Acupuncture

Sara Izadi-Najafabadi et al. (2025) · Integrative cancer therapies

This retrospective study compared 67 people with grade IV glioblastoma (GBM), a fast-growing brain cancer, who received integrative naturopathic care at a Canadian clinic with 243 matched patients from the U.S. SEER cancer registry. The clinic's approach added modulated electro-hyperthermia (mEHT), a radiofrequency treatment that heats tumour tissue, plus high-dose intravenous vitamin C, supplements, acupuncture and diet counselling, on top of standard surgery, radiotherapy and temozolomide chemotherapy. Standard care for GBM extends median survival only to about 14.6 months, so the authors looked for any signal that the extra treatments might add survival time. Patients had at least six mEHT sessions between 2010 and 2024, with a median of 13 sessions of up to 60 minutes each at powers rising from 50 to 140 watts. Controls were matched on age, sex, diagnosis year and whether they had surgery, radiation and chemotherapy. To avoid giving the clinic group credit for the months before they arrived, survival was counted from the start of clinic treatment (or the matched patient's start date for controls) and compared with Kaplan-Meier curves and Cox regression. Median survival from that starting point was 15 months with integrative care versus 11 months in controls, and the hazard ratio of 0.72 (95% CI 0.53-1.00, p = 0.05) sat right at the edge of statistical significance (a 28% lower hazard of death). The difference was concentrated in people who started within 120 days of diagnosis (hazard ratio 0.52, p = 0.006, roughly half the hazard of death) and in those under 50 (0.51, p = 0.009); starting later or being 50 or older showed no difference (0.98 and 0.96). Treatment began a median of 124 days after diagnosis, so these patients had already survived that long. The authors saw no seizures or other side effects. Those subgroup analyses were exploratory, unadjusted for multiple testing, and the matched groups still differed in how many had chemotherapy and radiotherapy. Because treatment was not randomised and many factors that shape GBM survival, such as tumour genetics, extent of surgery and general fitness, were unavailable, the results cannot show that the integrative care caused the longer survival. Clinic patients also paid for their own care, which may favour those with more resources, and the dose and timing of mEHT varied between individuals. The authors describe the findings as hypothesis-generating, a signal rather than an effect estimate, and call for randomised trials.

Sandra Utz et al. (2025) · Biomedicines

This prospective observational study followed 101 adults with long-standing fibromyalgia syndrome (FMS) through a two-week integrative inpatient stay in Bamberg, Germany, with no control group. FMS is a chronic condition marked by widespread pain, fatigue, sleep problems, anxiety and depression, and the authors describe it as the third most common rheumatic disease. The program was built on classical European naturopathy: water-based therapies and heat, exercise, plant-based nutrition or medical fasting, herbal remedies and mind-body practices such as relaxation. The question was whether such a combined approach would ease symptoms at discharge and six months later. Of 134 patients who joined (127 women, ages 22 to 80), 101 returned questionnaires on admission, at discharge and after six months. During the stay they took part in meditative movement, physical therapy, hydrotherapy, lectures and cooking classes, and some had whole-body heat sessions or a 5-day fast on under 300 kcal a day. Pain, fatigue, anxiety, depression, stress and quality of life were measured with standard questionnaires (such as the HADS for anxiety and depression and the MFI-20 for fatigue) and compared over time with repeated-measures statistics. Overall pain intensity dropped from 71.5 to 63.0 on a 0-100 scale at discharge (a moderate effect, dz = 0.62) and was still lower at six months (64.4). Current pain fell sharply during the stay (6.56 to 4.37 out of 10) but crept back to 5.96 at six months. Fatigue improved from 71.1 to 63.3 and then partly returned (68.0). Anxiety and depression scores each fell by roughly 2.5 points at discharge and were still lower than baseline at six months. Stress and feelings of helplessness improved mainly after discharge, and mental quality of life rose between discharge and follow-up. Patients who fasted kept their pain gains at six months (p = 0.006), whereas non-fasters did not (p = 0.062), although this difference was borderline (interaction p = 0.050) and not randomised. The results come from an uncontrolled, single-centre sample in which a quarter of the participants did not complete the six-month questionnaire, so the changes cannot be attributed to the program alone. More than half the patients reported obstacles to continuing the methods at home, such as lack of time and exhaustion. The authors call for randomised trials with long-term follow-up and propose a follow-up day-clinic programme to help consolidate the learned self-management skills and everyday routines.

