Acupuncture Benefits and Risks

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Acupuncture benefits may include pain management, stress relief, and physical and emotional well-being. A traditional Chinese medicine practice, acupuncture is based on the idea that a blockage or disturbance in the flow of the body's life energy, or qi, can cause health issues. Research into the benefits of acupuncture is mixed.

Acupuncturists insert thin needles into specific points throughout the body. This is believed to help balance the body’s energy, causing a reduction or resolution of symptoms.

Acupuncturist inserting a needle into a client's back.

Science Photo Library - ADAM GAULT / Getty Images

This article explains how acupuncture works, its benefits, and the potential side effects. It will also cover what conditions acupuncture may be used for.

What Is Acupuncture?

Acupuncture is a traditional Chinese medicine healthcare practice. It is believed to have originated at least 3,000 years ago. The first known description of an acupuncture procedure dates to 100 B.C.E.

Practitioners use thin, metallic needles to pierce the skin in specific locations on the body. The needles are activated with the practitioner's hands or with electrical stimulation.

There are approximately 2,000 acupuncture points that are connected to specific meridians, which are energy pathways that flow through the body.

Researchers don't fully understand how acupuncture might work, but some theories include:

  • Acupuncture may stimulate the release of endorphins, the body's natural pain-relieving chemicals.
  • Acupuncture may influence the autonomic nervous system, and needle placement may impact breathing, blood pressure, and heart rate.

What is auricular acupuncture?

Auricular acupuncture is a type of acupuncture that is applied to specific areas of the ear. It is often used to control chronic pain.

Acupuncture Benefits

The research into the effectiveness has been mixed, with some studies showing effectiveness and others showing that acupuncture is no better than "sham" or placebo treatments. Many of the existing studies have been small or poorly designed.

Research into the various conditions that are treatable with acupuncture has been ongoing for decades, with some uses more well-studied than others. Some research supports acupuncture to treat symptoms associated with the autonomic nervous system, including many different types of pain, mental health conditions, gastrointestinal problems, and sleep disorders.

Acupuncture may be useful for a variety of conditions, including:

  • Anxiety
  • Arthritis, which describes conditions that involve joint inflammation
  • Long-term pain
  • Depression
  • Insomnia, a condition that involves sleep-related difficulties
  • Migraines, which are intense headaches that often include other symptoms
  • Nausea
  • Sinus congestion, or nasal stuffiness
  • Stress
  • Infertility, which describes difficulty getting pregnant
  • Addiction
  • Skin appearance

The health benefits of acupuncture can vary depending on the individual. Keep in mind that it may take several acupuncture sessions before you notice any benefits.

Pain

Acupuncture is often combined with other therapies to treat various kinds of pain. Sometimes acupuncture is used as the only treatment for pain.

Acupuncture may help provide pain relief for people with chronic lower back pain. Studies have found that combining acupuncture with conventional therapies may be more effective at reducing lower back pain than conventional therapies alone.

Some studies have found that acupuncture may even be more effective for controlling lower back pain than conventional therapy for up to six months after treatment.

Acupuncture has also been studied for its effectiveness in reducing other types of chronic pain, such as shoulder pain, nonspecific musculoskeletal pain, neck pain, and others. Studies have found that acupuncture can help relieve pain for these conditions and that the benefits can't be completely explained as a placebo effect.

Arthritis

Research that looked at multiple studies suggested that acupuncture may be able to improve the physical function of the knee in the short and long term in individuals who have knee osteoarthritis. With this condition, the connective tissue in the knee breaks down. This study also found that acupuncture helped those with knee osteoarthritis decrease their knee pain, but this was only helpful in the short term.

Another review that looked at multiple studies found that acupuncture delayed and reduced the use of pain medication in those who had knee replacement surgery.

Acupuncture has also been studied for its effectiveness in treating other types of arthritis pain, including arthritis of the spine, hands, and feet. One study found that acupuncture helped reduce pain, swelling, redness, and stiffness in all patients in the study group. Because this was a small study group without a control or placebo group, however, more studies are needed to confirm the results.

