Acupuncture and the Body’s Natural Healing and Recovery Mechanisms

People often ask how acupuncture works. Acupuncture is an active therapeutic intervention: fine needles stimulate specific sites on the body and send signals through sensory nerves.

Acupuncture has therapeutic effects. Its effects can involve the body's own neural, immune, endogenous pain-control, autonomic regulatory, recovery, and repair-related mechanisms. Modern research has identified several important mechanisms involved in these effects, and research continues to advance.

Neuroimmune regulation: the vagal–adrenal pathway

Modern research has identified interactions between acupuncture stimulation and neural–immune regulatory pathways. A 2021 Nature animal study used electroacupuncture as a controlled experimental stimulus and identified a PROKR2+ sensory-neuron pathway linking stimulation at a specific body region with the vagal–adrenal axis and systemic inflammatory regulation. The study provided important neuroanatomical evidence for how somatosensory stimulation can interact with autonomic and immune regulation.

Inflammation and immune regulation

Inflammation is part of healing. Well-regulated immune signaling supports recovery; poorly regulated inflammation can prolong pain and tissue stress. The preclinical Nature findings, together with related somatosensory-autonomic research, show that acupuncture stimulation can influence inflammatory signaling and immune responses through nervous-system pathways. In other words, acupuncture can modulate immune activity as one of its therapeutic mechanisms.

Neuroplasticity and neurological recovery

Neuroplasticity is the nervous system’s ability to reorganize connections. Human mechanistic evidence from neuroimaging shows that acupuncture can change activity and connectivity in pain-related brain networks, including regions involved in descending pain control.

Preclinical mechanistic evidence from experimental ischemic-stroke models and related reviews describes changes in BDNF (brain-derived neurotrophic factor) and its receptor TrkB, synaptic remodeling, glial (microglia and astrocyte) regulation, and brain-network reorganization. These findings help explain recovery-related neural processes that acupuncture stimulation can engage.

Endogenous pain-control mechanisms

Classic studies showed that blocking opioid receptors can reduce acupuncture analgesia in people, supporting a role for the endogenous opioid system in acupuncture pain relief. Later experimental research also found that different stimulation parameters can involve different endogenous opioid peptides and pain-modulating pathways.

Tissue repair: experimental evidence

Preclinical mechanistic evidence. In animal wound models, acupuncture needling has been associated with faster wound closure, angiogenesis (new blood-vessel growth), collagen deposition, reduced pro-inflammatory cytokines, and a shift of macrophages toward a more repair-associated (M2) profile. These findings describe immune-circulatory processes involved in tissue repair that acupuncture stimulation can influence.

Human clinical evidence

A World Health Organization (WHO) review of acupuncture clinical trials covered more than 100 diseases, symptoms and clinical conditions, spanning pain, neurological, digestive, respiratory, gynaecological and other clinical areas. WHO classified the conditions according to the clinical evidence available at the time. In that report, some conditions were classified as having been shown through controlled trials to be effectively treated with acupuncture, while many others showed varying levels of therapeutic effect. Clinical research on acupuncture has continued to develop since then.

The studies on chronic pain, sciatica, low back pain and migraine discussed below are selected, more recent representative examples of human clinical research. They are not a complete list of acupuncture’s clinical research or treatment scope.

Human clinical evidence. An individual-patient-data meta-analysis by Vickers and the Acupuncture Trialists’ Collaboration, published in Archives of Internal Medicine (now JAMA Internal Medicine), analyzed 29 randomized trials (17,922 patients) of acupuncture for back and neck pain, osteoarthritis, chronic headache, and shoulder pain. Acupuncture was superior to both sham acupuncture and no-acupuncture controls.

In 2024, Tu and colleagues reported in JAMA Internal Medicine a multicenter randomized trial of 216 patients with chronic sciatica from a herniated disk: acupuncture reduced leg pain and improved function more than sham acupuncture at week 4, and the benefit persisted through 52 weeks. In 2025, DeBar and colleagues reported in JAMA Network Open a U.S. multicenter trial of 800 older adults with chronic low back pain: standard acupuncture and acupuncture plus maintenance sessions both improved back-related disability more than usual medical care at 6 months, with the advantage still present at 12 months.

For migraine without aura, a multicenter randomized trial by Zhao and colleagues in JAMA Internal Medicine (2017) found that true acupuncture produced a greater long-term reduction in migraine-attack frequency than sham acupuncture or a waiting list. A Cochrane review of acupuncture for prevention of episodic migraine concluded that adding acupuncture to usual care can reduce headache frequency.

These studies provide human clinical evidence of acupuncture’s therapeutic effects. They also sit at a different level of scientific evidence from the neural, endogenous pain-control, autonomic, and neuroimmune mechanism research discussed above.

What this means in clinic

At Apollo Wellness in Vancouver, acupuncture is offered as individualized, practitioner-guided care. The research above supports acupuncture as a therapeutic intervention whose effects include endogenous regulation of pain, neural signaling, autonomic function, immune responses, circulation, and recovery-related processes. Gentle technique and high-quality Japanese-made needles are part of our treatment standards.

If you are considering acupuncture for chronic musculoskeletal pain or related concerns, you can read more on our acupuncture services page and our fibromyalgia and chronic pain page, or book a visit.

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Selected references

1. 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
2. Pomeranz B, Chiu D. Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sciences. 1976;19(11):1757-1762.
3. Mayer DJ, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Research. 1977;121(2):368-372.
4. Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends in Neurosciences. 2003;26(1):17-22.
5. Miao C, et al. Effect of acupuncture on BDNF signaling pathways in several nervous system diseases. Frontiers in Neurology. 2023;14:1248348. doi:10.3389/fneur.2023.1248348
6. Qin S, Zhang Z, Zhao Y, et al. The impact of acupuncture on neuroplasticity after ischemic stroke: a literature review and perspectives. Frontiers in Cellular Neuroscience. 2022;16:817732.
7. Park SI, et al. Therapeutic effects of acupuncture through enhancement of functional angiogenesis and granulogenesis in rat wound healing. Evidence-Based Complementary and Alternative Medicine. 2012;2012:464586.
8. World Health Organization. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. Geneva: World Health Organization; 2002.
9. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine. 2012;172(19):1444-1453. doi:10.1001/archinternmed.2012.3654
10. Zhao L, Chen J, Li Y, et al. The long-term effect of acupuncture for migraine prophylaxis: a randomized clinical trial. JAMA Internal Medicine. 2017;177(4):508-515. doi:10.1001/jamainternmed.2016.9378
11. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews. 2016;(6):CD001218.
12. Tu JF, Shi GX, Yan S, et al. Acupuncture vs sham acupuncture for chronic sciatica from herniated disk: a randomized clinical trial. JAMA Internal Medicine. 2024;184(12):1417-1424. doi:10.1001/jamainternmed.2024.5463
13. DeBar LL, Wellman RD, Justice M, et al. Acupuncture for chronic low back pain in older adults: a randomized clinical trial. JAMA Network Open. 2025;8(9):e2531348. doi:10.1001/jamanetworkopen.2025.31348