Dry Needling

Probably one of the most common questions I get asked is: What do you think of dry needling? Or do you provide dry needling?

It’s a complicated thing to answer because I think there are two valid ways to see it.

The Legal & Scope-of-Practice Angle

As of writing, dry needling is illegal in California, Hawaii, New York, Oregon, and Washington. The essential issue is this: I don’t take a weekend course in chiropractic adjustments and call myself a “dry chiropractor” or “holistic joint manipulator” or something of the sort.

The primary argument against dry needling, as I understand it, is that the requirements for training aren’t stringent enough to ensure safe and effective treatment. Acupuncture licensure includes extensive training for years to make sure we can insert needles into people in ways that are consistently safe and beneficial.

There’s also the financial reality: it’s an encroachment on scope of practice that acupuncturists mostly deal with because they’re under-represented in a lobbying sense in most states.

But That’s Not the Whole Story

All that said, I don’t think the legal debate tells the full truth. I believe it is possible for a physical therapist or chiropractor to put in the time and effort to genuinely perform dry needling in a way that is safe and helpful.

In my clinical opinion, there is something beneficial about specifically targeting muscle tension through trigger points or neuromuscular junctions—without necessarily needing to interpret the more subtle energetic connections that traditional acupuncture focuses on.

Some acupuncturists even take dry needling classes for this reason: to supplement their traditional training with a more Western, physiology-based approach to the body, especially around trigger points and fascial connections. Traditional acupuncture is deeply enmeshed in Chinese herbal theory and an extremely detailed mapping of the energetic body. It’s rich—but it can also be overwhelming when sometimes you just want to get a spasmed muscle to relax.

Do I Do Dry Needling?

When people ask if I do dry needling, I say yes. I’m more than capable of palpating trigger points and treating them. I mainly let people know that I use a more subtle, gentle technique than most dry needlers. I say this based on both my own experience receiving dry needling and the experiences patients share with me.

Dry needling techniques can often be overly aggressive and, at times, can feel re-traumatizing rather than creating a consistently positive healing experience.

My Main Gripe: The “No Pain, No Gain” Mindset

Assuming someone doing dry needling is being safe about it, my real issue is that the intensity of the technique sometimes scares people away from acupuncture altogether. I’ve had many patients tell me they were afraid to try acupuncture because of a previous dry needling experience.

So then I have to educate: while acupuncture can come with some sensation, the intensity is much lower, and many patients feel little to nothing during an effective treatment. It is possible to resolve pain without causing pain.

Where I Land

So that’s my opinion overall. If I had to pick a side, I prefer a generous approach. I’d love to share this practice, and ideally more people would have access to safe, effective treatments to reduce pain.

I’d prefer more training and a shift in perspective—one that considers the nervous system as much as the tissue—so as to avoid treatments that feel like re-injury. But if pressed, I wouldn’t reduce access to acupuncture or to its relatively new Western spin-off: dry needling.

My experience with rotator cuff exercises

Back in 2019 did an oopsie. I was at a party and saw someone teaching the human flag pole exercise/party trick and I wanted to give it a go. I kept bending my elbow which is apparently a big no-no and I caused a strain in the front of my right shoulder.

Since then I’ve had minor pain on and off, and relative weakness in my right (dominant) shoulder compared to my left. Particularly with overhead movements my right shoulder is more stiff and gives out quicker. That is unless I do some PT exercises before I work out.

I’ve noticed that when I’m consistent in doing a proper rotator cuff warmup I don’t get pain, and my strength is more similar between my left and my right. This warm up always starts with a little mobility work, essentially stretching. And is followed by the real key for me which is stability work: slow controlled external rotation of the shoulder in different positions.

Working the small stabilizer muscles in external rotation helps to support my shoulder in its proper position, and re-educate my body to keep proper shoulder joint positioning throughout my workouts. Generally the urge will be to turn too much internally and pinch upward, causing pressure on the supraspinatus or bicep tendon. The exercises prime the stabilizers around the shoulder to properly activate and hold the shoulder in proper positioning.

