Acupuncture biomechanics: From mechanical stimulation to biological effects

This article presents a revolutionary proposal for the field of acupuncture: the establishment of acupuncture biomechanics as a new interdisciplinary scientific discipline. The authors argue that, despite thousands of years of proven clinical efficacy of acupuncture, scientific understanding of its mechanisms remains incomplete, primarily due to the lack of adequate characterization of the initial mechanical stimuli generated during the procedure. Traditional research in acupuncture has focused on downstream biological effects — such as changes in neurotransmitters, immune responses, and activation of neural pathways — without systematically quantifying the mechanical stimuli that initiate the entire cascade of effects. This methodological gap has limited the ability to establish precise dose-effect relationships and standardize treatment protocols.

The acupuncture biomechanics proposed by the authors focuses on the quantitative characterization of how the physical parameters of manipulation — needle depth, direction, frequency, amplitude, and retention time — generate specific stress and deformation fields in living tissues. The theoretical framework integrates three fundamental components: the generation and transmission of mechanical signals in vivo, the mechanisms of mechanobiological transduction at the cellular and molecular level, and the principles of systemic functional integration. From a methodological standpoint, the proposal includes advanced characterization techniques, such as instrumented needles with sensors, three-dimensional motion capture, and computational modeling to deconstruct and parameterize traditional manipulations such as lifting-thrusting and twisting. The authors highlight important findings that support this approach, including the identification of mechanosensitive ion channels (TRPV1, ASIC3, Piezo2) as key molecular receptors that sense the mechanical forces of acupuncture.

Studies with elastographic ultrasound revealed that the fascial network serves as an effective conductor for the transmission of mechanical signals, while molecular biology research has shown that calcium influx and ATP release function as bridges connecting the activation of non-neural cells to neural signal transmission. Clinical validation of this approach would involve multicenter studies with standardized collection of mechanical parameters, integration of neuroimaging and multi-omics analyses, and the development of clinical decision support systems based on quantified mechanical parameters. The authors propose that this approach can resolve persistent problems in acupuncture research, such as inconsistency of results across studies, difficulty replicating protocols, and the lack of a common scientific language to describe acupuncture interventions. The establishment of acupuncture biomechanics as a discipline would offer an innovative mechanical perspective on the mechanisms underlying acupuncture effects, catalyzing theoretical advances that modernize practice and pave the way for transformative theoretical frameworks in medicine.