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Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, Krag MH. "Evidence of connective tissue involvement in acupuncture." FASEB J 2002;16: 872-4.

A 2,000 Year-Old Technique May Hold The Key To Acupuncture's Therapeutic Effect; A New Study Establishes A Link Between Needle Manipulation And Biomechanical Effects 

Bethesda, MD -- Western medical experts have been inherently skeptical of acupuncture's therapeutic value for the treatment of pain and other medical conditions. One reason is that it seems very unlikely that the simple act of inserting fine needles into tissue could elicit any effect at all, let alone wide-ranging and long-lasting therapeutic effects. Acupuncture needles are of a finer gauge than even the finest hypodermic needles (not considered therapeutic); acupuncture rarely results in a single drop of blood being discharged.

What skeptics are not aware of is that acupuncture typically involves manual needle manipulation after needle insertion. Manual needle manipulation consists of rapidly rotating (back-and-forth or one direction) and/or pistoning (up-and-down motion) of the needle. The manipulation can be brief (a few seconds), prolonged (several minutes), or intermittent depending on the clinical situation. Manipulation occurs even when electrical stimulation is used (a relatively recent development in the history of acupuncture).

Traditionally, manipulation is performed to elicit the characteristic reaction to acupuncture needling known as "de qi." De qi has a sensory component, known as “needle grasp,” which is perceived by the patient as an ache or heaviness in the area surrounding the needle and a simultaneously occurring biomechanical component that can be perceived by the acupuncturist. During needle grasp, the acupuncturist feels as if the tissue is grasping the needle such that there is increased resistance to further motion of the manipulated needle. This "tug" on the needle is classically described as "like a fish biting on a fishing line.”

Needle grasp can range from subtle to very strong, with pulling back on the needle resulting in visible tenting of the skin. During acupuncture treatments, needle manipulation is used to elicit and enhance de qi, and de qi is used as feedback to confirm that the proper amount of needle stimulation has been used. De qi is widely viewed as essential to acupuncture's therapeutic effectiveness. Needle manipulation, de qi, and needle grasp, therefore, are potentially important components of acupuncture's therapeutic effect, yet the mechanisms underlying de qi and needle grasp are unknown.

University Of Vermont Study First To Confirm Acupuncture's Effect

Previous studies on acupuncture have focused on the ancient art’s therapeutic effects, but now – for the first time – there is scientific evidence of the response of body tissue to acupuncture needling. Conducted at the University of Vermont College of Medicine, the two-year study takes a major step towards establishing credibility among Western medical practitioners for the therapy long considered “alternative.” A report on the study, titled “Biomechanical response to acupuncture needling in humans,” will be featured in the December issue of the Journal of Applied Physiology.

Much of the skepticism about acupuncture stems from the fact that the insertion of hypodermic needles is routine in Western medicine, and is not itself considered to be therapeutic. The key to acupuncture’s biomechanical effect, says lead investigator Helene Langevin, M.D., assistant professor of neurology and a licensed acupuncturist, is not the insertion of each ultra-fine acupuncture needle, but its manipulation. No previous research has looked at the effect of the manipulation of the acupuncture needle on the tissue.

During an acupuncture session, each acupuncture needle is manipulated in order to elicit the “de qi” (pronounced “day-chee”) response. De qi is traditionally believed to be essential in achieving acupuncture’s therapeutic effect. A phenomenon called “needle grasp” is a component of de qi that is often described by acupuncturists as feeling like a fish tugging on a fishing line. When de qi occurs, patients typically experience an aching sensation.

To establish a scientific basis for acupuncture’s effect, the Vermont researchers sought to measure the force required to overcome the tissue-needle connection that occurs during needle grasp. Using a unique computer-controlled acupuncture-needling device, Langevin and her colleagues found that a much greater pullout force – 167 percent – was required when the needle was rotated in one direction after insertion than when it was not rotated. When the needle was rotated back and forth, the pullout force was 53 percent greater. This clinical study – which had a total of 60 participants – was the first to measure this effect using an objective methodology.