How Acupuncture Works: an overview

Where magic meets science

A tiny, hair-thin needle is placed at a specific acupoint, and the mind relaxes, or pain dissolves somewhere in a different area of the body. What makes it possible? How acupuncture works seems so far from our Western understanding of anatomy, that it was long suspected to be a placebo. Sometimes, it is put on par with superstitious folk remedies, somewhere in between witchcraft and eating garlic.
Nothing could be further from the truth. Acupuncture has been studied, re-studied, corrected according to evidence base as far as ancient China, and empirically shown to have a measurable biological impact on the body.
Luckily for us, we live in times when advances in imaging technology allow us an increasing insight into the science of how acupuncture works.


The proof of Magnetic Resonance Imaging

One of such inventions is magnetic resonance Imagining (MRI). Functional MRI, or fMRI, makes it possible to observe a structure, such as a brain, during a process or intervention. Several studies reveal a direct peak at the brain of a patient undergoing acupuncture treatment. These studies go as far as 25 years back. They prove beyond doubt that there is something – something major – going on in the brain of a person undergoing acupuncture.


Look at the image above, taken from a comprehensive meta-analysis by Huang et al, 2012. This fMRI scan shows clearly smaller and greater areas of brain activation. These differences are our proof of classic Eastern medical wisdom. The fMRI demonstrates that acupuncture points which work for a multitude of conditions stimulate many areas of the brain. For instance, look at ST36. It is one of the most widely used points that has a deep effect on pain, digestion, immune responses and gives you more energy – you are likely to have had it needled in the clinic. In an atlas of acupuncture points, you would find a few pages devoted to it’s use and historical examples. Now compare to BL62: this point is traditionally used for very specific conditions, and on the MRI it works on some very distinct areas only, “firing up” two or three “dots”. Isn’t it just amazing?
[image: face human polygons OR virtual reality psyche OR understanding spark from Pixabay]

Professor George Lewith thus summarised his 2005 systematic review of brain fMRI 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.”

Let’s summarise.

Acupuncture works on the neurological level consistently with the way it is described by classic Chinese Medicine. If a point is meant to treat hearing, it will “fire up” the corresponding area of the brain – do not be discouraged by the fact it is on the leg. Also, acupuncture can work to deactivate some areas of the brain, thus calming down overactive structures.

How did people without a modern imaging system know to create those maps of the body is a fascinating question and a topic for a whole other article. It has much to do with understanding Qi and the different ways of gathering knowledge in the East and the West.
The cool new kid on the block: fascia
And what is the mechanism by which our brain can be so profoundly affected by those little acupuncture needles?
It is fascia.

[Pixabay: neurons, brain structure by Geralt; OR annoy network butterfly]

Fascia is a connective tissue that envelops our whole body on the inside. It connects muscles, swaddles internal organs, and binds all our structures together while connecting to the Central Nervous System. It has been described as “a ubiquitous and multi-functional connective tissue that supports the body”. It is everywhere, it does everything, and it connects all elements that long thought to be distinct. 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 studied well on cadavers, and until the advent of modern imaging, all we knew about anatomy was the fruit of cutting up dead bodies. This was certainly a rather crude study method, which gave an incomplete picture of what is happening within a living organism. It is now suggested that fascia may have a role in facilitating communication, water, nutrient and immune resources (Langevin et al, 2006). Langevin and Yandow (2002) found an 80% overlap in acupuncture points and meridian pathways of the arm and fascia structures. From an acupuncturist’s point of view, this is completely expected: some points sit right on the apex of a muscle and those account for most of the missing 20%.

Acupuncture is not the only therapy which works on fascia. For instance, myofascial release has long been used in rolfing deep tissue massage to alleviate pain, promote the healing of sports injuries etc. Research indicates that acupuncture works just as well to relax fascia fibers as manual therapies, and often is also considerably less painful.

Now, imagine fascia as information pathways.

Or maybe motorways, as so much happens along them! There is electromagnetic activity, there are receptors that respond to hormones, and this whole fine network interacts in a multitude of complex ways with our Central Nervous System.

This is why acupuncture works on such complex internal syndromes as IBS or asthma.
This is why, with acupuncture, we can help conditions as different from each other as anxiety and acute back pain.
This also explains why we can use acupuncture to profoundly affect the Central Nervous System and relax, focus, or dissolve past traumas. You can read more about treatment here.

And finally, this is why we should never be afraid of something, or dismiss something, just because we cannot explain it. Just like acupuncture’s effect is coming to light now due to MRI technology, it might simply be the case of not being able to explain it… yet.


Huang et al, 2012. Online.

Langevin, H.M. and Yandow, J.A., 2002. Relationship of Acupuncture Points and meridians to Connective Tissue Planes. The Anatomical Record, 269, 257-265.

Langevin, H.M, 2006. Connective tissue: A body-wide signaling network?,
Medical Hypotheses, Volume 66, Issue 6, 2006,

Lewith, white and Pariente, 2005, Investigating acupuncture using brain imaging techniques: the current state of play. In: Evidence based complementary and alternative medicine. DOI: 10.1093/ecam/neh110


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