Acupuncture

Acupuncture is a practice from traditional Chinese medicine in which a trained practitioner places very fine, sterile needles at specific points on the body. In the tradition, these points lie along channels that carry qi, or vital energy. Modern researchers also study how needling may affect nerves, muscle, and the way the brain processes pain.

A first visit usually runs 60 to 90 minutes and begins with questions about your health, sleep, digestion, and stress. The practitioner then places several needles, often only a few millimeters deep, and you rest for 20 to 40 minutes. Most people feel little more than a mild tingle, ache, or heaviness, and many find the quiet time deeply relaxing.

People commonly seek acupuncture for chronic pain in the back, neck, shoulder, and knee, and for headaches and migraine. Others use it for stress, sleep difficulties, nausea, or support during cancer care. Practitioners often suggest a course of visits over several weeks, then adjust based on how you respond.

Acupuncture is one of the better-studied complementary practices. Large reviews suggest it may help with chronic musculoskeletal pain, knee osteoarthritis, migraine, and tension-type headache. The advantage over sham needling is real but small, and part of the benefit likely comes from expectation and the care of the visit. Evidence is more mixed for irritable bowel symptoms, hot flashes, and fertility.

Acupuncture is generally safe when a licensed practitioner uses sterile, single-use needles. Tell your practitioner if you are pregnant, take blood thinners, have a bleeding disorder, or have a pacemaker, and see a doctor first for new or severe symptoms. Acupuncture complements medical care and does not replace it.

Acupuncture developed in China, and its early history is debated among historians. Silk manuscripts from the Mawangdui tomb in Hunan, sealed in 168 BCE and excavated in 1973, describe a system of eleven channels, forerunners of the later twelve-channel system, but they list no acupuncture points and point to moxibustion and bloodletting, not clear needling. The Huangdi Neijing, the Yellow Emperor's Inner Canon, compiled between the Warring States and Han periods, sets out channel theory, and its Lingshu section is the main early source for needling. In the third century CE the physician Huangfu Mi organized the points in the Zhenjiu Jiayi Jing, the Systematic Classic of Acupuncture and Moxibustion.

Chinese medical knowledge reached Japan in the sixth century CE by way of the Korean peninsula, and distinct regional styles followed. In 1683 the Dutch physician Willem ten Rhijne, who had worked at the Dejima trading post in Japan, published one of the first detailed Western accounts, an essay on acupuncture appended to a treatise on arthritis. Wider American interest followed in 1971, when New York Times columnist James Reston described the acupuncture he received for discomfort after an emergency appendectomy in Beijing.

In 1997 an NIH consensus panel found clear evidence of benefit for postoperative and chemotherapy nausea and vomiting. In 2017 the American College of Physicians listed acupuncture among first-choice nonpharmacologic options for chronic low back pain. Medicare began covering it for chronic low back pain in 2020, and the VA includes it in its Whole Health approach. Practitioners are licensed through state boards, and many use national certification through the NCCAOM.