Skip to content
AlternativeMed

THERAPIES & TRADITIONS · GUIDE

What Is Acupuncture? Traditional and Contemporary Explanations and What Research Can Establish

What acupuncture is, how it is explained in tradition and in research, what studies can and cannot establish, and where to read more on every part of the subject.

Content last updated . This page has not been medically reviewed.

Back to Acupuncture

What acupuncture is

Acupuncture is a technique in which a practitioner inserts fine needles into the skin to treat health problems. The needles may be moved by hand or stimulated with small electrical currents, which is called electroacupuncture. [1] It is a needle procedure, so it is different from acupressure, which uses pressure only: see acupressure.

This page is information only. It is the starting point for the whole acupuncture section, and it does not replace advice from your own doctor.

Where it comes from, and how widely it is used

The U.S. National Center for Complementary and Integrative Health (NCCIH) says acupuncture has been in use in some form for at least 2,500 years, began in traditional Chinese medicine, and has become popular worldwide since the 1970s. [1] Historians and researchers date the early texts differently, which is explained on the history page.

The World Health Organization (WHO) reported in 2019 that acupuncture was the most common traditional medicine practice among its Member States, in use in 113 of them. [2] In the United States, 1.0 percent of adults used acupuncture in 2002 and 2.2 percent in 2022. [1] See use around the world.

Two ways of explaining it

Traditionally, acupuncture is described in terms of ideas such as yin and yang, qi (often translated as vital energy), wind and dampness. [3] Practitioners in this tradition describe channels, called meridians, along which qi is said to move, and points on the body where needling is aimed. [4] These are traditional frameworks. They are not anatomical structures that modern science has identified, and the research on this question is covered on do acupuncture points exist.

Researchers propose other explanations, such as effects on nerves, on the tissue around the needle and on expectation. NCCIH says how acupuncture works is not fully understood. [1] The two views, side by side, are on how acupuncture is explained.

What research can and cannot establish

Acupuncture is hard to test, because the practitioner knows what they are doing and a convincing fake is difficult to design. In many studies the benefit has been greater against no treatment than against sham (simulated) acupuncture, such as a device that pokes the skin without penetrating it. NCCIH reads this as a sign that nonspecific effects, such as belief in the treatment and the relationship with the practitioner, contribute. [1]

A pooled analysis of data on 20,827 people in 39 trials of chronic pain found acupuncture better than sham and better than no acupuncture, with differences of about 0.5 standard deviations against no acupuncture and about 0.2 against sham. The authors concluded the pain reduction could not be explained solely by placebo effects. [5]

Plainly stated:

  • Promising but limited: a modest benefit over sham, and a larger one over no treatment, for some chronic pain conditions.
  • Mixed: guidelines differ. England's NICE advises against offering acupuncture for low back pain, while it suggests considering a single course for chronic primary pain. [6][7]
  • Not established: that qi or meridians exist as physical things, or that points chosen by traditional theory work better than other points. Sham-controlled trials cannot settle this, and trials without a sham cannot rule out expectation.

For a fuller look, see does acupuncture work and sham acupuncture and placebo controls.

Evidence by use

5 findings · 2 supported · 1 mixed · 2 limited or unclearThe colour follows the evidence label on each card.

  1. Back or neck pain, knee osteoarthritis pain

    Promising but limited

    NCCIH describes acupuncture as possibly helpful; the gap over sham is smaller than over no treatment [1]

  2. Migraine prevention

    Promising but limited

    Slightly better than drugs in nine studies; small difference over sham [1]

  3. IBS symptoms

    No good evidence of benefit over sham

    No more effective than sham in a 2019 review of 41 studies [1]

  4. IVF success

    No good evidence of benefit

    No difference from sham in pregnancy or live birth in a 2021 review [1]

  5. Menopausal hot flashes

    Mixed

    Better than no acupuncture, not shown better than sham [1]

Each topic has its own page. Start with acupuncture for chronic pain, back and neck pain, knee osteoarthritis, headache and migraine or anxiety and depression. The full list is on the evidence index.

Where to read next

For the wider tradition, see what is traditional Chinese medicine.

Frequently asked questions

Does acupuncture work?

For some kinds of chronic pain, large reviews find it helps a little more than sham acupuncture and more than no treatment, though guidelines disagree and part of the benefit probably comes from expectation and context. [1][5]

Is acupuncture the same as acupressure?

No. Acupuncture inserts fine needles into the skin. [1] Acupressure uses pressure from fingers or a device without piercing the skin; see acupressure.

Is acupuncture safe?

Delivered properly with sterile single-use needles, complications are relatively few, but infections, punctured organs and nerve injury have been reported. [1] Ask about training and licensing before booking.

Does Medicare cover acupuncture?

As read from the Centers for Medicare & Medicaid Services on 2026-10-22, Medicare covers acupuncture only for chronic low back pain, up to 12 visits in 90 days and up to 20 in a year. [9] Coverage elsewhere varies. [1]

Can acupuncture replace my medical care?

No. NCCIH advises against using it to postpone seeing a health care provider. [1]

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 in brief
NCCIH says relatively few complications have been reported, but they have followed nonsterile needles and improper delivery, and serious effects can include infections, punctured organs and injury to the central nervous system. In the United States the Food and Drug Administration regulates acupuncture needles as medical devices, requiring them to be sterile and labeled for single use. [1] Details are on side effects and precautions and the safety quick reference.

Do not use acupuncture to put off seeing a health care provider about a health problem. [1] In the UK, the NHS says acupuncture may not be safe if you take blood-thinning medicine, are at increased risk of bleeding, or have a skin condition or skin infection. [8] Tell your practitioner about pregnancy, devices and medicines, and see who should take extra care. For emergencies in the United States call 911.

References
  1. NCCIH, Acupuncture: Effectiveness and Safety. Last updated October 2022. Read 2026-10-22.
  2. World Health Organization, WHO global report on traditional and complementary medicine 2019. Read 2026-10-22.
  3. Kaptchuk TJ, Acupuncture: theory, efficacy, and practice. Ann Intern Med. 2002. Abstract read 2026-10-22.
  4. Eigenschink M et al., Evidence underlying the basic concepts of traditional Chinese medicine. Wien Klin Wochenschr. 2020. Read 2026-10-22.
  5. Vickers AJ et al., Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain. 2018. Read 2026-10-22.
  6. NICE, Low back pain and sciatica in over 16s (NG59): recommendations. Read 2026-10-22.
  7. NICE, Chronic pain (primary and secondary) in over 16s (NG193): recommendations. Read 2026-10-22.
  8. NHS, Herbal medicines and complementary therapies. Page last reviewed 1 May 2026. Read 2026-10-22.
  9. Centers for Medicare & Medicaid Services, National Coverage Determination: Acupuncture for Chronic Lower Back Pain (30.3.3). Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.