Acupuncture and the Latest Research

November 27, 2022 Joe Brady
Posted by Joe Brady on

Research has shown that acupuncture may be helpful for several pain conditions, including back or neck pain, knee pain associated with osteoarthritis, and postoperative pain. There’s also evidence that acupuncture may help relieve seasonal allergy symptoms, stress incontinence in women, and nausea and vomiting associated with cancer treatment.

Acupuncture is a technique derived from traditional Chinese medicine in which practitioners insert fine needles into the skin to treat health problems. In the United States, it is most commonly used for pain, such as back, neck, or joint pain. The needles may be manipulated manually or stimulated with small electrical currents (electroacupuncture). 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.

What is acupuncture used for?

National survey data indicate that in the United States, acupuncture is most commonly used for pain, such as back, joint, or neck pain.

What does research show about the effectiveness of acupuncture for pain?

Research has shown that acupuncture may be helpful for several pain conditions, including back or neck pain, knee pain associated with osteoarthritis, and postoperative pain. It may also help relieve joint pain associated with the use of aromatase inhibitors, which are drugs used in people with breast cancer. 

An analysis of data from 20 studies (6,376 participants) of people with painful conditions (back pain, osteoarthritis, neck pain, or headaches) showed that the beneficial effects of acupuncture continued for a year after the end of treatment for all conditions except neck pain.

According to the World Health Organization, acupuncture is used in 103 of 129 countries that reported data.

Read more for the research on specific types of pain

In the United States, data from the National Health Interview Survey showed a 50 percent increase in the number of acupuncture users between 2002 and 2012. In 2012, the most recent year for which statistics are available, 6.4 percent of U.S. adults reported they had used acupuncture, and 1.7 percent reported they had used it in the past 12 months.

How does acupuncture work scientifically?

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

  • Studies in animals and people, including studies that used imaging methods to see what’s happening in the brain, have shown that acupuncture may affect nervous system function.
  • Acupuncture may have direct effects on the tissues where the needles are inserted. This type of effect has been seen in connective tissue.
  • Acupuncture has nonspecific effects (effects due to incidental aspects of a treatment rather than its main mechanism of action). Nonspecific effects may be due to the patient’s belief in the treatment, the relationship between the practitioner and the patient, or other factors not directly caused by the insertion of needles. In many studies, the benefit of acupuncture has been greater when it was compared with no treatment than when it was compared with sham (simulated or fake) acupuncture procedures, such as the use of a device that pokes the skin but does not penetrate it. These findings suggest that nonspecific effects contribute to the beneficial effect of acupuncture on pain or other symptoms. 
  • In recent research, a nonspecific effect was demonstrated in a unique way: Patients who had experienced pain relief during a previous acupuncture session were shown a video of that session and asked to imagine the treatment happening again. This video-guided imagery technique had a significant pain-relieving effect.

Back or Neck Pain

  • In a 2018 review, data from 12 studies (8,003 participants) showed acupuncture was more effective than no treatment for back or neck pain, and data from 10 studies (1,963 participants) showed acupuncture was more effective than sham acupuncture. The difference between acupuncture and no treatment was greater than the difference between acupuncture and sham acupuncture. The pain-relieving effect of acupuncture was comparable to that of nonsteroidal anti-inflammatory drugs (NSAIDs).
  • A 2017 clinical practice guideline from the American College of Physicians included acupuncture among the nondrug options recommended as first-line treatment for chronic low-back pain. Acupuncture is also one of the treatment options recommended for acute low-back pain. The evidence favoring acupuncture for acute low-back pain was judged to be of low quality, and the evidence for chronic low-back pain was judged to be of moderate quality.

For more information, see the NCCIH webpage on low-back pain.

  • Sciatica involves pain, weakness, numbness, or tingling in the leg, usually on one side of the body, caused by damage to or pressure on the sciatic nerve—a nerve that starts in the lower back and runs down the back of each leg.
  • Two 2015 evaluations of the evidence, one including 12 studies with 1,842 total participants and the other including 11 studies with 962 total participants, concluded that acupuncture may be helpful for sciatica pain, but the quality of the research is not good enough to allow definite conclusions to be reached.

Headache and Migraine

  • A 2020 review of nine studies that compared acupuncture with various drugs for preventing migraine found that acupuncture was slightly more effective, and study participants who received acupuncture were much less likely than those receiving drugs to drop out of studies because of side effects.
  • There’s moderate-quality evidence that acupuncture may reduce the frequency of migraines (from a 2016 evaluation of 22 studies with almost 5,000 people). The evidence from these studies also suggests that acupuncture may be better than sham acupuncture, but the difference is small. There is moderate- to low-quality evidence that acupuncture may reduce the frequency of tension headaches (from a 2016 evaluation of 12 studies with about 2,350 people).

For more information, see the NCCIH webpage on headache.

Osteoarthritis

  • In a 2018 review, data from 10 studies (2,413 participants) showed acupuncture was more effective than no treatment for osteoarthritis pain, and data from 9 studies (2,376 participants) showed acupuncture was more effective than sham acupuncture. The difference between acupuncture and no treatment was greater than the difference between acupuncture and sham acupuncture. Most of the participants in these studies had knee osteoarthritis, but some had hip osteoarthritis. The pain-relieving effect of acupuncture was comparable to that of NSAIDs.
  • A 2018 review evaluated 6 studies (413 participants) of acupuncture for hip osteoarthritis. Two of the studies compared acupuncture with sham acupuncture and found little or no difference between them in terms of effects on pain. The other four studies compared acupuncture with a variety of other treatments and could not easily be compared with one another. However, one of the trials indicated that the addition of acupuncture to routine care by a physician may improve pain and function in patients with hip osteoarthritis.
  • A 2019 clinical practice guideline from the American College of Rheumatology and the Arthritis Foundation conditionally recommends acupuncture for osteoarthritis of the knee, hip, or hand. The guideline states that the greatest number of studies showing benefits have been for knee osteoarthritis.

