Acupuncture for Pain Relief: Local Needling vs. Distal Needling

When treating acute or chronic pain with acupuncture, the practitioner can choose between local treatment or distal treatment. As mentioned in my previous post, local treatment, or local needling, involves placing needles directly in the area of the body where the pain is, while distal treatment, or distal needling, involves placing needles only in parts of the body that are far away from the pain. Both methods have been proven to be effective.

How does this work?


The explanation for why local treatment works is quite simple. Every time you insert a needle into the body, it causes an inflammatory, immune-like response. The body reacts to having a foreign object (ie an acupuncture needle) inserted into its tissues, essentially saying, “What is this foreign thing that has penetrated our defenses?!?” The area around the needle is quickly perfuse with blood, as blood vessels dilate, opening up pathways for all varieties of leukocytes (lymphocytes (T-cells, B-cells and NK cells), neutrophils, and monocytes/macrophages) to arrive at the scene, in effort to neutralize the invader. The body quickly recognizes that it’s not a bacterial or viral infection, but now, at least, we’ve got its attention. We pointed to an underlying issue that is causing pain, which often involves damage or injury to a muscle, bone or nerve tissue. At this point, the body has recognized the damaged cells and all the surrounding blood vessels are open, offering a clear path for transportation of nutrients and wastes. Now the osteoclasts, osteoblasts, fibroblasts and other cells that are responsible for breaking down damaged tissue and rebuilding healthy cells, can effectively do their job.


Simply put, we are creating healthy blood flow to the area of pain/injury, so the miraculous, innate healing potential of the body can work its magic. Better blood flow, equals better healing.


How does distal needling work? Our intention is the same, to bring more healthy blood to the affected area to maximize the body’s healing potential. How do we achieve this without even touching the area where the pain is? This answer is a little more abstract. With distal needling, we are stimulating the nociceptors, the part of the nerve ending that creates pain signals, for the purpose of detecting damaged cells or potentially damaging stimuli. We are creating a sharp pain signal, that travels up the spinal cord to the mid-brain, which interprets the pain signal as, “Something is damaged! We need to fix it.”


The first response is to flood the brain and blood stream with enkephalins and endorphins, our body’s naturally created pain-killers and feel-good hormones. Within a few minutes, pain anywhere in the body may be dramatically reduced, if not completely negated. Then, a similar physiological response happens as with local treatment, the blood vessels dilate, offering healthy blood supply to the affected area. This time the treatment has a more systemic effect, optimizing blood flow throughout the entire body, not limited to the area where the needles were placed. Again…Better blood flow, equals better healing.


Of course, this is a slightly oversimplified explanation of distal needling. Based on the above explanation, you could theoretically needle anywhere on the body and achieve the same results, as long as you create a strong enough pain stimulus. Unfortunately, this is not the case. Unfortunately, it is not that easy. There are specific points, specific meridians and meridian relationships that are most effective for relieving pain in each area of the body. At this point, the only viable explanation for this relies on the principles of Chinese medicine and classical meridian theory. Perhaps a discussion for another time…

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