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Acupuncture -
what you need to know

Acupuncture has been in use for at least 2,500 years. It originates from traditional Chinese medicine (TCM) and has gained popularity worldwide since the 1970s. In Chinese character 針灸 means "Acupuncture and Moxibustion".  It is a technique in which practitioners insert fine needles into the skin or burn mugwort to heat the skin in order to treat health problems under the guidance of TCM theory. According to the World Health Organization, acupuncture is used in 103 of 129 countries that reported data. Acupuncture is most commonly used to treat pain in the West. Increasingly, it is being used for overall wellness, including stress management, digestive issues, infertility, and more. 


The Philosophy of Acupuncture in
Traditional Chinese Medicine

The ancient Chinese came to some understanding of our reality without any of the modern instruments and yet much of those ancient knowledge are still found to be true and applicable in the modern world. Traditional Chinese medicine is a system built on ancient Chinese philosophy together with long term observation and experience. The core of Chinese Medicine and, within it, acupuncture is that human beings can live a healthy life, when they live in harmony with the laws of nature.  

TCM explains that health is the result of a harmonious balance of the complementary power of Yin and Yang, the Five phases of Energy, the abundance and smooth circulation of Qi. Disease occurs when any of these factors are imbalanced. According to TCM, Qi flows through meridians in the human body. These meridians and energy flows are accessible through 361 acupuncture points in the body. Inserting needles into these points with appropriate combinations will bring the energy flow back into balance thus being healthy.

How does acupuncture work scientifically?

Acupuncture is "a retrospective science, going on for 3,000 years. We know it works, we just don't know why.

How acupuncture works is not fully understood. However, there’s evidence that acupuncture may have effects on the nervous system, effects on other body tissues, and nonspecific (placebo) effects. Here are some of the theories or hypotheses about the acupuncture mechanism. 

  • Gate control theory[1]

  • The release of beta-endorphin[2]

  • The action on the viscero-cutaneous reflex[3]

  • Affect the hypothalamic-pituitary-adrenal (HPA) axis[4]

  • Affect nervous system functioning[5]

  • Affect the connective tissue[6]

What conditions may benefit from acupuncture?

The Acupuncture Evidence Project reviewed the effectiveness of acupuncture for 122 treatments over 14 clinical areas. They found some evidence of effect for 117 conditions. “Our study found evidence for the effectiveness of acupuncture for 117 conditions, with stronger evidence for acupuncture’s effectiveness for some conditions than others. Acupuncture is considered safe in the hands of a well-trained practitioner and has been found to be cost-effective for some conditions. The quality and quantity of research into acupuncture’s effectiveness is increasing.” Acupuncture Evidence Project, p55 [7]

Conditions that may benefit from acupuncture include the following:


  • Gastritis

  • Irritable bowel syndrome

  • Hepatitis

  • Hemorrhoids

  • Postoperative nausea and vomiting


  • Anxiety

  • Depression

  • Insomnia

  • Nervousness

  • Post-traumatic stress disorder


  • Rhinitis

  • Sinusitis

  • Sore throat



  • Menstrual pains

  • Infertility

  • Menopausal hot flushes

  • Back or pelvic pain during pregnancy


  • Arthritis

  • Back pain

  • Carpal Tunnel Syndrome

  • Knee osteoarthritis 

  • Muscle cramping

  • Muscle pain and weakness

  • Neck pain

  • Plantar heel pain

  • Postoperative pain

  • Post-stroke spasticity

  • Prostatitis/chronic pelvic pain

  • Sciatica

  • Shoulder pain

  • Temporomandibular pain



  • Cancer pain

  • Headaches

  • Migraines

  • Neurogenic bladder dysfunction

  • Parkinson's disease

  • Postoperative pain

  • Stroke



  • Allergic rhinitis

  • Asthma in adults

  • Sinusitis

  • Bronchitis



  • Cancer pain

  • Cancer-related fatigue

  • Hypertension (with medication)

  • Nausea induced by chemotherapy

  • Obesity



  • Dry eye

  • Irritable bladder

  • Male infertility

  • Restless legs syndrome

  • Some forms of impotence

  • Addiction

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Image by Nick Fewings

Is acupuncture safe? 

