There is a lot of research in this area mainly surrounding two specific areas of action; the nervous system and at the biomolecular level.
If we start with the nervous system, we have seen that when a needle is inserted into a point the needle stimulates sensory (afferent) nerves. We know this because cutting the afferent nerves eliminates the effect whereas cutting the efferent (motor) nerves does not. They have been able to map the pathways through the nervous system where acupuncture works including different neurotransmitters and at different levels of the nervous system such as the brain, spinal cord and nerves. Many of the identified pathways align closely with the traditional ‘meridians’ in Chinese medicine.
More recently the use of neuroimaging techniques such as functional MRI, have looked at the CNS acupuncture response. Data from studies using these techniques suggests that acupuncture might modulate the limbic system, which processes the cognitive and emotional aspects of pain in humans. Studies looking specifically at fMRI studies indicate that acupuncture activates the area of the brain that leads to greater self-regulation and decreases the area of the brain associated with fight or flight response.
So, in a nutshell in relation to the nervous system we can summarise that acupuncture stimulates peripheral nerves triggering a cascade that causes changes in the brain and internal organs.
From a biochemical perspective we know that acupuncture causes the release of endogenous opioids and increases opioid sensitivity, which means that patients may need less pain medication when combined with acupuncture which is cool. We know this because something called naloxone which blocks opioid effect also blocks acupunctures effect.
Another important molecule in acupuncture research is ATP, the body’s form of energy. When ATP is released from cells during acupuncture needling or via injury, it rapidly degrades to a chemical called adenosine which is a signaling molecule and pain reliever. This was recently found to be a neurotransmitter that not only acts as a local pain reliever and stimulates healing effects but also affects the CNS. Some human studies investigating acupuncture's role in adenosine release have found that adenosine concentration increased significantly during acupuncture and remained elevated or 30 minutes after the treatment. The adenosine release was specific to acupuncture points and was not observed when non acu points received the same needling.
Why is adenosine important? Well adenosine is now being linked with the stimulation of the body’s own healing response and protection against cellular damage, so it could be said that acupuncture stimulates the release of molecules associated with tissue healing and disease resolution. It is interesting to note that there are currently numerous adenosinergic drugs in clinical development to achieve a similar effect.
So, we have a combination of things happening, we have the body’s natural pain relief button being pressed, we have the central nervous system being triggered into responses and we have local cellular repair and inflammatory responses.
Reported clinical results make acupuncture one of the safest procedures available in contemporary medicine. When this safety profile is compared to, for instance, serious side effects of non-steroidal anti-inflammatory drugs and opioids and the number of deaths connected with their application, the safety of acupuncture becomes even more apparent.
The risks associated with acupuncture can be classified as negligible, and acupuncture is a very safe treatment in the hands of competent practitioners. The frequency of occurrence of serious adverse events at 11 per 4,441,103 procedures.
The most common side effects are things like localised pain in the point, bleeding, or bruising. Rare side effects would be nerve damage or organ puncture. The rate of adverse events drops significantly with increased levels of training.
Acupuncture is something called a ‘hormetic stressor’ (other hormetic stressors include exercise and intermittent fasting). It works by providing a stimulus that causes the body to respond with a stronger healing response and improved self-regulation. This is why it can treat so many different things.
These days numerous clinical guidelines now recommend acupuncture for a range of conditions. In fact, acupuncture has over 1,000 recommendations in international conventional medical guidelines. Acupuncture currently has over 8,000 published clinical trials and in a May 2016 bibliometric study, it showed that the growth of acupuncture research is twice that of biomedical research in general.
A few years ago, an evidence review got funded by the Australian Acupuncture regulatory body which investigated the state of the evidence regarding acupuncture, with the focus on systematic reviews and meta-analyses. This review found evidence of effect at various levels for 117 of the 122 conditions reviewed. ͚This review listed eight conditions with clear positive effects (migraine prophylaxis, headache, chronic low back pain, allergic rhinitis, knee osteoarthritis, chemotherapy-induced nausea and vomiting, post-operative nausea and vomiting and post-operative pain), and potential positive effects on a further 38 conditions. Based on this review, it isn’t possible to say that acupuncture’s effectiveness is due to the placebo effect or that it is useful only for musculoskeletal pain. The conditions which seem to have positive evidence are often the ones for which WMS effectiveness may have limitations or those conditions with a higher psycho somatic component where pharmaceutical management may not be appropriate.
