The National Center for Complementary and Alternative Medicine (N C C A M): Part of the National Institutes of Health

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Acupuncture: An Introduction

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Introduction

Acupuncture is among the oldest healing practices in the world. In the United States, where practitioners incorporate healing traditions from China, Japan, Korea, and other countries, acupuncture is considered part of complementary and alternative medicineA group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. (CAM).

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Key Points

  • Acupuncture has been practiced in China and other Asian countries for thousands of years.
  • Scientists are studying the efficacy of acupuncture for a wide range of conditions.
  • Relatively few complications have been reported from the use of acupuncture. However, acupuncture can cause potentially serious side effects if not delivered properly by a qualified practitioner.
  • Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

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About Acupuncture

The term "acupuncture" describes a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.

Practiced in China and other Asian countries for thousands of years, acupuncture is one of the key components of traditional Chinese medicine.  Acupuncture became better known in the United States in 1971, when New York Times reporter James Reston wrote about how doctors in China used needles to ease his pain after surgery. American practices of acupuncture incorporate medical traditions from China, Japan, Korea, and other countries.

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Acupuncture Use in the United States

The report from a Consensus Development Conference on Acupuncture held at the National Institutes of Health (NIH) in 1997 stated that acupuncture is being "widely" practiced—by thousands of physicians, dentists, acupuncturists, and other practitioners—for relief or prevention of pain and for various other health conditions. According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 3.1 million U.S. adults and 150,000 children had used acupuncture in the previous year. Between the 2002 and 2007 NHIS, acupuncture use among adults increased by approximately 1 million people.

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Acupuncture Side Effects and Risks

The U.S. Food and Drug Administration (FDA) regulates acupuncture needles for use by licensed practitioners, requiring that needles be manufactured and labeled according to certain standards. For example, the FDA requires that needles be sterile, nontoxic, and labeled for single use by qualified practitioners only.

Relatively few complications from the use of acupuncture have been reported to the FDA, in light of the millions of people treated each year and the number of acupuncture needles used. Still, complications have resulted from inadequate sterilization of needles and from improper delivery of treatments. Practitioners should use a new set of disposable needles taken from a sealed package for each patient and should swab treatment sites with alcohol or another disinfectant before inserting needles. When not delivered properly, acupuncture can cause serious adverse effects, including infections and punctured organs.

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Status of Acupuncture Research

Although millions of Americans use acupuncture each year, often for chronic pain, there has been considerable controversy surrounding its value as a therapy and whether it is anything more than placebo. Research exploring a number of possible mechanisms for acupuncture’s pain-relieving effects is ongoing. Some recent NCCAM-supported studies have looked at:

  • Whether acupuncture works for specific health conditions such as chronic low-back pain, headache, and osteoarthritis of the knee
  • How acupuncture might work, such as what happens in the brain during acupuncture treatment
  • Ways to better identify and understand the potential neurological properties of meridians and acupuncture points
  • Methods and instruments for improving the quality of acupuncture research

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Finding a Qualified Practitioner

Health care providers can be a resource for referral to acupuncturists, and some conventional medical practitioners—including physicians and dentists—practice acupuncture. In addition, national acupuncture organizations (which can be found through libraries or Web search engines) may provide referrals to acupuncturists.

  • Check a practitioner's credentials. Most states require a license to practice acupuncture; however, education and training standards and requirements for obtaining a license to practice vary from state to state. Although a license does not ensure quality of care, it does indicate that the practitioner meets certain standards regarding the knowledge and use of acupuncture.
  • Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training. If you have received a diagnosis from a doctor, you may wish to ask your doctor whether acupuncture might help.

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What To Expect from Acupuncture Visits

During your first office visit, the practitioner may ask you at length about your health condition, lifestyle, and behavior. The practitioner will want to obtain a complete picture of your treatment needs and behaviors that may contribute to your condition. Inform the acupuncturist about all treatments or medications you are taking and all medical conditions you have.

Acupuncture needles are metallic, solid, and hair-thin. People experience acupuncture differently, but most feel no or minimal pain as the needles are inserted. Some people feel energized by treatment, while others feel relaxed. Improper needle placement, movement of the patient, or a defect in the needle can cause soreness and pain during treatment. This is why it is important to seek treatment from a qualified acupuncture practitioner.

Treatment may take place over a period of several weeks or more.

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Treatment Costs

Ask the practitioner about the estimated number of treatments needed and how much each treatment will cost. Some insurance companies may cover the costs of acupuncture, while others may not. It is important to check with your insurer before you start treatment to see whether acupuncture is covered for your condition and, if so, to what extent. (For more information, see NCCAM's fact sheet Paying for CAM Treatment.)

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References

  • Acupuncture. Natural Standard Database Web site. Accessed at www.naturalstandard.com on June 28, 2007.
  • Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. CDC Advance Data Report #343. 2004.
  • Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of Internal Medicine. 2004;141(12):901–910.
  • Eisenberg DM, Cohen MH, Hrbek A, et al. Credentialing complementary and alternative medical providers. Annals of Internal Medicine. 2002;137(12):965–973.
  • Ernst E. Acupuncture—a critical analysis. Journal of Internal Medicine. 2006;259(2):125–137.
  • Kaptchuk, TJ. Acupuncture: theory, efficacy, and practice. Annals of Internal Medicine. 2002;136(5):374–383.
  • Lao L. Safety issues in acupuncture. Journal of Alternative and Complementary Medicine. 1996;2(1):27–31.
  • MacPherson H, Thomas K. Short-term reactions to acupuncture—a cross-sectional survey of patient reports. Acupuncture in Medicine. 2005;23(3):112–120.
  • National Cancer Institute. Acupuncture (PDQ). National Cancer Institute Web site. Accessed at www.cancer.gov/cancertopics/pdq/cam/acupuncture on August 16, 2007.
  • National Institutes of Health Consensus Panel. Acupuncture: National Institutes of Health Consensus Development Conference Statement. National Institutes of Health Web site. Accessed at consensus.nih.gov/1997/1997acupuncture107html.htm on June 22, 2007.
  • Reston J. Now, about my operation in Peking; Now, let me tell you about my appendectomy in Peking…. New York Times. July 26, 1971:1.
  • U.S. Food and Drug Administration. CFR—Code of Federal Regulations Title 21. U.S. Food and Drug Administration Web site. Accessed at www.accessdata.fda.gov/scripts/ cdrh/cfdocs/cfCFR/CFRSearch.cfm?FR=880.5580 on August 2, 2011.

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For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on NCCAM and complementary health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

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NIH Clinical Research Trials and You

The National Institutes of Health (NIH) has created a Web site, NIH Clinical Research Trials and You, to help people learn about clinical trials, why they matter, and how to participate. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov and other resources, and stories about the personal experiences of clinical trial participants. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCAM has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCAM.

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NCCAM Pub No.: 
D404
Date Created: 
December 2007
Last Updated: 
August 2011