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Acupuncture is a unique therapy because it uses fine needles to inoculate minute intrusive traumas or lesions into the tissue, which stimulates many of the survival mechanisms of the body. Acupuncture needling and the induced lesion activate self-healing mechanisms, including restoring homeostasis, facilitating repair mechanisms such as anti-inflammatory reaction and tissue regeneration and pain modulation, after the removal of the needles, the needle induced lesion continue to stimulate the body.

There are four defensive system physiological systems, they include:

1- Nervous system: which coordinates our responses to external and internal condition

2- Cardiovascular system which function as a highway to transport and provide energy and cellular cleansing

3. Endocrine system, which controls to hormonal response of the body

4. Immune system, which defends the body against pathogens

There are four ways which acupuncture heals the body:

1. Stress relief: needling induces endorphin secretion which causes the relaxation of the cardiovascular and muscular system, restoring homeostasis.

2. Activation and control of immune and anti-inflammatory mechanism: needling and needle induced lesion are foreign invaders to the body. Acupuncture causes lesion may increase the number and activity of immune cells and control the inflammatory process via BS-HPA axis which in turn reduces both acute and chronic inflammation.

3. Acceleration of tissue healing of soft tissues such nerves, muscles, connective tissues such as tendons, ligaments, joint capsules and facia, acupuncture can reduce the inflammation of these soft tissues which can be the result of an internal problem.

4. Pain relief: Acupuncture cans cause pain relief by achieving endorphin release and other chemicals.

The mechanism of pain relief in acupuncture is a complicated process, needling stimulates the following skin tissue:

A. Afferent somatic neurons such as cutaneous A-delta and C fibers which transmit the message from cutenous region to spinal cord and sympathetic neuron fibers which control sweat glands and blood vessels.

B. Fine arterial and venous blood vessels in the needled area

C. Lymphatic tissue and mast cells

D. Connective tissue

When acupoint transits from latent stage to passive phase, it becomes tender which causes an increase in skin electrical conductance and decreases resistance in the area around the acupoint. Inserting a needle into this acupoint with ll cause an acute inflammatory response; the first response is the flare response resulting in the redness of skin around the needle. This vasodilation function is via ANS (autonomic nervous system) which is mediated by substance P secreted from cutaneous nociceptive sensory nerves. The immune reaction is activated by mast cells which produce histamine, platelet activating factor and leukotrienes. 

Human body surface had an electrical energy since it is affected by electro-magnetic field of the earth. Dry skin had a DC resistance of of 200,000 to two million ohms, at acupuncture points this resistance is down to 50,000 ohms, in patient with chronic pain, there is no difference in conductance between acupuncture points and nearby control points. In a chronically sick person, the acupoints transit from a healthy tissue to tenser and sensitized tissue, the sensitive area of the acupoint get larger which contributes to high electrical conductance and low resistance. Insertion of a metal needle makes a short circuit from the skin battery and creates a micro-current called current of injury moving from inside to outside. The tiny lesion created by acupuncture needle causes negative charge at the needling site and produces 10mA of current of injury which benefit growth and regeneration.

These micro-currents created by needling are not sufficient to generate nerve pulses to spinal cord; therefore, repeated needling will not cause a "needling tolerance". It has been suggested that electro-acupuncture is more effective in relieving pain, and it depends on the level of frequency of stimulation. Studies have shown 4Hz releases enkephalin and beta-endorphin, and high frequency stimulation of 100Hz releases serotonin and norepinephrine. 

The main focus of the acupuncturist during the needling is to get the sensation of de qi, which is achieved by specific manipulation of the needles to increase the effectiveness of muscle relaxation and pain relief. When a needle is inserted into body tissue, there is an initial coupling between the metal needle shaft and elastic and collagen fibers, which is caused by both surface tension and electrical attraction between the metal needle and electrical tissue charges. The rotation and manipulation of the needle increases the tension of the fibers by winding them around the needle, which pulls and realigns the connective tissue fiber network. In response to this mechanical deformation, there are cascade of cellular and mechanical events generated by the cells which include: Interacellular cytoskeletal reorganization, cell contraction and migration, autocrine release of growth factors, and activation of intracellular signalling pathways and nuclear binding proteins that promote the transcription of specific gene.

All the above effects can lead to synthesis and local release of growth factors, cytokines, vasoactive substances, enzymes, and structural matrix elements which in turn promotes healing.

Ma Y.T, Ma M, Cho Z.H. Biomedical Acupuncture for pain management. Elsevier, 2005. Chapter 3&4.







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