La acupuntura es la inserción de agujas muy finas en puntos específicos del cuerpo, y tiene más ensayos aleatorizados detrás que casi cualquier otra cosa en la medicina china. Su historial más sólido es el dolor crónico: dolor de espalda y de cuello, artrosis de rodilla, cefalea crónica y dolor de hombro, evaluado en casi 21.000 pacientes. También previene la migraña y la cefalea tensional aproximadamente tan bien como los fármacos preventivos estándar, con menos efectos secundarios. Y aquieta las náuseas y los vómitos después de la cirugía.
Su ventaja sobre una aguja falsa es pequeña, aunque su ventaja sobre la ausencia de tratamiento es grande. La acupuntura no eleva las tasas de nacimiento vivo en la FIV, y la evidencia en depresión y alergia es escasa. La mayoría de los ensayos aplicaron una serie de seis a doce sesiones, y el daño grave por parte de un profesional capacitado es raro.
Findings & Outcomes
What It Is
Acupuncture is the insertion of fine, single-use needles at chosen points on the body, usually left in place for 20 to 30 minutes. The needles are sometimes gently twirled or connected to a small electric current. It comes out of Chinese medicine and is now one of the most studied practices in the field, with hundreds of randomized trials behind it. The needles are about the width of a hair, far thinner than the hollow needles used for injections. Most people feel a small prick on insertion, then a spreading ache as the needle settles.
A course is not a single visit. Almost every trial that found a benefit ran 6 to 12 sessions over several weeks. Electroacupuncture runs a mild current between paired needles. Several of the strongest nausea and pain trials used it for a steadier, stronger stimulus than the hand.
Anatomy of the Practice
1The first session
The practitioner takes a Chinese medicine history, looks at your tongue, and feels your pulse, then inserts several fine needles. You feel a brief prick, then a dull heaviness. The needles stay in for twenty to thirty minutes while you rest. Many people feel relaxed or a little drowsy afterward. Some feel a brief lift or ache in the first day or two, before the lasting benefit has had time to build.
2Over a course of weeks
Benefit builds across a course, not in one visit. The trials that worked ran six to twelve sessions over about six to eight weeks, often once or twice a week at first. For migraine and tension headache, headache days start dropping within this window. For chronic pain, function and pain scores shift over the course, not after a single needle.
3Over the following months
The relief from a completed course is unusually durable, holding for close to a year. Many people return for occasional maintenance sessions to keep the gain.
What The Evidence Best Supports
Acupuncture's strongest case is chronic pain. The strongest evidence is a meta-analysis that pooled the raw patient records, not just the published trial summaries, from 39 trials and 20,827 people. For low back and neck pain, knee osteoarthritis, chronic headache, and shoulder pain, it beat a fake needle by a small margin and no acupuncture by a large one. Over the following 12 months, the relief faded only about 15%.
- Migraine prevention. A Cochrane review of 22 trials and 4,985 people found that adding acupuncture cut migraine days. Half of those given real acupuncture, 50%, had their migraine days at least halved, against 41% given a sham, a small but consistent gap rated moderate-certainty. Head to head with the standard preventive drugs, 57% responded to acupuncture against 46% to the drugs at three months, with far fewer side effects.
- Tension-type headache. Across 12 trials and 2,349 people, 51% given real acupuncture had their headache days at least halved, against 43% given a sham. The gain over no treatment was much larger.
- Nausea and vomiting after surgery. Stimulating PC6 on the inner wrist cut post-surgery nausea (relative risk 0.68) and vomiting (0.60) against a sham procedure, across 59 trials and 7,667 people. It worked about as well as antiemetic drugs. Trial quality was mixed, but the finding was large and consistent.
- Chemotherapy nausea. After chemotherapy, electroacupuncture cut first-day vomiting (relative risk 0.76) across 11 pooled trials.
Past pain, headache, and nausea the evidence thins.
- Depression. A Cochrane review of 64 trials found acupuncture lowered depression scores against a fake needle by about 1.7 points on the Hamilton scale. The trials were rated low to very low quality, so that figure is uncertain.