The most interesting bit to me, and the reason I’m writing all of this, is just my personal experience about the good and bad news of these exercises. For me, there isn’t a point in which I’ve fully “fixed it”. While I don’t have unprovoked pain away from lifting, if I try to use my right shoulder without warming up with these exercises, the pain always comes back.

I’ve tried a few times now working out without these exercises, and the pain always comes back, even 6 years after the incident, and about a year of regular rotator cuff work.

So, bad news is, it isn’t a fix. If I stop my exercises the pain will return. But the great news is, I can manage my shoulder issues on my own with just about 5-10 minutes work before I plan to lift anything heavy with my shoulders. That works for me.

For more details about some of the stuff I do, check out my favorite PT’s article on shoulder stability: https://squatuniversity.com/2018/10/06/stabilizing-the-shoulder-blade-joint/

How does acupuncture work?

For a long time, I had trouble answering this question in my practice—not because I didn’t know, but because there are so many details and effects that it was hard to know where to start.

These days, I tend to compare acupuncture to exercise: I’ll say, “The ‘magic’ lies in how the body responds to a kind of good stress.” And then I’ll share a short sampler of some of the information below.

Everything that follows is from a Western physiological perspective—it doesn’t get into the traditional framework of moving Qi or energy through the body. When someone’s interested in that more energetic lens, I’m happy to talk about promoting flow and balance in as much or as little detail as they’d like. But for those who prefer a scientific explanation, here’s your answer:

Acupuncture’s mechanisms of action are multifaceted, involving both physiological and neurological pathways. While the full picture is still being refined, research across neurobiology, endocrinology, and immunology has identified several overlapping mechanisms that explain how acupuncture can produce analgesic, anti-inflammatory, and regulatory effects.

Here’s a clear breakdown of the major mechanisms of action:

🧠 1. Neurotransmitter and Neuromodulator Release

Acupuncture stimulates peripheral sensory nerves (especially Aδ and C fibers), leading to activation of the spinal cord and brain regions that modulate pain and emotion. This results in the release of several key neurochemicals:

Endorphins, enkephalins, dynorphins: endogenous opioids that reduce pain perception.
Serotonin and norepinephrine: involved in mood regulation and descending pain inhibition.
GABA and glutamate modulation: balancing excitatory/inhibitory signals in the nervous system.
Adenosine: increases locally, providing anti-inflammatory and analgesic effects.

🧩 Result: Reduced pain, relaxation, and modulation of mood and stress.

⚡ 2. Activation of the Gate Control Mechanism (Spinal Level)

Acupuncture can influence pain signaling at the spinal cord level:

Stimulated Aβ fibers inhibit pain transmission from C fibers (the “gate control theory”).
This dampens nociceptive (pain) signals before they reach higher brain centers.

🧩 Result: Decreased pain transmission and heightened threshold for pain perception.

🧬 3. Modulation of the Autonomic Nervous System (ANS)

Acupuncture appears to rebalance sympathetic and parasympathetic activity:

Reduces sympathetic overactivity (which is linked to stress, hypertension, and inflammation).
Enhances parasympathetic tone, promoting rest, digestion, and recovery.

🧩 Result: Lower heart rate and blood pressure, improved digestion, and stress reduction.

🔥 4. Anti-inflammatory and Immune Regulation

Acupuncture modulates immune cell activity and cytokine production:

Decreases pro-inflammatory cytokines like IL-1β, IL-6, TNF-α.
Increases anti-inflammatory mediators like IL-10.
Stimulates the hypothalamic-pituitary-adrenal (HPA) axis, influencing cortisol release and immune modulation.

🧩 Result: Reduced inflammation, improved healing, and immune balance.

🩸 5. Improved Local Circulation and Tissue Healing

Needle insertion causes a mild microtrauma that:

Increases local blood flow and oxygenation.
Enhances removal of metabolic waste products.
Promotes release of growth factors and nitric oxide.

