Acupuncture modulates the balance between Sympathetic system (fight-or-flight) and Parasympathetic system (rest-digest-health. It promotes parasympathetic dominance, leading to slower heart rate, lower blood pressure, improved digestion and relaxation. This is key in treating stress-related disorders, IBS, hypertension, and functional disorders.
Studies
Acupuncture Increases Parasympathetic Tone (HRV Analysis)
Electroacupuncture Modulates Blood Pressure via ANS
Acupuncture Balances Sympathetic/Parasympathetic Function
Auricular Acupuncture Stimulates Vagal Activity
Acupuncture Reduces Stress-Induced Sympathetic Activation
Autonomic Nervous System Regulation
While acupuncture has specific physiological effects, part of its effectiveness may involve patient-practitioner interaction, expectations, and beliefs (the placebo effect), as well as the ritual and meaning within a therapeutic context. However, neuroimaging studies show that real acupuncture activates different brain areas than sham acupuncture, supporting its specific efficacy.
Studies
Placebo Acupuncture and Brain Activation
Expectancy Enhances Acupuncture Analgesia
Contextual Healing and Open-Label Placebo
Real vs. Sham Acupuncture in Chronic Pain
Therapist Interaction Enhances Acupuncture Outcome
Placebo and Contextual Effects
Modulation of Neurotransmitters
Acupuncture affects several neurotransmitter systems:
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Serotonin (5-HT): Mood regulation, anti-depressant effect
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Dopamine: Motivation, motor control, reward
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Norepinephrine: Stress response, autonomic regulation
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GABA: Inhibitory neurotransmitter – relaxation, anti-anxiety
This underlies acupuncture’s effectiveness in insomnia, depression, stress, and autonomic dysfunctions.
Studies
Acupuncture Enhances Serotonin (5-HT) in the CNS
Acupuncture and Central Monoamine Levels
Acupuncture Increases GABA Activity
Acupuncture and Dopamine in Parkinson’s Disease
Modulation of Cortical and Subcortical Neurotransmitters
Serotonin and Acupuncture Analgesia
EA Restores Neurotransmitter Balance in Depression
Acupuncture activates pathways that reduce pro-inflammatory cytokines (e.g., TNF-α, IL-6), increase anti-inflammatory mediators (e.g., IL-10) and modulate the hypothalamic-pituitary-adrenal axis (HPA) to reduce systemic inflammation. This supports its use in autoimmune conditions, allergies, and chronic inflammation.
Studies
Acupuncture Inhibits Pro-Inflammatory Cytokines (IL-6, TNF-α)
Acupuncture Modulates Inflammatory Gene Expression
Acupuncture Reduces CRP and IL-6 in Humans
EA Suppresses Inflammatory Cytokines in Arthritis Model
ST36 Activation Drives Anti-Inflammatory Reflex
Anti-Inflammatory Effects
Moxibustion (灸法, Jiǔ fǎ) is a fundamental therapeutic technique in Traditional Chinese Medicine (TCM) that involves the burning of mugwort (Artemisia vulgaris, known as "moxa") near or on acupuncture points to warm the meridians, promote the flow of Qi and Blood, and dispel. Moxa is dried Artemisia vulgaris leaves, ground into a wool-like material and used in various forms (cones, sticks, loose wool). It has warming, tonifying, and moving properties. Moxibustion is primarily used to warm meridians and disperse Cold, tonify Yang, especially Kidney Yang and Spleen Yang, rescue Yang collapse (e.g., shock, fainting), promote circulation of Qi and Blood, strengthen the immune system and prevent illness (used seasonally on points like E36). Moxa is indicated when the pattern is Cold (Han 寒): e.g., Cold invading the uterus → use moxa to warm, Yang deficiency (阳虚): e.g., Kidney Yang deficiency → tonify with moxa, chronic conditions, fatigue, weakness, Qi or Blood stagnation due to Cold or to induce movement in blocked or frozen areas (e.g., shoulder, uterus)
Moxibustion
(Moxa 灸)
Electroacupuncture (电针, Diàn zhēn) is a modern acupuncture technique that integrates traditional needling with electrical stimulation to enhance the therapeutic effects of acupuncture. It is widely used for pain relief, neurological conditions, and chronic syndromes, and it aligns with TCM principles while incorporating biophysical stimulation. Electroacupuncture involves inserting acupuncture needles at appropriate points (as in classical acupuncture), connecting electrodes to the handles of the needles using wires, applying a mild electrical current (usually pulsed) between pairs of needles, the stimulation is adjustable in frequency and intensity. Unlike TENS (Transcutaneous Electrical Nerve Stimulation), the current in electroacupuncture passes through the needle into the acupuncture point, allowing deeper and more targeted action. Electroacupuncture is used to enhance the stimulation of acupuncture points, strengthen Qi and Blood circulation, relieve pain more effectively than manual needling alone, restore nerve and muscle function in paralysis, atrophy, or trauma, disperse stagnation of Qi/Blood/Phlegm and promote tissue regeneration and reduce inflammation
Electroacupuncture (电针, Diàn zhēn)
Tonification (补法, Bǔ fǎ)
Reinforce, nourish, support
Deficiency syndromes (Qi, Blood, Yin, Yang, organ function)
With the meridian flow (顺经而入)
Gentle, clockwise (rightward)
Slow insertion, quick withdrawal
Insert on inhalation, remove on exhalation
Longer duration (20–30 minutes)
Mild, warm, deep sense of fullness or heaviness
Often combined with moxibustion (especially for Yang Deficiency)
Dispersing (泻法, Xiè fǎ)
Eliminate, reduce, purge
Excess syndromes (pathogenic factors, stagnation, Heat, etc.)