- Seasonal allergies. For allergic rhinitis, acupuncture edged a sham needle on quality of life and cut antihistamine use in people allergic to birch and grass pollen. The authors judged the improvement small enough that it may not matter clinically.
The Research & Studies
Everything here is based on the research we have collected and checked, sorted into groups and ordered with the strongest evidence first. Click any claim to open the studies behind it.
Pain
Acupuncture beat sham and no-acupuncture for chronic pain, across nearly 21,000 patients
When researchers pooled the raw data from 39 trials and almost 21,000 people, those treated with acupuncture for chronic pain did a little better than people given fake needles, and much better than people given no acupuncture at all.
The 2018 update to the individual-patient-data meta-analysis (39 trials, 20,827 patients) covered back and neck pain, knee osteoarthritis, chronic headache, and shoulder pain. Effect sizes were close to 0.5 standard deviations versus no-acupuncture controls and close to 0.2 standard deviations versus sham acupuncture. Pooling patient-level data guards against the selective reporting that inflates study-level meta-analyses, which is why this is the anchor for the pain claim.
Who this may not transfer to:Pooled across 39 chronic-pain trials of both sexes; the individual conditions differ in sex balance (headache and osteoarthritis skew female).
The study · 1
Vickers et al., Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis · J Pain 2018;19(5):455-474
Counts once: this finding and 2 others here come from the same source, so they are one body of evidence, not separate confirmations.
Chronic-pain relief from a course of acupuncture persisted about a year
The pain relief did not vanish when treatment stopped. A year later, people had kept most of the improvement, with only about a 15% fade.
In the same individual-patient-data meta-analysis, the treatment effect for chronic pain decreased only about 15% at 12 months after a completed course, indicating the benefit is durable, not fleeting. Measured in: Adults with chronic pain followed for up to a year after a course of acupuncture, within 39 pooled trials. Durability was measured after a completed multi-session course, not a single treatment; not every included trial reported one-year follow-up, so the persistence estimate rests on the subset that did.
Who this may not transfer to:Same pooled chronic-pain population as the primary meta-analysis, both sexes.
The study · 1
Vickers et al., Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis · J Pain 2018;19(5):455-474
Counts once: this finding and 2 others here come from the same source, so they are one body of evidence, not separate confirmations.
Evidence And Methods
Most of acupuncture's pain benefit came from the treatment context, not needle placement
The jump from no treatment to a fake needle was bigger than the jump from a fake needle to a real one. So a lot of how acupuncture helps pain is the whole experience of being treated, which is a real effect, not the exact spot the needle went.
The effect over no acupuncture (about 0.5 SD) was more than double the effect over sham acupuncture (about 0.2 SD), so the difference between the two comparisons, the part attributable to attention, touch, ritual, and expectation, was larger than the part attributable to the specific needle placement. Measured in: Adults with chronic pain in the 39-trial individual-patient-data meta-analysis. This is a limitation and interpretation claim, not a benefit claim. It does not mean acupuncture fails to help; context effects are a genuine mechanism of pain relief that a patient receives in a real clinic. It does mean the needle-specific signal is modest and the point-specificity debate is unresolved.
Who this may not transfer to:Same pooled chronic-pain population, both sexes.
The study · 1
Vickers et al., Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis · J Pain 2018;19(5):455-474
Counts once: this finding and 2 others here come from the same source, so they are one body of evidence, not separate confirmations.
Headache And Migraine
Acupuncture prevented migraine about as well as preventive drugs, with fewer side effects
Added to usual care, acupuncture roughly halved migraine days for about half the people who tried it, a bit more than fake acupuncture did. It worked about as well as the standard preventive pills and caused fewer side effects.
Across 22 trials and 4,985 people, 50% of those given true acupuncture had migraine frequency at least halved versus 41% given sham acupuncture (number needed to treat 11, moderate-certainty). Against prophylactic drugs, 57% responded to acupuncture versus 46% to the drugs at three months, with fewer adverse effects (odds ratio 0.25). Measured in: Adults with episodic migraine. The gap over sham is small (9 percentage points) and blinding of a needling procedure is imperfect; the drug comparison at six months was no longer statistically significant (59% vs 54%).