🧩 Result: Faster tissue repair, muscle relaxation, and pain relief.

🧘 6. Central Nervous System Integration

Functional MRI studies show acupuncture activates or deactivates specific brain regions:

Activated: hypothalamus, periaqueductal gray, anterior cingulate cortex.
Deactivated: limbic structures involved in fear and pain perception (like the amygdala).

🧩 Result: Central modulation of pain, emotion, and homeostatic regulation.

🪶 7. Placebo and Expectation Effects

Although not the whole story, expectation and context play a measurable role:

Belief and relaxation during acupuncture can engage prefrontal and limbic systems.
These in turn activate real biochemical and autonomic responses.

🧩 Result: Enhanced therapeutic outcome through psychobiological synergy.

🧩 Summary Table

Mechanism	Primary Pathway	Key Effects
Neurochemical release	CNS + spinal	Analgesia, relaxation
Gate control theory	Spinal	Inhibits pain transmission
Autonomic modulation	ANS	Reduces stress, balances organs
Immune regulation	Cytokines, HPA axis	Anti-inflammatory
Local effects	Microcirculation	Tissue repair, pain relief
CNS network effects	Brain regions	Pain and emotional regulation
Placebo/expectancy	Psychobiological	Amplified healing response

Where to Start in Healing: Naturopathic Therapeutic Order

Today’s blog post is a little deep dive into my thought process as influenced by my Naturopathic Doctorate. While there’s a place and a purpose for every part of the pyramid, ideally in non-emergency conditions, the foundational aspects of health are addressed first and indefinitely.

While there’s different wording in my infographic vs chart below, essentially that baseline level is ideally removing whatever obstacle is interfering with the body naturally healing itself. This could be stress, insomnia, or continuing to do intense yard work when your forearms are very adamantly and persistently telling you to take a break (not to call you out Mom).

For many people, there’s things we keep repeatedly being exposed to that keep the dis-ease, pain, suffering, tension, etc. coming back. We might be ignoring our body’s signals to move differently, perhaps ignoring our hearts’ signals to change how we’re working/living, letting our emotions overly affect our diet, and whatever else we’re more attached to than feeling good in our bodymind. This is the best place to focus our efforts for lasting healing.

Certainly more targeted interventions can be necessary, and helpful for starting down a new path, but if the foundational needs for safety and rest aren’t being addressed, problems will keep cropping up no matter how many times we use targeted interventions to keep them at bay.

Feel free to read a bit more below regarding the tiers of intervention and a few notes about how doctors might use this information in practice.

Level	Focus / Goal	Typical Interventions or Strategies
1. Remove Obstacles to Health (Remove Obstacles to Cure)	Identify and eliminate factors that impair the body’s ability to heal	Diet & lifestyle changes, reducing toxic exposures, improving sleep, stress reduction, removing emotional/psychological barriers, correcting digestion, eliminating unhelpful habits 2
2. Stimulate the Healing Process (Vis Medicatrix Naturae)	Support and prime the body’s innate self-healing forces	Gentle therapies: hydrotherapy, nutrition, mild botanical remedies, exposure to nature, energetic modalities, light exercise 3
3. Strengthen Weakened Systems	Build resilience and capacity in physiological systems	Nutritional support, adaptogens, detoxification, supporting liver, immune system, hormonal regulation, antioxidants, lifestyle & restoration measures 4
4. Correct Structural Integrity	Restore proper alignment, mechanical function, and circulation	Physical medicine: chiropractic, osteopathy, massage, postural correction, ergonomics, movement therapies 5
5. Use Natural, Targeted Therapies	When necessary, apply more specific natural agents to address pathology	Herbal medicine, specific nutraceuticals, botanicals, other therapies selected for a given condition 6
6. Use Pharmacologic or Synthetic Agents	In cases where gentler methods are insufficient, use stronger tools	Pharmaceuticals, medications, more potent interventions (where within scope/licensing) 7
7. Use Invasive / Surgical / Life-Saving Interventions	The most forceful or invasive options, when essential	Surgery, radiation, hospitalization, advanced medical interventions, when no less invasive option suffices 8

