At Monarka, two ways of viewing the body coexist—seemingly belonging to different centuries: longevity medicine, grounded in data and biomarkers, and Chinese medicine, a body of knowledge built over millennia through observation, testing, and refinement.
Javier Valle’s proposal is not about choosing between the two traditions, but rather making them work together—and backing that work with what can actually be measured today. The result is an acupuncture approach in Barcelona that combines tradition with ultrasound imaging, and the needle with evidence.
Six years, not a weekend course.
Before discussing needles, it is worth talking about professional background. Javier Valle holds a degree in Chinese medicine from the University of Wales (2009)—a six-year program—and highlights a detail that is virtually unknown in Spain: there are only four graduating classes of Chinese medicine degree holders in the entire country.
Having studied for six years is not the same as taking a one- or two-month course.
That difference is, quite simply, what distinguishes a comprehensive background from a mere introduction. The program combines core subjects rooted in the tradition—such as point location, Chinese philosophy, and integrated treatments—with those any Western medical student would recognize: anatomy, pathology, histology, and biology. It is structured around the four major specialties of Chinese medicine: acupuncture and its derivatives, Chinese pharmacopeia, Chinese dietary therapy, and *tuina* (manual therapy). Added to these is something Javier considers fundamental: physical exercise, in the form of Tai Chi and Qigong.
His specialty: acupuncture for pain
From that entire universe, Javier chose to specialize in acupuncture—and, more specifically, in pain treatment. It was precisely because of those years dedicated to treating pain that he ended up incorporating a tool that does not appear in any ancient treatise: the ultrasound scanner.
“My approach is to combine traditional acupuncture with a more Westernized form,” he explains. That second perspective—more anatomical, more instrument-based—is what introduces technology into a practice that dates back thousands of years. It is not a matter of replacing one with the other. Traditional acupuncture provides the map: the meridians, the balance, and the logic of *chi* as energy flowing through the body. The Westernized version provides the detail: the precise structure beneath the skin—the tendon, the muscle—and the exact point the needle must reach.
The ultrasound scanner: seeing before inserting the needle
The ultrasound scanner allows for real-time visualization of what lies beneath the needle—a tendon, muscle, nerve, or vessel—before and during the puncture.
For Javier, that image serves two purposes. The first relates to precision and safety: he can guide the needle exactly to the area he wishes to treat while avoiding structures that must be spared. This is no minor detail—real-time ultrasound guidance increases the accuracy of the needle insertion and reduces the risk of striking delicate structures such as the pleura, nerves, or blood vessels, a factor of particular importance in sensitive areas. The second function is more subtle and connects to the very heart of traditional acupuncture: it helps him reliably locate the sensation of *chi* at the moment of insertion—the specific response an acupuncturist seeks when reaching the correct point.
At its core, it is a modern way of pursuing an age-old goal. What was once guided solely by touch and centuries of accumulated experience can now be confirmed through imagery.
What happens under the skin
For a long time, the major objection to acupuncture was that it was not understood why it worked. Today, that objection is weaker, because research has begun to describe some of its effects in physiological terms.
Locally, the act of puncturing is not inert: the tissue releases adenosine, a molecule with analgesic properties that acts on specific receptors—the A1 receptors—to alleviate pain at the puncture site itself. In experimental models, blocking this receptor abolishes the effect, while activating it with a drug reproduces it.1
At the central level, the needle activates the systems the body itself uses to modulate pain: the descending control pathways—such as the periaqueductal gray and raphe nuclei—and the release of endogenous opioids, namely the endorphins and enkephalins we produce naturally. This is why acupuncture-induced analgesia has a neurochemical basis, rather than a merely psychological one.3
At its core, it is the same target described in two languages. Where tradition speaks of *chi* and meridians, neuroscience describes adenosine, endogenous opioids, and pain-modulation circuits. Two maps of the same territory.
The current that powers the needle
The ultrasound scanner is not the only modern tool built upon an ancient foundation. Electroacupuncture—stimulating points with a low-level current—is, as Javier himself acknowledges, an addition that “is not Chinese”: as he explains, it arrived in Europe via Germany in the 1960s, after it was observed that stimulating the points with an electric current enhanced their effect.
