Chronic pain
The largest analysis to date pooled individual data from 39 high-quality trials and more than 20,000 patients with back, neck, joint, headache and shoulder pain. Acupuncture outperformed both sham acupuncture and no acupuncture; the advantage over sham was small, the advantage over usual care larger, and benefits largely persisted for up to a year. The authors concluded referral for acupuncture is a reasonable option for chronic pain.
› 2 sources
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Low back pain
The American College of Physicians' 2017 guideline lists acupuncture among the non-drug treatments to consider first for chronic low back pain. A 2020 Cochrane review found clear benefit versus no treatment, but only a small difference versus sham acupuncture. Expect a reasonable, guideline-endorsed option with modest benefit — not a cure.
› 2 sources
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- [2]Mu J, Furlan AD, Lam WY, et al. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. 2020;12(12):CD013814. PubMed 33306198 (opens in a new tab) · DOI 10.1002/14651858.CD013814 (opens in a new tab)· Cochrane systematic review
Migraine prevention
A 2016 Cochrane review of 22 trials found acupuncture reduces how often migraines occur, appearing at least similarly effective to preventive medications with fewer side-effect dropouts. Its advantage over sham acupuncture was small.
› 1 source
- [1]Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;2016(6):CD001218. PubMed 27351677 (opens in a new tab) · DOI 10.1002/14651858.CD001218.pub3 (opens in a new tab)· Cochrane systematic review
Safety
Large prospective studies support a good safety record. A UK survey of about 32,000 treatments found no serious adverse events; a German study of more than 229,000 patients found 8.6% reported a side effect, most often minor bleeding or bruising. Serious complications are rare but real, which is why training, sterile single-use needles and careful technique matter.
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Neck pain
In a large UK trial of people with long-standing neck pain, adding acupuncture to usual care modestly reduced pain and disability at 12 months. A 2025 review of 26 trials found acupuncture reduced neck pain and disability more than sham-type treatments, though evidence quality ranged from very low to moderate.
› 2 sources
- [1]MacPherson H, Tilbrook H, Richmond S, et al. Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial. Ann Intern Med. 2015;163(9):653-62. PubMed 26524571 (opens in a new tab) · DOI 10.7326/M15-0667 (opens in a new tab)· randomized controlled trial (pragmatic)
- [2]Xie CR, Zhang ZY, Tao QF, et al. Effectiveness of Acupuncture for Neck Pain: Systematic Review and Meta‑analysis with Trial Sequential Analysis. J Pain Res. 2025;18:6297-6316. PubMed 41322280 (opens in a new tab) · DOI 10.2147/JPR.S558059 (opens in a new tab)· systematic review and meta-analysis
Tension-type headache
A Cochrane review concluded acupuncture is effective for frequent or chronic tension-type headache, based on moderate- to low-quality evidence.
› 1 source
- [1]Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;4(4):CD007587. PubMed 27092807 (opens in a new tab) · DOI 10.1002/14651858.CD007587.pub2 (opens in a new tab)· Cochrane systematic review
Cancer-related pain
The 2022 Society for Integrative Oncology–ASCO guideline recommends acupuncture for aromatase-inhibitor-related joint pain and says it may be recommended for general cancer pain or musculoskeletal pain. Acupuncture is supportive care and does not treat cancer.
› 1 source
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Nausea (PC6 point)
Cochrane reviews of dozens of trials found that stimulating the PC6 point on the inner wrist reduces postoperative nausea and vomiting compared with sham, with minor side effects. For chemotherapy-related nausea, a 2023 review found acupuncture added to standard anti-nausea medicine may help, but with low to very low certainty.
› 3 sources
- [1]Lee A, Chan SK, Fan LT Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2015;2015(11):CD003281. PubMed 26522652 (opens in a new tab) · DOI 10.1002/14651858.CD003281.pub4 (opens in a new tab)· Cochrane systematic review
- [2]Lee A, Zhang JZ, Xie J, et al. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting: a network meta-analysis. Cochrane Database Syst Rev. 2025;9(9):CD003281. PubMed 40938065 (opens in a new tab) · DOI 10.1002/14651858.CD003281.pub5 (opens in a new tab)· Cochrane systematic review (network meta-analysis)
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Pregnancy
For pelvic and low-back pain in pregnancy, single studies suggest acupuncture may help, with minor, short-lived side effects (exercise has the most consistent evidence). For breech presentation, a 2023 Cochrane review found moderate-certainty evidence that moxibustion plus usual care probably reduces non-head-first presentation at birth. For nausea in early pregnancy, evidence for acupuncture is limited.
