In the Cochrane Central Register of Controlled Trials there are now more than 16,000 clinical trials of acupuncture listed, with around 2,000 new studies being added every year. Here is a summary of the current research evidence, based on National Health and Medical Research Council Level 1 evidence (systematic reviews) and a small number of good quality Level 2 studies (randomised controlled trials). All these trials used human subjects and all are less than 5 years old. Full references are given below the summary table.

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ACUPUNCTURE RESEARCH EVIDENCE BY CONDITION WITH REFERENCES

Chronic Pain

Acupuncture has been shown to be effective in relieving various types of chronic pain.

Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., . Linde, K. (2017). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. doi:10.1016/j.jpain.2017.11.005

MacPherson, H., Vertosick, E. A., Foster, N. E., Lewith, G., Linde, K., Sherman, K. J., . . . Vickers, A. J. (2016). The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain. Pain. doi:10.1097/j.pain.0000000000000747

MacPherson, H., Vickers, A., Bland, M., Torgerson, D., Corbett, M., Spackman, E., . . . Watt, I. (2017). Programme Grants for Applied Research Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library

MacPherson, H., Vertosick, E., Lewith, G., Linde, K., Sherman, K. J., Witt, C. M., & Vickers, A. J. (2014). Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One, 9(4), e93739. doi:10.1371/journal.pone.0093739

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2017). Systematic review and meta-analysis of acupuncture to reduce cancer-related pain. Eur J Cancer Care (Engl), 26(2). doi:10.1111/ecc.12457

Scottish Incollegiate Guidelines Network (SIGN). Management of Chronic Pain (SIGN publication no. 136). Scottish Incollegiate Guidelines Network (SIGN); 2013.

Acute pain

Acupuncture has been shown to be effective in relieving various types of acute pain, including studies where acupuncture was delivered in hospital Emergency Departments.

Schug, S. A., Palmer, G. M., Scott, D. A., Halliwell, R., & Trinca, J. (2016). Acute pain management: scientific evidence, fourth edition, 2015. Med J Aust, 204(8), 315-317.

Cohen, M. M., Smit, De Villiers, Adrianopoulos, Nick, Ben-Meir, Ben, Taylor, David McD, Parker, Shefton J, Xue, Charlie C, Cameron, Peter A (2017). Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. Medical Journal of Australia, 206(11), 494-499. doi:10.5694/mja16.00771

Grissa, M. H., Baccouche, H., Boubaker, H., Beltaief, K., Bzeouich, N., Fredj, N., . . . Nouira, S. (2016). Acupuncture vs intravenous morphine in the management of acute pain in the ED. Am J Emerg Med, 34(11), 2112-2116. doi:10.1016/j.ajem.2016.07.028

Low Back Pain

Acupuncture has been shown to be effective in relieving both acute and chronic low back pain and is given a strong recommendation for both in the clinical practice guidelines of the American College of Physicians.

Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med, 166(7), 514-530. doi:10.7326/m16-2367

Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. AHRQ Comparative Effectiveness Reviews. Noninvasive Treatments for Low Back Pain. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.

Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38.

Wellington J. Noninvasive and alternative management of chronic low back pain (efficacy and outcomes). Neuromodulation. 2014 Oct;17 Suppl 2:24-30.

Liu L, Skinner M, McDonough S, Mabire L, Baxter GD. Acupuncture for low back pain: an overview of systematic reviews. Evid Based Complement Alternat Med. 2015;2015:328196.

Taylor, P., Pezzullo, L., Grant, S. J., & Bensoussan, A. (2014). Cost-effectiveness of Acupuncture for Chronic Nonspecific Low Back Pain. Pain Pract, 14(7), 599-606. doi:10.1111/papr.12116

Sciatica

Acupuncture has been shown to be effective in relieving sciatic pain and compares favourably (in a network meta-analysis) with many other therapies.

