It’s a fair question, and one I get asked all the time. I wish there was an easy answer, and after 20 years in practice, I feel I should have come up with one by now! The trouble is, it’s complicated. If I start on a full explanation, I see people’s eyes glaze over, doubtless wishing they’d never asked. It may be the same for doctors if they are asked how conventional medicine works – see what I mean?

Anyway, for those who really are interested, here is an article from my website, , its my take on how acupuncture works.

Acupuncture is one part of a whole spectrum of treatments known as Chinese medicine. This includes herbs, Tui na (Chinese massage), T’ai Chi and Qi gong (exercise, breathing, meditation), lifestyle advice, and moxibustion as well as acupuncture. Chinese medicine has elegant and complex explanations about how acupuncture works. In order to understand it properly, it is necessary to understand concepts and terminology that don’t always fit comfortably with a biomedical understanding of human biology. For example, Chinese medicine involves the concept of Qi, which has no equivalent in western thought.

Biomedical research has begun to investigate how acupuncture works from the western point of view, and has suggested some theories largely based on the neurology of pain. None of them yet explain the effects of acupuncture adequately, but some research that is exploring a combined approach of psychology, neurology and immunology may be beginning to understand the wide-ranging benefits acupuncture can deliver.

Biomedical model

From the biomedical viewpoint, acupuncture is seen as a form of stimulation of the central nervous system through sensory nerves, including the polymodal receptors (Kawakita K, Okada K. 2006). Acupuncture works by stimulating certain sensitive and reactive places on the body. These sensitive areas are known as acupuncture points, and are thought to link to nerve junctions in other parts of the body. When needles are inserted into these points, they activate the endogenous descending inhibitory pain control pathways (Han 2003) and stimulate other central nervous system changes. This prompts the body to release natural pain killing substances, known as endorphins, which enter into the nerve pathways of the brain and spinal cord and help to relieve pain in the corresponding part of the body. For example, acupuncture needles are inserted into the tender areas of muscle in the neck and shoulders to treat headaches. There is good evidence that the effects of acupuncture are sustained, and increase during a course of treatment (Dyrehag et al 1997).

The release of other substances, such as serotonin, the ‘feel-good’ hormone, as a result of acupuncture stimulation, may explain the sense of well-being that many patients experience as a result of treatment. Functional neuro-imaging or brain scanning of people receiving acupuncture, shows complex reactions in the central nervous system (Esch et al 2004), and further research in this area may help our understanding of the ‘holistic’ effects of acupuncture.

Chinese medical theory model

Chinese medicine has an understanding of the way the body and mind works which is broader and more general than the biomedical model. It is a holistic system that sees symptoms in the context of a dynamic living organism, and accommodates the varied relationships between different parts of the body. One of the theories it uses to describe this dynamic set of relationships is Qi.

Qi is commonly translated as ‘life force’ or ‘energy’. The term ‘Qi’ is used extensively in the classic Chinese medical texts, (and throughout East Asian philosophy) and refers to natural phenomena and their relationship with one another. Rather than being a physical ‘thing’, ‘Qi’ describes, or provides a framework for describing, the activities and movements that make up relationships in the natural world. Birch and Felt (1999) propose that ‘Qi’ is a ‘generative matrix in which all things interact with all other things through the exchange of information’.

If we suppose that nature is observably ordered, Qi provides a useful construct for describing and predicting behaviour and events. Chinese medical theory describes the functions of the human body and mind in terms of ‘Qi’, and it is using ‘Qi’ that acupuncturists aim to treat their patients.

Qi is described as flowing through channels in the body. When the Qi flows freely, the body is healthy, and we feel well. If Qi stops flowing freely, or stagnates, we start to notice stiffness, pain or a compromise of function in the area of the stagnation. Acupuncture treatment aims to restore the flow of Qi by stimulating acupuncture points. Once the flow is restored, the stagnated area is moved and the problems resolve. In other words, treatment helps to restore normal function.

Chinese medicine is a rich source of interesting and dynamic theory explaining the functions of the internal organs and their relationships, the causes of disease, the substances and fluids of the body and their quality and circulation. This approach does not differentiate between mind and body, seeing the two as inextricably intertwined, and focuses on treating the individual, rather than the disease.

If you are interested to find out more about Chinese medical theory, I recommend the following books, journals and websites.


  • Maciocia G. The Foundations of Chinese Medicine, (1989) Churchill Livingstone, Edinburgh
  • Birch S., Felt R.L, Understanding Acupuncture (1999) Churchill Livingstone, Edinburgh
  • Cassidy CM Contemporary Chinese Medicine and Acupuncture (2002) Churchill Livingstone, Edinburgh
  • Hicks A., The Acupuncture Handbook (2005) Piatkus Books, London
  • Hecker H-U, Steveling A, Peuker E.T, Kastner J., Practice of Acupuncture (2002) Thieme, Stuttgart
  • Kaptchuk T Chinese Medicine – The Web That Has No Weaver. (2000) Contemporary Books


  • Journal of Chinese Medicine
  • Journal of Alternative and Complementary Medicine

Web sites


Kawakita K, Okada K. Mechanisms of action of acupuncture for chronic pain relief – polymodal receptors are key candidates. Acupunct Med 2006;23(Suppl):S58-66.

Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci 2003;26(1):17-22.

Dyrehag LE, Widerstroem-Noga EG, Carlsson SG, Andersson SA. Effects of repeated sensory stimulation sessions (electro-acupuncture) on skin temperature in chronic pain patients. Scand J Rehabil Med 1997;29:243-50.

Esch T, Guarna M, Bianchi E, Zhu W, Stefano GB. (2004) Commonalities in the central nervous system’s involvement with complementary medical therapies: limbic morphinergic processes . Med Sci Monit, 10(6): MS6-17

Birch S.J., Felt R.L. (1999) How does acupuncture work? (in) Understanding Acupuncture. Churchill Livingstone.