How does acupuncture work?

Despite being one of the fastest growing medical modalities in the western world, the medical system of acupuncture remains surrounded by a certain mystic. That's understandable given that it originated in a culture and belief system very different from our own. However, acupuncture is a very logical and organized practice. A practitioner takes clear, logical steps to identify the cause of illness in a patient and then similarly follows established logical steps in selecting of the points for treatment. If you have a clear understanding of how an acupuncturist diagnoses illness and decides on a treatment a lot of the mystic and skepticism about acupuncture may prove unwarranted.

Over the past several thousand years this system of medicine has been developed mainly through clinical experience. That means treating patient after patient and watching the results. The points have been mapped on the body and their functions established and elaborated on through thousands of medical texts written by acclaimed doctors over the centuries. Over time the number of identified points grew to what we have today, over two thousand specific acupuncture points on the body.

"Point" is the word that is most accepted in the west to describe these locations on the body, however the actual Chinese character, 腧穴, "shu xue" actually translates to "flowing hole." This is a powerful concept. Think of walking along an iced over river, and periodically there are holes through the ice where the water flowing underneath is exposed. This is the concept of shu xue. Acupuncture points are holes where you can exert influence on the regulation functions in the body. Each of these different points have specific functions inside the body. For instance there is a point on the shin, Zu San Li, that we know increases the rate of digestion. It moves the contents of our stomachs through the intestines more quickly. It also increases gastric acid secretion, treats infections in the breast, reduces abdominal pain, treats pain in the knee, and increases energy.

If it sounds to you like that's a lot for a single point to do, you're right, and that's typical for acupuncture points. Each single point has multiple functions in the body. Knowing that, now imagine seeing an acupuncturist for low back pain. With two thousand points on the body and each point having multiple functions, you may imagine there are a lot of possible points for your complaint, and you'd be right. There are a few dozen points just in the region where you are having pain. There are also several dozen points on the arms, legs, hands, feet, ears and scalp that can treat low back pain. All told, there are maybe 100 different points on the body that can be used to treat the pain in your low back. Fortunately for you, you do not have to put needles in all of these points to effectively treat your back pain. In fact several of these points won't have any effect for you, because they aren't the right points for your back pain. (because not just every type of back pain, but also every type of patient is different.) In order to figure out which points will be effective for you, your acupuncturist needs to investigate deeper. They may ask you a lot of questions about your pain: when does it occur, what sort of pain is it, is it better with heat or cold, is it worse with stress, or activity, or rest, and so on. They'll do a physical exam, just like your doctor does, to identify the structures involved-discs, muscles, nerves, bones. They also need to understand the context in which your back pain is occurring. That means they need to understand you and your health. They will set aside your chief complaint for a moment and ask questions ranging your entire life, even your family history, different illnesses, the various functions of your body outside of your back pain-digestion, skin, sleep, emotions, thirst, and so on. Those questions are all vitally important as they create a richly textured understanding of the context in which your symptoms occur, the landscape against which your symptoms are presenting. Once that rich texture has been created the acupuncturist returns to those hundred or so points for your back pain, and out of those points identifies which points also treat all the other areas of your health that appeared through the course of your conversation. Those are the points, or "flowing holes" that are active in your case, and where they will be able to influence your health and restore function and comfort. Because Chinese Medicine is a truly holistic medicine, it doesn't necessarily just treat your back pain. What it does is treat your back pain within the context of you as a whole person.