Ji, M., Wang, X., Chen, M., Shen, Y., Zhang, X., & Yang, J. (2015). The Efficacy of Acupuncture for the Treatment of Sciatica: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2015, 192808. doi:10.1155/2015/192808

Lewis, R. A., Williams, N. H., Sutton, A. J., Burton, K., Din, N. U., Matar, H. E., . . . Wilkinson, C. (2015). Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. Spine J, 15(6), 1461-1477. doi:10.1016/j.spinee.2013.08.049

Qin, Z., Liu, X., Wu, J., Zhai, Y., & Liu, Z. (2015). Effectiveness of Acupuncture for Treating Sciatica: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2015, 425108. doi:10.1155/2015/425108

Shoulder Pain

Acupuncture has been shown to be effective in relieving shoulder pain

Lee, S. H., & Lim, S. M. (2016). Acupuncture for Poststroke Shoulder Pain: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med, 2016, 3549878. doi:10.1155/2016/3549878

Wang, K. F., Zhang, L. J., Lu, F., Lu, Y. H., & Yang, C. H. (2016). Can Ashi points stimulation have specific effects on shoulder pain? A systematic review of randomized controlled trials. Chin J Integr Med, 22(6), 467-472. doi:10.1007/s11655-015-2107-4

Headache (Tension Type and Chronic)

Acupuncture has been shown to be effective in relieving and preventing tension-type and chronic headache.

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;4:Cd007587

Coeytaux RR, Befus D. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache. 2016 Jul;56(7):1238-40.

Migraine

Acupuncture has been shown to be effective in relieving and preventing migraine.

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016(6):Cd001218

Yang Y, Que Q, Ye X, Zheng G. Verum versus sham manual acupuncture for migraine: a systematic review of randomised controlled trials. Acupunct Med. 2016 Apr;34(2):76-83.

Neck Pain

Acupuncture has been shown to be effective in relieving neck pain.

Trinh K, Graham N, Irnich D, Cameron ID, Forget M. Acupuncture for neck disorders. Cochrane Database Syst Rev. 2016(5):Cd004870.

MacPherson, H., Tilbrook, H., Richmond, S., Woodman, J., Ballard, K., Atkin, K., . . . Watt, I. (2015). Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain: A Randomized Trial. Ann Intern Med, 163(9), 653-662. doi:10.7326/m15-0667

Post-operative pain

Acupuncture has been shown to be effective in relieving some types of post-operative pain.

Wu MS, Chen KH, Chen IF, Huang SK, Tzeng PC, Yeh ML, et al. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis. PLOS ONE. 2016;11(3):e0150367.

Barlow T, Downham C, Barlow D. The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review. Complement Ther Med. 2013 Oct;21(5):529-34

Fransen M, Nairn L, Bridgett L, Crosbie J, March L, Parker Mbbs D, et al. Post-acute rehabilitation after total knee replacement: A multicentre randomized clinical trial comparing long-term outcomes. Arthritis Care Res (Hoboken). 2016 Nov 21.

Elbow Pain

Acupuncture has been shown to be effective in relieving lateral elbow pain (tennis elbow).

Gadau, M., Yeung, W. F., Liu, H., Zaslawski, C., Tan, Y. S., Wang, F. C., . . . Zhang, S. P. (2014). Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC Complement Altern Med, 14, 136. doi:10.1186/1472-6882-14-136

Carpal Tunnel Syndrome pain

Acupuncture has been shown to be effective in relieving carpal tunnel syndrome pain.

Hadianfard, M., Bazrafshan, E., Momeninejad, H., & Jahani, N. (2015). Efficacies of Acupuncture and Anti-inflammatory Treatment for Carpal Tunnel Syndrome. J Acupunct Meridian Stud, 8(5), 229-235. doi:10.1016/j.jams.2014.11.005

Knee Osteoarthritis pain

Acupuncture has been shown to be effective in relieving knee osteoarthritis pain and compares favourably (in a network meta-analysis) with other physical therapies.

Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, et al. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis Cartilage. 2013 Sep;21(9):1290-8.

Manyanga T, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312.

Anxiety

Acupuncture and acupressure have been shown to relieve anxiety in a number of contexts, including pre-surgical anxiety, examination anxiety in students, anxiety during embryo transfer in IVF and anxiety during pregnancy.

