Acupuncture Side Effects and Precautions: Infection, Bleeding, Pregnancy and Serious Complications

Get urgent help first

If you have trouble breathing, chest pain, a fast spreading rash, heavy bleeding that will not stop, or you feel suddenly very unwell after acupuncture, call 911 in the United States. For anything less urgent that worries you, contact your own doctor and tell them you recently had acupuncture. The page on warning signs after acupuncture lists what to watch for.

The short version

Acupuncture is a needle-based treatment, so it carries real, if usually small, risks. The US National Center for Complementary and Integrative Health (NCCIH) says relatively few complications have been reported, but that they have followed the use of nonsterile needles and improper delivery of treatment, and that poorly delivered acupuncture can cause serious harm. [1] Most people who have problems have minor ones, such as a small bruise. Serious injuries are rare, and many described in the medical literature were linked to poor technique. [2]

This page is an overview. It does not teach needling, and needling yourself or using at-home kits is unsafe (see why at-home acupuncture kits call for care). For what acupuncture is, see what is acupuncture.

How common are problems?

The best large count comes from a German study of 229,230 patients treated by physicians, who received about 10 sessions each. [3] In that group, 8.6 percent reported at least one adverse effect, and 2.2 percent reported one that needed treatment. [3] The most common were bleeding or a bruise (haematoma), reported by 6.1 percent of patients, then pain at 1.7 percent. [3] Two patients had a collapsed lung (pneumothorax). [3]

An earlier review of nine prospective surveys found very wide ranges for minor effects: needle pain 1 to 45 percent, tiredness 2 to 41 percent, and bleeding 0.03 to 38 percent. Faintness was uncommon (0 to 0.3 percent). [4] The ranges differ because studies counted events differently.

What the evidence can and cannot show

Big observational studies are good at counting common, mild effects. They are poor at finding very rare events, and they depend on patients and practitioners reporting honestly. Rare serious harms mostly come from case reports, which cannot give a risk rate. [5] A review of 17 earlier reviews rated their overall quality as "mediocre", and found that serious events are rare but need attention, because the reviews of organ and tissue injuries reported a median of 4 deaths each. [6]

Where each risk is covered

The table points to the page that covers each topic in detail. The "strength" column describes how solid the evidence is, not how likely you are to be affected.

Simple ways to lower your risk

• Choose a practitioner whose license or certification you have checked; see how to choose an acupuncturist. The overview of 17 reviews says referrals should consider an acupuncturist's training credibility. [6]
• Ask whether needles are new, sterile and used once. In the United States the FDA regulates acupuncture needles as medical devices and requires them to be sterile and labeled for single use only. [1]
• Tell the practitioner about blood thinners, pregnancy, implanted devices, any condition that weakens your immune system, and anything else on your health history. The NHS advises telling any therapist about medical conditions, medicines and other treatments. [12]
• Do not use acupuncture to delay seeing a doctor about a health problem, and keep taking prescribed medicines unless your prescriber tells you otherwise. [13]
• If something goes wrong, see reporting an acupuncture adverse event or complaint.

A note on "natural" and "traditional"

Acupuncture has a long history, but a long history does not make a needle procedure risk-free. See natural and traditional do not mean risk-free. For a one-page recap, see the acupuncture safety quick reference.