Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture

TLDR

Acupuncture’s therapeutic effect is largely unexplained, but the de qi response—characterized by patient sensations and needle grasp felt by the practitioner—may be central to its mechanism. The study proposes that needle grasp results from mechanical coupling between the needle and connective tissue, and that needle manipulation transmits mechanical signals to connective tissue cells through mechanotransduction. Mechanical coupling and tissue winding around the needle during rotation are hypothesized to transmit signals to cells, forming the basis of the proposed mechanism. This mechanism could explain acupuncture’s local, remote, and long‑term therapeutic effects.

Abstract

The mechanism of action of acupuncture remains largely unknown. The reaction to acupuncture needling known as 'de qi', widely viewed as essential to the therapeutic effect of acupuncture, may be a key to understanding its mechanism of action. De qi includes a characteristic needling sensation, perceived by the patient, and 'needle grasp' perceived by the acupuncturist. During needle grasp, the acupuncturist feels pulling and increased resistance to further movement of the inserted needle. We hypothesize that 1) needle grasp is due to mechanical coupling between the needle and connective tissue with winding of tissue around the needle during needle rotation and 2) needle manipulation transmits a mechanical signal to connective tissue cells via mechanotransduction. Such a mechanism may explain local and remote, as well as long-term effects of acupuncture.