During a session, we will begin with an initial consultation where I will take a detailed health history and assess your overall health. This may involve palpation of the body or assessment of range of motion of muscles and joints. We will then discuss a treatment plan together, and I will answer any questions and ensure you consent to the treatment.
You will then lie comfortably on a treatment table, and I will clean the areas for needle insertion. Fine, sterile needles are inserted into specific points on your body, usually causing a slight pinch or tingling sensation. The needles remain in place for 15 to 25 minutes, during which you are encouraged to relax. After the needles are removed, you might receive aftercare advice, and if appropriate, I may incorporate additional therapies like cupping, moxibustion, or lifestyle advice to enhance the treatment's effectiveness.
This is a particularly tricky question to answer, as I imagine it is with most interventions where the patient’s response to a therapy or pharmaceutical is relatively unknown until undertaken. This is also influenced by external factors such as diet, sleep, life stressors, exercise, underling health conditions and so on.
Usually, I will ask patients to book up for a series of between three to six sessions, some will need less, and some will need more depending on the chronicity and severity of their condition. However, by the end of six sessions, a practitioner should have a fair idea of how the patient is likely to respond and can make an informed decision on whether further treatment is required.
After a treatment, you may feel relaxed, energized, or occasionally drowsy, with potential immediate or gradual relief from symptoms. Common physical sensations include mild soreness or tenderness at needle sites, and occasionally lightheadedness, which usually subsides quickly. Some people experience an emotional release, improved sleep, enhanced digestion, and a general sense of well-being.
When choosing a practitioner, it is recommended that patients only access those registered with the Chinese Medicine Council of New Zealand. The Council is also able to accept complaints or concerns about practitioners.
The Chinese Medicine Council of New Zealand was established as a Responsible Authority on the 1st of November 2021. They have now established the qualifications and competency standards necessary to be registered as a practitioner of Chinese medicine, and are currently registering practitioners.
The Council maintains a public register of all registered Chinese medicine practitioners, and issues annual practicing certificates to practitioners who meet all registration requirements, and have maintained their competence and fitness to practice. This register can be found on the Council website
https://www.chinesemedicinecouncil.org.nz/Post-treatment care involves staying hydrated, resting, and following lifestyle advice if given. If you experience unusual or severe symptoms, such as intense pain or significant bruising, you should contact me for advice.
Acupuncture is generally safe to use alongside conventional medical treatments, but it’s important to tell me about any medications, supplements, or other therapies you are using. This ensures that the treatment is tailored to your needs and avoids potential interactions. For instance, if you are on blood-thinning medications, there may be an increased risk of bruising or bleeding. People on immunosuppressive therapy should also exercise caution, as although the clinic is a clean environment and all precautions, it is not a sterile environment.
Acupuncture can complement treatments for chronic conditions like diabetes, heart disease, or cancer, and may help reduce reliance on pain medications. It’s crucial to keep your primary healthcare provider informed and coordinate your care. Monitor how your symptoms change and report any significant changes to both your acupuncturist and primary healthcare provider. Effective communication between all your healthcare providers ensures the safe and integrated use of acupuncture within your overall treatment plan.
There are no specific contraindications for acupuncture treatment. However, patients should advise the acupuncturist if they have any of the following conditions to allow the treatment to be tailored accordingly:
Currently in New Zealand there are two main styles of acupuncture practiced; you have Traditional Chinese Acupuncture (or TCM) which is underpinned by a philosophical framework dating back 1000s of years, and Western Medical Acupuncture or Dry needling which uses a subset of traditional acupuncture that is aimed at stimulating underlying myofascial trigger points and connective tissues for the management of musculoskeletal pain and movement impairments. Western style acupuncture is often a shorter model of training utilised to add needling as an adjunct to their main practice for a specific focus.
TCM acupuncturists complete their bachelor’s degree focusing solely on acupuncture practice and they use both local needing and distal points which have been found to be effective in cases where local needling may be ineffective or not indicated and also empirical points based on a systems biology understanding of illness. TCM treatment is also utilised for conditions outside pain management such as gynecology, mental health and gastrointestinal disorders.