All About Acupuncture

by Ryan Andrews
Disclaimer: This article deals with an alternative health therapy that
developed from Eastern medicine philosophies. I’ll do my best to explain the
original Eastern understanding of acupuncture while also reviewing the latest


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What is acupuncture?

Acupuncture originated in China nearly 2500 years ago as a holistic therapy
meant to treat the whole patient rather than a specific condition. The earliest
acupuncture tools were sharp pieces of stone, flint, bones or bamboo.
While it’s become one of the most popular complementary therapies worldwide,
it didn’t gain popularity in the West until the 1970s.

How is acupuncture performed?

Acupuncture involves puncturing the skin with a needle, but can include other
types of stimulation to the epidermis. Modern acupuncture can also include
electrostimulation through the inserted needles. The purpose of needle insertion
is to alter the flow of Chi (or Qi) through body meridians. (More on Chi
When needles are used as a method of treatment, they vary in size and length.
Most are about one inch long. Needles up to three inches long can be used in
fleshy areas like the glutes. To lower disease transmission, one-time disposable
needles should be used.
Needle insertion can be just under the skin or into the muscle and can
produce a mild ache or sense of heaviness, but is rarely sharply painful.
Needles are usually left in place for 15 to 30 minutes. Between six and eight
treatments might be required to detect any results, although patients may notice
some immediate effects.

Balancing Chi

In traditional Chinese medicine (TCM), the normal flow of body energies or
life force is called Chi (or Qi), and it’s in a constant state of flux. It’s
thought that Chi circulates through meridians (energy pathways), just as blood
circulates through vessels.
Unlike modern Western medicine, which focuses on “curing” disease symptoms,
traditional Chinese medicine focuses on achieving a dynamic balance between the
various elements that make up each person. Traditional practitioners claim that
when Chi is out of balance, illness results. It’s been said that humans are born
with a certain allotment of Chi, which we replenish with food and air.
TCM practitioners also look at the opposing but complementary forces of yin
and yang. Yin pertains to cold, slow, dark, and quiet; it’s sometimes viewed as
a “feminine” energy. Yang is hot, fast, bright, and loud; it’s sometimes viewed
as a “masculine” energy.
According to TCM, yin and yang must be balanced to maintain optimal health.
Chi can be bi-directional according to the yin or yang energy — for instance,
raising or lowering blood pressure; increasing or decreasing gastric secretions,
etc. It’s thought that acupuncture promotes this balance by using the body
meridians through which Chi flows. There are 12 pairs of meridians associated
with organs, joints and extremities. There is no known evidence for physical
existence of these meridians.

Image source: Berman B, et al. Acupuncture for chronic
low back pain. NEJM 2010;363:454-461.
Each meridian has five acupuncture points related to the five Chinese
elements – earth, wood, water, metal and fire (not related to the periodic table
of elements).
It’s thought that needling the meridian can improve the condition of the
associated organ. Some of the meridian relationships are apparent, like the
bladder relating to water. But some aren’t, like wood relating to the liver.

Harmful Chi is thought to contribute to illness and can arise from internal
and external sources. Examples include wind, cold, heat, wetness, dryness, joy,
anger, melancholy, obsessions, grief, fear, fright, irregular eating, excessive
stress, lack of exercise, and trauma.
The flow of Chi is controlled by a biological clock allowing practitioners to
assess the timing of symptoms (along with the actual symptoms) to get an idea of
the organ affected. For example, if someone had a cough, asthma or tightness in
the chest, it may be due to an excess or deficiency of lung meridian Chi,
especially if the symptoms are noticed early in the morning when the lung
meridian has a surge of energy.
Also, the pulse and tongue are checked by the acupuncturist to diagnose the
flow of Chi and organ status.

Modern Western medicine’s interpretation

Modern medicine has proposed 5 interacting explanations for how acupuncture

1 – Local

Acupuncture may stimulate nerve fibers in the skin and muscles, triggering
action potentials and the release of substances that can dilate vessels
(increasing local blood flow). This may help to encourage tissue healing.

Source: Wang GJ, et al. Meridian studies in China: A
Systematic Review. J Acupunc Meridian Stud 2010;3:1-9.

2 – Segmental

The action potentials that are triggered by the needle insertion can travel
along the nerve and depress responses to painful stimulus, in part due to
enkephalin release. This is likely the reason for pain relief. And when it comes
to pain relief, some data indicate acupuncture can be as effective as

3 – Extrasegmental

Action potentials can go a long way. They can make their way up to the brain
and stimulate the body’s pain-suppressing operations, in part due to endorphin
release. This result doesn’t depend so much on needling specific areas of the
body, rather, just getting enough nerve stimulation.

4 – Central regulatory

The hypothalamus and limbic system can be stimulated by acupuncture, which
may have an overall calming effect and regulate the autonomic nervous

5 – Myofascial trigger points

We hear about myofascial release using foam rollers and tennis balls, but
acupuncture can influence the fascia too. Small knots can form in tight muscles
with repetitive use or injury. These knots might act as protective mechanisms
ensuring the muscle rests/recovers, or it might just be a healing malfunction in
the body. Either way, fascial knots are sensitive and acupuncture can help in
their release. Moving the muscle through a full range of motion after treatment
may assist in recovery.

