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Aug 22, 2023

Acupuncture For Pain Relief

Alyssa Hui is a St. Louis-based health and science news writer. She was the 2020

Alyssa Hui is a St. Louis-based health and science news writer. She was the 2020 recipient of the Midwest Broadcast Journalists Association Jack Shelley Award.

Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years’ experience in consumer-oriented health and wellness content.

Catherine Falls Commercial / Getty Images

Pain management techniques run the gamut, ranging from physical therapy and medications to cold therapies and massages. One particular method that is growing in popularity is acupuncture.

According to a 2021 report by the World Health Organization (WHO), acupuncture is the most commonly used form of traditional medicine practice globally, and it's gaining more attention in the United States. In fact, more than 10 million acupuncture treatments are administered annually in the U.S. alone.

In this article, we'll cover how acupuncture works, what conditions it can help with, and how you can find a qualified acupuncturist for your needs.

Acupuncture is a medical practice that involves placing solid but very thin needles at specific points in the body to treat certain health problems, Gudrun Snyder, DAc, MSAc, LAc, Doctor of East Asian Acupuncture and founder of Moon Rabbit Acupuncture, told Verywell.

"The needles are 30 times thinner than the traditional needle you experience at your physician's office," she said, adding that they can be used manually or stimulated with small electric currents, called electroacupuncture.

Acupuncture originated in China about 3,000 years ago and is also known as an ancient practice of traditional Chinese medicine (TCM). Its use was first recorded in the ancient Chinese medical text Huang Di Nei Jing, or The Yellow Emperor's Classic of Internal Medicine.

Over the next few hundred years, TCM spread to Japan and other areas of Asia. In more recent years, the practice has boomed in acceptance and demand across the world, Snyder said.

From an Eastern perspective, acupuncture works by balancing the flow of qi (chi), also known as energy, which moves through meridians, or channels in your body.

"By inserting needles into specific points along these meridians, acupuncture re-establishes balance for overall health and wellbeing," she said.

When qi is imbalanced due to internal and external stressors such as diet, emotional upset, overwork, or even the weather, people can become ill, Stace Nelson-Hicks, DACM, Doctor of Acupuncture and Chinese Medicine and a licensed acupuncturist in California, told Verywell in an email.

She explains that by using ancient diagnostic techniques and comprehensive interviews, practitioners can determine which organ systems and meridians need to be addressed, and target acupuncture points accordingly. TCM practitioners believe there are more than 2,000 acupoints in the body.

"Each point has its own function: some increase energy, others decrease it, thereby helping balance our patients to support recovery," Nelson-Hicks said.

The Western perspective goes beyond energy healing, suggesting that acupuncture alleviates pain by stimulating nerves, muscles, and fascia (connective tissue), along with regulating immune response, nervous system response, lymph flow, and increasing muscle relaxation, Snyder said.

Multiple lineages, training, styles, and types of acupuncture have been modified and developed across the world, but all traditions involve needling into certain points, Nelson-Hicks said. Different types of acupuncture include:

Snyder said providers can combine and use various forms of acupuncture based on a patient's personal needs.

While more research is needed regarding acupuncture and the specific conditions it can aid, the most common conditions seen in modern clinics include pain, fertility, anxiety, depression, allergies, and cancer support, Tom Ingegno, DACM, MSOM, LAc, an acupuncturist at Charm City Integrative Health based in Baltimore, told Verywell.

"The nature of acupuncture makes it ideal for treating most conditions that are not life-threatening and a good ancillary therapy for both chronic and terminal conditions to improve quality of life," he said. "While acupuncture is an amazing therapy, people often look for it when no other therapy has helped."

Nelson-Hicks added menopause, PMS, digestive complaints, nausea, migraines, autoimmune conditions, recovery from chemotherapy, emotional distress, upper respiratory infections, and urinary tract infections are other conditions that respond well to TCM.

One 2022 analysis published in the BMJ that analyzed more than 2,000 scientific reviews of acupuncture therapies found acupuncture to be effective for post-stroke aphasia, neck, shoulder, and muscle pain, fibromyalgia pain, lactation issues after delivery, lower back pain, vascular dementia symptom, and allergy symptoms.

Additionally, a mouse study led by neuroscientists at Harvard Medical School suggests that electroacupuncture can calm inflammation.