Who this may not transfer to:Migraine is roughly three times more common in women, and the trial populations reflect that female majority.
The study · 1
Linde et al., Acupuncture for the prevention of episodic migraine (Cochrane review) · Cochrane Database Syst Rev 2016;6:CD001218
Acupuncture reduced tension-type headache frequency
For frequent tension headaches, about half the people given real acupuncture had their headache days at least halved, slightly more than with fake acupuncture and far more than with no treatment.
Across 12 trials and 2,349 people, 51% given real acupuncture had headache frequency at least halved versus 43% given sham acupuncture (risk ratio 1.3); the improvement over no treatment or routine care was much larger (response roughly 45 to 48% vs 4 to 19%). Measured in: Adults with frequent episodic or chronic tension-type headache. La certeza GRADE fue de moderada a baja, degradada por la falta de cegamiento y tamaños del efecto variables; el pequeño margen sobre el simulado es la medida del efecto específico de la aguja.
Who this may not transfer to:Tension-type headache trials enrolled both sexes with a modest female majority.
The study · 1
Linde et al., Acupuncture for the prevention of tension-type headache (Cochrane review) · Cochrane Database Syst Rev 2016;4:CD007587
Fertility
La acupuntura no elevó las tasas de nacidos vivos en la FIV
En un ensayo grande y cuidadoso, las mujeres que recibieron acupuntura real durante la FIV tuvieron una tasa de nacidos vivos casi exactamente igual que las mujeres que recibieron acupuntura simulada. No mejoró las probabilidades de tener un bebé.
En 824 mujeres sometidas a fecundación in vitro, la acupuntura en la recogida de óvulos y la transferencia de embriones dio una tasa de nacidos vivos del 18.3 % (74 de 405) frente al 17.8 % (72 de 404) con acupuntura simulada (diferencia de riesgo 0.5 %, IC del 95 %: -4.9 % a 5.8 %; riesgo relativo 1.02, IC del 95 %: 0.76 a 1.38). Measured in: Women undergoing IVF, randomized across 16 fertility centers in Australia and New Zealand. Un único ensayo grande y bien realizado con un resultado nulo genuino; evalúa la acupuntura sincronizada con el ciclo de FIV, que es el uso comúnmente comercializado, y no encuentra beneficio en los nacidos vivos.
Who this may not transfer to:IVF live birth is a women-only outcome, so there is no other-sex comparison.
The study · 1
Smith et al., Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial · JAMA 2018;319(19):1990-1998
Digestion
Estimular el punto PC6 de la muñeca redujo las náuseas y los vómitos después de la cirugía
Presionar o pinchar un único punto en la cara interna de la muñeca, PC6, redujo las náuseas y los vómitos después de la cirugía en aproximadamente un tercio en comparación con un procedimiento simulado, y funcionó aproximadamente tan bien como los fármacos antieméticos.
Estimular el punto PC6 en la cara interna de la muñeca redujo las náuseas posoperatorias (riesgo relativo 0.68, IC del 95 %: 0.60 a 0.77; 40 ensayos, 4742 personas) y los vómitos (riesgo relativo 0.60, IC del 95 %: 0.51 a 0.71; 45 ensayos, 5147 personas) frente a un procedimiento simulado, y funcionó aproximadamente tan bien como los fármacos antieméticos (RR de vómitos 0.93, IC del 95 %: 0.74 a 1.17). Measured in: Adults and children receiving general anesthesia for surgery, across 59 trials and 7,667 participants. La comparación con el simulado se calificó de baja calidad por la heterogeneidad y las limitaciones de los estudios, aunque el efecto es grande y consistente; la estimulación de PC6 incluye pulseras de acupresión y estimulación eléctrica, no solo la aguja.
Who this may not transfer to:Surgical trials enrolled both sexes; postoperative nausea is more common in women, and the populations reflect that.
