Medical acupuncture is an approach to acupuncture informed by contemporary knowledge of anatomy, physiology and clinical reasoning. It uses many of the same needling techniques as traditional acupuncture, but treatment is usually explained using modern biomedical concepts rather than traditional Chinese medicine theory.

Medical acupuncture is commonly incorporated into the practice of healthcare professionals who have undertaken additional training in acupuncture. It is often used as part of the management of musculoskeletal pain and other appropriate clinical presentations.

At Exeter Acupuncture & Osteopaths, medical acupuncture is not treated as a completely separate system of care. It is one of the approaches we can draw upon following appropriate consultation and assessment, according to the individual patient and their presentation.

Research into acupuncture has explored a number of possible physiological mechanisms.

The insertion and stimulation of acupuncture needles provides sensory input to the nervous system and can produce local, spinal and central nervous system responses. Proposed mechanisms include changes in pain processing, endogenous pain-modulating systems and activity within areas of the brain involved in the experience and modulation of pain.

There probably isn't one single mechanism that explains every response to acupuncture. Different needling techniques and different tissues are likely to produce different physiological responses, and this remains an interesting area of research.

One interesting area of research is whether the location of needling influences the physiological response. Medical acupuncture has traditionally placed less emphasis on the specific properties attributed to individual acupuncture points within Chinese medicine. However, emerging neurophysiological research suggests that location may sometimes matter.

A particularly interesting example is research involving the traditional acupuncture point ST36 (Zusanli), located on the lower leg. In animal studies, low-intensity electroacupuncture around ST36 activated a neural pathway associated with regulation of systemic inflammation, whereas comparable stimulation at an abdominal site did not. Researchers subsequently identified a population of sensory neurons within deep tissues of the hindlimb that appeared necessary for this response. (3)

This doesn't prove the traditional theory of acupuncture points, and the findings cannot simply be extrapolated from mice to clinical treatment in humans. What it does suggest is that different anatomical locations may recruit different sensory pathways and produce different physiological responses. For me, this is one of the particularly interesting areas where traditional acupuncture observations and modern neurophysiology may begin to meet.

Having trained in both traditional and medical acupuncture, I don't see a need to put a hard dividing line between the two. There are differences in how we understand and select points, but there is also considerable overlap in practice.

Both involve the insertion of fine acupuncture needles and may use many of the same anatomical locations. The main difference is usually the framework used to understand the patient, select points and explain treatment.

Traditional acupuncture may draw on Chinese medicine concepts and observations such as the pulse, tongue and wider patterns of health. Medical acupuncture tends to place greater emphasis on anatomy, neurophysiology, clinical examination and contemporary biomedical reasoning.

Medical acupuncture may include local needling around an area of symptoms, points selected according to relevant anatomy, and the treatment of sensitive muscular or myofascial points sometimes described as trigger points.

Traditional acupuncture may additionally select points away from the area of symptoms according to the wider pattern identified during a Chinese medicine assessment.

At Exeter Acupuncture & Osteopaths we don't regard the two approaches as mutually exclusive. Where appropriate, traditional acupuncture principles can sit alongside contemporary anatomy, physiology, research and clinical reasoning.

Treatment begins with a consultation and appropriate clinical assessment. We will discuss your symptoms, medical history and what you are hoping to achieve, as well as considering whether acupuncture is appropriate for you.

Fine, sterile, single-use acupuncture needles are then inserted at selected points. The number and location of needles varies according to the individual and the clinical reasoning behind the treatment.

Needles may be placed locally around an area of symptoms, within relevant muscles or at more distant points where there is a clinical rationale for doing so. They may be gently stimulated manually and, in some circumstances, electrical stimulation may also be used.

Treatment is adapted to the individual rather than applying exactly the same needling protocol to everyone with a particular diagnosis.

Our approach reflects experience in both traditional and medical acupuncture.

John Wyn Parry is trained in both approaches and also practises as a registered osteopath. His background in musculoskeletal medicine, anatomy, biomechanics and clinical reasoning naturally informs the way medical acupuncture can be incorporated into patient care.

This doesn't mean that every patient receives medical acupuncture, or that we consider one approach superior to another. In practice, we draw on whichever aspects of our training seem most appropriate for the person in front of us. Assessment, safety and good clinical reasoning come first, rather than trying to make every patient fit one particular model of acupuncture.

The physiological effects of acupuncture have been investigated through experimental pain research, neurophysiology and brain imaging.

Research has proposed mechanisms involving peripheral sensory input, spinal pain processing, endogenous pain-modulating systems and changes within areas and networks of the brain involved in pain perception and modulation. However, there is still no single agreed mechanism that explains all of acupuncture's effects. (1)

A systematic review examining neuroimaging studies in people with musculoskeletal pain found evidence of changes in pain-related functional connectivity within the central nervous system following acupuncture. The included studies were heterogeneous, however, and the authors highlighted the developing nature of this area of research. (2)

There is still plenty we don't understand, but research is giving us an increasingly interesting picture of how needling can influence pain processing and the nervous system.

You can also learn more about Five Element Acupuncture, traditional Chinese medicine acupuncture, Auricular Acupuncture or return to our Types of Acupuncture overview.

1. Leung L. Neurophysiological basis of acupuncture-induced analgesia – an updated review. Journal of Acupuncture and Meridian Studies. 2012;5(6):261–270.

2. Villarreal Santiago M, Tumilty S, Mącznik A, Mani R. Does acupuncture alter pain-related functional connectivity of the central nervous system? A systematic review. Journal of Acupuncture and Meridian Studies. 2016;9(4):167–177.

3. Liu S, Wang Z, Su Y, et al. A neuroanatomical basis for electroacupuncture to drive the vagal–adrenal axis. Nature. 2021;598:641–645. doi:10.1038/s41586-021-04001-4.