Amorim, D., Amado, J., Brito, I., Fiuza, S. M., Amorim, N., Costeira, C., & Machado, J. (2018). Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research. Complement Ther Clin Pract, 31, 31-37. doi:10.1016/j.ctcp.2018.01.008

Goyata, S. L., Avelino, C. C., Santos, S. V., Souza Junior, D. I., Gurgel, M. D., & Terra, F. S. (2016). Effects from acupuncture in treating anxiety: integrative review. Rev Bras Enferm, 69(3), 602-609. doi:10.1590/0034-7167.2016690325i

Fleckenstein, J., Kruger, P., & Ittner, K. P. (2018). Effects of single-point acupuncture (HT7) in the prevention of test anxiety: Results of a RCT. PLoS One, 13(8), e0202659. doi:10.1371/journal.pone.0202659

Au, D. W., Tsang, H. W., Ling, P. P., Leung, C. H., Ip, P. K., & Cheung, W. M. (2015). Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med, 33(5), 353-359. doi:10.1136/acupmed-2014-010720

Bazzan, A. J., Zabrecky, G., Monti, D. A., & Newberg, A. B. (2014). Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Rev Neurother, 14(4), 411-423. doi:10.1586/14737175.2014.892420

Kwon, C. Y., & Lee, B. (2018). Acupuncture or Acupressure on Yintang (EX-HN 3) for Anxiety: A Preliminary Review. Med Acupunct, 30(2), 73-79. doi:10.1089/acu.2017.1268

Smith, C. A., de Lacey, S., Chapman, M., Ratcliffe, J., Norman, R. J., Johnson, N. P., & Fahey, P. (2018). The effects of acupuncture on the secondary outcomes of anxiety, and quality of life for women undergoing IVF: a randomised controlled trial. Acta Obstet Gynecol Scand. doi:10.1111/aogs.13528

Smith, C. A., Shewamene, Z., Galbally, M., Schmied, V., & Dahlen, H. (2018). The effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis. J Affect Disord, 245, 428-439. doi:10.1016/j.jad.2018.11.054

Insomnia

Acupuncture has been shown to be effective in improving sleep quality and quality of life in primary insomnia, as well in various types of secondary insomnia including post-stroke, menopausal, depression-related and cancer-related insomnia.

Shergis, J. L., Ni, X., Jackson, M. L., Zhang, A. L., Guo, X., Li, Y., . . . Xue, C. C. (2016). A systematic review of acupuncture for sleep quality in people with insomnia. Complement Ther Med, 26, 11-20. doi:10.1016/j.ctim.2016.02.007

Lan, Y., Wu, X., Tan, H. J., Wu, N., Xing, J. J., Wu, F. S., . . . Liang, F. R. (2015). Auricular acupuncture with seed or pellet attachments for primary insomnia: a systematic review and meta-analysis. BMC Complement Altern Med, 15, 103. doi:10.1186/s12906-015-0606-7

Dong, B., Chen, Z., Yin, X., Li, D., Ma, J., Yin, P., … Xu, S. (2017). The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group: A Systematic Review and Meta-Analysis. BioMed Research International, 2017, 9614810.

Choi, T. Y., Kim, J. I., Lim, H. J., & Lee, M. S. (2016). Acupuncture for Managing Cancer-Related Insomnia: A Systematic Review of Randomized Clinical Trials. Integr Cancer Ther. doi:10.1177/1534735416664172

Lee, S. H., & Lim, S. M. (2016). Acupuncture for insomnia after stroke: a systematic review and meta-analysis. BMC Complement Altern Med, 16, 228. doi:10.1186/s12906-016-1220-z

Chiu, H. Y., Hsieh, Y. J., & Tsai, P. S. (2016). Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol, 127(3), 507-515. doi:10.1097/aog.0000000000001268

Menopausal signs and symptoms

Acupuncture has been shown to improve quality of life and symptoms such as hot flushes and insomnia in menopausal women.

Chiu HY, Pan CH, Shyu YK, Han BC, Tsai PS. Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause. 2015 Feb;22(2):234-44.

Dodin S, Blanchet C, Marc I, Ernst E, Wu T, Vaillancourt C, et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst Rev. 2013(7):Cd007410.

Dysmenorrhoea

Acupuncture and moxibustion have been shown to relieve pain and improve some aspects of quality of life for women with dysmenorrhoea.

Smith CA, Armour M, Zhu X, Li X, Lu ZY, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016;4:Cd007854.

