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Acupuncture

Acupuncture places fine needles at defined skin points; studies in humans show benefits for pain, sleep, nausea and other complaints.

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We evaluated 343 human studies on Acupuncture, including 44 randomised controlled trials and 294 meta-analyses or systematic reviews; the controlled studies include 11,913 participants in total. As of 30 September 2026.

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1. What is Acupuncture? Origin, use and variants

Acupuncture is a method from traditional Chinese medicine in which fine needles are inserted at defined points of the skin. Studies usually compare it with sham acupuncture, usual care or a waiting list – this comparison determines what a result means.

Acupuncture originated in China, where it has been practised for more than two thousand years. Today it is used worldwide; in Germany, statutory health insurance has covered it since 2007 for chronic lower back pain and chronic knee pain.

Besides classic body acupuncture there is electroacupuncture, in which a weak current flows through the needles, ear acupuncture, laser acupuncture without needles, and the combination with moxibustion, the warming of the points.

Variants studied

  • Body acupuncture
  • Electroacupuncture
  • Ear acupuncture (auriculotherapy)
  • Laser acupuncture
  • Acupuncture with moxibustion
  • Acupuncture in addition to other treatments – the other components are named

Not covered on this page:

2. What does Acupuncture do? Results by area

AreaResult in controlled studiesStrength of evidenceStudiesParticipants
Back, neck and joint painmostly improvedhigh84 meta-analyses · 13 controlled · 2 other4,876
Sleep, anxiety and depressionmostly improvedhigh77 meta-analyses · 10 controlled · 1 other1,529
Stroke and nervous systemmostly improvedhigh43 meta-analyses · 6 controlled · 1 other2,062
Stomach and gutmostly improvedhigh27 meta-analyses · 5 controlled · 1 other1,453
Nausea and vomitingmostly improvedhigh16 meta-analyses · 2 controlled · 0 other592
Gynaecology, pregnancy and fertilitymostly no differencemoderate27 meta-analyses · 3 controlled · 0 other442
Headache and migrainemostly improvedmoderate22 meta-analyses · 1 controlled · 0 other212
Smoking and addictionmostly improvedmoderate2 meta-analyses · 0 controlled · 0 other0
Other outcomesmostly improvedhigh140 meta-analyses · 19 controlled · 3 other3,633

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis. “Low” means one controlled study showing improvement. Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved.

