Acupuncture originates from Traditional Chinese Medicine (TCM) and is a treatment method in which, by inserting small needles into the so-called meridians, the body’s energy flow (Qi) is intended to be influenced. Qi represents the body’s life energy, and meridians are, so to speak, the “channels” of Qi. In TCM, it is assumed that a disturbed energy flow in the body can lead to illnesses and can be rebalanced through punctures into the meridians.
Mechanism of Action
How exactly acupuncture unfolds its effects is still not conclusively understood, and there is no consensus among scientists about what happens in the acupunctured body. Some researchers assume that acupuncture exerts its analgesic effect through interaction with the hypothalamic-pituitary-adrenal axis and the endogenous opioid system. Both represent important mediators of the stress response to pain (Li et al 2013). Various studies have shown that acupuncture activates the release of opioids in the central nervous system (Gao et al 2018, Goldman et al 2010, Huang et al 2002, Zhao 2008). Other scientists seek the answer to the mechanisms of action of acupuncture in the insertion of needles into the skin. The sensation created is referred to as “De Qi” in TCM and is considered an important factor for the therapeutic effect of needling in traditional acupuncture. “De Qi” can be perceived by both the patient (as a feeling of heaviness or pressure or a slight electrification) and the therapist (as a tearing/resistance of the needle in the skin). An American researcher and professor hypothesized that this phenomenon is due to the mechanical coupling between the needle and the connective tissue, whereby the tissue wraps around the needle during needle rotation, and needle manipulation transmits a mechanical signal to the connective tissue cells via mechanotransduction (Langevin et al 2001). Even though there is no definitive elucidation of the mechanism of action of acupuncture, it nevertheless has a scientific basis, which rests on a series of studies.
Effectiveness/Efficiency
For example, the efficacy of acupuncture in migraine has been proven by several clinical studies and some systematic reviews, which is why it is now used worldwide for migraine prophylaxis and the treatment of chronic pain (Linde et al 2016). Acupuncture can reduce the number of migraine days per month as well as pain intensity. Furthermore, it shows significantly fewer side effects than drug therapy (Giovanardi et al 2020). Evidence of good efficacy of acupuncture is also increasing for other clinical pictures. These include stroke-induced depression (Zhang et al 2020), Alzheimer’s (Huang et al 2020), alleviation of chemotherapy-induced side effects in breast cancer patients (Jang et al 2020), diarrhea-predominant irritable bowel syndrome or functional diarrhea (Guo et al 2020), anxiety before surgery (Tong et al 2020), and many more. ReferencesGao Z, Giovanardi CM, Li H, et al. Acupuncture for migraine: a protocol for a meta-analysis and meta-regression of randomised controlled trials. BMJ Open. 2018;8(11):e022998Giovanardi CM, Cinquini M, Aguggia M, et al. Acupuncture vs. Pharmacological Prophylaxis of Migraine: A Systematic Review of Randomized Controlled Trials. Front Neurol. 2020;11(December)Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci. 2010;13(7):883-888Guo J, Xing X, Wu J, et al. Acupuncture for Adults with Diarrhea-Predominant Irritable Bowel Syndrome or Functional Diarrhea: A Systematic Review and Meta-Analysis. Neural Plast. 2020;2020Huang C, Wang Y, Han J-S, et al. Characteristics of electroacupuncture-induced analgesia in mice: variation with strain, frequency, intensity and opioid involvement. Brain Res. 2002;945(1):20-25Huang J, Shen M, Qin X, et al. Acupuncture for the Treatment of Alzheimer’s Disease: An Overview of Systematic Reviews. Front Aging Neurosci. 2020;12:423Jang S, Ko Y, Sasaki Y, et al. Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: Systematic review and meta-analysis (PRISMA-compliant). Medicine (Baltimore). 2020;99(50)Langevin HM, Churchill DL, Cipolla MJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. FASEB J. 2001;15(12):2275-2282Li Q-Q, Shi G-X, Xu Q, et al. Acupuncture effect and central autonomic regulation. Evidence-Based Complement Altern Med. 2013;2013Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;(6)Tong Q, Liu R, Zhang K, et al. Can acupuncture therapy reduce preoperative anxiety? A systematic review and meta-analysis. J Integr Med. Published online 2020Zhang K, Cui G, Gao Y, et al. Does acupuncture combined with antidepressants have a better therapeutic effect on post-stroke depression? A systematic review and meta-analysis. Acupunct Med. Published online 2020:0964528420967675Zhao Z-Q. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol. 2008;85(4):355-375
