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What is Acupuncture and Qi?

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Acupuncture is the most commonly used modality in the medical system known as Chinese medicine. At its most basic, it is the insertion of fine needles into the body to bring about a therapeutic effect.  At its deepest, it is a complex medical system designed to bring balance and harmony to mind, body and spirit.

Acupuncture was widely believed to have begun in China around 5,000 years ago. However, a recent discovery in Europe has opened the possibility that acupuncture may have European origins which predate its emergence in the Orient. In 1991, a frozen, mummified human was found emerging from a glacier in Italy. Named Otzi, the mummy had approximately 57 carbon tattoes consisting of simple dots and lines on his lower spine, behind his left knee, and on his right ankle. Using X-rays, it was determined that the Iceman may have had arthritis in these joints. It has been speculated that these markings may be related to acupuncture. 1 (Alpine iceman reveals Stone Age secrets, Australian Broadcasting Corporation, 18 February 2005, archived from the original on 27 September 2006,, retrieved 1 October 2008 . )

Nonetheless acupuncture was most certainly popularized and refined in China, where its practice has a long and storied existence. It wasn't until the early 1970's that acupuncture began gaining popularity in the West. During President Nixon's historic visit to China, an American journalist underwent an appendectomy in which acupuncture was used as an anesthetic. The journalist, James Reston, wrote of his experience. That event marked the beginning of the rise in popularity of acupuncture in the United States.

To begin understanding acupuncture, one must get a basic idea of the concept of Qi. Often translated as energy in the broadest sense, this definition needs some refinement. Qi permeates the universe and gives form to the world as we know it. Similar to the Force from Star Wars lore, Qi is an energy which enriches us, protects us, nourishes us and animates us. Qi is contained in the food we eat and the air we breath. It is also the energy behind a seed's transformation into a plant.

According to the theories of Chinese medicine, acupuncture works by regulating the Qi flow in the body. Qi flows through a network of energy pathways called meridians. There are fourteen main meridians and many smaller ones throughout the body. Located along these meridians are the acupuncture points. By inserting needles into specific points on these meridians, the Qi flow of the body is influenced and regulated. When the flow of Qi is imbalanced, interrupted or deficient, illness ensues. Acupuncture regulates the harmonious flow of Qi, thereby returning balance to the body and restoring health.

In Chinese medicine, it is often said if there is free flow, there is no pain; if there is no free flow, there will be pain. This refers to the free and unobstructed flow of Qi. If the Qi flow is blocked, pain ensues. An acupuncture treatment reestablishes the correct flow of Qi, resulting in pain relief. Looking at this from a western perspective, a tight muscle can result in pain, and pain relief would result when the muscle relaxes. When acupuncture needles are inserted into the origin and insertions of muscles, or where muscles attach to bones, the muscles will relax. In this case, pain relief can be seen as either the muscles relaxing, or the reestablishment of proper flow of Qi, depending on the perspective.

The exact mechanism of how acupuncture works has never been well explained by Western science. Theories abound about increases in blood circulation, neurotransmitters sending signals to the brain or the stimulation and release of endorphins, but the fact remains that nobody really knows for sure. That is why when explaining how acupuncture works, it is best to use the Qi model.

Acupuncture points have different functions. As they relate to Qi, some are said to circulate Qi, others raise Qi, others strengthen Qi. Some points strengthen the function of certain organs. Others are located where muscles and tendons meet, thus being more useful for musculo/skeletal conditions such as shoulder pain or tennis elbow.

There are 365 acupuncture points on the fourteen main meridians, and many others known as extra points. Among these, approximately one hundred are thought of as major points and are more frequently used. Needles are disposable and made from stainless steel. They can be anywhere from one-half inch to two or more inches in length, however their diameters are very small, usually about the size of a dog's whisker.

During an acupuncture treatment, little sensation is felt when the needle is initially inserted. Once through the skin, a practitioner then gently manipulates the needle to obtain a sensation called “de qi.” In Chinese this means the arrival of the Qi sensation. This can feel like a dull ache, a sensation of heat, a feeling of prickles or numbness or a radiating sensation from the acupuncture point. Some people report feeling the movement of Qi during a treatment, but an equal number report not noticing any such sensation. However, both these groups still benefit equally from acupuncture treatment.

Acupuncture needles are usually left in for twenty to thirty minutes. An average of ten to fifteen acupuncture points are chosen. The points are usually chosen bilaterally (the same point on both limbs), but in some cases needling is done on only one side of the body. The points are chosen based on the person's ailment and their diagnosis according to the principles of Chinese medicine.

One thing commonly experienced after an acupuncture treatment is a deep sense of relaxation. Pain relief can be immediate, especially if the condition is acute like a recently sprained ankle. In situations of a chronic condition such as a bad back, it may take five or more treatments before one starts noticing a difference.

Using a headache as an example, an acupuncturist might place needles in the hands between the thumb and index finger, at the nape of the neck and along the temple. A couple extra sets of points in the arms or legs would likely be chosen based on the person's Chinese medicine diagnosis.

Acupuncture performed by a qualified practitioner is very safe. One large study found only 43 minor adverse events associated with over 30,000 acupuncture treatments. 2 (MacPherson P, et al. The York acupuncture safety study: prospective survey of 34,000 treatments by traditional acupuncturists. BMJ September 1, 2001;323:486-7) The number of treatments needed varies, anywhere from two to twelve or more is normal, depending on the condition. For instance, an acute headache may take just a couple treatments to obtain satisfactory results, whereas an ailment like chronic fatigue syndrome may take a year or more to obtain satisfactory results.

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