Ying Cao et al. (2025) · QJM : monthly journal of the Association of Physicians

This randomized trial with 84 emergency department patients explored whether acupuncture started right away, before a diagnosis is confirmed, eases the pain of suspected renal colic, the sudden, severe cramping pain in the back or abdomen that usually comes from a kidney or urinary stone. Imaging to confirm a stone takes time while patients are in extreme pain, and the authors note that the usual painkillers have drawbacks: anti-inflammatory drugs can raise heart risk with higher doses and longer use, and opioids cause side effects including nausea, drowsiness and dependence concerns. Acupuncture, a traditional Chinese medicine technique that places thin needles at specific body points, had already been reported by this group to reduce pain in confirmed cases. Adults aged 18 to 80 with one-sided colicky pain and tenderness over the kidney area, and pain of at least 4 on a 0 to 10 scale, were treated at a Beijing hospital emergency department. Half received needles in the back of both hands at Yaotongdian, a point the authors use for lumbar pain, with the needles lifted and rotated until a soreness or heaviness sensation appeared and then left in for 30 minutes. The other half had very shallow needling with tiny short needles at spots that are not acupuncture points, with no manipulation. Ten minutes after needling, 64.3% of the acupuncture group (27 of 42) had at least halved their pain, versus 16.7% of the sham group (7 of 42), a 47.6 percentage point gap (P < 0.01, so chance is very unlikely to explain it). By 30 minutes the figures were 85.7% versus 31.0%. Average pain scores at 10 minutes were 3.38 versus 6.00. Fewer acupuncture patients needed an analgesic injection by 30 minutes (33.3% vs 59.5%; P = 0.03) and satisfaction scores were higher (4.69 vs 3.69). Patients, outcome assessors and statisticians did not know the group, and patients guessed their group at similar rates, so the blinding held. Surgery and return visits did not differ between groups, and each group had one adverse event (bleeding with acupuncture; nausea and vomiting with sham). The authors suggest that early acupuncture is a safe option for pain relief while a diagnosis is awaited and that it did not appear to interfere with later care. The authors also note that a single acupuncture point may give limited improvement in critically ill patients. They state plainly that the study was done at one center with experienced acupuncturists, included only 3 acupuncture-group patients who turned out not to have a urinary stone, and did not analyze results by stone size. They call for multicenter confirmation.

Jian-Feng Tu et al. (2022) · JAMA network open

This randomized trial with 80 emergency department patients explored whether adding acupuncture to a standard painkiller injection brings faster relief from renal colic, the severe cramping flank pain that occurs when a kidney stone blocks or moves through the urinary tract. Renal colic is described by the authors as one of the worst types of pain, and the guideline first-choice drugs, nonsteroidal anti-inflammatory medicines such as diclofenac, take time to work: in an earlier study, 37.5% of patients still had moderate or severe pain 15 minutes after an injection. Acupuncture, a traditional Chinese medicine technique that inserts thin needles at specific body points, had shown quick pain reduction in other settings. Adults aged 18 to 75 with stone-related renal colic and pain of at least 4 out of 10 on a visual analog scale (a line on which patients mark their pain) were treated at a Beijing hospital emergency department in 2020. Everyone received a 50 mg diclofenac injection into the muscle. Half then had 30 minutes of needling at Yaotongdian, a point on the back of each hand, with the needles twisted and lifted until a soreness or heaviness sensation (called De qi) appeared. The other half had shallow needle pricks at forearm spots that are not acupuncture points. Ten minutes after needling, 77.5% of the acupuncture group (31 of 40) had at least halved their pain score, compared with 10.0% of the sham group (4 of 40), a gap of 67.5 percentage points (P < .001, so chance is very unlikely to explain it). Average pain fell to 3.0 versus 5.9 out of 10. Acupuncture also led at 0, 5, 15, 20 and 30 minutes (97.5% vs 80.0% at 30 minutes; P = .03). Patients, assessors and the statistician did not know the group, and patients guessed their group about equally often in both arms (P = .48). The advantage faded as the injection took effect: by 45 and 60 minutes both groups had about 92% to 98% responding (P = .62), and only 1 patient needed stronger rescue medication. No adverse events were recorded. The authors suggest acupuncture may serve as an optional add-on for faster relief, since it uses a single point and needs no individual diagnosis. They attribute the absence of a rescue-medication difference to a possible ceiling effect from the diclofenac. They note limitations plainly: one hospital, treatment given after diagnostic imaging, experienced acupuncturists who could not be blinded, and no follow-up of pain beyond 60 minutes or analysis by stone size. They plan to study acupuncture before imaging.