All therapies come with both risks and benefits. A person should always seek medical advice before undertaking any therapy. Relatively few complications from using acupuncture have been reported. However, complications have resulted from use of nonsterile needles and improper delivery of treatments. Acupuncture needles must be sterile, nontoxic, and labeled “for one use only” by a trained practitioner.

Possible risks of acupuncture are the following:

  • Bleeding, bruising, and soreness may occur at the insertion sites.

  • Unsterilized needles may lead to infection.

  • In rare cases, a needle may break and damage an internal organ.

Before having acupuncture treatment, be sure to tell the practitioner if you:

  • Have a bleeding disorder. Your chances of bleeding or bruising from the needles may be increased if you have a bleeding disorder or if you're taking blood thinners.

  • Have a pacemaker. Acupuncture that involves applying mild electrical pulses to the needles may potentially interfere with a pacemaker's operation.

  • Are pregnant. Some acupuncture points are thought to stimulate labor, which could result in premature delivery.

What are the different types of acupuncture?

Most people do not know that there are different types of acupuncture. This is because acupuncture as an activity is not regulated, as physiotherapists, chiropractors, and general practitioners can take a weekend course in acupuncture and then offer it to their patients. Sometimes this is called "dry needling" or "trigger point acupuncture". Traditional acupuncture does not recognize any of these types. In most regulated countries, Acupuncture Only Programs require a minimum of 3 academic years (6 terms) with 705 hours of Chinese Medicine (CM) instruction, 660 hours of clinical training, 450 hours of biomedicine, and 90 hours of communication/ethics/practice management. A total of 1,905 educational hours.

The full Traditional Chinese Medicine/Oriental Medicine program, which also includes herbal studies, requires a minimum of 4 academic years (8 terms) with 705 hours of CM instruction, 450 hours of herbal instruction, 870 hours of clinical training, 510 hours in biomedicine, and 90 hours in communications/ethics/practice management. A total of 2,625 educational hours.

School Library
Girl Relaxing

What does acupuncture feel like?

Acupuncture is done using hair-thin needles. Most people report feeling minimal pain as the needle is inserted. The needle is inserted to a point that produces a sensation of pressure or ache. Needles may be heated during the treatment or mild electric current may be applied to them. Some people report acupuncture makes them feel energized. Others say they feel relaxed.

Instead of needles, other forms of stimulation are sometimes used over the acupuncture points, including:

  • Heat (moxibustion or infrared heating lamp)

  • Pressure (acupressure)

  • Suction (cupping)

  • Impulses of electromagnetic energy (electroacupuncture)

What to expect from
acupuncture treatment?

Each person who performs acupuncture has a unique style. To determine the type of acupuncture treatment that will help you the most, your practitioner may ask you about your symptoms, behaviors and lifestyle using Traditional Chinese medicine diagnostics. In the initial consultation the doctor will examine:

  • The parts of your body that are painful

  • The shape, coating and color of your tongue

  • The color of your face

  • The strength, rhythm and quality of the pulse in your wrist


Individuals will typically sit or lie down during the procedure. The acupuncturist should use single-use, disposable, sterile needles. People may feel a very brief stinging or tingling sensation upon needle insertion. They may then experience a dull ache at the base of the needle.

Typically, the needles will stay in place for 20–60 minutes, although this will vary depending on the procedure. In some practices, the acupuncturist will sometimes heat needles after insertion.

The number of treatments a person will need depends on their individual case. Someone with a chronic condition may need one or two treatments per week over several months. An acute health issue typically improves after 8–12 sessions.

