Acupuncture: what it involves and what is known
Acupuncture uses thin needles at set points on the body. People try it mostly for pain; research supports it for some chronic pain, less for other uses.
What the evidence says
Some evidence
Several studies, including some well-designed ones, show a modest benefit for specific uses. The legend
The US National Center for Complementary and Integrative Health (NCCIH) reports that large reviews and clinical guidelines support acupuncture for some chronic pain, including low-back and neck pain, knee osteoarthritis and headache prevention. Its edge over sham acupuncture is often small, and for many other conditions the evidence is weak, mixed or negative.
What practitioners say it does
- Believed by practitioners to rebalance the flow of energy or life force, called qi, along pathways known as meridians
- Described by many Western practitioners as stimulating nerves and tissue to boost natural painkillers
- Used by many people to ease back, neck and joint pain, headaches and migraine
- Said to ease nausea and vomiting after surgery or chemotherapy
- Used by many people for stress relief and general wellness
Origin
Began in traditional Chinese medicine and has been used in some form for at least 2,500 years; it has spread worldwide since the 1970s
Acupuncture is a practice from traditional Chinese medicine in which a practitioner places very thin needles at chosen points on the body. Most people try it for pain, such as back, neck or knee pain and headaches. Research gives it some support for specific kinds of chronic pain, but the support is not strong or consistent for most other uses.
What it is
Acupuncture began in traditional Chinese medicine and has been used in some form for at least 2,500 years. It has spread worldwide since the 1970s.
In the traditional view, needles placed along pathways called meridians rebalance the flow of energy or life force, known as qi. Many Western practitioners describe the points differently. They see them as places where nerves, muscles and connective tissue can be stimulated, which may prompt the body’s own painkillers. Qi and meridians have not been shown to exist in scientific terms.
People most often seek acupuncture for back, neck and joint pain, headaches and migraine. Others use it for nausea after surgery or chemotherapy, or for stress and general wellness.
What a session is like
An acupuncture session usually starts with questions about your symptoms and lifestyle. The practitioner may look at painful areas, your tongue and your face, and feel the pulse at your wrist. You then lie on a padded table, with a gown or towel if clothing needs moving.
Usually 5 to 20 needles go in, sometimes far from where it hurts. Insertion causes little discomfort for most people, though a mild ache is common. The needles may be gently moved, warmed or connected to mild electrical pulses, then left for 10 to 15 minutes while you rest. Many people feel relaxed or energized afterward. If nothing improves within a few weeks, it may not suit you.
Before booking, ask:
- What training and credentials do you have?
- How likely is it to help my problem?
- What does it cost, and will my insurance cover it?
What research says
How acupuncture might help is not fully understood. The US National Center for Complementary and Integrative Health (NCCIH) lists possible explanations: effects on the nervous system, effects on tissue at the needle site, and nonspecific effects such as belief and the relationship with the practitioner. In many studies acupuncture did better against no treatment than against sham (fake) acupuncture, which suggests those nonspecific effects play a part.
The clearest support is for chronic pain. For back and neck pain, reviews found it beat both no treatment and sham, though the gap over sham was smaller. A US physicians’ guideline lists it as a first-line nondrug option for chronic low-back pain. Reviews also found modest benefits for knee osteoarthritis and moderate-quality evidence that it may reduce how often migraines happen.
For other uses the evidence is weaker. It did no better than sham for irritable bowel syndrome, carpal tunnel syndrome, menopausal hot flashes or IVF outcomes. Mayo Clinic notes that benefits can be hard to measure and that not everyone responds.
Who should be careful
Complications are uncommon when a competent, certified practitioner uses sterile, single-use needles. Done badly, it can cause infections, punctured organs and nerve injury.
Check with your doctor and tell the practitioner first if you take blood thinners, have a bleeding disorder, a skin condition or infection, a pacemaker, or are pregnant. Do not let acupuncture delay a visit to a health care provider, and tell your doctors you are using it. If you have symptoms that are new, severe or not improving, see a doctor or other licensed clinician rather than relying on acupuncture alone.
How it fits with the pillars
Acupuncture sits in the body pillar. It is a physical, needle-based practice used mostly for pain. In the traditional Chinese view it belongs to a wider system that links the body with emotions and lifestyle. If that tradition interests you but needles do not, tai chi is a gentle movement practice from the same broad roots.
Safety
- Choose a certified practitioner who uses sterile, single-use needles; poor technique or nonsterile needles can cause infections, punctured organs or nerve injury.
- Tell the practitioner first if you take blood thinners, have a bleeding disorder, or have a skin condition or infection.
- Mention a pacemaker before any electroacupuncture, as the electrical pulses can interfere with it.
- If you are pregnant, tell the practitioner first, because some points are thought to stimulate labor.
- Soreness and minor bleeding or bruising where the needles went in are the most common side effects.
What a session involves
The practitioner first asks about your symptoms and may check your tongue and pulse; then you lie on a padded table, with a gown or towel if clothing needs moving. Usually 5 to 20 very thin needles go in and stay for 10 to 15 minutes; a mild ache is common. A session lasts up to about an hour, and many people feel relaxed or energized afterward.
Training and regulation
In the US, most states license acupuncturists, and most require non-physician acupuncturists to pass a national certification exam; California runs its own. Rules vary elsewhere; in England, registration is not required by law.
Questions people ask
Is acupuncture safe?
For most people the risk is low when a competent, certified practitioner uses sterile, single-use needles. The most common side effects are soreness and minor bleeding or bruising where needles went in. Serious harm, such as infection or a punctured organ, has happened when needles were not sterile or technique was poor. Tell the practitioner first if you take blood thinners, have a pacemaker or are pregnant.
How many acupuncture sessions do people usually need?
It depends on the problem, but Mayo Clinic describes a common plan as one or two sessions a week, often 6 to 8 sessions in total. Each session lasts up to about an hour. If you notice no improvement within a few weeks, acupuncture may not suit you, and it is reasonable to stop and talk to your doctor about other options.
How do I find a qualified acupuncturist?
In the US, most states license acupuncturists, and most require non-physician acupuncturists to pass a national certification exam, so check that your practitioner is licensed in your state. In England, registration is not required by law, and the NHS advises choosing someone on a register accredited by the Professional Standards Authority. Ask about training, experience and cost before you book.
Can acupuncture replace seeing a doctor?
No. Health agencies such as the NCCIH and the NHS advise against using acupuncture to put off seeing a health care provider about a problem. Tell your doctors about any complementary therapy you use so they can account for it in your care. Acupuncture is best seen as something some people add alongside medical care, not a substitute for it.
Sources
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