The National Center for Complementary and Integrative Health notes that acupuncture may be helpful for:

Beyond helping with pain and symptoms of health conditions, acupuncture can improve sleep, digestion, and stress, Ingegno said.

When acupuncture is given by a highly trained, licensed, and certified acupuncturist, it is extremely safe, Nelson-Hicks said.

"We have some of the lowest medical malpractice rates of all providers because of TCM's safety rating," she added.

An analysis published in 2021—which included 21 studies and almost 13 million treatments—estimated the overall risk of serious adverse events at about 8 per million treatments. The most common serious adverse events were pneumothorax (collapsed lung), cardiovascular problems, and fainting (which in some cases caused trauma. such as fractures).

Snyder noted there are some short-term risks associated with acupuncture, such as:

While there are some serious side effects associated with acupuncture, like a punctured lung or infection, these are very rare.

If you have a metal allergy, infection, or open wound in the area to be needled, Snyder said it's best to avoid acupuncture. People who have a bleeding disorder, are taking any medicines such as an anticoagulant, or are pregnant, should talk to their acupuncturist before starting a session.

If you decide to see an acupuncturist, find a practitioner who is board-certified, licensed, and has the proper training and credentials, Ingegno said.

You can check to see if a practitioner is certified in your state by visiting the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) website.

"Many will be nationally certified through the NCCAOM. Some may even specialize in the condition for which you are seeking treatment," Ingegno said. "Read their bios, and make sure it's a good fit for you."

While the NCCAOM is the most centralized source to check a provider's accreditation, participation is voluntary, so not all acupuncturists will be listed there. If you are unable to find the acupuncturist you wish to see, you can call the NCCAOM at 202-381-11140 to try and learn more.

"These accredited associations guarantee that your practitioner has studied Eastern and Western medicine and has completed a supervised internship needling hundreds of patients over hundreds of hours," Nelson-Hicks said. "My advice is to always receive acupuncture from a licensed, certified acupuncturist who specializes in your particular need."

While everyone's visit will be tailored to their specific needs, Snyder said, in general, your first visit will likely last an hour or two. Your initial evaluation will require you to fill out a full medical/health history form and questionnaire. You’ll also spend a few minute discussing your concerns and health goals with an acupuncturist.

In most cases, patients will be asked to change into a gown or to lay under sheets on the acupuncture table so the practitioner can access their limbs, back, and abdomen without having to move their clothing aside, Nelson-Hicks said.

After needles are inserted, they’ll need to stay in place for about 20 to 30 minutes. During this time, you can relax, meditate, sleep, and listen to music or a podcast.

Your practitioner may monitor if and how your pulses have changed and may add or remove needles as they see fit. They may also use other methods like cupping, gua sha, or herbal medicine. After the needles are removed, your practitioner will determine your course of treatment.

"Sometimes one is all you need, and oftentimes, depending on how chronic or severe [your condition is], they may suggest several treatments over the course of several weeks," Nelson-Hicks said.

World Health Organization. WHO benchmarks for the practice of acupuncture.

Jishun J, Mittelman M. Acupuncture: past, present, and future. Glob Adv Health Med. 2014;3(4):6-8. doi:10.7453/gahmj.2014.042

Johns Hopkins Medicine. Acupuncture.

Lu L, Zhang Y, Tang X, Ge S, Wen H, Zeng J et al. Evidence on acupuncture therapies is underused in clinical practice and health policy. BMJ. 2022; 376 :e067475 doi:10.1136/bmj-2021-067475

Liu S, Wang ZF, Su YS, et al. Somatotopic organization and intensity dependence in driving distinct NPY-expressing sympathetic pathways by electroacupuncture. Neuron. 2020;108(3):436-450.e7. doi:10.1016/j.neuron.2020.07.015

National Center for Complementary and Integrative Health. Acupuncture: what you need to know.

Bäumler P, Zhang W, Stübinger T, Irnich D. Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ Open. 2021;11(9):e045961. doi:10.1136/bmjopen-2020-045961

By Alyssa HuiAlyssa Hui is a St. Louis-based health and science news writer. She was the 2020 recipient of the Midwest Broadcast Journalists Association Jack Shelley Award.