Notes & caveats

The order is not rigid. A patient’s condition may require “jumping” to a higher level sooner (for instance, in emergencies) or combining levels concurrently. 9
The principle behind this is to use the least force necessary to achieve healing, minimizing potential harm or side effects. AANMC 10
The first step—removing obstacles—is foundational: without clearing the blockages (diet, toxins, stress, structural impediments, etc.), further therapies may be less effective. 11
In practice, a naturopath may blend different steps: e.g. they might remove obstacles, stimulate healing, and support weakened systems in parallel, then escalate if needed.

The Perception of Safety: Polyvagal Theory, Trauma, and Healing

Polyvagal Theory

Polyvagal Theory is a framework developed by Dr. Stephen Porges that explains how our autonomic nervous system (ANS) responds to stress, safety, and social connection. It builds on the traditional “fight-or-flight” understanding of the nervous system, but adds a more nuanced view of how our bodies regulate states of arousal and safety.

Core Idea

The ANS isn’t just binary (on/off, stressed/relaxed). Instead, it has three main pathways, each linked to the vagus nerve (hence poly–many, vagal–vagus nerve):

1. Ventral Vagal System (Social Engagement State):

Activated when we feel safe.
Supports calm, connected, socially engaged behavior.
Regulates facial expressions, vocal tone, listening, and emotional attunement.
This is the “rest and connect” mode.

2. Sympathetic Nervous System (Mobilization / Fight-or-Flight):

Activated when we sense danger or threat.
Increases heart rate, adrenaline, and readiness for action.
Useful for escaping or defending against threats.
This is the “action under stress” mode.

3. Dorsal Vagal System (Shutdown / Immobilization):

Activated under extreme threat or when escape isn’t possible.
Can lead to collapse, freeze, dissociation, numbness, or withdrawal.
This is the “shutdown” or “conservation” mode.

The Hierarchy

The nervous system typically tries ventral vagal first (social connection and safety).
If safety cues fail, it shifts into sympathetic fight-or-flight.
If that doesn’t resolve the threat, it can default into dorsal vagal shutdown.

This hierarchy helps explain why people under stress might become hyper-reactive, avoidant, or even “numb out.”

Neuroception

Porges introduced the concept of neuroception — our nervous system’s unconscious scanning for cues of safety, danger, or life-threat. It happens below awareness, shaping our state before we even consciously interpret the situation.

Applications

Trauma Therapy: Helps explain why trauma survivors may freeze, dissociate, or struggle with connection.
Clinical Practices: Therapists use polyvagal-informed techniques (breathwork, safe touch, prosody in voice, co-regulation) to help clients move back toward ventral vagal states.
Everyday Life: It helps us understand patterns like why stress makes us withdraw, why social connection soothes us, and why safety is essential for healing.

The Effects of Trauma

Trauma can condition the nervous system to prioritize survival responses over connection, changing which vagal pathway gets activated and how easily someone can return to ventral vagal safety. Here’s how it often shows up:

A. Ventral Vagal (Safety & Social Engagement)

Without Trauma: People can fluidly return here after stress. They feel safe enough to connect, self-soothe, and co-regulate with others.
With Trauma: The ventral vagal “baseline” often weakens. Safety cues may not register as safe—eye contact, gentle touch, or even quiet moments might feel threatening. People may mistrust closeness or stay guarded, making it harder to feel grounded in calm connection.

B. Sympathetic (Mobilization: Fight or Flight)

Without Trauma: Stress triggers short bursts of fight-or-flight, then the body resets once the danger passes.
With Trauma: The system can become hypersensitive. Everyday challenges feel like threats, leading to chronic anxiety, hypervigilance, irritability, or restlessness. The nervous system “jumps” into sympathetic activation and may struggle to downshift.