Kazi Md Azman Hossain et al. (2026) · Brain and behavior

This multicenter randomized controlled trial with 120 stroke survivors explored whether adding one of two non-drug therapies to standard physiotherapy could better ease post-stroke spasticity-the abnormal muscle tightness and stiff reflexes that affect roughly a quarter to a third of people after a stroke. The two add-ons were extracorporeal shockwave therapy (ESWT), which delivers mechanical pressure-wave pulses through the skin into stiff muscle tissue, and acupoint-based TENS (Acu-TENS), a mild electrical current applied over traditional acupuncture points rather than through needles. Both are theorized to calm overactive stretch reflexes and support the nervous system's own capacity for recovery (neuroplasticity, the brain and nerves' ability to reorganize and adapt). Participants, aged 40 to 70 with spasticity in one arm and leg after an ischemic stroke, were randomly assigned to 18 supervised sessions over six weeks: shockwave therapy plus physiotherapy, Acu-TENS plus physiotherapy, or physiotherapy alone. The shockwave group received pulses at set energy levels over affected muscle bellies; the Acu-TENS group received electrical stimulation over four standardized acupuncture points on the weak side. Physiotherapy itself included stretching, range-of-motion work, strength training, balance, and gait practice. Blinded assessors measured spasticity, arm and leg movement, walking speed, and quality of life at 6 and 18 weeks. Everyone improved on physiotherapy alone, but the shockwave group saw the biggest gains. Upper-limb spasticity scores dropped significantly more with shockwave therapy than physiotherapy-only (mean difference -0.73, close to a full point less muscle tightness on the 5-point Ashworth scale), and Acu-TENS also beat physiotherapy-only (-0.40). Arm movement scores (Fugl-Meyer Assessment) rose 6 to 8 points more with shockwave therapy than physiotherapy alone-a difference generally considered clinically noticeable-and Acu-TENS added 3.5 to 4.3 points. Quality-of-life scores climbed roughly 12 points more with shockwave therapy than physiotherapy alone by 18 weeks, with Acu-TENS partway between the two. Walking speed improved in every group, though the therapies didn't clearly separate from each other on that measure. The differences between the two add-on therapies themselves were mostly small. Thirteen people had minor, short-lived side effects-mostly brief soreness or tiredness-and nobody had a serious complication. These results suggest shockwave therapy, and to a lesser extent Acu-TENS, may give stroke survivors an extra edge on top of standard physiotherapy for loosening spastic muscles and regaining movement. Physiotherapy remains the backbone of recovery regardless of which add-on, if any, is used. Limitations include a single-country sample, therapists and patients knowing their assigned treatment, no direct nerve or muscle imaging to confirm how the therapies work, and only 18 weeks of follow-up. Bigger, longer, multi-country trials are the next step before either add-on becomes routine stroke-rehab practice.

Nor Azila Mohd Nafiah et al. (2022) · International journal of environmental research and public health

This randomized controlled trial with 90 hospitalized pregnant women tested whether pressing on a specific wrist point (P6, also known as Nei Guan) could relieve hyperemesis gravidarum -- a severe, dangerous form of pregnancy sickness marked by relentless nausea and vomiting, weight loss, and dehydration, distinct from ordinary "morning sickness." P6 sits about two finger-widths above the inner wrist crease and has long been used in Traditional Chinese Medicine to settle the stomach; commercial acupressure wristbands apply steady pressure to this same point. The trial compared wristband acupressure directly against standard intravenous anti-nausea medication, rather than against a placebo. Ninety women under 16 weeks pregnant with moderate-to-severe nausea and vomiting were admitted to a Malaysian hospital and randomly assigned, 1:1, to either wear acupressure wristbands on both wrists three times a day for at least 10 minutes before meals, or receive standard intravenous anti-nausea medicine (metoclopramide) every 8 hours. Both groups received the same IV fluids. Researchers tracked nausea and vomiting severity with a validated symptom score at 8, 16, and 24 hours, and separately tracked how quickly ketones (a dehydration marker) cleared from the urine. Every enrolled woman completed the trial. The acupressure group had significantly milder nausea and vomiting than the medication-only group at every checkpoint (8, 16, and 24 hours; p=0.001-0.006) -- by 24 hours, 93% of the acupressure group had only mild symptoms left, compared to 60% on medication alone. Acupressure also cleared the dehydration marker (urine ketones) faster on average (about 22 hours versus 28 hours, p=0.02) and cut the need for rescue anti-nausea injections sharply: over a quarter of the acupressure group needed no extra medication at all, while the medication-only group received three scheduled doses regardless. No side effects were reported in either group. These results position P6 acupressure as a genuinely useful, risk-free option for easing severe pregnancy nausea and reducing how much anti-nausea medication a hospitalized patient needs. The key caveat: there was no realistic way to "fake" acupressure for comparison, so some of the benefit could reflect expectation rather than the specific pressure point itself -- and the trial was conducted at a single hospital. Still, hyperemesis gravidarum has very few rigorously tested nondrug treatments, making this a meaningful addition to the evidence.

