The Neuroanatomy of Acupuncture
A neuroanatomical approach to acupuncture offers a powerful, science-backed method for pain relief by targeting nerves and fascia through precise needling techniques, integrating modern knowledge with traditional wisdom. In this discussion, we’ll explore the work of Dr. Poney Chiang.
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Dr. Poney Chiang is a leader in combining traditional acupuncture with modern neuroscience. As an expert in neuroanatomy and acupuncture, he emphasizes that acupuncture interacts directly with the fascia surrounding nerves to produce specific responses. His approach is grounded in understanding anatomy and nerve pathways, ensuring precise and effective treatments.
Let's discuss some key concepts in Dr. Chiang's work:

Acupuncture as Neuroanatomy
At the core of Poney Chiang’s approach is the idea that acupuncture directly interacts with the nervous system. Many acupuncture points align with peripheral nerve branches. This explains how acupuncture influences both pain relief and internal conditions by affecting how the nervous system processes signals. The body responds with a unique sensation known as deqi, which varies based on the nerve affected.
Neuromodulation and Descending Pain Modulation
Neuromodulation involves techniques that directly affect how nerves process pain signals, either amplifying or reducing their intensity. In acupuncture, needling plays a crucial role in this process by influencing the nervous system to "turn down the volume" on pain. One key mechanism is descending pain modulation, in which the brain sends signals down the spinal cord to determine which pain signals to suppress and which to address.
​Neuroanatomical Approaches Informed by Nerve Blocks
Dr. Chiang’s neuroanatomical acupuncture techniques are informed by his dissection work and research into nerve block methods, targeting fascia near nerves to effectively influence them. His approach underscores the importance of precise anatomical knowledge for optimizing therapeutic outcomes.
 (FN = Femoral Nerve) Image from: Tips for a femoral nerve block
How Acupuncture Talks to the Fascia Around Nerves
A key element of Dr. Chiang’s work is how acupuncture interacts with the fascia—the connective tissue surrounding nerves. When needles are inserted, they create a mechanical stimulus affecting both the fascia and the nerves it encases, helping to release tension, reduce pain, and promote healing.
Overlay of Acupuncture Points and the Suprascapular Nerve.
Nerves & fascia in the lumbar region, corresponding to the huatuojiaji and inner bladder points of traditional acupuncture
(medial & lateral branches of the dorsal rami of lumbar spinal nerves respectively).
A SMART Approach
Dr. Chiang's SMART approach in acupuncture stands for Sensory, Motor, Autonomic, Radiculopathy, and Trigger points, offering a structured framework for selecting acupuncture points based on their neuroanatomical significance. ​For instance, when treating shoulder pain, Dr. Chiang's SMART approach might involve targeting a motor point to improve muscle function, a trigger point to release muscle tension, and a point at the spine to stimulate the relevant spinal nerve (radiculopathy). It could also include a distal sensory branch to modulate pain perception, and an autonomic point to regulate nervous system responses, creating a comprehensive treatment plan based on the neuroanatomical significance of each point.
Key Resource & Research: ​
Other Neuroanatomical Acupuncture Resources:
Compiled by Joe Liguori