Acupuncture After Surgery: Pain, Opioid Use and Recovery
What reviews and trials found for acupuncture and related methods around surgery, including pain, opioid use, knee and hip replacement and bowel recovery, and what remains uncertain.
Content last updated . This page has not been medically reviewed.
Pain after an operation is often treated with opioid medicines, which can cause side effects. Researchers have asked whether acupuncture, electroacupuncture or similar methods can ease pain, reduce the need for opioids or speed recovery. This page reports what reviews and trials found. It is information only. Your surgical team decides your pain plan, and a prescribed medicine should not be stopped without talking to your doctor. [1]
Terms used here
Acupuncture-related methods in these reviews include manual acupuncture, electroacupuncture, and transcutaneous electrical acupoint stimulation, or TEAS, which stimulates acupuncture points electrically through the skin rather than with needles. [2]
What the overall reviews found
| Question | What the source found | Strength of evidence |
|---|---|---|
| Does acupuncture or a related technique lower pain on the first day after surgery? | A review of trials in adults (searched to September 2014) found less pain and less opioid use on day 1 compared with controls; it found conventional acupuncture and TEAS reduced pain, while electroacupuncture was similar to control [3] | Promising but limited |
| Does it reduce opioid use? | In that review, TEAS did; conventional acupuncture and electroacupuncture showed no benefit for opioid use [3] | Mixed |
| TEAS alone | 17 trials with 1,375 participants found lower pain scores and less opioid use, but results varied widely between trials (I2 of 96%) [2] | Promising but limited |
NCCIH summarizes a 2016 evaluation of 11 studies (682 participants) as finding less pain and less opioid use one day after surgery. [4]
Knee and hip replacement
- Knee replacement. A JAMA Surgery review of 39 trials (2,391 patients) of drug-free approaches found moderate-certainty evidence that acupuncture delayed the first opioid dose by about 46 minutes, and low-certainty evidence that it improved pain by 1.14 points on a visual analog scale at 2 days. [5]
- Seven-trial review. Another review of 7 studies (891 participants) found pain relief and concluded that acupuncture, as an add-on, was associated with less pain and less pain medicine use. [6]
- Network comparison. A 2025 analysis of 28 trials, 21 of them from mainland China and Taiwan, found electroacupuncture ranked best for pain and reported no serious adverse events. [7]
- Before and during surgery. A systematic review of 8 studies (7 randomized trials, one cohort study) in hip and knee replacement reported less intra-operative fentanyl and less patient-controlled pain medicine, but patient-reported outcomes varied with no consistent trend. A pooled analysis was not possible. [8]
- Hip replacement. Proper evidence not found for a completed hip-only systematic review: a PubMed search on 2026-10-22 found a hip-specific review that was only a published protocol. [9] One small blinded trial of 54 patients compared ear acupuncture with sham points after hip replacement. Opioid use over 36 hours was lower in the real group (37 mg versus 54 mg), while pain scores and side effects were similar. [10] One small trial is not enough to draw firm conclusions.
Bowel recovery after abdominal surgery
Postoperative ileus is a temporary slowdown of the bowel after surgery. In a 2023 sham-controlled trial of 248 people after laparoscopic colorectal cancer surgery in China, electroacupuncture shortened time to first bowel movement (median 76.4 hours versus 90.0 hours) and lowered the rate of prolonged ileus (10% versus 20%), with no severe adverse events. [11] A 2025 trial in 578 people after laparoscopic stomach cancer surgery, at 7 hospitals in China, found electroacupuncture shortened time to first flatus compared with both sham and standard care. [12]
Evidence label: promising but limited. Both trials were done in China and tested a set of 4 sessions, so they cannot be assumed to apply to other surgeries or health systems.
Why the results are hard to compare
- Trials differ in when treatment is given (before, during or after surgery), the type of acupuncture and the comparison group. [8]
- In one network analysis, 21 of 28 trials came from mainland China and Taiwan. [7]
- Some trials are not blinded, so expectation can affect pain reports. See sham acupuncture and placebo controls.