The clinical data

Acupuncture sounds great – but isn’t it all just anecdotes? Is any of this
legit science?
Evidence from clinical trials indicates that acupuncture isn’t just a placebo
effect. Still, rigorous trials are difficult since it’s hard to mimic a needle
or perform a “sham” puncture in blind studies, especially in cultures familiar
with the practice.
Clinical research suggests that acupuncture is helpful for:
  • Relief of nausea and vomiting
  • Relief of back pain
  • Relief of chronic knee pain
  • Relief of post-operative dental pain
Beyond these areas, research hasn’t been accomplished, isn’t conclusive, or
has shown no effect.
Data indicates that acupuncture is safe when a skilled practitioner is
performing the treatment. Mild adverse events might include bleeding and
drowsiness. Significant events are uncommon but might include infections,
nerve/vessel injury, exacerbations of asthma, and seizure. All treatments should
be performed lying down, due to the potential of fainting. Always avoid the use
of embedded needles and self-acupuncture.

My acupuncture experience

While researching this article, I figured I should experience the world of
acupuncture. Since I currently don’t have any illnesses or complaints, I
requested a “general health” session, focusing on tendonitis (medial elbow) and
cold hands (since I maintain a lean body year round, I’ve noticed colder
The practitioner showed me the needles (36 gauge, single-use disposable),
explained her procedure, examined my pulse and tongue, and then moved forward
with needle insertion.
She inserted one needle in each foot, two needles in each calf, two needles
in my upper abdomen, one needle by each thumb, and one needle inside each elbow.
Oh – and one needle in my forehead for relaxation.
I definitely felt all the punctures, and the needles on the right side of my
abdomen, thumb, and calf resulted in some sharp and lingering pains. The
practitioner told me this was Chi. I think it was my nerve endings.
After all the needles were inserted the practitioner told me to relax and
take myself to a calm place. She turned off the lights and then left for about
12 minutes.
I wasn’t very relaxed because I didn’t want to move my body and bump a needle
insertion. Also, my scalp started itching and I couldn’t itch it because I
didn’t want to jam a needle into my head.
Let me be straight — I’m fine with needles. I donate blood, I’ve been
certified in venipuncture, and I’ve even injected myself with veterinary
vitamins when I was bodybuilding (don’t ask about it and don’t try it). But
something about multiple small needles in my body at one time didn’t go very
well. If you don’t like needles, you probably won’t like acupuncture.
When the practitioner returned, she explained that it can take up to 12
treatments to notice relief, depending on the ailment being addressed. She said
my flow of Chi, pulse, and tongue were excellent. That’s always nice to
I had very minimal bleeding at two of the insertion sites and there was some
lingering dull pain in my calf, thumb and abdomen after leaving.
Keep in mind that I completed the acupuncture treatment for “general health,”
and I don’t think the potential benefits outweighed the discomfort and cost ($75
for 90 minutes). I probably wouldn’t pursue acupuncture again unless I had a
specific health concern.

Summary and recommendations

It’s difficult to draw strong conclusions since the acupuncture experience
tends to be governed by social and psychological factors.
Acupuncture might be useful for the relief of nausea and vomiting, and some
forms of pain relief. The effects seem to take place locally, along nerve
segments, centrally, and at fascial trigger points.
Acupuncture does appear to be safe when working with an experienced
practitioner. If you seek treatment, make sure to find a legit professional, see
here for more:

Extra credit

Tattoo marks found on prehistoric human remains may have had a medical
purpose similar to acupuncture. This was discovered around 3300 BC.
An unhealthy tongue can indicate buildup of harmful Chi.
One of the most respected medical universities in Canada, McMaster
University, also offers a medical acupuncture program.
Semi-permanent acupuncture needles placed into the rim of the ear (see image
below) have been used in the military to decrease pain.

Image source: Ambron T. The ancient art of acupuncture
is new again. JAAPA 2010;23:51-52.

About dkpilates

Pilates Instructor, Yoga Instructor, Personnel trainer and Group Fitness Instructor. Don teaches Contemporary and the Authentic forms of Pilates, in the later 90's, Don began his study of Yoga. His study of Yoga includes the Hatha, Iyengar, Bikram, and Astanga disciplines. His other areas of interest in fitness include Martial Arts, Spin, Boot Camp Training, and Weight Training. Don has extensive training and certifications from AFFA, IDEA, MadDog, B-Fit and Polestar. Don Continues his of Pilates education with Michelle Larson in Santa Fe New Mexico. His personal philosophy related to fitness is to aid students in a personalized balance of strength, stamina and flexibility. He is dedicated to design a program specifically for his students independent of the season of their life to create functional movement and help them reach their fitness goals.
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