Against the meridian flow (逆经而入)
Stronger, counterclockwise (leftward)
Quick insertion, slow withdrawal
Insert on exhalation, remove on inhalation
Can be shorter or combined with multiple insertions
Stronger, spreading, moving or even sharp sensation
May be combined with bleeding (saignée), cupping, or gua sha
The tonification needling method (补法, Bǔ fǎ) is one of the core techniques in acupuncture, used to strengthen or nourish a deficiency in the body. It is a method applied when a patient is diagnosed with a deficiency syndrome (虚证), such as qi deficiency (气虚), blood deficiency (血虚), yin deficiency (阴虚), yang deficiency (阳虚) and organ (Zang-Fu) deficiency, e.g., Spleen Qi deficiency, Kidney Yang deficiency, etc. Tonification is used to reinforce the vital substances: Qi, Blood, Yin, Yang, restore organ function, reestablish energetic balance, support the body’s self-regulation. Tonification is applied in deficiency patterns, which may present with signs like fatigue, spontaneous sweating, shortness of breath, pale tongue, weak pulse, cold limbs and dizziness
Tonification
The dispersion needling method (泻法, Xiè fǎ) is a classical acupuncture technique used to eliminate excess, move stagnation, and expel pathogenic factors from the body. It is the counterpart to tonification (补法, Bǔ fǎ) and is applied when there is an excess syndrome (实证) in Traditional Chinese Medicine (TCM). The aim of dispersion is to reduce pathogenic factors (Wind, Cold, Heat, Dampness, Phlegm, etc.), clear stagnation of Qi, Blood, or Fluids, sedate an overactive organ, purge internal Heat or Fire and calm emotional agitation caused by excess. Dispersion is indicated in syndromes such as stagnation of Liver Qi (肝气郁结), excess Heat in the Heart or Liver, retention of Phlegm-Dampness, exterior invasions (Wind-Heat, Wind-Cold), Qi/Blood stasis causing pain and full patterns of Zang-Fu organs (e.g., Full Heat in Stomach)
Dispersion
Acupuncture
What is Acupuncture?
Acupuncture is a therapeutic technique rooted in Traditional Chinese Medicine (TCM) that involves inserting fine, sterile needles into specific points on the body—called acupuncture points —to regulate the flow of Qi and restore balance between Yin and Yang. There are 12 primary meridians (each linked to a Zang-Fu organ) and 8 extraordinary vessels, which distribute Qi and Blood throughout the body. Each organ has physical and energetic functions. Acupuncture affects these by targeting specific points. Acupuncture aims to:
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Disperse stagnation of Qi or Blood
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Tonify a deficiency (e.g., tonify Qi, Blood, Yin, or Yang)
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Clear pathogenic factors (e.g., Wind, Cold, Heat, Dampness)
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Restore balance of the internal organs (Zang-Fu) and elements (Wood, Fire, Earth, Metal, Water)
Cupping therapy (拔罐, bá guàn) is a traditional technique used in Chinese medicine, often integrated with acupuncture to move Qi and Blood, expel pathogenic factors, and relieve pain or stagnation. Though no needles are involved directly, cupping is considered part of acupuncture therapy within the broader scope of meridian and point-based treatments. Cupping involves placing glass, bamboo, plastic, or silicone cups on the skin to create negative pressure (suction). This draws the skin and superficial muscle layer into the cup, promoting circulation and stimulating acupuncture points and meridians. From a TCM perspective, cupping moves stagnant Qi and Blood (行气活血), dispels Wind, Cold, Damp, Heat (especially from the muscles and surface), opens the meridians (通经络), draws out toxins and pathogenic factors, releases the exterior (especially in early-stage Wind invasions) and reduces swelling and pain
Cupping
Gua Sha (刮痧) is a traditional therapeutic technique in Chinese medicine often used alongside acupuncture. Though it does not involve needles, Gua Sha works by stimulating acupuncture points and meridians through scraping the skin to move Qi and Blood, release the exterior, and dispel pathogenic factors. It is considered part of acupuncture therapy under the broader umbrella of meridian-based treatments. "Gua" 刮 means to scrape. "Sha" 痧 refers to the reddish petechiae or bruising that appears after scraping. Gua Sha is performed by rubbing lubricated skin with a smooth-edged tool (e.g., jade, buffalo horn, porcelain spoon) along specific meridians or muscle groups until petechiae (Sha) appear. These marks are diagnostic and therapeutic. According to Traditional Chinese Medicine, Gua Sha moves stagnant Qi and Blood (行气活血), releases the exterior (解表) – expels Wind, Cold, and Heat, opens meridians and collaterals (通经活络), reduces swelling and pain, stimulates Wei Qi – enhances immune function and resolves Phlegm, Dampness, and Toxic Heat. It is particularly effective for superficial or muscular layer disorders involving stagnation or pathogenic invasion.
