Acupuncture, a therapy within traditional Chinese medicine, is one of the most widely accepted components of integrative therapies in the western world. Specific points on the body are stimulated, usually by inserting thin needles into the skin and underlying tissues. Stimulating these specific points is believed to affect the flow of qi (a universal life force) along energy pathways (meridians) and thus restore balance.
The procedure is generally not painful but may cause a tingling sensation. Sometimes stimulation is increased by twisting, warming, or otherwise manipulating the needle.
Acupuncture points may also be stimulated by
Pressure (called acupressure)
Lasers (also called low-level laser therapy)
A very low voltage electrical current (called electroacupuncture) applied to the needle
(See also Overview of Integrative, Complementary, and Alternative Medicine.)
Evidence and Uses for Acupuncture
Acupuncture research is inherently difficult to conduct. Blinding is challenging and so-called "sham" acupuncture often puts pressure on acupressure points, thereby creating a different treatment experience that may not be truly inert. In regions where acupuncture is more part of the culture, particularly in China, published acupuncture studies are more abundant and broader in scope. Results showing efficacy should be interpreted in light of the fact that interventions include the full schema of traditional Chinese medicine of which acupuncture is only a component.
The World Health Organization (WHO) has helped with this clinical challenge by issuing a list of conditions for which they have deemed evidence of efficacy to be strong or available but for which additional study is recommended, including
Symptoms of cancer therapy
Depression
Dysmenorrhea
Pain
Headache
Hypertension
Post-operative symptoms
Some complications of pregnancy
Stroke complications
The WHO also provides a reference document with guidance for practicing acupuncture in a safe and effective manner (see WHO benchmarks for the practice of acupuncture).
Possible Adverse Effects and Contraindications
Adverse effects of acupuncture are difficult to quantify and, although treatments are generally safe, skill and care vary among practitioners. A 2023 systematic review of adverse effects after acupuncture included the following (1):
Systemic reactions (eg. headache, dizziness, sleepiness, nausea)
Syncope
Tissue injury
Infection
Although some of these adverse effects are serious, most were mild or clinically insignificant.
Reference
1. Xu M, Yang C, Nian T, et al: Adverse effects associated with acupuncture therapies: An evidence mapping from 535 systematic reviews. Chin Med 18(1):38, 2023. Published 2023 Apr 10. doi:10.1186/s13020-023-00743-7
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, 2002—WHO's list of symptoms, diseases, and conditions that have been shown through controlled trials to be treated effectively by acupuncture, made available by the British Acupuncture Council
WHO benchmarks for the practice of acupuncture, 2021—WHO's guidance for the administration of acupuncture treatment
WHO traditional medicine strategy: 2014-2023, 2013—WHO's guidance for developing proactive policies and implementing action plans that will strengthen the role traditional medicine plays in keeping populations healthy