And there is a fairly precise explanation for that observation today. The frequency of the current is not a mere detail: the work of physiologist Ji-Sheng Han demonstrated that low-frequency stimulation (around 2 Hz) primarily mobilizes enkephalins and β-endorphin, whereas high-frequency stimulation (around 100 Hz) releases dynorphin; alternating between the two tends to produce the greatest analgesic effect.3 In other words, adjusting the current is, in practice, a matter of choosing which of the body’s own painkillers are activated.
It is another example of the same principle that runs through his entire practice: an ancient technique that continues to accommodate new layers without losing its essence.
Pain, point by point
The clearest example of how everything fits together is pain treatment. When faced with an injury—say, to a tendon—Javier first performs a local treatment, using an ultrasound scanner to visualize the structure and target the affected area precisely. But the work doesn’t end there.
“Then I always do a combination of stitches around the edge.”
Those peripheral points are not chosen at random; they follow the meridians that run through the region. The approach is twofold: on one hand, to treat the problem at its source; on the other, to improve the flow of *chi*—the energy that, in the traditional framework, travels along those channels—throughout the affected area, rather than just at the painful spot. The local and the global, anatomy and meridian, working together in the same session.
What really matters
If there is one thing the patient needs to understand, it is this: acupuncture does not hurt. No matter how many needles are used, the experience bears no resemblance to the pain people imagine.
But before the first needling session, there is something even more important: sitting down to talk. “It’s not just a matter of lying down for twenty minutes and getting needled right away,” he explains. It involves explaining what the treatment entails, how deep the needle will go, what the patient will feel, and what sensation to look for. And, if there is a fear of needles, taking whatever time is needed to address it. Only then comes the technical part—and it is performed, he says, “with the utmost care, so as not to cause pain.”
As for the results, pain relief is usually immediate: the analgesic effect is felt during the session itself. However, the real effect—the one that truly counts—tends to set in a couple of days later.
A tradition with backing
It is best to be honest about the territory we are dealing with. The concepts of *chi* and meridians belong to the explanatory framework of Chinese medicine; Western physiology translates them into a different language. But, beyond the mechanism, does it work?
The most robust analysis to date—conducted by the Acupuncture Trialists’ Collaboration, which pooled individual patient data from nearly 18,000 participants across some thirty high-quality trials—concluded that acupuncture is superior to both no treatment and sham acupuncture for chronic back and neck pain, osteoarthritis, and headache, with an effect that persists over time and cannot be explained solely by the placebo effect.2 The difference compared to sham needling is modest but consistent.
This support has extended to clinical guidelines: bodies such as the UK’s NICE recommend acupuncture for chronic primary pain and as an option for the prophylaxis of migraine and tension-type headache.4 It is not, therefore, a practice outside the realm of evidence-based medicine, but rather one that has increasingly earned its place within it.
The Monarka hallmark. This way of working encapsulates the clinic’s philosophy: not pitting the old against the new, but integrating them. Six years of formal training, four millennia of patient observation of the body, and technology that enables precision, measurement, and verification. The needle and the ultrasound scanner in the same hand—reflecting the same logic we apply to our longevity approach: measure before treating, and treat based on evidence-backed methods.
Javier Valle
Head of Acupuncture · Monarka Clinic
Holds a degree in Chinese medicine from the University of Wales (2009). Specializing in acupuncture for pain, he combines traditional methods with ultrasound guidance and electroacupuncture.
Selected references
- Goldman N, Chen M, Fujita T, et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nature Neuroscience, 2010. PubMed
- Vickers AJ, Cronin AM, Maschino AC, et al. (Acupuncture Trialists’ Collaboration). Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine, 2012. PubMed
- Han JS. Acupuncture and endorphins. Neuroscience Letters, 2004. PubMed
- NICE. Chronic pain (primary and secondary) in over 16s: assessment and management (NG193), 2021. NICE.org.uk
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