Gua Sha
Tui Na (推拿) is a manual therapy within Traditional Chinese Medicine (TCM), often practiced alongside acupuncture, based on the same meridian and point theory. While it does not use needles, Tui Na stimulates acupuncture points, meridians, and Zang-Fu organs through therapeutic touch, making it a fully integrated part of acupuncture-based treatment strategies. Tui Na means "Tui" (推) – to push and "Na" (拿) – to grasp. It involves a wide range of massage and manipulation techniques applied to specific areas, meridians, and acupuncture points, to move Qi and Blood, correct musculoskeletal imbalances, and regulate organ function. According to Chinese medicine theory, Tui Na moves Qi and Blood (行气活血), unblocks meridians and collaterals (疏通经络), relieves muscle tension and pain (止痛), regulates internal organs (调理脏腑功能), dispels external pathogens (如风寒湿邪) and balances Yin and Yang It is used for both musculoskeletal and internal disorders, depending on the techniques and areas treated.
Tui Na
Scientific Mechanisms of Acupuncture
While acupuncture originates from Traditional Chinese Medicine (TCM) with concepts like Qi, meridians, and Yin-Yang, modern biomedical research has explored scientific mechanisms to explain how acupuncture works in physiological terms.
Neurophysiological Mechanisms
Acupuncture stimulates the nervous system, activating both central and peripheral pathways:
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Peripheral Nervous System: Insertion of needles stimulates A-delta and C fibers in the skin and muscle. These signals are transmitted to the spinal cord, modulating local reflexes and pain signal
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Central Nervous System: Stimulates brain regions involved in pain modulation: hypothalamus, amygdala, periaqueductal gray (PAG), and somatosensory cortex. Triggers release of neurotransmitters and neuropeptides (see below)
Studies
Endogenous Opioids and Analgesia
Neural Pathways and Brain Imaging
Neurotransmitters and Electroacupuncture
Neuroimaging Review: Brain Effects of Acupuncture
Pain Regulation via Descending Pathways
Acupuncture increases the production and release of natural pain-relieving chemicals, such as:
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β-endorphin: Long-lasting analgesia, mood regulation
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Enkephalin: Spinal pain modulation
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Dynorphin: Inhibits pain transmission
This explains why acupuncture relieves pain, especially in chronic conditions like arthritis, migraines, or back pain.
Studies
Han JS – A Pioneer in Acupuncture and Opioid Research
Neuropeptides in Acupuncture Analgesia
Electroacupuncture and Opioid Peptide mRNA Expression
Opioid Antagonists Block EA Analgesia
Endogenous Opioid Release
Recent studies show that acupuncture mechanically stimulates fascia. Needle manipulation winds connective tissue around the needle. This creates a mechanotransduction signal that affects fibroblast activity, intercellular communication and local circulation and inflammation. This supports the idea of meridians as connective tissue planes, aligning with the TCM concept of Qi flow along meridians.
Studies
Mechanical Signaling through Connective Tissue
Needle Grasp and Tissue Pulling
Connective Tissue Planes as Meridian Pathways
Fibroblast Cytoskeletal Remodeling
Delayed Onset and Long-Range Effects of Acupuncture via Fascia
Fascial and Connective Tissue Response
Acupuncture increases local blood flow at the needled site. It improves oxygenation, tissue perfusion, and waste clearance. This helps with healing of soft tissue injuries, trigger points, and edema. Infrared imaging and Doppler studies confirm these effects.
Studies
Acupuncture Increases Local Microcirculation
Needling ST36 Enhances Gastric Blood Flow
Cerebral Blood Flow Increase After Acupuncture
Laser Doppler Study: LI4 and Facial Blood Flow
Peripheral Circulation Changes with Moxa and Acupuncture
Acupuncture Improves Uterine Blood Flow in Infertility