C. Dorsal Vagal (Shutdown, Freeze, Dissociation)

Without Trauma: This only kicks in under overwhelming threat (like fainting, collapsing, or “playing dead” in nature).
With Trauma: The dorsal pathway can become more easily activated. People may dissociate, feel numb, “check out,” or struggle with energy and motivation—even in situations that aren’t life-threatening. This is especially common with chronic trauma or when fight/flight felt impossible or unsafe.

Trauma’s Lasting Imprint

Rigidity of Response: Trauma makes the nervous system less flexible—people can get “stuck” in sympathetic arousal or dorsal shutdown rather than cycling smoothly back to ventral vagal calm.
Distorted Neuroception: The unconscious scanning system becomes biased toward perceiving threat. Even neutral or safe situations can feel unsafe.
Fragmented Regulation: Someone might swing between hyperarousal (sympathetic) and hypoarousal (dorsal) without ever settling into ventral vagal connection.

Healing Implications

Restoring access to the ventral vagal state is central to trauma recovery.
Practices like safe social connection, attuned therapy, breathwork, grounding, gentle movement, and co-regulation with trusted others help re-train the nervous system to recognize safety and reestablish flexibility across all states.
On a daily level, even small routines—a consistent safe space, regular grounding practices, and reliable rhythms—can serve as anchors that remind the body it can return to safety.

Healing is a gradual process that asks for patience, repetition, and courage—but with consistent care, our nervous system can learn to trust safety again and the world itself can begin to feel less threatening, more genuinely safe.

Qi Gong and the Egg Timer: How to Keep Healing Between Treatments

“As long as you are awake, you can be mindful.
All it takes is wanting to and remembering
to bring your attention into the present moment.”
— Jon Kabat-Zinn

So you’re getting regular bodywork… but the aches keep coming back?

The problem isn’t you. The problem is the economy. More specifically: hours hunched over a desk, eyes locked on a screen, posture slowly folding in on itself.

Even with good treatments, your body is up against a daily tide of stress, static positions and repetitive movement. Both our body and our mind calcify into the same painful patterns unless we consistently make intentional efforts to shift them.

Enter: the hourly reset

I often suggest patients set a simple alarm every hour. When it goes off, it’s your cue to:

Best: Get up, walk around, shake it out.
Good: Take 1–3 deep, conscious breaths before diving back in.
At least: Notice your body. Are your shoulders creeping up toward your ears? How’s your neck doing?

Qi Gong shaking (a favorite)

Qi Gong has a simple, joyful reset:

Rise up on your toes.
Drop down and let your whole body shake.
Add sound if you want—hum, sigh, or let out whatever noise you want!

It’s about moving energy, loosening tension, and resetting your nervous system.

Alternatively, just put on a song and dance it out.

Why it matters

Your body and nervous system both need regular resets, especially if you’re doing stressful or intense work. These micro-pauses are huge for shifting the pattern of stress solidifying into recalcitrant habits of tension. Without body mindfulness and consistent movement, even the best therapeutic treatment is just a temporary fix.

Conclusion

If you’re investing in regular treatments but not feeling lasting progress, don’t give up. Try adding micro-resets: mindful movement, a shake, or even just one intentional breath each hour.

Because mindfulness is magic and movement is medicine.

Rethinking Back Pain: The Role of Fascia

Today I want to talk about something I’ve seen as a primary source of pain in countless patients—yet it’s rarely mentioned in medical school or by most doctors. While I’m still exploring the best ways to keep fascia healthy over the long term—through stabilizing exercises, muscle balancing, and movement practices—I’ve consistently found that massage, cupping, and acupuncture can bring meaningful relief.

For now, let’s start with the basics: what fascia is, and more specifically, the type I most often hear patients describe as the exact spot of their pain—the thoracolumbar fascia.

What Is Fascia?