Jing-Yu Tan et al. (2022) · BMC complementary medicine and therapies

This preliminary randomized controlled trial with 114 breast cancer patients starting their first round of chemotherapy explored whether auricular acupressure -- pressing small seeds against specific points on the outer ear -- could ease chemotherapy-induced nausea and vomiting (CINV), a side effect that standard anti-nausea drugs do not fully control. The study is grounded in the idea, borrowed from Traditional Chinese Medicine, that stimulating certain ear points can influence nausea pathways elsewhere in the body. To find out how much of any benefit was real versus expectation, researchers compared a "true" acupressure group against a look-alike "sham" version and against standard care alone. Women scheduled for chemotherapy known to cause significant nausea were split into three groups of 38: true acupressure (firm seeds pressed on seven ear points three times a day for five days), sham acupressure (soft, non-stimulating seeds at the same points and schedule), and standard antiemetic care alone. Everyone received standard anti-nausea medication regardless of group. Nausea and vomiting were tracked using the MASCC Antiemesis Tool, a validated eight-item scale, on the second and sixth days of the chemotherapy cycle, and quality of life was measured separately. Both acupressure groups did better than standard care alone for CINV occurring in the first 24 hours (acute CINV). More than half of the true acupressure group (52.6%) had no nausea or vomiting at all in that window, compared to under a quarter (23.7%) on standard care alone (a meaningful and statistically significant difference, p=0.01). Total symptom scores were also meaningfully lower with true acupressure across several measures (p-values from 0.001 to 0.004, with effect sizes edging toward "large"). The catch: the sham acupressure group did almost as well as the true group on nearly every measure, meaning much of the benefit looks like a placebo effect rather than something unique to real acupressure -- though the researchers note that a placebo effect big enough to meaningfully reduce nausea is still clinically useful. Neither approach measurably helped with nausea that showed up later (days 2-5) or with quality of life. Practically, this suggests auricular acupressure is a safe, low-cost option worth adding alongside standard anti-nausea medication for the first day of chemotherapy, with only mild, temporary ear discomfort reported by about 1 in 7 participants. The main limitation is that the study was small and not designed to definitively prove acupressure's own mechanism works beyond expectation -- a larger, more rigorously powered trial is needed to confirm whether the benefit holds up and how much is truly attributable to acupressure itself versus the ritual of treatment.

Gert Bronfort et al. (2022) · Chiropractic & manual therapies

Low back pain touches an estimated 40-80% of adults at some point, and when it becomes chronic, it is a major driver of disability, missed work, and long-term opioid use. Guidelines recommend combining conventional care with complementary approaches like spinal manipulation, exercise, and acupuncture, but most back pain treatment in practice still relies on a single approach. This year-long randomized trial in Minneapolis compared standard chiropractic care against a coordinated team approach -- chiropractors, acupuncturists, massage therapists, psychologists, exercise therapists, and a physician working together -- to see whether combining disciplines beats chiropractic care alone for people with ongoing low back pain. 201 adults with long-standing back pain (on average, pain for 8 to 9 years) were randomly assigned to 12 weeks of either chiropractic-only care or the multidisciplinary team approach, with a case manager coordinating each patient's individualized plan. Both groups showed strong participation -- over 90% attended their recommended visits. Researchers tracked back pain intensity as the main outcome, alongside disability, quality of life, and patient satisfaction, checking in at 4, 12, 26, and 52 weeks after the study began. Over the full year, the team-based approach edged out chiropractic-only care on pain intensity, with the clearest advantage showing up at the one-year mark. The team approach also showed a meaningful, statistically significant advantage for disability, overall improvement, satisfaction with care, and how often people experienced back symptoms -- though pain relief itself, while favoring the team approach throughout, only reached statistical significance at certain checkpoints (mainly week 52). Things like quality of life, medication use, and fear of movement did not differ meaningfully between the two approaches. Both approaches were very safe: only five serious health events occurred over the year (mostly unrelated conditions like pneumonia or a fractured foot), and about half of participants in both groups reported mild, temporary side effects like increased soreness -- at nearly identical rates whichever approach they received. In people with chronic low back pain, this trial found that a coordinated team of practitioners — rather than chiropractic care alone — gave a modest edge, mainly on disability and overall satisfaction, without added safety risk. That said, the study's participants were not very racially or economically diverse, and the exact process used to decide each patient's treatment plan had not itself been formally validated, so the results may not translate perfectly to every clinic. Still, the findings support integrated, team-based care as a reasonable option on the evidence here.

