>Background: As an important modality of Traditional Chinese Medicine, acupuncture has been widely accepted by the Western world in the past 4 decades because of this modality's efficacy and safety. A vast amount of acupuncture research has been done. However, the mechanisms of acupuncture actions are still elusive. It is believed that the effects of acupuncture treatment begin from the moment of needle insertion.>Methods: This review focuses on the acupuncture points and the three major reactions at the acupuncture points when needling is performed. These initial reactions may be the beginning of the healing process that initiates downstream effects through neuronal and humoral pathways. In addition to the physical reactions, this article also discusses the possibility of the effects of acupuncture on the healing process through a holistic pathway.>Conclusions: Needling is the first step of traditional acupuncture therapy. Needling reactions— neuronal, biophysical, and biochemical—are the beginning of healing. The messengers of the three reactions involved may include neurotransmitters, cytokines, hormones, and inflammatory factors. Healing may be potentiated through these messengers in neuronal and humoral pathways. The reactions manifest as erythema and De Qi—both of which are common phenomena used as positive signs in acupuncture treatment. Acupuncture may also play a role in the healing process through the holistic pathway, which needs further study.
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