› 3 sources
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- [2]Coyle ME, Smith C, Peat B Cephalic version by moxibustion for breech presentation. Cochrane Database Syst Rev. 2023;5(5):CD003928. PubMed 37158339 (opens in a new tab) · DOI 10.1002/14651858.CD003928.pub4 (opens in a new tab)· Cochrane systematic review
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Anxiety
Reviews suggest acupuncture may reduce anxiety symptoms, with side effects similar to control treatments, and a 2026 meta-analysis of 12 trials reported a benefit. Study designs vary widely and high-quality sham-controlled evidence is limited. Best viewed as a complement to established anxiety care.
› 2 sources
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Cupping & gua sha
Reviews found cupping reduced chronic pain and neck pain compared with no treatment, though it didn't clearly beat sham cupping and studies were generally low quality. A small trial found gua sha gave short-term neck-pain relief compared with a heat pad. Both commonly leave temporary marks.
› 3 sources
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How acupuncture may work
Needling stimulates nerves in skin and muscle; those signals reach the spinal cord and brain and can engage the body's own pain-modulating systems, including endogenous opioids. Imaging shows measurable brain effects. Mechanisms are not fully understood, and some benefit in trials comes from non-specific effects such as expectation, attention and the care setting.
› 3 sources
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Knee osteoarthritis
The American College of Rheumatology conditionally recommends acupuncture for knee, hip and hand osteoarthritis — it may help some people. Trials vary: one large 2021 trial found intensive electroacupuncture beat sham, while a 2014 trial found no benefit over sham. Exercise and weight management remain the cornerstones; acupuncture can be an add-on.
› 4 sources
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- [2]Tu JF, Yang JW, Shi GX, et al. Efficacy of Intensive Acupuncture Versus Sham Acupuncture in Knee Osteoarthritis: A Randomized Controlled Trial. Arthritis Rheumatol. 2021;73(3):448-458. PubMed 33174383 (opens in a new tab) · DOI 10.1002/art.41584 (opens in a new tab)· randomized controlled trial (sham-controlled)
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- [4]Manheimer E, Cheng K, Linde K, et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev. 2010;2010(1):CD001977. PubMed 20091527 (opens in a new tab) · DOI 10.1002/14651858.CD001977.pub2 (opens in a new tab)· Cochrane systematic review
Fibromyalgia
A Cochrane review found acupuncture improved pain and stiffness compared with no treatment or standard care, but not compared with sham; benefits faded by six months. A 2025 review reported improvements in pain, fatigue and mood but called for larger, high-quality studies.
› 2 sources
- [1]Deare JC, Zheng Z, Xue CC, et al. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013;2013(5):CD007070. PubMed 23728665 (opens in a new tab) · DOI 10.1002/14651858.CD007070.pub2 (opens in a new tab)· Cochrane systematic review
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IVF & assisted reproduction
A large, rigorous trial of 848 women undergoing IVF found no difference in live births between acupuncture and sham acupuncture. The Cochrane review found no evidence that acupuncture improves live birth or pregnancy rates. A 2019 review found more pregnancies when acupuncture was compared with no added treatment, but not when compared with sham — suggesting general effects such as relaxation and support. Some patients choose acupuncture for comfort and stress support during IVF; it should not be thought of as increasing the chance of a baby.
› 5 sources
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- [2]Cheong YC, Dix S, Hung Yu Ng E, et al. Acupuncture and assisted reproductive technology. Cochrane Database Syst Rev. 2013;2013(7):CD006920. PubMed 23888428 (opens in a new tab) · DOI 10.1002/14651858.CD006920.pub3 (opens in a new tab)· Cochrane systematic review
- [3]Smith CA, Armour M, Shewamene Z, et al. Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reprod Biomed Online. 2019;38(3):364-379. PubMed 30658892 (opens in a new tab) · DOI 10.1016/j.rbmo.2018.12.038 (opens in a new tab)· systematic review and meta-analysis
- [4]Su C, Wang X, Liu X, et al. Effect of acupuncture for poor ovarian response: a multicenter randomized controlled trial. Front Endocrinol. 2026;17:1765527. PubMed 41837144 (opens in a new tab) · DOI 10.3389/fendo.2026.1765527 (opens in a new tab)· randomized controlled trial (no sham control)
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Hot flashes
Pragmatic trials have found real-world improvement: in a US trial, hot-flash frequency fell by 36.7% at six months with acupuncture versus no acupuncture, and an Italian trial in women with breast cancer found benefit when added to self-care. However, a Cochrane review found no significant difference between real and sham acupuncture, and acupuncture appeared less effective than hormone therapy.