Dilara Onan et al. (2025) · Journal of oral & facial pain and headache

Chronic tension-type headache (CTTH) -- headaches on 15 or more days a month for at least three months -- is thought to involve tight, tender muscles in the head, neck, and face, though scientists are not fully certain why it happens. This systematic review and meta-analysis pulled together randomized trials testing physiotherapy-style treatments -- things like massage, exercise, acupuncture, and relaxation training -- to see whether they actually ease CTTH symptoms. The researchers followed a pre-registered research plan and searched two major databases through mid-2024, aiming to answer a focused question: do these hands-on and movement-based approaches beat sham treatment, no treatment, or medication alone? Two physiotherapist researchers with PhD degrees independently screened 237 studies and settled on nine randomized trials -- ranging from 25 to 169 patients each, mostly women, treated for 3 to 12 weeks. The approaches tested included trigger point massage, electroacupuncture, relaxation with muscle-tension biofeedback, yoga, and neck-and-shoulder strengthening exercises, among others. Seven of the nine trials had comparable enough data to combine mathematically (meta-analysis), and each study's methodological rigor was scored using a standard 11-item checklist. When the researchers pooled the numbers, physiotherapy approaches meaningfully reduced headache intensity compared to control (a large, statistically significant effect), cut the number of headache days per month by more than one day on average, and shortened how long headaches lasted -- all statistically significant improvements. A fourth measure, day-to-day headache impact on daily life, trended in favor of physiotherapy but did not reach statistical significance. Looking at individual studies: electroacupuncture beat sham treatment for headache intensity; combining a hands-on release technique with ibuprofen worked better than ibuprofen alone; and yoga added to standard medical care outperformed medical care by itself on several measures. Importantly, though, the researchers rated their overall confidence in these pooled results as low to very low -- the studies were small, methods varied a lot between them, and most carried some risk of bias. No serious side effects were reported in any trial. The takeaway is cautiously encouraging: physiotherapy-based approaches -- especially those combining exercise, hands-on techniques, or relaxation training with standard care -- show a real signal for easing CTTH symptoms, and they appear safe. But because the underlying evidence is still thin and inconsistent, these findings should not be read as proof that any one specific technique is the best choice. The authors call for larger, more consistently designed trials before physiotherapy can be confidently recommended as a primary CTTH treatment, though the current evidence supports trying it as a reasonable, low-risk complement to standard care.

Yan-Kun Chen et al. (2023) · Frontiers in endocrinology

This literature review asks two connected questions: what actually drives obesity and type 2 diabetes at a biological level, and whether Traditional Chinese Medicine has anything to offer in managing them. The two conditions are closely linked — the review notes that type 2 diabetes accounts for roughly 90% of all diabetes cases and is strongly tied to excess weight. There is a practical bind behind the question, too: several standard diabetes drugs, including insulin and sulfonylureas, make weight loss harder rather than easier. The authors searched PubMed, Scopus and Web of Science for work published between 2019 and 2023, covering molecular, cellular and clinical studies of how obesity, diabetes and TCM interact. It is important to be clear about what kind of review this is: a narrative overview rather than a systematic one. There is no count of included trials, no pooled statistics and no formal assessment of study quality, so it maps a field rather than measuring an effect. On mechanism, the review draws a useful distinction between visceral fat — stored around the liver, pancreas and kidneys, hormonally active, and the type that drives insulin resistance — and subcutaneous fat sitting under the skin. This is why apple-shaped fat distribution carries more metabolic risk than pear-shaped. The scale of the problem is stark: the World Health Organization counted 1.9 billion overweight adults in 2016, 650 million of them with obesity, and 38.2 million children under five overweight or obese in 2019. The TCM proposal is that acupuncture, herbal remedies and dietary therapy act on inflammation, oxidative stress, insulin resistance and the balance of gut bacteria. What this review does not provide is evidence of how well any of that works. No effect sizes, no confidence intervals, no trial results for any specific TCM intervention appear. The authors themselves conclude only that TCM may be promising and that well-designed studies are still needed to confirm both efficacy and safety. Read it as a map of plausible mechanisms and an argument for research, not as grounds for choosing a treatment.

Shuang Liang et al. (2024) · BMJ open

This systematic review and meta-analysis pooled 8 randomized controlled trials with 463 participants (229 receiving acupuncture, 234 receiving a comparator) to test acupuncture for atopic dermatitis — also called atopic eczema — a chronic, relapsing inflammatory skin condition marked by itch (pruritus), dryness and rash. The most frequently needled points were LI11 (Quchi), ST36 (Zusanli) and SP10 (Xuehai), acupoints from Traditional Chinese Medicine's meridian system traditionally used to clear heat, calm itch and support immune balance; here they were tested against blank controls, sham (non-penetrating) acupuncture, or standard medicines like antihistamines and topical steroids. Across the eight trials — two from Germany, two from South Korea and four from China — treatment took two main forms: manual acupuncture (5 trials, mostly needling LI11, ST36 and SP10 for 15-30 minutes, one to seven times weekly over 10 days to 5 weeks) and fire acupuncture, where a heated needle is briefly inserted (3 trials, mainly paired with standard medicine). Two trials added retained press-tack needles at LI11 and the ear point Shenmen. Severity was tracked with the SCORAD index (combining physician and patient ratings) and the EASI (physician-only); itch with a 0-100 visual analogue scale (VAS); and quality of life with the DLQI questionnaire. Acupuncture significantly lowered SCORAD scores compared with control (MD=-10.61, 95% CI -17.77 to -3.45, p=0.004 — a drop large enough to clear the 8.7-point threshold doctors consider clinically noticeable). It cut itch scores even more clearly (VAS MD=-14.71, 95% CI -18.20 to -11.22, p<0.00001 — also above its meaningful-change threshold) and improved DLQI quality-of-life scores (MD=-2.37, p<0.0001), though that change fell short of the threshold considered clinically important. The EASI score, which relies only on a physician's rating rather than patient-reported itch and sleep, showed no significant group difference (p=0.08), and neither did blood IgE levels (p=0.07). Compared specifically with sham (fake-point) acupuncture rather than no treatment, real acupuncture still won out on SCORAD (p<0.00001) — evidence the effect is not just expectation or attention. Only mild, short-lived side effects were reported (bruising, limb numbness, mild stomach upset), and no serious harms occurred in any of the five trials that tracked safety. In atopic dermatitis, these results suggest acupuncture — especially manual or fire acupuncture at LI11, ST36 and SP10 — may help as an add-on to standard treatment, with itch relief the most consistent benefit and a good safety record. The review authors caution that only 8 small trials (463 people total) were available, most had weaknesses like unclear allocation concealment or blinding, and results varied a great deal between studies. Larger, more rigorously blinded multicentre trials are needed before acupuncture earns a stronger recommendation than a promising adjunct therapy.