Abaraogu, U. O., & Tabansi-Ochuogu, C. S. (2015). As Acupressure Decreases Pain, Acupuncture May Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic Review with Meta-Analysis. J Acupunct Meridian Stud, 8(5), 220-228.

Xu, T., Hui, L., Juan, Y. L., Min, S. G., & Hua, W. T. (2014). Effects of moxibustion or acupoint therapy for the treatment of primary dysmenorrhea: a meta-analysis. Altern Ther Health Med, 20(4), 33-42.

Low back/pelvic pain during pregnancy

Acupuncture has been shown to be effective in relieving low back pain and pelvic pain during pregnancy.

Martins, E. S., Tavares, T., Lessa, P. R. A., Aquino, P. S., Castro, R., & Pinheiro, A. K. B. (2018). Acupuncture treatment: multidimensional assessment of low back pain in pregnant women. Rev Esc Enferm USP, 52, e03323. doi:10.1590/s1980-220×2017040303323

Close, C., Sinclair, M., Liddle, S. D., Madden, E., McCullough, J. E., & Hughes, C. (2014). A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy. J Adv Nurs, 70(8), 1702-1716. doi:10.1111/jan.12360

Soliday, E., & Betts, D. (2018). Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. J Acupunct Meridian Stud, 11(1), 25-30. doi:10.1016/j.jams.2017.11.005

Post-operative nausea/vomiting (PONV)

Acupuncture and acupressure are effective in relieving post-operative nausea and vomiting (used in combination with state-of-the-art antiemetics, or alone).

Gan, T. J., Diemunsch, P., Habib, A. S., Kovac, A., Kranke, P., Meyer, T. A., . . . Tramer, M. R. (2014). Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 118(1), 85-113. doi:10.1213/ane.0000000000000002

Lee, A., Chan, S. K., & Fan, L. T. (2015). Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev(11), Cd003281. doi:10.1002/14651858.CD003281.pub4

Nilsson, I., Karlsson, A., Lindgren, L., Bergenheim, T., Koskinen, L. O., & Nilsson, U. (2015). The efficacy of P6 acupressure with sea-band in reducing postoperative nausea and vomiting in patients undergoing craniotomy: a randomized, double-blinded, placebo-controlled study. J Neurosurg Anesthesiol, 27(1), 42-50. doi:10.1097/ana.0000000000000089

Shin, H. C., Kim, J. S., Lee, S. K., Kwon, S. H., Kim, M. S., Lee, E. J., & Yoon, Y. J. (2016). The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta-analysis and systematic review. Laryngoscope, 126(8), 1761-1767. doi:10.1002/lary.25883

Chemotherapy induced nausea/vomiting (CINV)

Acupuncture has been shown to reduce the frequency of chemotherapy-induced acute vomiting and also the use of rescue medication, while acupressure has been shown to decrease the frequency of nausea

McKeon C, Smith, C.A., Hardy, J. & Chang, E. Acupunctrue and acupressure for chemotherapy-induced nausea and vomiting : a systematic review. Australian Journal of Acupuncture and Chinese Medicine. 2013;8(1):2-17.

Garcia MK, McQuade J, Lee R, Haddad R, Spano M, Cohen L. Acupuncture for symptom management in cancer care: an update. Curr Oncol Rep. 2014 Dec;16(12):418.

Molassiotis, A., Russell, W., Hughes, J., Breckons, M., Lloyd-Williams, M., Richardson, J., . . . Ryder, W. (2013). The effectiveness and cost-effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: Assessment of Nausea in Chemotherapy Research (ANCHoR), a randomised controlled trial. Health Technol Assess, 17(26), 1-114. doi:10.3310/hta17260

Chronic prostatitis /chronic pelvic pain syndrome

Acupuncture has been shown to be effective for relieving chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and may be comparable to usual care.

Chang SC, Hsu CH, Hsu CK, Yang SS, Chang SJ. The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome: A systemic review and meta-analysis. Neurourol Urodyn. 2016 Jan 6.

Qin Z, Wu J, Zhou J, Liu Z. Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Medicine (Baltimore). 2016 Mar;95(11):e3095.

Summary of acupuncture research evidence