The study · 1
Lee et al., Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting (Cochrane review) · Cochrane Database Syst Rev 2015;11:CD003281
La electroacupuntura redujo los vómitos del primer día tras la quimioterapia
En ensayos más antiguos, pasar una corriente suave a través de agujas de acupuntura redujo los vómitos del primer día tras la quimioterapia en aproximadamente un cuarto. Los ensayos son anteriores a los fármacos antieméticos actuales, por lo que su valor añadido hoy en día no está claro.
En un análisis combinado de 11 ensayos y 1247 personas, la electroacupuntura redujo los vómitos agudos (primer día) tras la quimioterapia (riesgo relativo 0.76, IC del 95 %: 0.60 a 0.97); la acupresión alivió las náuseas agudas pero no los vómitos, y los síntomas retardados no mejoraron. Measured in: Adults receiving chemotherapy, most trials predating modern antiemetics. Esta revisión se retiró posteriormente en espera de una actualización, y los ensayos son anteriores a los fármacos antieméticos actuales, por lo que el beneficio añadido sobre la atención estándar de hoy no está probado; el hallazgo se refiere solo a los vómitos agudos, no a los síntomas retardados.
Who this may not transfer to:Chemotherapy trials enrolled both sexes across several cancer types.
The study · 1
Ezzo et al., Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting (Cochrane review) · Cochrane Database Syst Rev 2006;(2):CD002285
Allergy
La acupuntura mejoró modestamente los síntomas de alergia estacional
Para la fiebre del heno, las personas que recibieron acupuntura se sintieron algo mejor y usaron menos antihistamínicos que las que recibieron acupuntura simulada, pero el equipo del ensayo consideró que la diferencia era lo bastante pequeña como para que quizás no importe mucho en la vida diaria.
En 422 personas con alergia al polen de abedul y de gramíneas, la acupuntura mejoró la calidad de vida en la escala RQLQ (0 a 6) en 0.5 puntos frente a la acupuntura simulada y en 0.7 puntos frente al antihistamínico de rescate solo, y redujo el uso de antihistamínicos, todo estadísticamente significativo a las 8 semanas. Measured in: Adults with seasonal allergic rhinitis and confirmed IgE sensitization to birch and grass pollen. Los autores del ensayo consideraron que la mejora era lo bastante pequeña como para que quizás no sea clínicamente significativa, ya que los síntomas iniciales ya eran leves; el efecto sobre el simulado fue modesto.
Who this may not transfer to:The ACUSAR trial enrolled both sexes.
The study · 1
Brinkhaus et al., Acupuncture in patients with seasonal allergic rhinitis: a randomized trial (ACUSAR) · Ann Intern Med 2013;158(4):225-234
Mood & stress
La acupuntura podría reducir las puntuaciones de depresión, pero la evidencia es débil
La acupuntura redujo ligeramente las puntuaciones de depresión en comparación con la acupuntura simulada, pero los estudios fueron de baja calidad, por lo que cuánto ayuda realmente no está claro.
En 14 ensayos controlados con simulado y 841 personas, la acupuntura redujo la gravedad de la depresión en aproximadamente 1.69 puntos en la Escala de Calificación de Depresión de Hamilton (una escala en la que de 0 a 7 se considera normal), una diferencia pequeña calificada como evidencia de baja calidad; frente a la ausencia de tratamiento la reducción fue mayor (DME -0.66) pero también de baja calidad. Measured in: Adults with depression. La revisión Cochrane calificó la evidencia de baja a muy baja calidad, citando un alto riesgo de sesgo de realización, una notificación deficiente de eventos adversos, y seguimiento faltante, por lo que tanto la magnitud como la fiabilidad de cualquier beneficio son inciertas.
Who this may not transfer to:Depression trials enrolled both sexes with a female majority typical of the condition.
The study · 1
Smith et al., Acupuncture for depression (Cochrane review) · Cochrane Database Syst Rev 2018;3:CD004046
How It Works
A needle in muscle triggers local nerve signaling and a small release of the body's own painkillers, endorphins and adenosine, at the site. It also shifts activity in the spinal cord and brain regions that process pain. None of this depends on a classical acupuncture point, so a needle set slightly off the traditional points still relieves pain. That is why its edge over a fake needle is small, about 0.2 of a standard deviation. Its edge over no treatment is much larger, near 0.5.
