Acupuncture and the research

I’m Paul, an acupuncturist in Australia. Here’s a plain-English summary of what high-quality research says about acupuncture—where it shines, where it helps alongside other care, and where we still need better studies. I use Australian spelling and I link straight to the sources.

What the strongest evidence says

Across hundreds of randomised trials and several large meta-analyses, acupuncture is more than placebo for a number of common problems. Here are stand-outs where evidence is strongest:

  • Migraines and tension-type headaches: fewer headache days and less medication use [3], [4].
  • Chronic low back pain and knee osteoarthritis: less pain, better function and quality of life; benefits are modest to moderate and build over a short course of care [1], [5], [6], [16].
  • Cancer treatment–related nausea and vomiting: adding acupuncture/acupressure to usual antiemetics improves control for many people [7], [8].
  • Post-operative nausea and vomiting: stimulation at PC6/Neiguan helps prevent PONV in adults and children [9].
  • In the emergency department: in a large Australian trial, acupuncture provided pain relief equivalent to standard drug therapy for selected acute pains [10].

Note: effects vary person-to-person. In pain conditions, improvements are usually small to moderate at a population level, but can be clinically meaningful for individuals—especially when combined with exercise and sensible self-care [16].

Is acupuncture safe?

Acupuncture is very safe when I provide it as a qualified practitioner. Large prospective studies report mostly minor, short-lived side effects (like a small bruise or brief light-headedness). Serious adverse events are rare—about 1 per 10,000 treatments or less in high-quality studies [11], [12]. In Australia, registered acupuncturists follow the Chinese Medicine Board of Australia’s infection-control guidelines: single-use, sterile needles, proper hand hygiene, a clean field, and safe sharps disposal [13].

Where acupuncture fits with other care

I think of acupuncture as a complement to the basics: graded movement, simple strength work, better sleep, pacing, and nutrition. Evidence maps show a growing research base across pain, headaches, osteoarthritis, nausea, allergy and more. Some areas are well-supported; others are promising but need better trials [14], [16].

For knee osteoarthritis, for example, acupuncture can reduce pain and improve function, and pairing it with targeted exercise often adds benefit [5], [6]. For pregnancy-related pelvic girdle pain, older trials and a Cochrane review suggest benefit for some women, but overall certainty is low—so I weigh risks and preferences carefully and coordinate with your midwife or GP [17], [18].

How acupuncture works (in short)

Modern neurobiology shows acupuncture modulates pain through several pathways: it nudges the body’s own pain-relief systems (endorphins and related opioids), engages descending inhibitory pathways from the brainstem (serotonin and noradrenaline), and calms sensitised nerves and local inflammation. That helps explain why many people feel looser and more comfortable after a session, even before tissue changes catch up [15].

What to expect in a session

  • First visit (45–60 min): I make a clear diagnosis, set a plan, and give your first treatment. I cover benefits, risks and alternatives in plain English and answer questions.
  • Number of sessions: for pain and headaches, a short trial is 4–6 weekly treatments. Many people notice change within 2–4 visits; we review and adjust as we go (if there’s no progress by session 4–6, we rethink).
  • During treatment: I use single-use sterile needles; you may feel a dull ache, warmth or heaviness for a few seconds—then a calm, relaxed state.
  • Aftercare: gentle movement, hydration, and the simple self-care we agreed on. For migraines, we’ll tidy up common triggers and a prevention plan.

My take

I’m pro-acupuncture and pro-science. The best results come when we combine acupuncture with movement, sleep, and lifestyle tweaks. I’ll be honest about what we can expect and keep your GP in the loop when needed. If a different therapy is likely to help more, I’ll say so.

References

  1. Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for chronic pain: Update of an individual patient data meta-analysis. J Pain. 2018;19(5):455–474. doi:10.1016/j.jpain.2017.11.005. PubMed
  2. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. JAMA Intern Med. 2012;172(19):1444–1453. doi:10.1001/archinternmed.2012.3654. PubMed
  3. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;(6):CD001218. doi:10.1002/14651858.CD001218.pub3. Cochrane
  4. Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;(4):CD007587. doi:10.1002/14651858.CD007587.pub2. Cochrane
  5. Liu C-Y, Xu Y, Wang J, et al. Clinical effect and contributing factors of acupuncture for knee osteoarthritis: systematic review and meta-analysis. BMJ Evid Based Med. 2024;29(6):374–384. doi:10.1136/bmjebm-2023-112209. PDF
  6. Chen J, Guo H, Pan J, et al. Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res. 2023;18:1–14. doi:10.1186/s13018-023-04198-2. Article
  7. Yan Y, López-Alcalde J, Zhang L, Siebenhüner AR, Witt CM, Barth J. Acupuncture for the prevention of chemotherapy-induced nausea and vomiting in cancer patients: a systematic review and meta-analysis. Cancer Med. 2023;12(11):12504–12517. doi:10.1002/cam4.5962. Publisher
  8. CAM-Cancer. Acupuncture for chemotherapy-associated nausea and vomiting (summary of SIO 2017/ASCO 2018 guidance). Updated 2025. Summary
  9. Lee A, Chan SKC, Fan LTT. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2015;(11):CD003281. doi:10.1002/14651858.CD003281.pub4. Cochrane
  10. Cohen MM, Beaton T, Thomas G, et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence trial. Med J Aust. 2017;206(11):494–499. doi:10.5694/mja16.11499. MJA
  11. Bäumler P, Irnich D, Witt CM, et al. Acupuncture-related adverse events: systematic review and meta-analysis of prospective studies. BMJ Open. 2021;11:e045961. doi:10.1136/bmjopen-2020-045961. Article
  12. Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97,733 patients. Arch Intern Med. 2004;164(1):104–105. doi:10.1001/archinte.164.1.104. Article
  13. Chinese Medicine Board of Australia. Guidelines on infection prevention and control for acupuncture and related practices. Effective 1 Dec 2023. CMBA
  14. Shekelle PG, et al. Use of acupuncture for adult health conditions, 2013–2021: An evidence map. JAMA Netw Open. 2022;5(12):e2246926. doi:10.1001/jamanetworkopen.2022.46926. JAMA Netw Open
  15. Zhao Z-Q. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol. 2008;85(4):355–375. doi:10.1016/j.pneurobio.2008.05.004. Publisher
  16. Cashin AG, Furlong BM, Kamper SJ, et al. Analgesic effects of non-surgical and non-interventional treatments for low back pain: systematic review and meta-analysis of placebo-controlled randomised trials. BMJ Evid Based Med. 2025;30(4):222–233. doi:10.1136/bmjebm-2024-112974. Article
  17. Elden H, Ladfors L, Olsen MF, et al. Effects of acupuncture and stabilising exercises as adjuncts to standard treatment in pregnant women with pelvic girdle pain: randomised single-blind controlled trial. BMJ. 2005;330:761. doi:10.1136/bmj.38397.507014.E0. BMJ
  18. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;(9):CD001139. doi:10.1002/14651858.CD001139.pub4. Cochrane
  19. McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). AACMA; 2017. PDF