Frequently asked questions
Does acupuncture reduce pain after surgery?
Some reviews found less pain on the first day after surgery, but the results are not uniform across techniques and the trials vary. [3] [4]
Can acupuncture reduce opioid use after surgery?
Evidence is mixed. In one review, TEAS reduced opioid use but conventional acupuncture and electroacupuncture did not. [3] After knee replacement, acupuncture delayed the first opioid dose by about 46 minutes. [5]
Is acupuncture used after knee or hip replacement?
It has been studied in both, mostly in combined or knee-only reviews. [8] [6]
Can acupuncture help my bowels recover after surgery?
Two sham-controlled trials after cancer surgery in China found faster return of bowel function with electroacupuncture. [11] [12] Ask your surgical team before trying it.
Is it safe right after an operation?
Safety depends on your surgery, medicines and wound care. The NHS lists blood-thinning medicine and skin conditions as reasons acupuncture may not be safe. [1] Check with your surgical team first.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Safety and planning with your surgical team
NCCIH reports relatively few complications, but improper delivery or nonsterile needles can cause infections, punctured organs and injury to the central nervous system. [4] The NHS says acupuncture may not be safe if you take blood-thinning medicine, have increased bleeding risk, or have a skin condition or skin infection. [1]
Before any acupuncture around surgery, tell your surgeon and anesthesia team, and tell your acupuncturist about the operation and your medicines. See coordinating acupuncture with medical care, bleeding and blood thinners and infection risk and clean needle technique. For nausea after surgery, see acupuncture for postoperative nausea.
After surgery, follow your surgical team's instructions about when to call them, and call 911 for an emergency.
References
- NHS (England). Herbal medicines and complementary therapies. Page last reviewed 1 May 2026. Read 2026-10-22.
- Wang D et al. Efficacy and Safety of Transcutaneous Electrical Acupoint Stimulation for Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials. Pain Res Manag 2022;2022:7570533. Read 2026-10-22.
- Wu MS et al. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLoS One 2016;11(3):e0150367. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH). Acupuncture: What You Need To Know. Read 2026-10-22.
- Tedesco D et al. Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. JAMA Surg 2017;152(10):e172872. Read 2026-10-22.
- Ko HF et al. Effects of Acupuncture on Postoperative Pain After Total Knee Replacement: Systematic Literature Review and Meta-Analysis. Pain Med 2021;22(9):2117-2127. Read 2026-10-22.
- Li WX et al. Acupuncture for rehabilitation after total knee arthroplasty: a systematic review and network meta-analysis. Int J Surg 2025;111(1):1373-1385. Read 2026-10-22.
- Tanghe KK et al. A systematic review of pre-operative and intra-operative acupuncture in total hip and knee arthroplasty. Acupunct Med 2025;43(6):307-315. Read 2026-10-22.
- Shin HR et al. Acupuncture for perioperative care of total hip arthroplasty: a systematic review of controlled trials and meta-analysis (protocol). Medicine (Baltimore) 2019;98(15):e15198. Read 2026-10-22.
- Usichenko TI et al. Auricular acupuncture for pain relief after total hip arthroplasty: a randomized controlled study. Pain 2005;114(3):320-327. Read 2026-10-22.
- Wang Y et al. Electroacupuncture vs Sham Electroacupuncture in the Treatment of Postoperative Ileus After Laparoscopic Surgery for Colorectal Cancer: A Multicenter, Randomized Clinical Trial. JAMA Surg 2023;158(1):20-27. Read 2026-10-22.
- Pei L et al. Electroacupuncture Reduces Duration of Postoperative Ileus After Laparoscopic Gastrectomy for Gastric Cancer: A Multicenter Randomized Trial. Gastroenterology 2025;169(1):73-84. Read 2026-10-22.