Merck Manual

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Denise Millstine

, MD, Mayo Clinic

Reviewed/Revised Oct 2021 | Modified Sep 2022

Acupuncture, a therapy within traditional Chinese medicine Traditional Chinese Medicine Originating > 2000 years ago, traditional Chinese medicine (TCM) is a medical system based on the philosophy that illness results from improper flow of the life force (qi). The movement of... read more , is one of the most widely accepted components of integrative therapies in the western world. Specific points on the body are stimulated, usually by inserting thin needles into the skin and underlying tissues. Stimulating these specific points is believed to affect the flow of qi (a universal life force) along energy pathways (meridians) and thus restore balance.

The procedure is generally not painful but may cause a tingling sensation. Sometimes stimulation is increased by twisting, warming, or otherwise manipulating the needle.

Acupuncture points may also be stimulated by

  • Pressure (called acupressure)

  • Lasers (also called low-level laser therapy)

  • A very low voltage electrical current (called electroacupuncture) applied to the needle

Evidence and Uses

Acupuncture research is inherently difficult to conduct. Blinding is challenging and so-called "sham" acupuncture often puts pressure on acupressure points, thereby creating a different treatment experience that may not be truly inert. In regions where acupuncture is more part of the culture, particularly in China, published acupuncture studies are more abundant and broader in scope. Results showing efficacy should be interpreted in light of the fact that interventions include the full schema of traditional Chinese medicine of which acupuncture is only a component.

The World Health Organization (WHO) has helped with this clinical challenge by issuing a list of conditions for which they have deemed evidence of efficacy to be strong or available but for which additional study is recommended, including

  • Symptoms of cancer therapy

  • Depression

  • Dysmenorrhea

  • Pain

  • Headache

  • Hypertension

  • Post-operative symptoms

  • Some complications of pregnancy

  • Stroke complications

Possible Adverse Effects and Contraindications

Adverse effects of acupuncture are difficult to quantify and, although treatments are generally safe, skill and care vary among practitioners. A 2013 systematic review of the rare adverse effects (1.3 per 1000 treatments) after acupuncture included the following (1 Reference Acupuncture, a therapy within traditional Chinese medicine, is one of the most widely accepted components of integrative therapies in the western world. Specific points on the body are stimulated... read more ):

  • Infection

  • Epidural and other hematoma

  • Peripheral nerve palsy

  • Cardiac tamponade

  • Pseudoaneurysm

Although some of these adverse effects are serious, 95% of the total adverse effects reported caused little or no harm.


  • 1. Xu S, Wang L, Cooper E, et al: Adverse events of acupuncture: a systematic review of case reports. Evid Based Complement Alternat Med 581203, 2013. doi:10.1155/2013/581203

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

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