How Does Acupuncture Work?

Acupuncture works by stimulating the body’s nervous system and influencing a range of processes involved in pain, inflammation, stress and healing.

Modern research suggests that acupuncture does not act through a single mechanism. Instead, it appears to influence multiple interconnected systems, including the nervous, immune, vascular and endocrine systems.

How acupuncture can help with pain

1. Natural pain relief

Acupuncture can stimulate the release of the body’s own pain-relieving chemicals, including endorphins, enkephalins and other endogenous opioids. These substances can help reduce the perception of pain and support the body’s natural pain-regulating systems.

2. Calming inflammation

Acupuncture has been shown to influence inflammatory pathways involved in pain and tissue sensitivity. Research suggests it may affect inflammatory mediators, neuropeptides and immune-cell activity, potentially helping to reduce processes associated with pain, heat, redness and swelling.

3. Releasing muscle tension and spasm

Muscle spasm and protective muscle tension can contribute to acute and persistent pain. Acupuncture may help reduce excessive muscle activity and relax tight or spasming muscles, which can improve comfort and movement.

4. Supporting the nervous system

Pain is influenced not only by tissues in the body but also by how the brain and nervous system process pain signals.

Acupuncture may help regulate pain processing within the central and peripheral nervous systems. Research suggests that it can influence neurotransmitters, pain-related brain networks and the body’s systems for regulating pain.

Acupuncture and the stress response

Pain and stress often reinforce each other. When the body is under stress, the sympathetic nervous system — commonly described as the “fight or flight” response — can remain activated.  Acupuncture can promote the parasympathetic nervous system or the “rest and digest” response supporting relaxation and creating a calmer state.

By addressing both pain and the stress response, acupuncture may help interrupt the cycle of pain, tension and stress.

A whole-body approach to pain

Current research increasingly describes acupuncture as a multi-target treatment rather than one that works through a single pathway.

Acupuncture may influence:

• Neurotransmitters involved in pain regulation
• The nervous system, including central pain-processing pathways
• Inflammatory and neuroimmune processes
• Blood vessel regulation
• The endocrine system and stress response
• Muscle activity and tension
• The body’s natural pain-relieving chemicals

These systems are interconnected. Changes in one system can influence the others, which may help explain why acupuncture can have effects on pain as well as associated symptoms such as stress and muscle tension.

Other ways acupuncture may support the body

Research is also investigating acupuncture’s effects on a range of other physiological processes, including:

• Gastrointestinal motility and function
• The stress-response system, including the HPA axis
• Neuroplasticity and brain function
• Brain-derived neurotrophic factor (BDNF)
• Circadian rhythm regulation
• Vascular function
• The gut-brain connection

These areas are still being studied, and the strength of evidence varies between conditions and mechanisms.

What does this mean for you?

Rather than simply masking symptoms, acupuncture aims to influence the body’s own systems involved in pain regulation, inflammation, muscle tension and nervous-system function.

Your treatment is tailored to your individual presentation, with the aim of addressing the factors that may be contributing to your symptoms and supporting your body’s capacity to regulate and recover.

The research

MacPherson H, Vertosick EA, Foster NE, et al. The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. 2017;158(5):784–793.

Xiang H, Zhu C, Yang G, et al. From single-target mechanisms to multi-target network regulation: Mechanisms of acupuncture in migraine. World Journal of Acupuncture – Moxibustion. 2026. DOI: 10.1016/j.wjam.2026.06.003.