During the procedure

Acupuncture points are situated in all areas of the body. Sometimes the appropriate points are far removed from the area of your pain. Your acupuncture practitioner will tell you the general site of the planned treatment and whether you need to remove any clothing. A gown, towel or sheet will be provided. You lie on a padded table for the treatment, which involves:

  • Needle insertion. Acupuncture needles are inserted into various depths at strategic points on your body. The needles are very thin, so insertion usually causes little discomfort. People often don't feel them inserted at all. The typical treatment uses 5 to 20 needles. You may feel a mild aching sensation when a needle reaches the correct depth.

  • Needle manipulation. Your practitioner may gently move or twirl the needles after placement or apply heat or mild electrical pulses to the needles.

  • Needle removal. In most cases, the needles remain in place for 10 to 15 minutes while you lie still and relax. There is usually no discomfort when the needles are removed.


After the procedure

Some people feel relaxed and others feel energized after an acupuncture treatment. But not everyone responds to acupuncture. If your symptoms don't begin to improve within a few weeks, acupuncture may not be right for you.

Treating with Acupuncture
Image by 愚木混株 cdd20

Limitations and Misconceptions about Acupuncture

Although acupuncture therapy is growing as an option to treat chronic pain and mental health conditions, many people, including medical doctors, have misconceptions about the treatment.

  • Acupuncture is painful
    Since the acupuncture needle is only hair thin, most people do not feel the pain from the needle. In fact, many patients report a feeling of relaxation during treatment. Some even fall asleep during a session.

  • Acupuncture is mystical in nature
    Scientific evidence shows acupuncture works—though the mechanism by which it works is still being studied. Numerous clinical studies have demonstrated positive results from acupuncture treatments.

  • Acupuncturists do not have any medical or clinical training
    In most Asian countries, acupuncture or TCM training takes 5 to 6 years of full time education and clinical training in the hospital or clinics. In the West, a practitioner must attend at least 3 years of a graduate school program that covers acupuncture, ethics, Western medicine and nutrition. Students must also have clinical experience with real patients under the skill of a licensed practitioner.

  • Acupuncture is a replacement for pain kill or medication
    It is true that many studies and patients show good results from acupuncture treatment, individuals must keep in mind that acupuncture works in a different way from conventional medicine. Acupuncture targets to regulate the holistic functions of the body, not just for the elimination of symptoms. The whole treatment process also involves adjustment of diet, lifestyle, sometimes in combination with Chinese herbal medicine.

Image by Henry & Co.

A holistic approach to long-term health

List of main literature:
  1. Melzack R. [Acupuncture and pain mechanisms (author's transl)]. Der Anaesthesist. 1976 May;25(5):204-207. PMID: 183560.

  2. Han JS. Acupuncture and endorphins. Neurosci Lett. 2004 May 6;361(1-3):258-61. doi: 10.1016/j.neulet.2003.12.019. PMID: 15135942.

  3. Chen CY, Chern RS, Liao MH, Chang YH, Hsu JY, Chien CH. The Possible Neuronal Mechanism of Acupuncture: Morphological Evidence of the Neuronal Connection between Groin A-Shi Point and Uterus. Evid Based Complement Alternative Med. 2013;2013:429186. doi: 10.1155/2013/429186. Epub 2013 Feb 28. PMID: 23533481; PMCID: PMC3603327.

  4. Wang SJ, Zhang JJ, Yang HY, Wang F, Li ST. Acupoint specificity on acupuncture regulation of hypothalamic-pituitary-adrenal cortex axis function. BMC Complement Altern Med. 2015 Mar 27;15:87. doi: 10.1186/s12906-015-0625-4. PMID: 25887143; PMCID: PMC4378553.

  5. Li QQ, Shi GX, Xu Q, Wang J, Liu CZ, Wang LP. Acupuncture effect and central autonomic regulation. Evid Based Complement Alternative Med. 2013;2013:267959. doi: 10.1155/2013/267959. Epub 2013 May 26. PMID: 23762116; PMCID: PMC3677642.

  6. Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow JA, Fox JR, Krag MH. Evidence of connective tissue involvement in acupuncture. FASEB J. 2002 Jun;16(8):872-4. doi: 10.1096/fj.01-0925fje. Epub 2002 Apr 10. PMID: 11967233.


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