Mental Health

Acupuncture has been used to treat a number of mental health conditions, including depression, post-traumatic stress disorder, and anxiety.

  • Depression: There is some low-quality evidence that acupuncture may reduce the severity of depression symptoms. However, the effects appear to be mild to moderate. Acupuncture's effectiveness for treating depression is unclear, and more well-designed studies are needed to support its use for this purpose. Acupuncture should not be used as the sole treatment for depression.
  • Post-traumatic stress disorder: Acupuncture has also been studied for its effectiveness in treating other mental health conditions such as post-traumatic stress disorder (PTSD). A review of studies, however, advised caution in promoting acupuncture as a treatment for PTSD, since the evidence to support this use is limited.
  • Generalized anxiety disorder: A review of studies and meta-analysis did find that acupuncture had some benefits for people with generalized anxiety disorder. The study found that people receiving acupuncture experienced a greater reduction in symptoms than those in control groups.
  • Addiction: Acupuncture is sometimes used to treat substance use conditions such as alcohol or drug use. However, the evidence to support its effectiveness for this is mixed. Studies have been poorly designed, small, or have used different protocols, treatment durations, and acupoints and have had contradictory results. Therefore, it is difficult to draw any conclusions about how well acupuncture might work for addiction.

Headaches

Acupuncture has been well-studied for treating headache pain, including migraine headaches and tension headaches.

  • Migraines: Research on migraines done over a six-month period showed that acupuncture was able to reduce the frequency of migraine symptoms by half in 41% of those in the study compared to those not getting any acupuncture. It was also noted as being about as helpful as preventative migraine medications.
  • Tension headaches: According to research, having at least six acupuncture sessions may also be helpful for those with frequent head pain or pressure, also known as tension headaches. This study also noted that acupuncture added along with pain medication led to less headache frequency when compared to those only given medication.

Sleep Disorders

Acupuncture is sometimes used to treat insomnia. There is some evidence that it is effective for this, though it's unclear whether it is acting as a placebo.

One review of studies found that acupuncture provided better relief of symptoms after more than three weeks of treatment than pharmacological treatments.

Fertility

Acupuncture is sometimes used to treat infertility. Much of the research into this use has focused on women undergoing assisted reproductive techniques such as in vitro fertilization.

One review of studies found that combining acupuncture with other fertility treatments might help improve the chances of pregnancy, but the authors also noted that the evidence is not yet robust enough to form a solid conclusion.

Other studies have found no benefit compared to placebo for women undergoing in vitro fertilization.

Acupuncture has also been used to treat male infertility. A review of studies, however, noted that most of the scientific evidence to support this use comes from poorly designed studies or studies with a small sample size. Some studies have also reported that control groups receiving "sham" treatments also experienced a therapeutic benefit.

A separate review study also concluded that acupuncture does not seem to help improve sperm quality, though it noted that research has so far been limited and larger studies are needed.

Skin Health

Cosmetic acupuncture, also known as facial acupuncture, is used to improve the appearance of the skin on the head, face, and neck.

This use has not been well studied, but a 2018 review of studies found that existing trials were well-designed and showed positive benefits. The authors did note that further research is needed.

Respiratory Health

Acupuncture is sometimes used as an adjunctive or complementary therapy for people with chronic respiratory conditions. 

For example, one review of studies found that people with chronic obstructive pulmonary disease (COPD) experienced significant improvement in symptoms when acupuncture was used as an adjunctive therapy.

People with advanced cancers may also benefit from acupuncture. Another review of studies found that acupuncture could help reduce breathlessness and improve quality of life for people experiencing severe breathlessness as a result of advanced cancers or COPD.

Nausea

People undergoing treatment for cancer or recovery from surgery often experience nausea and vomiting. Some studies have found that acupuncture can help reduce these symptoms.

For example, one review of studies concluded that using acupuncture alongside standard treatments could help control vomiting compared to standard treatments alone. However, the study authors noted that the quality of the evidence was low, and more studies are needed to confirm the usefulness of acupuncture for treating chemotherapy-associated nausea and vomiting.

