How does acupuncture work?

People often ask me, How does acupuncture work? The answer is that we do not really know. We do know however that it has an effect on 50-60% of people. I use acupuncture to relax a muscle group, improve blood flow and relieve pain in fascia. Fascia is the internal membrane that covers and links everything together in your body.
To help us understand we use models that place events into our our own framework of understanding.
With my linear Western mind that links cause and effect, I cannot understand the complex Chinese philosophy of medicine. There are no points of reference for me. I try to explain to patients in terms that they understand. For instance, imagine a group of computers on a network. One of the computer screens tells you that it cannot establish a connection to the network or to the internet. In most cases there is a physical reason. You go through all of the physical connections, take them out, push them in and it works again. You might have loaded new software so you uninstall and re-install it. But what if there is no physical reason? You want to know whether the computer can 'speak' to the router. So you try to 'ping the router' by sending a packet of information. Once the router recognises that computer's IP address it can start sending information back again until it has 'learned' what that computer needs. Once you have made a connection with the router (or hub), it is an easier matter to find the server on the internet or the other computers, or a printer.
Let's take the model into the body. The computers are the muscles or local fascia. The router is a part of the brainstem called the thalamus. The Server is the cortex or higher thinking brain. Muscles work in patterns of behaviour called engrams. They never work individually. However if a muscle or the nerve endings are damaged it does not behave in the same way as other muscles. An acupuncture needle acts as an irritant or stimulus to 'ping' the router. The thalamus passes on this information via the same pathways that pain stimuli run up the spinal chord. The brain responds by re-establishing connection with the local area. Chemicals called endorphins flood there and blood flow increases. The muscles start to switch on and off and the fascia relaxes. This could be called unlocking energy, increase of qi or any other term to show a change. MRi studies on acupuncture have shown that needles stimulate a part of the brain called the limbic system.
I never tell people what to expect during acupuncture. Some people say that they feel a dull ache like toothache in the muscle, a heaviness. Some people say that they feel a bubbly sensation as if air were being pumped in. Some say that it floods through the area to another more distant part of the body. Some people feel a deep sharp, electrical sensation. The needle might be too close to a nerve so I withdraw it a little. A person might feel sweaty and a little faint. That is a sympathetic nervous response.
Sometimes acupuncture acts as a trigger to stimulate the immune system or has a systemic effects. Systems in the body start to work again. Even the symptoms of hay fever can respond well.
Personally I find that combining acupuncture with subtle adjustments to the alignment of the body, massage, stretching and nutrition or selected supplements works far better than acupuncture alone.
You could use other models like a member of an orchestra playing a different tune to everyone else. You are only limited by your own imagination.