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Acupuncture: What It Is, Effects and Risks
Acupuncture: What It Is, Effects and Risks
What may happen during acupuncture, which conditions have been studied, and where are the limits of the evidence?
Original article by: Ing. František Kokoš and colleagues · Updated: 24 October 2026
Does acupuncture work?
Acupuncture is sometimes presented as an almost universal treatment, and sometimes as entirely ineffective. Research paints a more complex picture. It may help relieve symptoms in some pain conditions and certain forms of nausea. However, effects vary between conditions, and it does not replace necessary treatment.
Pain and nausea
These are among the most widely studied applications. Results depend on the specific condition and the comparison used.
The nervous system
Researchers study nerve and tissue stimulation alongside the effects of expectations and the therapeutic relationship.
Complementary care
Acupuncture is not a reason to delay diagnosis, stop medication or decline a necessary procedure.
What is acupuncture, and what happens during a session?
Conventional acupuncture involves inserting very thin, sterile, single-use needles into selected locations on the body. Appointment length varies and includes a consultation, needle insertion and time with the needles in place. The number of visits depends on the condition, treatment goals and individual response.
The traditional view: qi and meridians
Traditional Chinese medicine explains acupuncture through qi, understood as vital energy, and meridians through which it is said to flow. This is a traditional explanatory model.
The modern view: nerves and tissues
Qi and meridians have not been established as anatomical structures comparable to nerves or blood vessels. Modern research focuses on the nervous system, tissue responses and pain processing. [1]
What may happen during acupuncture?
The mechanism is not fully understood. Its overall effects may involve several processes. The following explanations are being investigated; they do not, by themselves, establish effectiveness for a particular condition.
Tissue and nerve stimulation
Needle insertion provides a mechanical stimulus to the skin and other tissues. Researchers investigate its effects on nerve signals and local responses.
Pain processing
Stimulation may affect the transmission and processing of pain signals in the spinal cord and brain. The involvement of the body’s own pain-relieving substances is also being studied.
The treatment context
Expectations, a sense of safety, attention and the relationship with the practitioner may influence pain perception. [1]
A person may feel less pain even when damaged tissue has not healed. Evaluating a treatment therefore requires distinguishing symptom relief from treatment of the underlying condition.
Acupuncture effects: which conditions have been studied?
Research has focused on chronic back and neck pain, pain associated with knee osteoarthritis, migraine and tension-type headaches. Postoperative pain and certain forms of nausea, including those associated with surgery or cancer treatment, have also been studied. [1]
Some people may experience symptom relief. However, findings cannot be generalised to every type of pain or nausea. The diagnosis, technique, comparison treatment and quality of the studies all matter.
Acupuncture may form part of a broader care plan alongside rehabilitation, exercise, sleep management, psychological support or medication. The appropriate approach depends on the cause of the symptoms.
Why might stimulation outside traditional points also help?
Studies often compare acupuncture with sham or simulated acupuncture. This may involve shallow needling, stimulation outside traditional points or a device that does not penetrate the skin.
| Observation | Possible explanation |
|---|---|
| The difference compared with no treatment is often larger. | The result reflects the whole procedure and its context. |
| The difference compared with sham acupuncture is often smaller. | Some benefits may not depend on the precise traditional point. |
| Control stimulation may also affect the skin. | The comparison procedure may not be completely biologically inactive. |
| Expectations and practitioner contact influence outcomes. | These factors can alter the actual experience of pain. [1] |
This does not mean a person is imagining their pain. The brain is part of the pain-processing system. Equally, it does not establish a unique, precisely proven effect for every traditional acupuncture point.
Can acupuncture treat disease?
Relieving symptoms
For selected conditions, it may reduce pain or nausea and improve everyday functioning.
Treating the underlying cause
Relief does not establish that a disease has been cured. Acupuncture does not replace, for example, insulin for type 1 diabetes, treatment for a serious bacterial infection or necessary cancer treatment.
It is best understood as a possible complementary approach in selected situations. It should not delay medical assessment.
What do specific studies show?
Results also depend on whether acupuncture is compared with no treatment, usual care, sham acupuncture or another intervention. Findings from one study cannot automatically be applied to a different condition.
