were like literally shutting. After a few treatments, her eyes were much more open and her depression started to improve. So acupuncture lifts the chi and it also moves chi that's just stagnant or stuck. Stagnant chi often results in feeling stuck emotionally or feeling frustrated or feeling moody or irritable. When acupuncture resolves the stagnant chi, the emotions flow more freely, which lifts the mood. And then endorphins also act as the body's natural painkillers. And as I talked about earlier, acupuncture relieves pain by moving the chi in blood. Okay, so that's endorphins. 

Now let's talk about the endocrine system. As I talked about in episode twelve, acupuncture has been shown to help regulate the endocrine system in a number of ways. But how does that actually work? Well, I'm starting to sound like a broken record. Probably but once again, it is because of acupuncture's action to move the chi. So the endocrine system is very interesting. It's basically just a bunch of feedback loops. One gland will release a hormone which will relay a message to another gland to release another hormone and so forth. And eventually the message gets back to the original gland and the whole thing just continues in an endless loop. So in episode twelve, I talked about the hormones as chemical messengers. And the endocrine system is the system of highways and roads that they travel along. And in a perfect world, these highways and roads are always clear and open. There's never any traffic, no construction, no accidents, no delays. Everything just moves right along. But in real life, we know that's not always how it works. There are all kinds of forces and factors that can cause these same type of traffic jams in our endocrine system. It could be that the Qi is just sluggish or stagnant. It could be there's a physical impediment, like a mass or a blood clot or a collection of phlegm. The internal conditions of your body might be too hot or too cold, or there could be a deficiency of chi or blood. So when an acupuncturist is assessing you, they're looking for signs that will point to exactly what kind of impediment are we dealing with here? Is there too much heat? Is there not enough blood? Is the chi stuck? And the treatment will do is targeted to the specific patient and their pattern of dysfunction. We might clear heat or transform dampness or nourish the blood. But anytime we're dealing with endocrine dysfunction, there will always be some action to move the Qi in our treatment approach because the endocrine system relies on movement to function. Okay, so that's the endocrine system. 

Finally, let's talk about my favorite brainwaves. So bear with me. I'm going to talk about Qi again. And one way that I think of Qi is I think of it as a vibration. Think of a hummingbird and how it moves. It moves very rapidly and erratically, and its wings are beating so fast that they just look like a blur. It's vibrating at a high frequency. Now think of a crane. It glides. Its wings beat much more slowly. Its vibrational frequency is low. So chi can move in our bodies and our brains at different frequencies too. When chi is moving rapidly in the brain, you might feel scatterbrained or maybe frantic or anxious. When you're relaxed and calm, chi movement slows down. When you're in a deep sleep, the Qi is still moving, but at an even lower frequency. So when acupuncture modulate brain waves, when it gets your brain into those relaxed alpha and theta and delta wave states, it's helping your Qi to slow down and settle. That's why you get so relaxed during acupuncture. Your chi, instead of acting like a geyser and spewing everywhere, erratically, starts to flow like a deep, fast, slow moving river. You go from being a hummingbird to being a crane. And with that, I think I will wrap up my completely unscientific discussion of how acupuncture works. I hope you've enjoyed this episode and this little crash course on acupuncture and Chinese medicine theory. If you have a question about acupuncture and holistic health, I would love to hear from you. You can comment on Substack or message me directly on Facebook or Instagram. Bonus points if you share a voice memo, because then I can share it on the air. Be well out there, friends. Thanks for listening. 

Thank you for listening to today's episode of Notes From Your Acupuncturist. If you liked what you heard, please follow this show, leave a rating or review, or just tell someone about it. And if you want to join the conversation, you can subscribe to Notes From Your Acupuncturist on Substack, where you can comment, ask questions, participate in discussion threads. Watch videos, and read more of my reflections on acupuncture and healing. Huge thanks as always to our paid subscribers for helping keep this work sustainable. You too can become a paid subscriber for just a few dollars a month. Just head over to Substack.com and search Notes From Your Acupuncturist, or click the link in the show notes. Until next time, this is Alexa Bradley Hulsey, your Acupuncturist, signing off with love and gratitude.