Understanding Traditional Acupuncture: Bridging Classical Theory and Modern Science
What is Traditional Acupuncture?
Traditional acupuncture is a holistic healthcare practice with roots extending back thousands of years in China. It is founded on a complex understanding of the human body as an interconnected system, where Qi (vital energy), blood, and bodily fluids circulate through pathways called meridians. Health depends on the smooth, balanced flow of these elements throughout the body’s networks. When this flow is disrupted—whether blocked, depleted, or imbalanced—symptoms may develop, manifesting physically, emotionally, or both.
Classical Chinese medical texts document detailed observations on circadian rhythms, endocrine function, and blood circulation, forming a sophisticated system for recognising and treating patterns of disharmony related to organ function, emotional states, seasonal changes, and life transitions (Birch & Felt, 1999).
Acupuncture involves inserting fine needles at specific points on these meridians to regulate and restore balance, encouraging the body's innate capacity to self-repair. Diagnosis considers not only presenting symptoms but also underlying constitutional tendencies, lifestyle factors, mental health, and environmental influences. This comprehensive approach tailors treatments to each individual’s unique pattern of imbalance.
The National Institute for Health and Care Excellence (NICE) in the UK supports acupuncture for managing chronic pain (NG193) and certain headache types (CG150), highlighting its evidence-informed clinical value (NICE, 2021; NICE, 2012).
The Traditional Framework Meets Modern Evidence
While traditional acupuncture is often described in terms of energetic flow and meridians, contemporary research has shed light on the physiological processes triggered by needling.
The insertion and gentle manipulation of needles activate A-delta and C afferent nerve fibres, which send signals to the spinal cord, brainstem, and various brain regions. These signals engage pain modulation pathways, regulate autonomic nervous system function, reduce inflammation, and promote the release of neurochemicals such as endorphins, oxytocin, and serotonin (Zhang et al., 2019; Zhao, 2008).
Functional MRI studies have demonstrated that stimulating specific acupuncture points corresponds with altered activity in brain regions associated with sensation, emotion, and cognition (Hui et al., 2010). This neurophysiological basis helps explain acupuncture’s reported benefits in managing conditions such as fibromyalgia, Parkinson’s disease, stroke rehabilitation, slipped discs, depression, sciatica, and vertigo (Zhou et al., 2021; Vickers et al., 2018).
How Does This Work Together?
Traditional Chinese Medicine (TCM) and modern biomedical science offer complementary perspectives on acupuncture’s effects:
TCM provides a holistic diagnostic and therapeutic framework, interpreting symptoms within wider patterns of organ function, emotional wellbeing, lifestyle, and environmental context.
Neuroscience explains measurable biological mechanisms activated by acupuncture needling, grounding these ancient practices in current scientific understanding.
By integrating these viewpoints, practitioners can deliver nuanced care that addresses the whole person, beyond isolated symptoms or anatomy.
Neurophysiological Mechanisms of Traditional Needling Practice via Delta and C Afferent Nerve Pathways
Neuroimaging allows researchers to non-invasively measure altered neural activity within the spinal cord, brainstem, and brain. These areas are involved in pain modulation and central sensitisation, which are crucial in managing chronic pain conditions (Millan, 1999).
When a needle stimulates A-delta (myelinated, fast-transmitting, sharp sensation) or C (unmyelinated, slow-transmitting, dull, warm sensation) fibres, it triggers cellular and connective tissue responses. These nerve stimulations deactivate limbic–paralimbic–neocortical networks encompassing emotional regulation centres while activating somatosensory brain regions (Napadow et al., 2010).
Can You Feel That?
You might hear me ask “Can you feel that?” during treatment. This helps me assess whether the sensation is sharp or dull, indicating which nerve fibres are responding and how cellular communication is functioning locally.
This nuanced sensory feedback informs the treatment approach, guiding needle placement and manipulation to optimise therapeutic effects on the nervous system.
Through these mechanisms, acupuncture supports the nervous system in rebalancing itself, reducing central sensitisation associated with chronic pain, and promoting emotional regulation.
The Huangdi Neijing, one of Chinese Medicine’s foundational texts, explains that acupuncturists should feel the ‘deqi’ sensation and maintain focused attention to sustain it. Additionally, when palpating the skin, if the practitioner senses tension or tightness in the muscle fibres, the patient often simultaneously feels sensations such as soreness, numbness, fullness, or heaviness (Yang et al., 2013).
In everyday terms: this dual effect may reduce feelings of pain, ease muscular tension, and support emotional balance. Similar neurophysiological patterns have been observed in studies investigating acupuncture’s role in fibromyalgia, chronic back pain, Parkinson’s disease, stroke recovery, depression, and anxiety (Zhou et al., 2021).
Regulation and Training in the UK
Acupuncture is not statutorily regulated in the UK, but reputable practitioners complete accredited training programmes, commit to professional codes of conduct, and engage in ongoing continuing professional development (British Acupuncture Council, 2023).
I am a member of the British Acupuncture Council (BAcC) – the largest UK professional body for Traditional Acupuncture, which is accredited by the Professional Standards Authority (PSA).
