Acupuncture works by inserting very fine needles at specific points on the body, which stimulates sensory nerves under the skin and triggers a measurable response: the nervous system dampens certain pain signals and releases the body's own pain-relieving chemicals. In short, three things happen in sequence: the needle is inserted, sensory nerves are stimulated, and the nervous system responds by releasing endorphins and partially closing the body's own pain gate. Traditional Chinese Medicine describes the same points and pathways in terms of meridians and the flow of qi, using its own diagnostic logic to decide which points to combine. Either lens helps explain what happens on the table, even though they are not simply two labels for one idea.
What actually happens when the needle goes in
The needles used in acupuncture are solid, hair-thin, and nothing like the hollow needles used for injections or blood draws. When one is inserted at a point, usually to a shallow depth of a few millimetres to a couple of centimetres depending on the area, it stimulates sensory nerve fibres in the skin and underlying muscle. Those nerves carry a signal up the spinal cord to the brain.
From there, a few things happen almost immediately. Local blood flow to the area tends to increase. The muscle around the needle may twitch slightly or release tension, something practitioners sometimes feel as a subtle grab on the needle itself. And the nervous system starts the process described below, which is where most of acupuncture's pain-relief effect comes from.
The pain gate: how the nervous system turns pain signals down
Pain is not a straightforward, wire-to-brain signal. Signals from an injury or chronic pain source travel up the spinal cord alongside other kinds of sensory input, and the spinal cord can prioritize which signals get through to the brain and which get dampened. This is often called gate control: certain kinds of input, including the pressure and sensation from an acupuncture needle, can partially close that gate, reducing how much pain signal reaches conscious awareness.
At the same time, needle stimulation prompts the release of the body's own opioid-like chemicals, including endorphins, in the spinal cord and brain. These bind to the same receptors that painkillers target, which is part of why acupuncture is used to support pain management for certain conditions. This is a modulation effect, turning the volume of pain signalling down, not a numbing effect and not a cure for whatever is causing the pain in the first place.
The TCM view: meridians, qi, and why the language is different
Traditional Chinese Medicine describes acupuncture points as sitting along meridians, pathways through which qi, often translated loosely as vital energy or functional activity, is understood to flow. When qi is blocked or imbalanced along a meridian, that framework holds, function in the related area suffers, whether that shows up as pain, tension, or another symptom. Needling a point along that meridian is described as clearing the blockage and restoring flow.
Traditional Chinese Medicine uses its own diagnostic framework to guide acupuncture treatment. Point selection may be based on meridian theory and an individualized assessment of patterns involving qi, blood, yin, yang, and organ-system relationships. Modern biomedical research investigates acupuncture through a different lens, including sensory nerve stimulation, pain modulation, local tissue responses, and neurochemical signalling. These frameworks developed from different medical traditions and should not be treated as direct equivalents. A practitioner trained in both traditions is often reasoning in TCM terms about point selection while the physiological effect plays out through the nervous system pathways described above. Neither framework needs to be rejected for the other to be useful.
In practice, this diagnostic step is not just theory. A practitioner assessing you through a TCM lens typically checks your pulse at several positions on the wrist and looks at the colour, coating, and shape of your tongue, both used as diagnostic markers for patterns such as heat, cold, or stagnation. This is part of why an initial visit usually takes longer than a follow-up: the practitioner is gathering the information needed to choose a specific combination of points, rather than applying the same protocol to every patient with a similar complaint.
What a session actually feels like
Most people expect acupuncture to hurt more than it does. Because the needles are so fine, insertion is usually described as a quick pinch or nothing at all, followed by a dull ache, heaviness, warmth, or a mild tingling around the point once it is in place. These sensations are sometimes described as de qi in Traditional Chinese Medicine and may occur during acupuncture treatment. They are generally not a cause for concern, although the experience varies from person to person.
Once the needles are in, most people lie still for fifteen to thirty minutes while they take effect, and this part is where the nervous system response described above tends to become noticeable. Many people feel their breathing slow and their muscles soften, and it is common to feel drowsy or to doze off during this part of a treatment. Some people feel a change in the area being treated right away. Others notice more of a cumulative effect that becomes clearer across a short course of visits, which a practitioner will track with you rather than assume.
Because the needles are solid and no medication is injected, most people can resume normal activities immediately afterward. Mild, short-lived bruising at a needle site is possible, particularly in areas with more surface blood vessels, and typically resolves within a few days on its own.
Where the evidence is strongest, and where it is not
The research base for acupuncture is uneven, and it is worth being direct about that rather than treating every use the same way. The evidence is strongest for certain kinds of chronic pain, such as low back pain, neck pain, and osteoarthritis of the knee, and for migraine prevention, where a reasonable number of good-quality trials point toward a real, if moderate, effect beyond what would be expected from attention and expectation alone. For many other uses, including stress support, sleep, and general wellbeing, the research is thinner and more mixed, even though people commonly report benefit.
None of that means acupuncture only works for pain, and it does not mean the traditional framework is wrong where the trial evidence has not caught up. It means acupuncture is best approached as a genuinely useful tool for specific things, evaluated honestly, rather than a cure-all. A registered practitioner should be willing to say plainly when something is not the right fit rather than continuing treatment on hope alone.
At Herbs Meta, acupuncture treatment in Richmond Hill is provided by registered practitioners who explain both frameworks as part of an initial assessment, so you understand why a particular set of points is being used before treatment starts. For patients using extended health benefits, direct billing for acupuncture is available where a plan allows it, which is worth confirming before your first visit.
Frequently asked questions
What actually happens during acupuncture?
A practitioner inserts several hair-thin, sterile needles at specific points, usually left in place for fifteen to thirty minutes. This stimulates sensory nerves, which triggers pain-modulating and relaxation responses in the nervous system, while the point selection itself is generally guided by the traditional meridian framework.
Is acupuncture painful?
For most people, no. Insertion is typically described as a quick pinch or barely noticeable, sometimes followed by a dull ache, heaviness, or mild tingling around the point once it is in. Sensation varies by person and by area treated, and pressure or depth can be adjusted if something feels too intense.
Is there evidence that acupuncture actually works?
Yes, though it is stronger for some uses than others. The evidence is most consistent for certain types of pain and for migraine prevention. For other uses it is more mixed, which is why a registered practitioner should be transparent about what acupuncture may and may not help with rather than presenting it as a cure for everything.
Acupuncture at Herbs Meta is provided by practitioners registered with the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO).
Acupuncture and Traditional Chinese Medicine are complementary therapies and do not replace medical advice, diagnosis, or treatment from your physician.