A small trial looked at acupuncture as a preventative measure for postoperative nausea and vomiting in children undergoing tonsillectomy. It found that the incidence of nausea and vomiting was reduced significantly when acupuncture was used during early recovery.

What to Expect

Prior to getting acupuncture, your acupuncturist will ask about your health history and may give you a physical examination.

During the acupuncture session, thin needles are placed in specific areas to address your concern or condition. The acupuncturist may gently twist the needles for added effect. The needles are often left in for 15 to 20 minutes, with the total session lasting anywhere from 30 minutes to an hour.

Your acupuncturist may use additional techniques during your session including:

  • Moxibustion: This involves the use of heated sticks, made from dried herbs, held near the acupuncture needles to warm and stimulate the acupuncture points.
  • Electroacupuncture: An electrical device is connected to several needles, providing a weak electrical current that stimulates the acupuncture needles during the treatment.
  • Cupping: Glass or silicone cups are applied to the skin so that there is a suction effect, which aims to help stimulate blood flow and balance your energy.

After the treatment, some people may feel relaxed, while others may feel energetic. If you experience any unusual symptoms, you should contact your healthcare provider.

Is It Painful?

You may feel a slight sting, pinch, ache, or some pain as the acupuncture needle is being inserted. Some acupuncturists move the needle after it has been placed in the body, which can cause additional pressure.

Once the needle has been properly placed, you may feel a tingling or heavy feeling, which is referred to as de qi.

Let your acupuncturist know if you are uncomfortable or in a lot of pain at any point during the session. Intense pain may mean the needle has not been inserted or placed correctly.

Results

Some people believe that acupuncture helps relieve pain by releasing endorphins, which are pain-relieving chemicals produced by the human body. This may be why some people report immediate relief of symptoms. This type of pain relief, however, may be short-term.

How long acupuncture takes to work also depends on the condition being treated. For some people, it may take a few sessions before considerable improvement is noted. The effects may persist for some time after treatment ends, but it is unknown how long acupuncture can continue to provide relief after stopping sessions.

Side Effects

As with any treatment, acupuncture may cause side effects in some individuals. Side effects may include:

In order to reduce the risk of side effects, acupuncture should always be done by a licensed and properly trained healthcare provider using clean, disposable needles.

Risks

Acupuncture is generally considered safe as long as it's done by a licensed professional using clean, sterilized needles. Still, it's a good idea to speak with your primary care physician before getting acupuncture, as this treatment may not be right for people with certain health conditions.

One of the risks of acupuncture is the accidental insertion of a needle into the space between the lungs and the chest wall. This can lead to pneumothorax or collapsed lung. However, this is uncommon.

It is also possible to experience blood vessel and nerve injury, complications from the needle breaking during treatment, organ injuries, as well as brain and spinal cord injuries. While rare, acupuncture complications can lead to death.

Who Should Not Have Acupuncture?

Acupuncture is not recommended for people who have a pacemaker. You should not have acupuncture if you are at high risk for infection or you have chronic skin problems.

People with bleeding disorders or who are taking a blood thinning medication should also avoid acupuncture. You should also avoid getting acupuncture in any areas where you have had lymph nodes removed, as acupuncture could increase the risk of infection.

People who are pregnant or who have cosmetic implants such as breast implants should ask a healthcare provider before having acupuncture. Make sure to tell your healthcare provider about any medications or dietary supplements you're taking.

Is Acupuncture Covered by Insurance?

Not every insurance policy covers acupuncture, but some do. It is best to check with your insurance company before setting up an appointment. Be sure to ask your provider whether they accept your insurance.

Summary

Researchers aren't exactly sure how acupuncture works, however, theories suggest that it may help release endorphins, as well as influence the autonomic nervous system.

Acupuncture may be helpful for a variety of concerns, including some mental health disorders, pain, inflammatory conditions, stress, and skin appearance. However, keep in mind that acupuncture can lead to mild or serious side effects in some individuals.

An acupuncture session can take anywhere from 30 minutes to an hour and usually involves about 20 minutes with the needles in. Some individuals may feel some pain or pressure while the needles are inserted, while others may feel different sensations while the needles are in.

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By Cathy Wong
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.