Therapeutic acupuncture involves the insertion and manipulation of fine needles at specific points. Although acupuncture has been proven effective for a number of conditions, the mechanisms that underlay these effects remain unknown. A critical first step is to identify the local changes that occur during needle manipulation, which can then be related to longer-term and more remote consequences. In vivo and ex vivo studies have demonstrated that loose collagenous subcutaneous connective tissue couples to needles during therapeutic manipulation, which deforms the tissue and exposes resident cells to altered mechanics and triggers morphologic and phenotypic changes. The resultant alignment of the tissue and cells may additionally help to propagate signals along acupuncture meridians.

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