Scientific Basis of Acupuncture
The scientific basis of acupuncture in the treatment of injuries and to promote soft-tissue healing may involve platelets secreting growth factors (e.g. cytokines) and metabolites promoting a healing cascade, and stimulation of collagen regeneration.
Modern research shows the efficacy of acupuncture in relieving pain, particularly muscle and joint pain. This analgesic effect of acupuncture is partly explained by the gate control theory of pain (Melzac and Wall). Changes in neurotransmitter function, endorphins, and serotonin are also thought to be involved.
In 2017 The Acupuncture Evidence Project: A Comparative Literature Review was published. Although primarily concerned with conditions that may be treated with acupuncture, this report also mentions (in section 3) research into the mechanisms of acupuncture:
"Mechanisms underlying acupuncture analgesia have been extensively researched for over 60 years. In animal models, acupuncture and/or electroacupuncture have been shown to be effective for the alleviation of inflammatory, neuropathic, . . . and visceral pain. Ascending neural pathways involving Aδ, Aβ and C sensory fibres have been mapped, the mesolimbic loop of analgesia in the brain and brain stem has been identified and descending pathways have also been mapped. Numerous mediators have been identified including opioid and non-opioid neuropeptides, serotonin, norepinephrine, dopamine, cytokines, glutamate, nitric oxide and gamma-amino-butyric-acid (GABA). Acupuncture analgesia has been shown to involve several classes of opioid neuropeptides including enkephalins, endorphins, dynorphins, endomorphins and nociceptin (also known as Orphanin FQ). Among the non-opioid neuropeptides, substance P (SP), vasoactive intestinal peptide (VIP) and calcitonin gene-related peptide (CGRP) have been investigated for their roles in both the analgesic and anti-inflammatory effects of acupuncture. Two recent reviews of acupuncture analgesia research further demonstrate the complexity of this area of study. The anti-inflammatory effects of acupuncture involve numerous mediators, receptors and signalling pathways, as outlined in two recent reviews. The anti-inflammatory effects of acupuncture have particular relevance to allergic rhinitis, irritable bowel syndrome, post-surgical recovery, migraine, . . . and inflammatory aspects of a range of musculoskeletal conditions. In allergic rhinitis, acupuncture has been shown to down-regulate total and specific IgE, as well as SP and VIP. Acupuncture has been shown to down-regulate transient receptor potential vanilloid 1 (TRPV1) in inflammatory pain and there is indirect evidence to suggest that acupuncture may down-regulate TRPV1 expression and sensitivity in allergic rhinitis. In irritable bowel syndrome, acupuncture has been shown to down-regulate SP, VIP and CGRP. In migraine, acupuncture has been reported to down-regulate CGRP and SP which are also powerful vasodilators."
Recently CT scans have shown the anatomical structures of acupuncture points. This new research demonstrates the physical existence of acupuncture points. In a study published in the Journal of Electron Spectroscopy and Related Phenomena, researchers used in-line phase contrast CT imaging with synchrotron radiation on both non-acupuncture points and acupuncture points. The CT scans revealed clear distinctions between the non-acupuncture point and acupuncture point anatomical structures. Acupuncture points have a higher density of micro-vessels and contain a large amount of involuted microvascular structures.
Suggested Resources:
- British Acupuncture Council — Acupuncture and back pain on the NHS
For more on research into Acupuncture and controlled clinical trials — and some conditions that can be treated with Acupuncture — please see our page on What Acupuncture Treats.
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