For more information, see the NCCIH webpage on osteoarthritis.

Fibromyalgia

  • A 2019 review of 12 studies (824 participants) of people with fibromyalgia indicated that acupuncture was significantly better than sham acupuncture for relieving pain, but the evidence was of low-to-moderate quality.

For more information, see the NCCIH webpage on fibromyalgia. 

Seasonal Allergies (Allergic Rhinitis or Hay Fever)

  • A 2015 evaluation of 13 studies of acupuncture for allergic rhinitis, involving a total of 2,365 participants, found evidence that acupuncture may help relieve nasal symptoms. The study participants who received acupuncture also had lower medication scores (meaning that they used less medication to treat their symptoms) and lower blood levels of immunoglobulin E (IgE), a type of antibody associated with allergies.
  • A 2014 clinical practice guideline from the American Academy of Otolaryngology–Head and Neck Surgery included acupuncture among the options health care providers may offer to patients with allergic rhinitis.

For more information, see the NCCIH webpage on seasonal allergies.

What is auricular acupuncture good for?

  • Auricular acupuncture is a type of acupuncture that involves stimulating specific areas of the ear. 
  • Research on auricular acupuncture for chronic back pain and cancer pain has had promising results. 
    • In a 2019 review of 15 studies (930 participants) of auricular acupuncture or auricular acupressure (a form of auricular therapy that does not involve penetration with needles), the treatment significantly reduced pain intensity, and 80 percent of the individual studies showed favorable effects on various measures related to pain.
    • A 2020 review of 9 studies (783 participants) of auricular acupuncture for cancer pain showed that auricular acupuncture produced better pain relief than sham auricular acupuncture. Also, pain relief was better with a combination of auricular acupuncture and drug therapy than with drug therapy alone.
  • An inexpensive, easily learned form of auricular acupuncture called “battlefield acupuncture” has been used by the U.S. Department of Defense and Department of Veterans Affairs to treat pain. However, a 2021 review of 9 studies (692 participants) of battlefield acupuncture for pain in adults did not find any significant improvement in pain when this technique was compared with no treatment, usual care, delayed treatment, or sham battlefield acupuncture.

Is acupuncture safe?

  • 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 adverse effects, 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.

Is acupuncture covered by health insurance?

  • Some health insurance policies cover acupuncture, but others don’t. Coverage is often limited based on the condition being treated.
  • An analysis of data from the Medical Expenditure Panel Survey, a nationally representative U.S. survey, showed that the share of adult acupuncturist visits with any insurance coverage increased from 41.1 percent in 2010–2011 to 50.2 percent in 2018–2019.
  • Medicare covers acupuncture only for the treatment of chronic low-back pain. Coverage began in 2020. Up to 12 acupuncture visits are covered, with an additional 8 visits available if the first 12 result in improvement. Medicaid coverage of acupuncture varies from state to state.

Do acupuncturists need to be licensed?

  • Most states license acupuncturists, but the requirements for licensing vary from state to state. To find out more about licensing of acupuncturists and other complementary health practitioners, visit the NCCIH webpage Credentialing, Licensing, and Education. 

NCCIH-Funded Research

NCCIH funds research to evaluate acupuncture’s effectiveness for various kinds of pain and other conditions and to further understand how the body responds to acupuncture and how acupuncture might work. Some recent NCCIH-supported studies involve:

  • Evaluating the feasibility of using acupuncture in hospital emergency departments.
  • Testing whether the effect of acupuncture on chronic low-back pain can be enhanced by combining it with transcranial direct current stimulation.
  • Evaluating a portable acupuncture-based nerve stimulation treatment for anxiety disorders.

More To Consider

  • Don’t use acupuncture to postpone seeing a health care provider about a health problem.
  • Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.

For More Information

NCCIH Clearinghouse

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226

Telecommunications relay service (TRS): 7-1-1

Website: https://nccih.nih.gov/

Email: info@nccih.nih.gov

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Know the Science

NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information.

Explaining How Research Works (NIH)

Know the Science: 9 Questions To Help You Make Sense of Health Research

Understanding Clinical Studies (NIH)

PubMed®

A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed.

Website: https://pubmed.ncbi.nlm.nih.gov/

NIH Clinical Research Trials and You

The National Institutes of Health (NIH) has created a website, NIH Clinical Research Trials and You, to help people learn about clinical trials, why they matter, and how to participate. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov and other resources, and stories about the personal experiences of clinical trial participants. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.

Website: https://www.nih.gov/health-information/nih-clinical-research-trials-you

Research Portfolio Online Reporting Tools Expenditures & Results (RePORTER)

RePORTER is a database of information on federally funded scientific and medical research projects being conducted at research institutions.

Website: https://reporter.nih.gov

Key References

Other References

Acknowledgments

NCCIH thanks Pete Murray, Ph.D., David Shurtleff, Ph.D., and Helene M. Langevin, M.D., NCCIH for their review of the 2022 update of this fact sheet. 

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

Last Updated: October 2022