What Is Acupuncture?

Acupuncture is a therapeutic method involving the insertion of very thin needles into specific points on the body. These needles may be used alone or enhanced by manual techniques or electrical stimulation (known as electroacupuncture). Practiced for over 2,500 years, acupuncture has its roots in traditional Chinese medicine and began receiving international attention in the 1970s, becoming widespread in many countries.

Global Use of Acupuncture

Data from the World Health Organization indicates that acupuncture is practiced in 103 out of 129 countries that submitted information.

In the United States, adult usage of acupuncture has more than doubled over two decades. According to the National Health Interview Survey, usage increased from 1.0% in 2002 to 2.2% in 2022.

Applications of Acupuncture

According to national survey statistics, people in the U.S. primarily turn to acupuncture to manage pain, particularly in the back, joints, or neck.

Scientific Understanding of Acupuncture

While the exact mechanisms behind acupuncture are still being explored, research suggests effects on the nervous system, local tissues, and placebo-related factors:

• Brain imaging and physiological studies show acupuncture may influence nerve activity in humans and animals.
• Localized physical effects on tissues like connective tissue have been identified where needles are applied.
• Placebo effects—such as expectations and provider interactions—are a known contributor to the therapy’s effectiveness.
• In innovative trials, imagining a prior acupuncture session reduced pain, showcasing the power of psychological response.

Scientific Evidence: Pain Relief

Scientific studies support acupuncture's usefulness in addressing various types of pain, including chronic low back and neck pain, arthritis-related knee issues, joint pain from cancer medications, and more.

One major analysis across 20 trials (6,376 individuals) found that acupuncture's benefits often lasted for a year post-treatment, especially in conditions other than neck pain.

Back and Neck Pain

• A 2018 review across 12 trials (8,003 individuals) found acupuncture more effective than no treatment, and moderately better than sham acupuncture. Its benefits were on par with NSAIDs.
• ACP guidelines from 2017 recommend acupuncture as one of the first options for chronic and acute low-back issues, although evidence quality for acute conditions was lower.

Osteoarthritis

• A 2018 review suggests acupuncture has a pain-relieving role in osteoarthritis, particularly in the knees, and compared favorably to sham and no treatment conditions.
• Limited evidence was found for hip osteoarthritis, but one study found acupuncture might enhance standard care for hip pain and function.
• The 2019 ACR/AF guidelines tentatively recommend acupuncture for osteoarthritis in the hand, hip, and knee, with the strongest evidence for the knee.

Migraines and Headaches

• A 2020 review found acupuncture slightly more effective than medication for migraine prevention, with fewer adverse reactions.
• Moderate evidence supports acupuncture's role in migraine and tension headache frequency reduction, though differences compared to sham procedures were small.

Myofascial Pain Syndrome

• This condition involves muscle and connective tissue pain called "trigger points." Stimulating these with acupuncture yielded better pain control than traditional acupuncture techniques.

Sciatica

• Two separate 2015 reviews found acupuncture may lessen sciatica symptoms. However, methodological shortcomings in studies prevent any firm conclusions.

Post-Surgical Pain

• A 2016 evaluation of 11 trials revealed reduced pain and lower opioid use post-surgery among patients who received acupuncture treatments.

Cancer Treatment–Related Pain

• While acupuncture alone wasn't better than medications, it may enhance the effects when combined, especially for breast cancer patients on aromatase inhibitors.
• A 2018 study involving 226 women found acupuncture significantly reduced joint pain compared to sham or no treatment.

Chronic Pelvic Pain / Prostatitis

• Preliminary findings suggest acupuncture helped manage symptoms better than sham interventions, though more comprehensive studies are needed for clarity.

Irritable Bowel Syndrome

• While sham-controlled trials did not show clear benefits, adjunct acupuncture with other treatments might offer symptomatic relief.

Fibromyalgia

• Acupuncture appears to reduce fibromyalgia-related pain more than sham treatments, but the overall quality of evidence remains moderate at best.

Acupuncture for Non-Pain Conditions

Beyond pain, acupuncture research has explored over 50 differing health issues. Positive outcomes have been seen in treating allergies, urinary incontinence, and chemotherapy-related nausea. It may also enhance quality of life in asthma patients, though not necessarily lung capacity.

Seasonal Allergies

• Findings from 13 studies highlight acupuncture’s capacity to relieve nasal allergy symptoms and reduce dependence on additional medications.
• The American Academy of Otolaryngology–Head and Neck Surgery supports it as a treatment option.

Urinary Incontinence

• In a large 2017 trial, electroacupuncture was shown to reduce stress incontinence episodes by at least 50% in most patients after 18 treatments.

Nausea in Cancer Care

• While thought beneficial for nausea related to cancer treatment, older research predates modern anti-nausea protocols.

Asthma

• A 2017 study saw improved life quality in asthma patients when acupuncture was added to regular care.
• A meta-analysis supports symptom relief but no measurable improvement in lung function.

Depression

• Though a 2018 meta-analysis found acupuncture may ease depressive symptoms, the findings are tempered by generally low-quality studies.

Smoking Cessation

• U.S. health authorities haven’t endorsed acupuncture for quitting smoking due to limited evidence. Prior studies suggest possible minor short-term benefits.

Infertility

• Analysis of six studies found no added value of acupuncture over placebo in enhancing IVF outcomes.
• In men, acupuncture studies targeting sperm quality yielded inconclusive results owing to small, poorly designed trials.

Carpal Tunnel Syndrome

• Studies reviewed in 2018 found minimal benefits from acupuncture; however, a separate 2017 trial showed promising neurological effects from electroacupuncture.

Menopausal Hot Flashes

• Acupuncture eased vasomotor symptoms better than no treatment, but was not superior to placebo techniques.

Uses of Auricular Acupuncture

• This form of therapy targets specific points on the ears to influence various body systems.
• Promising evidence suggests it helps reduce pain linked to back problems and cancer, particularly when combined with standard drug therapies.
• The “battlefield acupuncture” method lacks strong support for pain, according to a 2021 review.

Safety Considerations

• Serious complications with acupuncture are rare but can occur if needles are not sterile or procedures are improperly done.
• Punctured organs, infections, or nerve damage are potential risks if not administered correctly.
• The FDA classifies acupuncture needles as medical devices, requiring them to be sterile and single-use only.

Insurance Coverage

• Health coverage for acupuncture varies by provider and condition. Some plans cover it, while others do not.
• The number of insured acupuncture visits grew from 41.1% in 2010–2011 to 50.2% in 2018–2019.
• Medicare has covered acupuncture for chronic low-back pain since 2020. Medicaid policies differ by state.

Licensing for Acupuncturists

• Licensing is required in most U.S. states, although regulations and standards may differ by jurisdiction.
• For information about practitioner credentials, visit the NCCIH Credentialing and Licensing webpage.

NCCIH Research Efforts

The National Center for Complementary and Integrative Health funds numerous studies designed to:

• Assess the application of acupuncture in hospital emergency settings.
• Explore if combining acupuncture with brain stimulation can enhance outcomes in low-back pain.
• Evaluate portable nerve-stimulation technology inspired by acupuncture to help anxiety sufferers.

Important Points

• Never use acupuncture as a substitute for professional medical consultation or diagnosis.
• Always involve your healthcare provider when considering complementary therapies to ensure safe, coordinated care.

Where to Find More Information

References and Credits

The content above is supported by a wide range of research and literature. NCCIH thanks its contributors for the accuracy and currency of this update. This work is in the public domain and may be freely shared. Please consult your healthcare provider for personal medical advice or treatment decisions.