Acupuncture

Overview

Acupuncture is an ancient traditional Chinese medicine technique involving the insertion of sterile needles into specific body points to treat various conditions, most notably chronic pain. While its biological mechanisms are not fully understood, it is recognized as a safe, regulated complementary therapy when performed by licensed practitioners.

What is Acupuncture?

Acupuncture has been in use in some form for at least 2,500 years. It originated from traditional Chinese medicine but has gained popularity worldwide since the 1970s. In the United States, the use of acupuncture by U.S. adults more than doubled between 2002 and 2022. It is most commonly used for pain, such as back, joint, or neck pain.

Most acupuncture methods use disposable, stainless-steel needles that are slightly thicker than a human hair. The needles are inserted into the skin at acupoints. The needles may be twirled, moved up and down at different speeds and depths, heated, or charged with a weak electric current. Needles are typically left in place for 15 to 30 minutes after insertion.

Acupuncture has several related variations:

• Acupressure: Applying pressure to acupuncture points using fingers or devices rather than penetration with needles
• Acupuncture point injection: Injecting drugs, vitamins, herbal extracts, or other fluids into the body at an acupuncture point using a needle
• Auricular (or ear) acupuncture: Inserting thin needles at specific points on the outer ear
• Battlefield acupuncture: An inexpensive form of auricular acupuncture used by the U.S. Department of Defense and Department of Veterans Affairs
• Battlefield auricular acupressure: A type of acupressure where ear beads or magnets are placed on the ear to reduce pain.
• Cupping: Using cups to create a vacuum on the skin surface to stimulate acupuncture points
• Electroacupuncture: Sending a weak electrical current through acupuncture needles into acupuncture points in the skin
• Laser acupuncture: Using low-level laser beams instead of needles
• Microwave acupuncture: Using a microwave device attached to an acupuncture needle to give microwave radiation at an acupuncture point
• Moxibustion: Using a type of heat therapy in which an herb is burned on or above the skin to warm and stimulate an acupuncture point or affected area
• Trigger point acupuncture: Inserting needles into trigger points, which are places on the body where injury has occurred
• Zhen jiu: The traditional Chinese term for acupuncture and moxibustion

Related Terms

• Stylostixis
• Needle therapy/treatment
• Needle insertion therapy/treatment

How is Acupuncture Used?

Acupuncture may be helpful for several pain conditions. These include:

• Back and neck pain
• Knee pain associated with osteoarthritis
• Migraines and tension headaches
• Myofascial pain syndrome when applied to trigger points
• Sciatica
• Postoperative pain
• Fibromyalgia

Acupuncture has also been studied for at least 50 other health problems. It may help with:

• Cancer-related symptoms: Acupuncture can help treat nausea and vomiting caused by chemotherapy. Acupuncture treatment may also help reduce joint pain from aromatase inhibitors in people with breast cancer.
• Allergic rhinitis (seasonal allergies)
• Asthma symptoms and quality of life (not lung function)
• Depression symptoms and severity
• Menopausal vasomotor symptoms, such as hot flashes and night sweats

Acupuncture has been studied for many other conditions as well, but the evidence is limited or mixed. These include irritable bowel syndrome, smoking cessation, and infertility.

How Does Acupuncture Work?

How acupuncture works is not fully understood. However, there is evidence that it may have effects on the nervous system, effects on other body tissues, and nonspecific (placebo) effects.

Acupuncture is closely associated with Chinese meridian theory. According to this theory, a vital energy known as qi flows through a particular course along the body and helps regulate various bodily functions. Along the meridians are approximately 360 points that can serve as sites for acupuncture treatments.

What to Expect During Acupuncture

People may have a needling feeling during acupuncture, known as the de qi sensation, making them feel heaviness, numbness, or tingling.

Minor adverse effects that have been reported include:

• Pain at needling sites
• Hematoma (bruising)
• Tiredness
• Lightheadedness
• Drowsiness
• Localized skin irritation

These minor adverse effects can be minimized by appropriate patient management, including local pressing and massage at the needling site after treatment.

Clinical Practice Guidelines

Major medical organizations have included acupuncture in their clinical practice guidelines:

• A 2017 guideline from the American College of Physicians included acupuncture among the nondrug options recommended as first-line treatment for chronic low-back pain, and as an option for acute low-back pain.
• A 2019 guideline from the American College of Rheumatology and the Arthritis Foundation conditionally recommends acupuncture for osteoarthritis of the knee, hip, or hand.

Potential Complications From Acupuncture

Relatively few complications from using acupuncture have been reported. However, complications have resulted from use of nonsterile needles and improper delivery of treatments. When not delivered properly, acupuncture can cause serious problems, including infections, punctured organs, and injury to the central nervous system. The U.S. Food and Drug Administration (FDA) regulates acupuncture needles as medical devices and requires that they be sterile and labeled for single use only.

• Do not use acupuncture to postpone seeing a healthcare provider about a health problem.
• If you're considering acupuncture, do not use it to replace or delay seeking conventional care.
• Tell all your healthcare providers about any complementary or integrative health approaches you use to help ensure coordinated and safe care.
• If you have a health condition, talk with your healthcare provider before using complementary approaches.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on acupuncture.

Find Treatment

Most states license acupuncturists, but the requirements for licensing vary from state to state. The National Certification Commission for Acupuncture and Oriental Medicine certifies practitioners of acupuncture and traditional Chinese medicine (TCM), and most states require this certification.

If you are considering a practitioner-provided complementary health practice such as acupuncture, ask a trusted source, such as your healthcare provider or nearby hospital, to recommend a practitioner, and find out about the training and experience of any practitioner you are considering. Learn more about talking with your doctor about complementary health approaches.

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.  

NIH funds research to evaluate acupuncture's effectiveness for various kinds of pain and other conditions. It also funds studies to further understand how the body responds to acupuncture. Research on acupuncture in cancer care has also been active.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.