3. What the studies show in detail

Acupuncture, back, neck and joint pain: human studies

In several meta-analyses, acupuncture reduced pain intensity more than control treatments, for example for neck and chronic pelvic pain and after cesarean section 5179137153. Functioning also improved in several controlled studies, for example for neck pain, myofascial pain syndrome and chronic back pain 51137190. Special forms such as Fu's subcutaneous needling for cervical spondylosis 42 and cheek acupuncture for pain 64 achieved higher response rates than the control groups. For knee osteoarthritis, electroacupuncture improved stiffness more than painkillers, while for pain and joint function it acted similarly 140. Laser acupuncture improved pain, function and stiffness in knee osteoarthritis compared with placebo laser, but only in the short term 224. For cancer pain, ear acupuncture acted better than sham ear acupuncture and as an addition to medication, but alone it was not better than medication 241. For chronic back pain, electroacupuncture was mostly not superior to manual acupuncture in a systematic review 235. Compared with spinal manipulation, acupuncture performed worse for pain and the same for function 255. The results apply to the variant investigated in each case, including body acupuncture, electroacupuncture, laser acupuncture and ear acupuncture. For lumbar disc herniation, moxibustion together with acupuncture reduced pain and functional impairment more than conventional treatment 31. Stimulation of acupuncture points in addition to opioids relieved severe tumor pain better than opioids alone; the authors do not yet consider the evidence conclusive 37. For shoulder-hand syndrome after stroke, acupuncture or moxibustion in addition to rehabilitation relieved pain more than rehabilitation alone 44.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
4 Foster et al. 2021meta-analysis · 20,827 participantsAcupuncture (body acupuncture, variant not further specified); vs. Sham acupuncture and non-acupuncture controlsDifference in skewness of pain change vs non-acupuncture control: no difference (0.124 (p = 0.047)); Difference in skewness of pain change vs sham acupuncture: no difference (0.141 (p = 0.029)); Difference in skewness vs sham in sensitivity analysis: no difference (p = 0.2)
5 Xie et al. 2025meta-analysis · 9,549 participantsacupuncture, electroacupuncture, moxibustion, some with TCM/usual medicine; vs. usual medicineNRS pain score: improved (MD = -1.83, 95% CI: -2.86 to -0.80); cancer pain relief: improved (OR = 30.86, 95% CI: 3.75-254.20)
6 Rubinstein et al. 2010systematic review · 8,298 participantsAcupuncture (20 RCTs); short-term; vs. waiting list control or added to another interventionshort-term clinically relevant effect: improved
7 Wan et al. 2025meta-analysis · 8,287 participantsManual acupuncture versus various sham acupuncture methods; vs. Waiting group, acupoint no penetration, nonacupoint no penetrationPain variation: waiting group vs. manual acupuncture: improved (mean difference 1.86 (95% confidence interval 1.36 to 2.35)); Pain variation: acupoint no penetration vs. manual acupuncture: improved (mean difference 1.14 (95% confidence interval 0.74 to 1.55)); Pain variation: nonacupoint no penetration vs. manual acupuncture: improved (mean difference 1.00 (95% confidence interval 0.35 to 1.65))
11 Chi et al. 2021systematic review · 7,113 participantsEye acupuncture, needles around the orbit (horizontal outer orbital edge); small needles (φ0.25 × 13 mm), retained ≤30 min, mostly without manipulation; vs. 45 RCTs, 5 CCTs, 31 case series; controls not further reportedpain relief: improved
12 Yu et al. 2023systematic review · 6,876 participantsAcupuncture (needling) or sham acupuncture; vs. Sham acupuncture (SANA, NPA, NPANA) and blank controlPain indicators (effectiveness): improved; Ranking of sham acupuncture procedures (SUCRA): no difference (SANA (SUCRA, 65.3%), NPA (SUCRA, 46.2%), and NPANA (SUCRA, 34.2%))
31 Du et al. 2026meta-analysis · 4,399 participantsMoxibustion alone or combined with acupuncture, tuina, traction, TCM, conventional therapy; vs. conventional intervention (CT)JOA score: improved (MD = 11.93, 95% CI: 8.88 to 14.98); JOA score: improved (MD = 7.81, 95% CI: 4.4 to 11.23); ODI score: improved (MD = -10.11, 95% CI: -11.92 to -8.3)
37 Zhang et al. 2023meta-analysis · 4,026 participantsAcupuncture-point stimulation (fire needle, body, auricular, electroacupuncture, moxibustion, TEAS, point embedding, wrist-ankle acupuncture); vs. Opioids aloneTotal pain relief rate: improved

Further studies in this area: 42 44 50 51 52 58 62 64 67 69 73 75 79 85 89 90 94 96 101 102 110 111 113 123 129 135 137 138 140 146 153 161 165 182 184 188 189 190 192 197 200 201 204 213 221 224 230 232 235 241 242 245 247 248 252 255 257 259 261 262 263 264 265 267 271 274 279 281 283 284 286 287 288 290 291 292 295 296 298 300 304 307 309 311 320 324 331 333 334 339 343

