What happens in your brain when you have Acupuncture? How it provides Pain Relief
- Ben Elliot
- Oct 15, 2024
- 5 min read
Updated: Oct 28, 2024
While there may be many possible answers to this question, there is limited research into acupuncture using brain scanning technology. However, having been involved in one of the few ventures using fMRI technology to take pictures of the brain while subjects have acupuncture, I am able to tell you about one way acupuncture effects the brain which explains a reason we get pain relief with acupuncture.
My experience was as a result of a study that was carried out at York University. The study looked at blood flow in the brain while having an acupuncture point stimulated. Researchers specifically wanted to see what happened to the pain matrix of the brain when 'de qi' was elected to LI4 with an acupuncture needle. Assuming there are a few unfamiliar terms in that last sentence, I'll provide some further explanation and context:
The pain matrix is areas of the brain and central nervous system that work together in response to stimulus from the body, and create our experience of pain. When have knee pain, it is not the damage to the body tissue that creates the we feel as pain, it is the pain matrix that creates the experience of pain.
'De Qi' is a term used by acupuncturists that describes the sensation a patient can feel when an acupuncture needle is stimulated. If you've had acupuncture before this might be a familiar thing, and while most people experience it differently to each other, its often described as a dull ache, a tingling, a numbness or a warm sensation in the area the needle has been inserted. From the traditional acupuncture theory viewpoint, it is seen as a connection between the needle and the body's energy and pathways. From the western medicine perspective, it has been explained as a response by the nerve fibres, muscles and connective tissue is the area the needle is inserted. Whichever explanation resonated with you best doesn't change the thoughts that treatments are often stronger and more effective when this response is elicited.
LI4 is a shorthand term for the acupuncture point Large Intestine 4, or Hegu as it Chinese pinyin translation. If you've had acupuncture before, you have probably had LI4 needled as it is a commonly used point with a number of uses. One of its uses is for pain relief which is why it was chosen for this trial. I can only speculate, but I imagine other reasons for using this point, would be due to its ease of access on the hand, and the relative ease in eliciting de qi in comparison to other acupuncture points.
For added context, some of the more eagle eyed of you may be thinking how a metal acupuncture needle could be used along side an MRI machine, aka a giant magnet. Acupuncture needles are most commonly made from stainless steel, however for this trial, titanium needles were specially ordered from the US to safely carry out the acupuncture.
So that's the context, but what were the results of this trial, and what does any of it have to do with me?
The results were unexpected. Those involved with the study had anticipated some measurable changes in the brain activity, however the changes they measured were far more tangible than they had expected. The images produced by the MRI machine shows red in areas of increased blood flow, and blue in areas of decreased blood flow. In the observable areas of the pain matrix system of the brain, the colouring was distinctly blue at the point the needle was stimulating LI4, whereas it had not been when no needle was present. This showed the pain matrix to be deactivating with acupuncture as red would have indicated the blood flow stimulating the system to tell us to feel pain. We are still not able to explain why acupuncture does this, but we can say with certainty that it does.
This study was carried out around 2007, and a number of papers were published as a result over the next few years. This is where my experience begins. In the early 2010s, I had started working within the York University Health Science department by invitation from the late Dr. Hugh MacPherson, with whom I had been working alongside at York Clini, the acupucture clinic we both worked at. I had been asked to come and help with data entry and analysis for acupuncture trials on depression, anxiety, and neck pain. Though data entry and data analysis can be a laborious task, there was a need for an acupuncturist to decipher some of the less familiar terminology when entering the data. Being early in my career as an acupuncturist, I was more than happy to be involved.
By this point, the MRI study had gained some attention, and the BBC programme 'Trust Me I'm Doctor' had asked to feature the study and Hugh on their section about acupuncture. Hugh asked me if I would be the MRI model for some filming when the filming crew came to York to plan how they would film it. Thankfully, this was just a test shooting, and the presenter of the programme would come a few weeks later for the proper filming. So, my job was to just lie still in the MRI at the Science Park at York University, as the scene was mocked up. Perhaps for authenticity's sake or perhaps to see how the filming equipment reacted around a very high-tech super magnet, the MRI was run while the filming was planned.
I had been warned how loud an MRI machine could be, but I cannot say I was prepared. I lay still while the machine whirred and banged, and my LI4 acupuncture point was vigorously stimulated. I continued to lie still as the filming crew spoke with the team of researchers for some time between each 'rehearsal'. When I was finally slid out of the chamber, I was apologised to as I'd been in there for nearly two hours. Perhaps it was sensory deprivation, but it hadn't seemed that long. The crew had all the information they needed to do the filming with the presenter in a couple of weeks, and a few days later, I received some lovely photos of my brain sliced into layers.
I was informed that my brain had reacted appropriately and the blue areas related to the pain matrix and the red areas related to motor, sensory and higher mental function areas. While motor areas are usually related to movement, I put these results down to the immense and unexpected effort it took to stay still for such a long time, and although I was impressed to have such active 'higher mental function', I have since reflected that this activity was more to do with the mental struggles associated with being strapped into a small metal cylinder for a lengthy time.
The experience was an unexpected, but very interesting one and gave me a deeper insight into how acupuncture works for my western, pragmatic brain. It also gave me more faith in the aspects of acupuncture which aren't yet fully explained, and is a tale I often tell patient's when they ask the inevitable first-appointment question - So how does it work? I do hope more research is conducted in the fashion to help unravel the mysteries of acupuncture.
Below is the aforementioned picture of my brain being effected by acupuncture, plus some links to the studies, and BBC programme referenced in this blog.
Summary of the fMRI work undertaken by Hugh MacPherson
Acupuncture section of 'Trust me I'm a doctor'
Research Report: Acupuncture needling sensation: The neural correlates of deqi using fMRI
Appointments available at my York Acupuncture and Massage clinic via http://www.benelliot.co.uk