Min He et al. (2022) · European journal of medical research

This systematic review and meta-analysis combined 30 randomised controlled trials with 4,413 participants to test whether acupuncture helps allergic rhinitis — the sneezing, congestion and runny nose caused by an allergic reaction in the lining of the nose. What sets it apart is that the authors then stress-tested their own findings using trial sequential analysis, a method that asks whether enough participants have been studied for a pooled result to be trusted rather than treated as a chance finding. Trials came mostly from China (22 of 30), with others from Germany, Australia, South Korea and Sweden, ranging from 24 to 981 participants and lasting between two and twelve weeks. Three needling approaches were used: standard needle acupuncture, electroacupuncture, and warm needling, in which mugwort is burned on the needle to heat it. Acupuncture was compared against no treatment, against sham needling at non-acupuncture points, and against antihistamines including cetirizine and loratadine. Symptoms were scored with the Total Nasal Symptom Score and quality of life with the Rhinoconjunctivitis Quality of Life Questionnaire. Against no treatment, acupuncture improved both nasal symptoms and quality of life in adults. Against sham needling it also came out ahead, improving nasal symptoms (mean difference -0.60, 95% CI -1.16 to -0.04, from 489 participants) and quality of life (mean difference -8.47, 95% CI -14.91 to -2.03, from 248 participants) — both statistically significant, since neither confidence interval crosses zero. Against cetirizine or loratadine no clear difference appeared, suggesting acupuncture performs about as well as standard antihistamines. But the trial sequential analysis failed to confirm any of these results, meaning the pooled evidence has not yet accumulated enough participants to be considered reliable. Effects in children and adolescents could not be determined at all. The honest summary is a promising signal that has not yet been confirmed. Performance and attrition bias were serious in most of the included trials, and the authors' own robustness check contradicted their own positive findings. For an adult who would rather not take daily antihistamines, acupuncture is a defensible option on current evidence; it is not yet a demonstrated one. Larger and better-conducted trials, especially in children, are what would settle the question.

YuJuan Zhang et al. (2020) · Current rheumatology reports

This review examined five years of research — 16 review articles and 11 randomized controlled trials published between 2016 and 2020 — to answer a question millions of people ask: does acupuncture actually work for chronic musculoskeletal pain? That umbrella covers osteoarthritis, rheumatoid arthritis, fibromyalgia, and chronic low back pain, which together form the leading cause of disability worldwide. About three million American adults already use acupuncture yearly, most of them for these very conditions. The reviewers, writing in Current Rheumatology Reports, held studies to clear standards: randomized trials with at least 20 adults, pain as a measured primary outcome, and a genuine control group — sham needling, waiting list, active therapy, or routine care. They excluded dry needling and moxibustion so the conclusions would apply specifically to classical acupuncture at standard points. The answer turned out to be condition-specific, and refreshingly honest. Knee osteoarthritis and chronic low back pain earned the strongest support: short-term pain relief is real, and the authors call acupuncture a safe and reasonable referral option for both — a stance Medicare has since echoed by covering acupuncture for chronic low back pain. Fibromyalgia sits in the middle: acupuncture may help, but the evidence is thinner. Hip osteoarthritis and rheumatoid arthritis land on the other side: the available evidence does not support acupuncture for either, a negative finding stated without hedging. Safety was favorable across the board. For joint or back pain, this review is essentially a map of where the evidence for acupuncture stands. It is a narrative synthesis rather than a statistical meta-analysis, so it pools no numbers of its own, and its authors close with the field''s standing caveat: the short-term benefits reported across these trials still need confirmation in larger, more rigorous studies, especially for the conditions in the middle ground.

Shabei Xu et al. (2020) · BMJ (Clinical research ed.)