Fascia is a type of connective tissue in your body—it’s kind of like a full-body spiderweb made of collagen that surrounds and supports everything: muscles, bones, nerves, blood vessels, and organs. It’s not just passive packing material—it’s dynamic, sensitive, and deeply involved in how your body moves and feels.

🧠 Key Facts

Structure: Tough but flexible, fascia is made mostly of collagen fibers arranged in a multidirectional web.
Function: It holds things in place, transmits force, reduces friction, and allows structures to slide smoothly over each other.
Layers:
- Superficial fascia: just beneath the skin, often containing fat.
- Deep fascia: wraps around muscles and bones.
- Visceral fascia: encases internal organs.

Fascia can get tight, stuck, or inflamed, contributing to pain and mobility restrictions—even far from the original source. It’s richly innervated, meaning it plays a major role in proprioception and pain perception. Manual therapies (like massage, myofascial release, or acupuncture) often aim to restore its glide and elasticity.

🧱 Thoracolumbar Fascia (TLF)

The thoracolumbar fascia (TLF) is a major fascial structure in your lower back—like a thick, multilayered tension bridge connecting your upper and lower body. It’s central to stability, movement, and force transmission, especially through your core and spine.

📍 Location

The TLF spans from the thoracic spine to the sacrum, stretching laterally to the ribs and hips, and includes three layers:

Posterior layer: Just under the skin and superficial muscles like the latissimus dorsi.
Middle layer: Between the deep back muscles (e.g., multifidus) and quadratus lumborum.
Anterior layer: Deepest, lying in front of quadratus lumborum and connecting to the psoas.

🏋️‍♂️ Function and Importance

Core Stability:
Acts like a natural weightlifting belt by anchoring key muscles:
- Latissimus dorsi
- Gluteus maximus
- Transversus abdominis
- Internal obliques
  These muscles create tension through the fascia to stabilize the spine.
Force Transmission:
Transfers power between upper and lower body—especially important in walking, running, lifting, and rotation.
Back Pain:
Adhesions or tension in the TLF can reduce mobility and contribute to chronic or mechanical low back pain.
Sensory Function:
Fascia is packed with sensory nerves. Dysfunction here doesn’t just feel tight—it can generate real pain and disrupt body awareness.

🔧 Clinical Implications

Manual therapies (massage, cupping, acupuncture) can reduce tension and improve glide between fascial layers.
Engaging muscles like the transversus abdominis through exercises (planks, dead bugs, etc.) strengthens the fascial tensioning system.
Dysfunction in the glutes, lats, or obliques can create asymmetrical pulls, affecting spinal mechanics via the TLF.

🧩 Summary

The thoracolumbar fascia acts as a central tension system for the torso, tying together posture, movement, stability, and sensation. If something’s off in your core, hips, or back, chances are the TLF is part of the story.

PTSD, Healing & Happy Tears

Crying at the Happy Ending

“Crying at the Happy Ending” is an article by psychoanalyst Joseph Weiss (1952), popularized in Michael Bader’s 2014 article on Psychology Today. Its a powerful piece that explores why, even in the context of watching a movie, we often wait until a resolution to let ourselves feel—and cry.

The core idea is:

During the tension or crisis, our nervous system is in survival mode—fight, flight, freeze—so we suppress emotions to stay focused and safe.
Once the conflict resolves, we subconsciously perceive safety, and emotions we’ve been holding back—sadness, relief—can finally surface. That release often comes as tears at the happy ending.

Studies and later commentary support this “safety-signal” theory. A neuroscientific review explains that safety signals—learned cues predicting the absence of threat—actively inhibit fear and stress responses in humans and animals. In conditions like PTSD, this safety learning is often impaired, making it difficult to shift out of fear mode (Hamm & Jentsch, 2012).

This idea of emotional release being tied to a sense of safety? It’s not just emotional—it’s physiological. Let’s talk nervous system…

The Body Keeps the Score

As Bessel van der Kolk wrote in The Body Keeps the Score, trauma and chronic stress don’t just live in the mind. They live in the body.

