Acupuncture involves the insertion of extremely thin needles through your skin at strategic points on your body. A key component of traditional Chinese medicine, acupuncture is most commonly used to treat pain.

Traditional Chinese medicine explains acupuncture as a technique for balancing the flow of energy or life force — known as qi or chi (CHEE) — believed to flow through pathways (meridians) in your body. By inserting needles into specific points along these meridians, acupuncture practitioners believe that your energy flow will re-balance.

In contrast, many Western practitioners view the acupuncture points as places to stimulate nerves, muscles and connective tissue. Some believe that this stimulation boosts your body's natural painkillers and increases blood flow.

Acupuncture is used mainly to relieve discomfort associated with a variety of diseases and conditions, including:

  • Chemotherapy-induced and postoperative nausea and vomiting
  • Dental pain
  • Fibromyalgia
  • Headaches, including tension and migraine headaches
  • Labor pain
  • Low back pain
  • Neck pain
  • Osteoarthritis
  • Menstrual cramps

The risks of acupuncture are low if you have a competent, certified acupuncture practitioner. Possible side effects and complications include:

  • Soreness. After acupuncture, you might have soreness, minor bleeding or bruising at the needle sites.
  • Organ injury. If the needles are pushed in too deeply, they could puncture an internal organ — particularly a lung. This is an extremely rare complication in the hands of an experienced practitioner.
  • Infections. Licensed acupuncturists are required to use sterile, disposable needles. A reused needle could expose you to diseases, such as hepatitis.

Not everyone is a good candidate for acupuncture or for particular types of acupuncture. Conditions that may increase your risks of complications include:

  • Bleeding disorders. Your chances of bleeding or bruising from the needles increase if you have a bleeding disorder or if you're taking blood thinners, such as warfarin (Coumadin), so let your acupuncturist know.
  • Having a pacemaker. Acupuncture that involves applying mild electrical pulses to the needles can interfere with a pacemaker's operation.
  • Being pregnant. Some types of acupuncture are thought to stimulate labor, which could result in a premature delivery.

No special preparation is required before acupuncture treatment.

Choosing a practitioner

If you're considering acupuncture, take the same steps you would to choose a doctor:

  • Ask people you trust for recommendations.
  • Check the practitioner's training and credentials. Most states require that nonphysician acupuncturists pass an exam conducted by the National Certification Commission for Acupuncture and Oriental Medicine.
  • Interview the practitioner. Ask what's involved in the treatment, how likely it is to help your condition and how much it will cost.
  • Find out whether your insurance covers the treatment.

Tell your doctor you're considering acupuncture. He or she may be able to tell you about the success rate of using acupuncture for your condition or recommend an acupuncture practitioner.

Each person who performs acupuncture has a unique style, often blending aspects of Eastern and Western approaches to medicine. To determine the type of acupuncture treatment that will help you the most, your practitioner may ask you about your symptoms, behaviors and lifestyle. He or she may also closely 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

This initial evaluation may take up to 60 minutes. Subsequent appointments usually take about a half-hour. A common treatment plan for a single complaint would typically involve one or two treatments a week. Number of treatments will depend on the condition being treated and its severity, but six to eight treatments are common.

During acupuncture

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 if you need to remove any clothing. If appropriate, a gown, towel or sheet will be provided to preserve your modesty. You lie on a padded table for the treatment, which involves:

  • Needle insertion. Acupuncture needles are very thin, so insertion usually causes little discomfort. Between five and 20 needles are used in a typical treatment. 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 20 minutes while you lie still and relax. There is usually no discomfort when the needles are removed.

After acupuncture

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.

The benefits of acupuncture are sometimes difficult to measure, but many people find it helpful as a means to control a variety of painful conditions.

Several studies, however, indicate that some types of simulated acupuncture appear to work just as well as real acupuncture. There's also evidence that acupuncture works best in people who expect it to work.

Since acupuncture has few side effects, it may be worth a try if you're having trouble controlling pain with more-conventional methods.

  • Expertise. At Mayo Clinic, acupuncture is done only by doctors trained in acupuncture and by licensed acupuncturists trained in traditional Chinese medicine.
  • Experience. Mayo Clinic specialists in complementary and integrative medicine perform nearly a thousand of acupuncture treatments each year.
  • Integrated care. At Mayo Clinic, acupuncture specialists integrate their care with the care provided by your other doctors to blend the best of conventional and complementary treatments.
  • Research leader. Mayo Clinic researchers rigorously test complementary treatments such as acupuncture to determine their effectiveness.

At Mayo Clinic, acupuncture is offered to people who have been referred by a Mayo provider for complementary and integrative treatment. At Mayo, acupuncture treatments are tailored to your unique needs, concerns and diagnosis, and may include:

  • Manual stimulation. The needles are gently twisted by hand after placement.
  • Heat and electrical stimulation. The needles are gently stimulated with a low current of electricity or heat, or both, after placement.

Acupuncture is usually done in a series of weekly treatments. During each visit, your Mayo specialist will conduct a physical exam and assess your condition before starting needle therapy. An acupuncture visit usually takes 30 to 60 minutes.

A study reviewed the use of acupuncture in more than 900 people at Mayo Clinic in Rochester, Minnesota, between 2004 and 2008. It found the three most common problems for which acupuncture was used were back and neck pain, other pain, and joint pain. These uses accounted for 70 percent of the more than 6,000 acupuncture treatments during that time.

Acupuncture is also occasionally used to treat other conditions, including (in descending order of frequency):

  • Fibromyalgia
  • Headache, including migraine
  • Myofascial symptoms
  • Gastrointestinal disorders
  • Chronic fatigue syndrome

The study also found that 42 percent of the visits weren't covered by health insurance and were paid for by the people treated.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Specialists in physical medicine and rehabilitation perform acupuncture at Mayo Clinic for people referred by a Mayo doctor.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in physical medicine and rehabilitation perform acupuncture at Mayo Clinic for people referred by a Mayo doctor.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in complementary and integrative medicine perform acupuncture at Mayo Clinic for people referred by a Mayo doctor.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

Mayo Clinic also offers acupuncture at the Mayo Clinic Healthy Living Program rejuvenate spa, which doesn't require a physician referral. For appointments with the Healthy Living Program, call 507-293-2933 8 a.m. to 8 p.m. Central time, Monday through Friday and 8 a.m. to 2 p.m. Central time Saturday for pricing and services information or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Researchers in the Complementary and Integrative Medicine Program are committed to developing evidence-based treatments that can be combined with conventional medicine. Among other things, they have studied use of acupuncture for:

  • Noncyclical breast pain
  • Hot flashes
  • Fibromyalgia
  • Prevention of nausea in people having cardiac surgery

See a list of publications by Mayo authors on acupuncture on PubMed, a service of the National Library of Medicine.

Feb. 21, 2015