The rest of the benefit comes from the setting: unhurried attention, physical touch, a credible explanation, and a strong expectation of relief. That combination measurably lowers pain and nausea on its own, through the body's expectation and reward systems. Across that meta-analysis, the setting explained more of the total effect than where the needle went.
How to Start
Needling needs a trained practitioner. The free starting point is acupressure, the same points pressed by hand, including PC6.
Ways to Do It
Start where your situation fits, and give any approach a course of several weeks before judging it, the same span the trials used.
The best-evidenced antiemetic point, PC6, works through steady pressure as well as a needle, which is why motion-sickness wristbands target it. Firm pressure for a few minutes at points matched to your issue is free, safe, and self-administered, though weaker than needling. It is the starting point for most readers and a reasonable daily add-on to a course of sessions.
Community acupuncture clinics treat several people at once in a shared room on a sliding scale, often $15 to $40 a visit. Acupuncture schools run low-cost teaching clinics supervised by faculty. Both make a full course affordable. Ask for a reclining chair if lying flat is hard, and say what you are there for so the points are chosen for it.
A private session with a licensed acupuncturist (LAc, or a doctorate-level DACM) runs roughly $75 to $150, and a benefit-level course is six to twelve of them. In the United States, Medicare covers acupuncture for chronic low back pain, and a growing number of private plans cover it for pain; coverage varies by plan. Look for single-use sterile needles, clean-needle technique, and a practitioner who takes a proper history before choosing points.
The strongest form is a supervised course of electroacupuncture with an experienced licensed acupuncturist. Several of the best pain and nausea trials used this setup, and it is the most likely to reproduce their results. The self-directed form is daily acupressure on the points that match your complaint. It takes steady effort to keep up.
Go Deeper
Acupuncture is more than 2,000 years old, and it shares its channel map with related practices.
- Acupressure and self-massage: the needle-free version, the same points worked by hand.
- Moxibustion: warming a point by burning mugwort.
- Cupping: pulling on the tissue with suction.
- Condition guides: fibromyalgia, anxiety, insomnia, and restless legs.
The Chinese Medicine View
In Chinese medicine, acupuncture works on the Qi, the vital activity of the body, moving through a network of channels, the 經絡 (jingluo, or "meridians"). Along these channels lie the acupoints, and each links the body's surface to its internal organs.
Health is Qi flowing freely and in balance. Pain and illness are Qi blocked, deficient, or moving the wrong way, the classical phrase 不通則痛, "no free flow, then pain."
The needle sensation is 得氣 (de qi), the arrival of qi, a dull, spreading heaviness that signals the point is engaged.
The practitioner reads the pattern, then chooses points and technique to move, drain, or tonify the Qi. The same Western complaint can rise from different patterns, so it is needled differently.
- Someone who is depleted or deficient (weak, exhausted, or recovering from illness) is needled gently with tonifying technique. Strong "draining" would spend reserves the tradition sees as already low.
- Someone in an acute excess or heat pattern may get stronger, draining technique, where the tradition expects the fastest change.
- The practice is traditionally avoided on an empty stomach, in extreme fatigue, or after alcohol, because fainting is more likely then.
The tradition holds that the exact point and technique matter greatly. The trials found only a small gap between traditional points and needling slightly off them. Point selection is meant to fit each person's pattern, and a fixed-point trial cannot test that.
Cautions
Cautions For This Practice
Everything to be aware of is here, in one place. This practice suits most healthy people; a few situations call for real care.