Muscles clench. Breathing gets shallow. The gut stops working smoothly.
We might “move on” intellectually, but the body hasn’t gotten the memo.
Why? Because safety isn’t an idea. It’s a felt experience.

And until the body believes it’s safe, it won’t let go—of tension, pain, or emotion.

This Is the Core of My Work

In my opinion, my #1 priority in the clinic is to create space for my patients to experience a parasympathetic, relaxed sense of safety.

I will often tell my patients, “I take all snoring and drooling as compliments”. And many patients do fall asleep during massage, acupuncture, or cupping treatments.

Sometimes my patients feel more comfortable talking about their lives rather than hitting snooze, and I think that can be helpful as well. The combination of nervous system ease, physical comfort, and open conversation creates a potent cocktail for healing—one that includes both mind and body.

When things get complicated, I return to what I believe is most essential in healing—and in both my personal and professional experience, safety is key.

More Than Relaxation: How Massage Supports Whole-Body Health

Most people know massage feels good. What fewer realize—especially here in the U.S.—is how much real, measurable benefit it can have on your health. In places like Norway or much of Western Europe, massage is often seen as a regular part of staying well, not just an occasional treat. But in America, it’s still mostly viewed as a luxury or indulgence. The reality? Massage can help with chronic pain, poor sleep, anxiety, and even immune function. If you’ve ever walked away from a session feeling clearer, calmer, or more at home in your body, that wasn’t just in your head. There’s solid research behind those effects—and for a lot of people, massage is more than relaxation. It’s part of how they stay healthy.

1. Reduces Stress and Lowers Cortisol
Massage therapy has been shown to significantly reduce cortisol levels and increase serotonin and dopamine.

[Field, 2005 – Int J Neurosci]
[Rapaport et al., 2010 – J Altern Complement Med]

2. Alleviates Muscle Tension and Improves Range of Motion
Regular massage decreases muscle stiffness and improves joint flexibility, supporting athletic recovery and injury prevention.

[Weerapong et al., 2005 – Sports Med]

3. Improves Sleep Quality
Massage has been shown to improve both the depth and duration of sleep, including an increase in delta wave activity—the kind linked to deep, restorative rest.

[Richards et al., 2000 – J Clin Rheumatol]
[Field et al., 1998 – Early Hum Dev]

4. Reduces Pain—Both Acute and Chronic
Massage can reduce chronic low back pain, neck pain, fibromyalgia symptoms, and postoperative pain.

[Furlan et al., 2008 – Cochrane Review]
[Moyer et al., 2004 – Pain Med]

5. Supports Mental Health: Anxiety & Depression
Massage therapy can reduce symptoms of anxiety and depression, likely via nervous system regulation and oxytocin release.

[Moyer et al., 2004 – Psychol Bull]
[Field et al., 1996 – Int J Neurosci]

6. Boosts Immune Function
Massage may enhance immune markers like natural killer cells and lymphocyte count—particularly helpful in people under stress.

[Field et al., 2005 – J Altern Complement Med]

Final Thoughts
Whether you’re in pain, managing stress, or simply trying to stay well, massage therapy can be a valuable part of your routine. For anyone looking to prioritize feeling better, massage is a surprisingly prudent choice as a regular therapy.

From Needle to Nervous System: How Acupuncture Reduces Pain

I really enjoyed working on this post—it’s been a while since I sat down and revisited all the specific ways acupuncture helps the body heal. One of my first thoughts was:
“Oh! Look at all these great things I do at work each day. Nice!”

In the clinic, I usually keep things broad when explaining how acupuncture works. That’s partly to keep it relatable for my patients, but if I’m honest, sometimes I also forget the specifics—I’m focused on the work itself, not the mechanisms underneath.

Before we get into what the research says, I want to share a metaphor I often use to explain how acupuncture helps reduce pain.