This randomized controlled trial with 150 participants, published in The BMJ, tackled the biggest criticism of acupuncture research head-on: that acupuncture only beats "sham" needling when the sham is badly designed. Seven hospitals in China enrolled adults with episodic migraine without aura who had never received acupuncture before, so nobody could tell true needling from fake by experience. Participants were randomized to twenty sessions of manual acupuncture (real needles at true points, with the classical rotation and lift-thrust manipulation), twenty sessions of non-penetrating sham (blunt needles at non-acupuncture points that never break the skin), or usual care alone, all over eight weeks. Blinding was formally tested and held — 79% of the real-acupuncture group and 75% of the sham group believed they had received penetrating needles, a statistical dead heat (P=0.891). Migraine days and attacks were counted in four-week blocks through week 20. Real acupuncture pulled ahead of sham, and the gap grew after treatment ended. By weeks 17–20, manual acupuncture had cut 3.9 migraine days per four weeks versus 2.2 for sham (adjusted difference −2.1 days, 95% CI −2.9 to −1.2, P<0.001 — meaning roughly two extra migraine-free days a month attributable to true needling), and attacks dropped by 2.3 versus 1.6 (P<0.001). Both needle groups beat usual care alone, which is itself informative: part of acupuncture's benefit comes from the ritual and attention of treatment, and part — the two extra migraine-free days — from the needling itself. No severe adverse events were reported, and 147 of 150 participants completed the analysis. For the millions of people with migraine who cannot tolerate preventive drugs — or prefer not to start them — this trial provides unusually clean evidence that manual acupuncture has a real, specific preventive effect beyond placebo. The benefit emerged gradually, months into follow-up, suggesting patience matters. The trial ran in a single country and followed patients only to week 20, so durability beyond five months remains an open question.

He Chen et al. (2024) · Current pain and headache reports

Does acupuncture keep helping knee osteoarthritis after the needles stop? A 2024 systematic review and meta-analysis in Current Pain and Headache Reports pooled 10 randomized controlled trials with 3,221 participants to answer exactly that, and found benefits lasting roughly 3 to 6 months after the final session. The durability depended on the comparison. Against sham acupuncture, real acupuncture kept function measurably better for 4.5 months after treatment ended, and overall pain stayed lower through 4.5 months as well. Against usual care, both pain relief and functional improvement remained large enough to matter clinically for 5 months. One trial comparing dry needling with the anti-inflammatory drug diclofenac found relief persisting 6 months after treatment ended. Not every comparison favored acupuncture. When it was added on top of exercise-based physical therapy, it added nothing measurable for up to 11 months — exercise appears to occupy much of the same therapeutic ground. And two no-treatment-controlled trials disagreed, one showing 3 months of persistence and the other showing benefits only at end of treatment. Safety was consistently good across trials, with no significant excess of adverse events. For the estimated one in five adults over 40 living with knee osteoarthritis, the practical takeaway is that a 4-to-12-week course of acupuncture (typically 1–3 sessions weekly) can deliver relief that outlasts treatment by months — something NSAIDs and steroid injections generally cannot claim. It works best as its own treatment or alongside routine care, not stacked on structured exercise therapy, and results should be weighed knowing each individual comparison rested on relatively few trials.

Lynn L DeBar et al. (2025) · JAMA network open

This randomized trial with 800 participants asked a question no large study had answered: does acupuncture help adults 65 and older with chronic low back pain? Acupuncture — the Traditional Chinese Medicine practice of inserting fine needles at specific points — is already guideline-recommended for back pain in general adults, but older adults face the highest risks from pain medications and had never had a dedicated large trial. The results were designed to inform Medicare coverage. Participants (average age 74, and 41% over 75) were randomized to three groups: standard acupuncture (8–15 sessions over 12 weeks), enhanced acupuncture (the same plus 4–6 maintenance sessions), or usual medical care alone. Real-world community acupuncturists — more than 50 of them — tailored needling to each patient, and disability was measured with the Roland-Morris questionnaire, a standard count of daily activities limited by back pain. At six months, both acupuncture groups functioned meaningfully better than usual care. The share of people achieving at least 30% improvement — the accepted bar for a clinically meaningful change — was 43.8% with enhanced acupuncture and 39.1% with standard, versus 29.4% with usual care alone (a relative 49% and 33% higher chance of meaningful improvement). Benefits held at twelve months. Pain intensity and anxiety also improved, and maintenance sessions added a modest edge on pain. Safety was excellent: serious adverse events were rare, equal across groups, and less than 1% were possibly related to acupuncture. For older adults weighing pain options, this is the strongest evidence yet: acupuncture delivered by community practitioners produced lasting improvement with almost no risk — in a population where the usual alternatives (opioids, NSAIDs, gabapentinoids) carry their highest dangers. The authors suggest it may deserve first-line status for this age group.

