The science of acupuncture: MRI and beyond

We are very lucky to live in times when advances in technology are allowing us an ever greater insight into the biomechanisms of acupuncture. This was not the case when acupuncture first arrived in the West. In fact, for many years, our understanding of how it works was so painfully lacking that it cast a stifling shadow of doubt on whether it works, even when multiple clinical cases could attest to its benefit. It clashed with our understanding of what the body is and what medicine should be: pills delivered by serious-looking folk in white frocks. It is still suspected by many to be a “just a placebo”, or is put on par with superstitious folk remedies. Nothing could be further from the truth. - researchers have discovered several tangible, biomedical effects which attest to the fact that acupuncture has stood the test of time, helping people in East achieve healthier bodies and more resilient minds for centuries.

Without further ado, let me introduce you to some of acupuncture’s physiological effects.

1. Influencing your governing body: Effects on the brain

Since quite a few decades ago, acupuncture’s ability to regulate mood lead researchers to hypothesise that it modulates the so-called hypothalamic-pituitary axis: an area responsible for releasing such important “wellbeing” hormone as oxytocin, and many more. Nowadays, another most exciting technological advance: the magnetic resonance imagining (MRI), allows us to take a direct peak at the brain of a patient undergoing acupuncture treatment. Brain MRI / FMRI scans have been used for about two decades to map responses to acupuncture, and they clearly show us that something – something major - is going on. Professor George Lewith thus summarised his 2005 systematic review of such studies: “these studies show that specific and largely predictable areas of brain activation and deactivation occur when considering the traditional Chinese functions attributable to certain specific acupuncture points. For example, points associated with hearing and vision stimulate the visual and auditory cerebral areas respectively.”

Another important finding we can observe on the brain MRI scans is that points which are described in Chinese literature as having a multitude of functions stimulate many areas of the brain, while points traditionally used for very specific conditions, "fire up" two or three “dots”. Just take a look yourself at point ST36 and BL62: the difference on the FMRI is clearly observable even to a completely lay person. In a description of acupoint use, the first one would typically have a few pages devoted to it, while the latter - a paragraph, and modern imaging  confirms traditional knowledge.

 

2. Relaxing the fascia

Fascinating new research originated in Vermont, USA, about the effects of acupuncture on fascia. For the non-biogically minded: fascia is a connective tissue that envelopes our whole body on the inside, muscles as well as organs, binding the them together (https://en.wikipedia.org/wiki/Fascia). This fascinating structure has been in the focus of research only since relatively recent times – the first international conference devoted to fascia took place in 2007, This is because fascia harden and cannot be comprehensively studied in cadavers – and until the advent of modern imaging, anatomy was studied by cutting up dead bodies, and therefore gave an incomplete picture of what is happening in a living organism. It is now hypothesised that fascia may have a role in facilitating communication, water, nutrient and immune resources (Langevin et al, 2004). Langevin and Yandow (2002) found an 80% overlap in acupuncture points and meridian pathways of the arm and fascia structures (I should add that from an acupuncturist’s point of view, a bigger overlap would not be expected as some points are supposed to sit right on apex of the muscle).

Myofascial release has become a popular technique of body therapists, used in rolfing deep tissue massage to alleviate pain, promote healing of sports injuries etc. The research on fascia indicates that acupuncture is just as effective in relaxing fascia fibers as manual therapies. In my experience, it can also be less painful.

3. Localised immune response (The Splinter Effect)

 

This effect has been described quite early on the history of Western research into acupuncture (see: “Understanding Acupuncture” by Stephen Birch). It works like this:

when you insert a tiny sterile needle in the skin, our body recognises it as a foreign object. It does not differentiate between a splinter and a sterile needle. Therefore, an inflammatory reaction kicks in: there is an increased blood and lymph flow to the site of insertion, and increased immune system activity. As there is no “real” enemy to fight, as no dirt and bacteria enter the body as would be the case with a splinter, all those mobilised resources are free to work on the body’s own problems instead: repairing tissue damage, flushing away old debris, delivering extra portions of oxygen and nutrients, and in general promoting local healing.

Interestingly, this does not cause the immune system to go into an overdrive, but rather regulates it, hence acupuncture is still a useful therapy for those suffering with autoimmune diseases.

Using non-needle techniques, such as acupressure or moxibustion, differs from the splinter effect, however, strong localised stimulation also increases the flow of blood and lymph, and promotes healing through the benefits of higher oxygenation, nutrient supply and immune cell presence.

inflammation

So all in all, we may still not know everything about this ancient system of healing, but as new technologies emerge, we are discovering ever more. We do know for a fact that acupuncture stimulates and de-activates various specific areas of the brain, that it relaxes fascia, which can accumulate tension and which somewhat mysteriously connects all of the body, and that it boost local immune response. These discoveries are, slowly but surely, helping to build a bridge between traditional Eastern Wisdom and modern Western understanding of the body.