Acupuncture, sleep, anxiety and depression: human studies

For sleep disorders, acupuncture improved subjective sleep quality compared with waiting list 34 and sham acupuncture 66, but not objective sleep values 66. In cancer patients, it improved sleep quality compared with control groups 49112193, but differed hardly from sham acupuncture 280. For depression, acupuncture relieved complaints more than sham acupuncture and similarly to antidepressants 41; another meta-analysis found a small advantage compared with medication 157. For anxiety disorders, acupuncture relieved complaints more than sham acupuncture and usual treatment or waiting list 152176. The findings apply to the variant investigated in each case, predominantly body and electroacupuncture, less often ear acupuncture 98 or laser ear acupuncture 283. What remains open is the informative value compared with sham acupuncture for several endpoints, the transferability to individual acupuncture variants and the question of how strongly combined applications carry the results.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
3 Yeo et al. 2022systematic review · 31,748 participantsAcupuncture (most frequent form) plus mind-body practices and natural products; vs. Western medicine, sham/placebo acupuncture, no treatmentPittsburgh Sleep Quality Index (PSQI): improved (positive effect in 89.5% (17/19) of SRs/MAs); PSQI sleep quality: improved (superior effect to western medicine, sham/placebo, and no treatment)
9 Tang et al. 2026systematic review · 8,062 participantsAcupuncture and related therapies, partly combined; vs. western medicine, conventional rehabilitation, other acupuncture formsPittsburgh Sleep Quality Index total score: improved; sleep duration and sleep latency: improved; subjective sleep quality: improved
10 Fang et al. 2026meta-analysis · 7,791 participantsvarious acupuncture therapies; short-term and long-term; vs. conventional medication, sham acupuncture, other interventionsshort-term PSQI score: improved (MD -3.73; 95% CrI [-6.88, -0.55]); short-term PSQI score: improved (MD -1.96; 95% CrI [-2.64, -1.27]); short-term PSQI score: improved (MD -3.08; 95% CrI [-5.18, -0.93])
15 Gui et al. 2026meta-analysis · 5,864 participantsManual or electroacupuncture, alone or as an adjunct to SSRIs; short-term, including four weeks; vs. sham acupuncture, waitlist, psychotherapy, or SSRIsdepressive symptom severity versus non-active controls: improved; additional short-term improvement at four weeks as an adjunct to SSRIs: improved (MD -3.02; 95% CI -3.49 to -2.56); earlier symptomatic improvement with electroacupuncture: improved
19 Hu et al. 2025meta-analysis · 5,362 participantsElectroacupuncture, mostly as complementary therapy; vs. Control group (usual care/sham)Clinical effectiveness: improved (RR = 1.16, 95% CI [1.11, 1.22]); HAMD score: improved (SMD = -0.56, 95% CI [-0.72, -0.40]); SDS score: improved (SMD = -0.56, 95% CI [-0.87, -0.24])
25 Yang et al. 2025meta-analysis · 4,579 participantsVarious acupuncture modalities, some combined with Western or Chinese medicine; vs. Comparison of acupuncture modalities with each other (network meta-analysis)Depression: improved; Anxiety: improved; Sleep: improved
26 Liu et al. 2025meta-analysis · 4,443 participantsVarious acupuncture therapies, some combined with moxibustion or auriculotherapy; vs. HypnoticsPSQI sleep quality: improved; Clinical effectiveness rate: improved
29 Chen et al. 2025meta-analysis · 4,406 participantsAcupuncture (manual, electro) alone or with CHM/WM; vs. Western medicine or other acupuncture combinationsClinical response rate: improved (RR = 1.52, 95 % CI: 1.12-2.08); Depressive symptoms (HAMD): improved (MD = -5.04, 95 % CI: -6.97 to -3.12); Anxiety symptoms (HAMA): improved (MD = -8.40, 95 % CI: -14.31 to -2.49)

Further studies in this area: 33 34 39 41 49 58 63 65 66 76 77 78 85 88 92 98 107 110 112 122 124 132 133 144 146 152 156 157 160 166 168 176 178 181 185 187 193 201 202 204 207 209 211 212 214 216 221 223 226 231 234 239 242 246 253 263 264 266 268 270 271 275 279 280 283 285 288 293 294 315 316 317 320 324 326 329 332 333 335 339

Acupuncture, stroke and nervous system: human studies

After a stroke, manual acupuncture improved cognitive function more than sham acupuncture and waiting list 303; meta-analyses also found advantages compared with control groups 117128196. Swallowing function improved more than under sham acupuncture 310. Scalp acupuncture performed better than conventional rehabilitation 170; neck acupuncture improved swallowing function compared with control groups 114. For depression after stroke, electroacupuncture lowered not only depression scores but also neurological deficits on the NIHSS scale 234. The findings apply to the variant investigated in each case, often as an addition to conventional treatment; the control groups are very different.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
2 Li et al. 2026systematic review · 63,493 participantsTraditional Chinese acupuncture, incl. fire needling, CPBLC, Fu's needling, plum-blossom needle; vs. Randomized controlled trials within systematic reviewseffective rate: improved; visual analog scale (VAS) score: improved; adverse reactions: improved
13 Yin et al. 2026meta-analysis · 6,259 participantsAcupuncture (body, electro, scalp) plus add-on therapies; vs. standard of care (SOC), single-modality acupuncture, conventional rehabilitationMontreal Cognitive Assessment (MoCA): improved (SMD = 1.89, 95% CI: 1.59-2.19); Mini-Mental State Examination (MMSE): improved (SMD = 2.41, 95% CI: 1.64-3.19); Barthel Index (BI): improved (SMD = 1.50, 95% CI: 0.77-2.22)
36 Su et al. 2026meta-analysis · 4,080 participantsacupuncture or electroacupuncture plus noninvasive brain stimulation; vs. single-modality therapies or conventional rehabilitationMotor function (FMA total): improved; Upper extremity motor function (FMA-UE): improved; Lower extremity motor function (FMA-LE): improved
44 Wang et al. 2026systematic review · 3,730 participantsAcupuncture or moxibustion plus rehabilitation; vs. Rehabilitation aloneefficacy rate: improved (RR = 1.24, 95 % CI: 1.20 to 1.28); motor function (FMA): improved (MD = 8.35, 95 % CI: 6.96 to 9.74); SHS severity (SHSS): improved (MD = -1.60, 95 % CI:1.99 to -1.22)
45 Du et al. 2026meta-analysis · 3,718 participantsmoxibustion alone or combined with acupuncture, massage, herbal medicine; vs. conventional treatmentcommon peroneal motor nerve conduction velocity: improved (MD = 6.14 m/s, 95% CI 3.82 to 8.46); median motor nerve conduction velocity: improved (MD = 6.35 m/s, 95% CI 2.35 to 10.36); common peroneal sensory nerve conduction velocity: improved (MD = 8.44 m/s (95% CI 4.80 to 12.08))
47 Huang et al. 2024meta-analysis · 3,604 participantsacupuncture plus conventional treatment; vs. conventional treatment aloneNIHSS: improved (MD:1.70, 95 %CI [-2.27, -1.14], P < 0.00001); efficiency (NIHSS): improved (RR: 1.21, 95 %CI [1.12, 1.31], P < 0.00001); Chinese Stroke Scale: improved (MD:4.33, 95 %CI [-5.67, -2.98], P < 0.00001)
57 Li et al. 2026meta-analysis · 3,261 participantsacupuncture combined with rTMS; vs. rTMS aloneFugl-Meyer Assessment total score: improved (MD 7.11, 95% CI 5.51-8.70); Fugl-Meyer upper-extremity score: improved (MD 8.21, 7.68-8.75); Fugl-Meyer lower-extremity score: improved (MD 5.06, 4.42-5.71)
58 Yu et al. 2025systematic review · 3,248 participantsAcupuncture of various modalities added to standard PD therapy; ≥10 acupoints, thrice weekly, moderate session duration; vs. Western medicine or standard PD therapyUPDRS domains (motor): improved; treatment-related motor complications: improved (SMD: -2.16; 95% CI: -3.10 to -1.22)

