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

Overview

Relatively few complications are reported, but they have occurred with nonsterile needles and improper treatment. Done badly, acupuncture can cause serious harm, including infections, punctured organs and injury to the central nervous system. [1] Safety depends heavily on the practitioner's training: see licensing and training. This page does not teach needling, and needling yourself is unsafe.

Side effects

UCLH, a London hospital pain clinic, lists common effects as temporary drowsiness, a temporary increase in pain, minor bleeding or bruising, and nausea and headache, usually lasting hours to a couple of days. Rare effects are fainting, especially at a first treatment, and a broken needle. Very rare are infection and puncture of the lung. [2] A Cochrane review of neck pain also noted increased pain, bruising, fainting, swelling and dizziness. [3]

Infection prevention and single-use needles

In the United States the FDA regulates needles as medical devices and requires them to be sterile and labeled for single use only. [1] Cleveland Clinic says needles are thrown away after one use. [4] Ask whether the needles are new, sterile and single-use. Do not have treatment on skin that is infected or has a condition affecting it. [5]

Bleeding and blood thinners

The NHS says acupuncture may not be safe if you take blood-thinning medicine or have a higher risk of bleeding. [5] Two studies offer reassurance with caveats:

• A systematic review found one moderate bleeding event in 3,974 treatments of anticoagulated patients, and concluded acupuncture appears safe with appropriate needling location and depth. [6]
• A chart study of 169 patients on anticoagulant or antiplatelet drugs and 259 not on them found no difference in the risk of bleeding-related adverse events, and thicker needles increased risk. [7]

Tell the practitioner what you take. Do not stop a prescribed medicine to have acupuncture. [5]

Pregnancy

A systematic review of 105 studies found adverse events in pregnancy that were causally related to acupuncture were all mild or moderate, with needling pain the most frequent. The incidence of events judged possibly, probably or certainly related was 1.3 percent. It concluded acupuncture appears to have few adverse events when correctly applied, though only a quarter of the studies reported adverse events in detail. [8] Tell the practitioner if you are or may be pregnant, and see therapies in pregnancy and pregnancy and breastfeeding safety.

Electroacupuncture precautions

A study measuring the current paths concluded electroacupuncture should not be applied so that current is likely to cross the heart, and that currents from needles placed far apart can reach the chest. [9] Tell the practitioner if you have a pacemaker or other implant. [2]

Serious complications

An overview of 17 systematic reviews found organ or tissue injuries, infections, local reactions, and dizziness or fainting. Serious events were rare, but the reviews that covered organ or tissue injuries reported a median of 4 deaths, so they need attention. [10] A review of Chinese-language reports of 479 cases found the most frequent were pneumothorax (collapsed lung), fainting, subarachnoid hemorrhage and infection, and most arose from improper technique. [11] These come from case reports and cannot give a risk rate.

When to get urgent help

UCLH says that if you feel very unwell afterward, contact your own doctor or the local emergency department. [2] Lung puncture is a rare risk when needles are placed over the chest [2], so get emergency care for breathing difficulty or chest pain after treatment. In the U.S., call 911.

See reporting adverse events and what is acupuncture.