Jun J Mao et al. (2021) · JAMA oncology

This randomized clinical trial with 360 cancer survivors asked a practical question: for people who finished cancer treatment but still live with chronic musculoskeletal pain, does acupuncture work better than usual care — and which kind of acupuncture is better? The PEACE trial, run across six sites in New York and New Jersey and published in JAMA Oncology, compared electroacupuncture (electrical stimulation through needles placed in the body) with auricular acupuncture (needles placed at standardized points on the ear). Participants — mean age 62, about 70% women — had a prior cancer diagnosis, no current disease, and pain of at least three months. They were randomized to ten weekly sessions of electroacupuncture (145 people), ear acupuncture (143), or usual care (72), with pain scored on the Brief Pain Inventory, a 0-to-10 scale. Electroacupuncture points were tailored to where each person hurt, while ear acupuncture used the same standardized points for everyone — a deliberately pragmatic design reflecting how each style is really practiced. Nearly everyone (94.4%) completed the twelve-week assessment, unusually high retention for a pain trial in this population. Both acupuncture styles delivered real relief. Electroacupuncture reduced pain by 1.9 points more than usual care (97.5% CI 1.4–2.4, p<0.001 — roughly a one-third drop from the average starting pain of 5.2), and auricular acupuncture by 1.6 points more (97.5% CI 1.0–2.1, p<0.001). But ear acupuncture failed to prove itself as good as electroacupuncture, and it was harder to tolerate: 10.5% of ear-acupuncture patients stopped because of side effects — mostly ear discomfort — versus just 0.7% with electroacupuncture. For cancer survivors seeking alternatives to long-term pain medication, this trial makes electroacupuncture the stronger evidence-backed choice, with ear acupuncture as a workable fallback when body needling isn't practical. The design was pragmatic and the analysis blinded, though there was no sham-needle arm, so expectation effects can't be fully separated — and follow-up ended at 24 weeks, leaving durability an open question.

Jinglan Mu et al. (2020) · The Cochrane database of systematic reviews

Does acupuncture help chronic low back pain? A Cochrane systematic review — the reference standard for evidence synthesis in medicine — pooled 33 randomized controlled trials with 8,270 adults whose low back pain had lasted more than three months without an identifiable cause, and the answer depends entirely on what acupuncture is compared against. The trials, conducted across Europe, Asia, and the Americas, compared real acupuncture with three alternatives: sham needling (needles placed superficially or away from true acupuncture points), no treatment at all, and usual medical care such as medication and physiotherapy. Pain was measured on 0–100 scales, function with validated back-specific questionnaires like the Hannover Functional Ability Questionnaire, and the review graded how trustworthy each pooled result was using the GRADE framework. Against no treatment, acupuncture delivered a 20-point pain reduction (95% CI 16–25 — well past the roughly 15 points patients can actually feel) along with clear functional improvement. Against usual care, pain improved by about 10 points and physical quality of life rose measurably (4.2 points on the SF-12), though mental well-being did not change. Against sham needling, however, the advantage shrank to 9 points — a real but sub-clinical difference — and back function did not separate at all. Side effects were minor and no more frequent than with sham: needle-site pain, bruising, occasional bleeding, with no serious harms attributed to treatment. For the many people living with chronic low back pain, this review supports acupuncture as genuinely better than doing nothing and a reasonable, safe addition to routine care — while being honest that much of the measured benefit may ride on components shared with sham treatment, such as expectation, focused attention, and the treatment ritual itself. Trial quality was mixed, seven German studies contributed two-thirds of all participants, and the authors conclude the choice should ultimately weigh availability, cost, and personal preference.

Andrew J Vickers et al. (2017) · The journal of pain

This meta-analysis pooled the raw, patient-by-patient data of 20,827 people from 39 rigorously screened randomized trials — the largest and most careful analysis of acupuncture for chronic pain ever conducted. Acupuncture is the Traditional Chinese Medicine practice of inserting fine needles at specific body points; classical theory describes it as regulating qi (the body's vital functional energy) flowing through meridians (the mapped channels of that flow), while researchers here tested it purely on outcomes. Only trials with airtight randomization were included, covering four conditions: back and neck pain, osteoarthritis, chronic headache, and shoulder pain. The team obtained original data from trial authors and re-analyzed everything centrally — a gold-standard approach that removes many shortcuts ordinary meta-analyses must take. Acupuncture beat both comparison types for every condition (p < .001 — highly unlikely due to chance). Against no-acupuncture care the effect was about 0.5 standard deviations — in plain terms, starting from pain of 60/100, patients ended near 30 with acupuncture versus 43 without, and half of acupuncture patients achieved 50% pain reduction versus 30% of controls. Against sham (fake) acupuncture the margin was smaller (≈0.2 SD), meaning needle placement is only part of the benefit — but sham could not explain it all. Benefits lasted, fading only about 15% by one year. Neck and shoulder pain responded best (effect sizes 0.83 and 0.57 versus sham), and more sessions produced more relief (p = 0.001). Notably, the pooled effect matches or beats common anti-inflammatory drugs, whose effect sizes run below 0.23 for the same conditions. The authors' bottom line, unchanged since: referring a chronic pain patient for a course of acupuncture is a reasonable clinical option — with real, persistent, not-just-placebo benefit and an excellent safety profile.