Los efectos secundarios leves son comunes y autolimitados
En un estudio prospectivo de 229,230 pacientes que recibieron en promedio 10.2 tratamientos, el 8.6 % informó al menos un efecto adverso y el 2.2 % uno que requería tratamiento; los más comunes fueron sangrado o moretones (6.1 %), dolor o molestias (1.7 %), y mareo u otros síntomas autonómicos (0.7 %). Esto mide la acupuntura administrada por médicos en Alemania, por lo que las tasas podrían diferir con otros profesionales y entornos; los eventos son autoinformados, y la mayoría son leves y de corta duración.Witt et al., Safety of acupuncture: results of a prospective observational study with 229,230 patients
El daño grave por la acupuntura de un profesional capacitado es poco frecuente
Entre 229,230 pacientes, dos experimentaron un neumotórax (una perforación pulmonar: uno necesitó tratamiento hospitalario, otro observación), y el evento de mayor duración fue una lesión nerviosa en la extremidad inferior que persistió 180 días; los autores concluyeron que la acupuntura administrada por médicos es un tratamiento relativamente seguro. El riesgo de neumotórax es específico de la aguja profunda sobre el pecho y la parte superior de la espalda, razón por la cual importan la formación del profesional y la profundidad de la aguja; los eventos graves poco frecuentes no se pueden cuantificar por completo ni siquiera en un estudio de este tamaño.Witt et al., Safety of acupuncture: results of a prospective observational study with 229,230 patients
Serious harm is rare, and it comes from where the needle goes
The main serious risk is a punctured lung (pneumothorax) from a needle placed too deeply over the chest or upper back. In 229,230 patients it happened twice. A trained practitioner who knows needle depth and angle avoids it. Infection is possible if needles are not sterile. Single-use disposable needles and clean technique are the standard to insist on.
Bruising, bleeding, and feeling faint are common and minor
About 1 in 12 people report a minor effect: small bruises or a spot of bleeding at the needle site, brief soreness, or lightheadedness. Fainting is more likely at a first session and on an empty stomach, so eat something beforehand. Tell the practitioner if you feel woozy so they can lay you flat and remove the needles. If you take blood thinners or have a bleeding disorder, say so, since bruising will be more pronounced.
Pregnancy, pacemakers, and lymphedema need a heads-up
In pregnancy, several points are traditionally avoided: LI4 (Hegu) on the hand, SP6 (Sanyinjiao) on the lower leg, and points over the lower abdomen and sacrum. Tell your practitioner you are or may be pregnant. Electroacupuncture is avoided across the chest and near an implanted pacemaker or defibrillator. Needling into a limb affected by lymphedema, or into active skin infection, broken skin, or a numb area, is avoided to prevent infection and injury.
What acupuncture should not replace
Acupuncture manages a symptom; it does not treat the underlying disease. For knee arthritis or chronic headache, keep it alongside the care that does. New or changing symptoms, a headache unlike any before, weakness, numbness, or loss of bladder or bowel control are reasons to see a doctor promptly.
Start slow, be smart, read the research, and consult a professional if you have any concerns. This is here to inform your choice, not make it for you.
Common Questions
Is it just a placebo?
Part of it is expectation, and expectation is real medicine. Calling that a placebo undersells a measurable biological effect.
How many sessions will I need, and what does it cost?
Benefit comes from a course of weekly sessions. Out of pocket, a visit runs from about $15 at a community clinic to $150 with a private licensed acupuncturist. In the United States, Medicare covers a course for chronic low back pain.
Is it safe, and does it hurt?
It hurts little: a brief prick, then a mild ache as the needles sit. Serious harm from a trained practitioner is rare, and the common effects are minor and short-lived.
Does it improve IVF success?
No. A rigorous trial randomized 824 women having in vitro fertilization. Acupuncture around egg collection and embryo transfer gave a live birth rate of 18.3%, against 17.8% with a sham procedure.
That gap is essentially zero, one of the clearest "no effect" findings in the field, even though fertility clinics widely promote acupuncture for IVF.
Explore Related
Other pages this one connects to, by the evidence they share, the outcomes they touch, and the ground they cover.
All 12 sources on this page independently checked and cross-referenced.
Thomas Dehli, Founder & Editor, Sacred Lotus
Sacred Lotus has published Chinese medicine reference material since 2001. Integrative pages are held to the same standard as the herb and formula library: cite the source, grade the claim at its real strength, and say where the research has not looked. This page is educational and it is not medical advice. Last reviewed and updated August 11, 2026.
Evidence strength
How confidently the research supports a claim. Strength describes the evidence, not our endorsement.