› 5 sources
- [1]Avis NE, Coeytaux RR, Isom S, et al. Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial. Menopause. 2016;23(6):626-37. PubMed 27023860 (opens in a new tab) · DOI 10.1097/GME.0000000000000597 (opens in a new tab)· randomized controlled trial (pragmatic, waitlist-controlled)
- [2]Lesi G, Razzini G, Musti MA, et al. Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT). J Clin Oncol. 2016;34(15):1795-802. PubMed 27022113 (opens in a new tab) · DOI 10.1200/JCO.2015.63.2893 (opens in a new tab)· randomized controlled trial (pragmatic)
- [3]Dodin S, Blanchet C, Marc I, et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst Rev. 2013;2013(7):CD007410. PubMed 23897589 (opens in a new tab) · DOI 10.1002/14651858.CD007410.pub2 (opens in a new tab)· Cochrane systematic review
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Chemotherapy-induced peripheral neuropathy
A small pilot trial found acupuncture improved neuropathy symptoms compared with usual care, and a 2026 review of 40 trials found some symptom improvement — but with very low certainty. Standard treatment options are limited as well; ASCO identifies duloxetine as the only agent with adequate evidence for painful CIPN.
› 3 sources
- [1]Bao T, Patil S, Chen C, et al. Effect of Acupuncture vs Sham Procedure on Chemotherapy-Induced Peripheral Neuropathy Symptoms: A Randomized Clinical Trial. JAMA Netw Open. 2020;3(3):e200681. PubMed 32159808 (opens in a new tab) · DOI 10.1001/jamanetworkopen.2020.0681 (opens in a new tab)· randomized controlled trial (pilot)
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PCOS
A large, high-quality trial of 1,000 women with PCOS found acupuncture did not increase live births compared with control acupuncture (the medication clomiphene did). The 2025 Cochrane review found no clear difference between real and sham acupuncture for live birth, ovulation, pregnancy or cycle regularity. Acupuncture is not an evidence-based fertility treatment for PCOS; at Seven Medicine it is offered only as complementary wellbeing support.
› 3 sources
- [1]Wu XK, Stener-Victorin E, Kuang HY, et al. Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial. JAMA. 2017;317(24):2502-2514. PubMed 28655015 (opens in a new tab) · DOI 10.1001/jama.2017.7217 (opens in a new tab)· randomized controlled trial (factorial, sham-controlled)
- [2]Zhang GS, Lim ECN, Cheng NCL, et al. Acupuncture for polycystic ovary syndrome. Cochrane Database Syst Rev. 2025;10(10):CD007689. PubMed 41147529 (opens in a new tab) · DOI 10.1002/14651858.CD007689.pub5 (opens in a new tab)· Cochrane systematic review
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Menstrual pain
A 2016 Cochrane review of 42 trials found lower pain scores with acupuncture than with no treatment or NSAIDs in several studies, but results versus sham were inconsistent and overall quality was low. The reviewers concluded there isn't enough evidence to say whether acupuncture or acupressure work for period pain.
› 1 source
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Endometriosis pain
An older Cochrane review found only one eligible trial. A 2025 review of nine small trials found acupuncture reduced endometriosis-related pain but noted methodological weaknesses and called for larger studies. Acupuncture may be considered as a complement to gynecologic care.
› 2 sources
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Insomnia
A Cochrane review found evidence too low-quality to support or refute acupuncture for insomnia. A 2025 Cochrane review in people with cancer found it may help versus no treatment but may make little difference versus sham, and was likely less effective than CBT-I — which remains the recommended first-line treatment.
› 2 sources
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Cosmetic acupuncture & microneedling
Evidence for cosmetic facial acupuncture is a single small, uncontrolled pilot study showing some improvement in a facial elasticity measure, with mild bruising as the main side effect. For microneedling, reviews suggest improvement in acne scars and signs of skin aging with short downtime; studies are generally small, and pigment changes are possible.
› 4 sources
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