🏋️‍♂️ Acupuncture as Exercise

Strength training is a hobby of mine, and so I’ve learned that when you do a bicep curl, you’re not immediately growing your biceps brachii muscle. You’re causing micro-tears, triggering a release of endorphins, and setting off a healing cascade: increased circulation, immune activation, growth hormone, tissue repair. Most of that “magic” happens later—especially during sleep—when the body adapts to the stress you just gave it.

Acupuncture works similarly. When a needle enters the tissue, it’s a gentle, targeted disruption—a stimulus that the body responds to with a series of healing actions. As you’ll see below, that response includes everything from increased blood flow to reduced inflammation to the release of your own natural painkillers.

So what we’re doing is twofold:

Immediate relief – Downregulating pain signaling in the nervous system.
Long-term healing – Supporting circulation, reducing inflammation, and easing tension so real progress can happen over time.

Acupuncture can support many different conditions, but for today—and for the primary focus of my clinic—we’re talking pain.

📊 Summary: How Acupuncture Helps Reduce Pain

Effect	Mechanism	What Research Shows
⬆️ Local blood flow	Vasodilation via neuropeptides (like CGRP, Substance P) and nitric oxide	Increased circulation at needled sites; enhanced healing response
🌿 Muscle/fascia release	Mechanical stimulation of connective tissue and myofascial modulation	Needles create local tissue stretch and relaxation, reducing muscle tone and tightness
😊 Pain relief	Release of endogenous opioids (endorphins, enkephalins, etc.)	Natural painkillers released; pain pathways inhibited in brain and spinal cord
🔥 Inflammation reduction	Suppression of pro-inflammatory cytokines; immune system modulation	Lower levels of IL-6, TNF-α, and other inflammatory markers after acupuncture
🧠 Nervous system shift	Activation of parasympathetic system; modulation of brain pain perception	Changes in limbic system and somatosensory cortex; improved nerve conduction (e.g., CTS)

🧠 Digging Into the Research

1. Nerve Stimulation & Circulation

Inserting a needle activates local sensory nerves, triggering neuropeptide release (e.g., Substance P, CGRP), which leads to vasodilation and increased blood flow around the point.
At the Zusanli point (ST36), stimulation increases cerebral blood flow via nitric‑oxide–mediated vasodilation and reduces inflammatory markers like IL‑6.

2. Muscle Relaxation & Connective Tissue Response

Research indicates that needle insertion mechanically deforms tissues—including fascia—which may relax tight muscle fibers and reset tension via connective‑tissue modulation.

3. Endorphin & Opioid Peptide Release

Acupuncture—especially electro-acupuncture—stimulates the release of endogenous opioids like enkephalins, β‑endorphin, endomorphin, and dynorphin. Different stimulation frequencies affect which peptides are released. These peptides block pain signals in both the central and peripheral nervous systems, similar to morphine, but naturally produced by your body.

4. Anti-Inflammatory Effects

Acupuncture exerts strong anti-inflammatory effects by reducing cytokine release, suppressing inflammatory cell activity, and recruiting neutrophils that help resolve local inflammation.
In stroke patients, it has even been shown to improve neurological recovery by dampening inflammatory processes.

5. Modulation of Pain Signal Processing

There’s evidence that acupuncture inhibits hyperactive pain pathways: reducing activity in pain-related ion channels, suppressing glial cell activation, and stimulating descending inhibitory systems that release serotonin, norepinephrine, and opioid peptides.
In carpal tunnel syndrome, real acupuncture (especially electro-acu) improved nerve conduction and triggered cortical brain remodeling—while sham acupuncture yielded only temporary symptom relief.

🧾 Conclusion

The World Health Organization (WHO) has recognized acupuncture as a potentially effective treatment for over 100 conditions—ranging from migraines and digestive issues to anxiety, allergies, and infertility. Each of those conditions involves its own unique physiological patterns, and in each case acupuncture works through a wide range of mechanisms to support the body’s return to balance.

For today though, addressing some of the ways in which acupuncture helps with pain seems like plenty—both by calming the nervous system and by supporting long-term healing where the body needs it most.