Traditional Chinese Medicine (TCM) acupuncture is one of the main traditional approaches to acupuncture practised in the UK. It uses the principles of Chinese medicine to understand an individual's symptoms alongside their general health and wider patterns of wellbeing.

A traditional acupuncture consultation therefore tends to look beyond the main reason someone has come for treatment. We may ask about sleep, digestion, energy, temperature, stress and emotional wellbeing, as well as taking a detailed history of the presenting problem. Examination of the pulse and tongue may also form part of this traditional assessment.

Treatment is then individualised. Rather than simply using the same group of acupuncture points for everyone with a particular symptom, point selection can be influenced by both the presenting problem and the broader pattern identified during the consultation.

At Exeter Acupuncture & Osteopaths, traditional acupuncture forms an important part of our clinical approach. We also draw on contemporary anatomy, physiology, research and clinical reasoning where appropriate. For us, traditional and modern perspectives don't have to be mutually exclusive.

One of the things I find particularly interesting about Chinese medicine is the way it tries to make sense of patterns across the whole person.

Modern physiology gives us increasingly sophisticated ways of observing how the body responds and adapts. Heart rate variability (HRV), for example, can provide a window into aspects of autonomic regulation and the body's response to changing demands.

I sometimes think about traditional Chinese medicine in a similar conceptual way. Pulse and tongue findings, sleep, digestion, temperature, energy, emotional state and the nature of someone's symptoms were brought together historically to form a picture of how that individual was functioning at that particular time.

These traditional observations are not direct measurements of autonomic function, and traditional Chinese medicine and modern physiology are different frameworks developed in very different ways. However, I find it interesting to consider where some of the patterns described within traditional Chinese medicine may overlap with contemporary ideas around autonomic regulation, stress physiology and adaptation.

For me, this provides a useful bridge between traditional theory and contemporary physiology, while recognising that they are not the same thing.

There is scientific interest in whether acupuncture itself can influence autonomic regulation.

Heart rate variability has been used in a number of studies to investigate this. A 2023 systematic review and meta-analysis of randomised trials reported changes in some HRV measures consistent with increased parasympathetic activity following acupuncture compared with sham acupuncture. However, the authors also highlighted heterogeneity and limitations in the underlying studies, so the findings should be interpreted cautiously. (1)

This isn't entirely settled science. An earlier systematic review found variable results and concluded that there was no clear evidence at that time for a specific effect of acupuncture on HRV. (2)

For me, that's an interesting area of ongoing research rather than proof of traditional Chinese medicine theory. It offers one possible avenue through which some physiological effects of acupuncture can be investigated using modern methods.

In practice, we don't expect patients to choose between a "traditional" and a "modern" view of acupuncture.

Your consultation starts with you: why you've come, your medical history, your symptoms and what you're hoping to achieve.

Where appropriate, traditional Chinese medicine assessment can provide an additional framework through which we consider the presentation. Modern clinical reasoning, anatomy, physiology, safety and the available evidence remain equally important.

The result is an individual approach to acupuncture rather than treatment determined solely by a diagnostic label.

You can also learn more about Five Element Acupuncture, Medical Acupuncture, Auricular Acupuncture and Electroacupuncture, or return to our Types of Acupuncture overview.

Hamvas S, Hegyi P, Kiss S, et al. Acupuncture increases parasympathetic tone, modulating HRV – Systematic review and meta-analysis. Complementary Therapies in Medicine. 2023;72:102905.

Lee S, Lee MS, Choi J-Y, et al. Acupuncture and heart rate variability: a systematic review. Autonomic Neuroscience. 2010;155(1–2):5–13.