Acupuncture is increasingly understood to work through a combination of mechanotransduction involving the extracellular matrix (and connective tissue) and neuromodification of peripheral nerve endings. Understanding the cellular physiology that constitutes mechanotransduction is important to the acupuncture practitioner, as it develops the language of understanding how the practice integrates with a living organism. The cellular building blocks of mechanotransduction are being explored. With a mechanical input to any cell, a diverse variety of reactions involving: nuclear reception of the input, changes in metabolism and genetic expression may occur. These reactions can vary widely between different cell types, as there are many components to the reception of these signals. This new understanding illuminates multiple unexplained aspects of the peripheral actions of acupuncture and invites us to inquire about not just the fibroblasts and connective tissues, but really every cell type present in the vicinity of an acupuncture needle.