The BAcC sets the highest standards of professional practice for the acupuncture profession in the UK and, as a member, I am committed to following both their Code of Professional Conduct and the Code of Safe Practice for Acupuncture, which defines the standards for the safe and hygienic practice of acupuncture.
I am degree-level trained in acupuncture (a minimum of three years and 3,600 hours of training). I have had full anatomy and physiology training with an extensive focus on risk and safety. Prior to graduating I completed at least 400 hours of in-person clinical training and, having qualified, I now carry out regular risk assessments and yearly continuous professional development (CPD).
Traditional Acupuncture vs Dry Needling
| Traditional Acupuncture | Dry Needling |
|---|---|
| Based on a comprehensive TCM system of Qi, meridians, and holistic diagnosis | Based on Western anatomy and musculoskeletal trigger point theory |
| Addresses physical, emotional, lifestyle, and environmental factors | Primarily targets local muscle and connective tissue dysfunction |
| Needles inserted at points along meridians to restore systemic balance | Needles inserted into specific trigger points or taut muscle bands |
| Requires extensive clinical training over several years | Often learned in short courses by manual therapists |
| Supported by clinical guidelines (NICE) for chronic pain and headaches | Not recognised as acupuncture by professional regulatory bodies |
Trigger-point dry needling involves inserting a thin needle into the skin and muscle to target myofascial trigger points, these are sensitive, tight knots found within muscle fibres. The needling can be done at shallow or deeper layers of the muscle tissue (Physiopedia, 2024). Dry needling is often performed by massage therapists, physio therapists, osteopaths, GPs or chiropractors.
Though both acupuncture and dry needling involve the insertion of fine needles, they differ substantially. Dry needling courses may be as brief as two days and lack the comprehensive diagnostic framework inherent to acupuncture practice (Acupuncture and Dry Needling, 2025).
Summary
Traditional acupuncture remains a dynamic, living healthcare system that blends deep classical knowledge with evolving scientific insight. It acts by regulating Qi and blood flow within the body's networks while simultaneously activating neurophysiological pathways that modulate pain, inflammation, and emotional states.
Used responsibly as part of an integrated health plan, acupuncture can offer meaningful support for a wide range of chronic pain conditions, neurological rehabilitation, and emotional wellbeing.
At Emma Hart Acupuncture, I welcome people navigating many of the areas mentioned above. Whether you’ve been referred by a GP, are living with long-term symptoms, or are simply curious about how acupuncture may support your wellbeing, I aim to provide a safe, grounded, and personalised experience.
Every session is tailored to your unique presentation and can be used alongside most conventional healthcare approaches. If you’d like to find out more, you’re warmly invited to get in touch.
This blog is for general information only and does not replace medical advice. Always consult your GP before making decisions about your care.
References
Acupuncture and dry needling. (2025, April 29). The Chartered Society of Physiotherapy. https://www.csp.org.uk/professional-clinical/professional-guidance/insurance/acupuncture-dry-needling
Birch, S., & Felt, R. (1999). Understanding acupuncture (1st ed.). Elsevier.
British Acupuncture Council. (2023). Training standards. https://www.acupuncture.org.uk/public-content/training-standards.html
Dry Needling. (2024, July 4). Physiopedia, . Retrieved 03:16, August 13, 2025 from https://www.physio-pedia.com/index.php?title=Dry_Needling&oldid=356087.
Hui, K. K., Marina, O., Claunch, J., & Vangel, M. (2010). Characterization of the “De Qi” response in acupuncture. Brain Research, 1315, 46–53. https://doi.org/10.1016/j.brainres.2009.11.071
Millan, M. J. (1999). The induction of pain: An integrative review. Progress in Neurobiology, 57(1), 1–164. https://doi.org/10.1016/S0301-0082(98)00048-2
Napadow, V., Dhond, R., Park, K., et al. (2010). Brain correlates of autonomic modulation: Combining heart rate variability with fMRI. NeuroImage, 47(3), 790–795. https://doi.org/10.1016/j.neuroimage.2009.05.011
National Institute for Health and Care Excellence (NICE). (2012). Headaches in over 12s: Diagnosis and management(CG150). https://www.nice.org.uk/guidance/cg150
National Institute for Health and Care Excellence (NICE). (2021). Chronic pain (primary and secondary) in over 16s: Assessment of all chronic pain and management of chronic primary pain (NG193). https://www.nice.org.uk/guidance/ng193
Vickers, A. J., Vertosick, E. A., Lewith, G., et al. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. The Journal of Pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005
Zhao, Z. Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355–375. https://doi.org/10.1016/j.pneurobio.2008.05.004
Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2019). Mechanisms of acupuncture–electroacupuncture on persistent pain. Anesthesiology, 120(2), 482–503. https://doi.org/10.1097/ALN.0000000000001810
Zhou, K., Yang, H., Zhou, M., et al. (2021). Acupuncture for neurological diseases: A review of clinical and neuroimaging evidence. Frontiers in Neuroscience, 15, 675857. https://doi.org/10.3389/fnins.2021.675857
Yang, X., Shi, G., Li, Q., Zhang, Z., Xu, Q., & Liu, C. (2013). Characterization of Deqi sensation and acupuncture effect. Evidence-based Complementary and Alternative Medicine, 2013, 1–7. https://doi.org/10.1155/2013/319734