Chronic non-specific low back pain
A 2020 Cochrane review found more favourable results compared with no treatment immediately after the intervention. Compared with sham acupuncture, however, the benefit for pain was not convincing. [3]
Chronic primary pain
Under specified conditions, NICE guideline NG193 allows consideration of a single course of acupuncture for people aged 16 and over with chronic primary pain. This is not a general recommendation for every cause of pain. [4]
Can acupuncture cause harm?
Yes, acupuncture can have adverse effects. Professional delivery and sterile, single-use needles reduce risks but do not eliminate them.
Milder reactions
Pain or tenderness at the insertion site, minor bleeding, bruising, tiredness or dizziness may occur. [2]
Serious complications
Incorrect or unhygienic delivery can cause infection or organ injury. Pneumothorax is one of the serious risks associated with needling around the chest. [1]
What should you tell the practitioner beforehand?
- A bleeding disorder or use of medicines that affect blood clotting.
- Pregnancy.
- A significantly weakened immune system.
- Skin infection or injury at the proposed insertion site.
- An implanted electrical device, particularly when considering electroacupuncture.
Suitability and any necessary adjustments must be assessed individually. Do not stop medication without consulting your doctor.
Acupuncture for “nerves”: stress or nerve pain?
Stress and anxiety are different from pain caused by nerve damage. Research findings in one area cannot be transferred to the other. Feeling relaxed after a session does not, by itself, establish treatment of an anxiety disorder.
An older Cochrane review from 2017 could neither reliably confirm nor rule out effectiveness for neuropathic pain. The evidence was of very low certainty. This review does not establish that acupuncture repairs damaged nerves. [5]
Personal experiences of acupuncture: how should we interpret them?
A personal account may describe relief or an adverse reaction, but it cannot establish why the condition changed. Stimulation, expectations, other treatments and natural fluctuations in symptoms may all contribute. Reviews and testimonials therefore do not replace controlled clinical studies.
Acupuncture techniques and related methods
Conventional acupuncture
Uses thin needles inserted into selected locations on the body.
Electroacupuncture
Mild electrical stimulation is applied through the needles. Suitability requires individual assessment, especially for people with implanted electrical devices.
Laser acupuncture
Uses light stimulation. It is a different technique, so findings from needle acupuncture cannot automatically be applied to it.
Moxibustion
A traditional heat-based method using burning material near selected locations. Its risks include burns.
Acupressure
Applies mechanical pressure without inserting needles. Evidence must still be assessed for the specific application.
How should you choose a practitioner?
Check their professional training and experience with the relevant condition. Hygiene, sterile single-use needles and willingness to work with your treating doctor are important.
When should you seek medical advice?
Medical assessment is important for new, unexplained or worsening pain, unexplained weight loss, persistent fever, marked weakness, changes in sensation or movement, or unusual bleeding.
Frequently asked questions about acupuncture
Which conditions are most often studied?
Research most often addresses certain types of chronic pain, headaches and selected forms of nausea. Findings vary according to the specific condition.
Is acupuncture a placebo?
Research investigates both specific and non-specific effects. Tissue stimulation, expectations, the setting and practitioner contact may all contribute. Differences compared with sham acupuncture are often smaller than those compared with no treatment.
How long does an acupuncture session take?
Duration depends on the technique and procedure. Check beforehand whether the quoted time includes the initial consultation and assessment.
Is acupuncture safe?
Professional delivery and sterile, single-use needles reduce risks. However, the procedure is not risk-free or suitable for everyone.
Can acupuncture cause harm?
Yes. It can cause pain, minor bleeding, bruising or dizziness. Serious complications include infection and organ injury.
Can it replace medication or other treatment?
It should not lead to interruption or delay of recommended diagnosis or treatment. Discuss combined approaches with your treating doctor.
Scientific sources
- NCCIH – Acupuncture: Effectiveness and Safety. Overview of effectiveness, mechanisms and risks.
- Guy’s and St Thomas’ NHS – Acupuncture. Patient information and adverse effects.
- Cochrane (2020) – Acupuncture for chronic non-specific low-back pain. Findings according to the comparison group.
- NICE NG193 – Chronic primary pain. Recommendations for a defined clinical situation.
- Cochrane (2017) – Acupuncture for neuropathic pain in adults. An older review with very low-certainty evidence.
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Back to the Academy → ↑ Back to contentsThis article is for information and education and does not replace an individual medical assessment. Consult a doctor if you have health concerns, take medication, are pregnant or are unsure whether acupuncture is appropriate for you.