Further studies in this area: 97 100 103 105 114 117 121 126 127 128 130 134 139 141 142 145 170 179 186 187 196 206 218 228 229 234 239 243 249 250 251 262 269 272 281 297 301 303 310 315 328 339

Acupuncture, stomach and gut: human studies

For functional gastrointestinal disorders and irritable bowel syndrome, body acupuncture showed higher response rates and a greater improvement in general gastrointestinal symptoms than sham acupuncture, usual treatment or Western medication in several controlled studies and meta-analyses 21194312313. After cesarean section 79 and after cancer surgery 119123, acupuncture shortened the time to first passage of wind, also compared with sham acupuncture 119. For gastric cancer, acupuncture with moxibustion accelerated intestinal recovery after surgery and chemotherapy 173. For cancer pain under opioids, constipation occurred less frequently when acupuncture procedures were used in addition, sometimes with Chinese herbal medicine applications 537129. For functional dyspepsia, acupuncture improved complaints and quality of life more than sham acupuncture, without more adverse events 87. For very severe chronic constipation, electroacupuncture in a randomized study acted overall similarly to prucalopride, weaker initially, with fewer adverse events 308. The findings apply to the variant investigated in each case, often as an addition to usual treatment; the comparisons range from sham acupuncture to usual treatment to medication.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
5 Xie et al. 2025meta-analysis · 9,549 participantsacupuncture, electroacupuncture, moxibustion, some with TCM/usual medicine; vs. usual medicineincidence of constipation: improved (OR = 0.16, 95% CI: 0.04-0.66)
20 Zhang et al. 2026systematic review · 5,311 participantsAcupuncture (variant not specified)Methodological quality: low-risk randomization: unclear (83.6%); Allocation concealment implemented: unclear (3.6%); Blinding implemented: unclear (1.8%)
21 Wan et al. 2025meta-analysis · 5,100 participantsAcupuncture (variant not specified); vs. Sham acupuncture, usual care, or Western medicationResponse rate versus sham acupuncture: improved (RR 1.65, 95 %CI 1.35-2.03); Response rate versus Western medication: improved (RR 1.15, 95 %CI 1.07-1.23); General GI symptoms versus sham acupuncture or usual care: improved (SMD 0.48, 95 % CI 0.25-0.72)
37 Zhang et al. 2023meta-analysis · 4,026 participantsAcupuncture-point stimulation (fire needle, body, auricular, electroacupuncture, moxibustion, TEAS, point embedding, wrist-ankle acupuncture); vs. Opioids aloneIncidence of constipation: improved
55 Liu et al. 2026systematic review · 3,351 participantsacupuncture-related therapies (AA, AP, APA etc.), alone or with osmotic laxatives; vs. osmotic laxatives or other controlsBFI score: improved (statistically significant reductions in BFI scores compared with OSM); CCS: no difference (No statistically significant differences were detected for CCS); weekly spontaneous bowel movements: no difference (No statistically significant differences were detected for ... weekly SBMs)
65 Xu et al. 2025meta-analysis · 3,005 participantsnon-pharmacological interventions incl. acupuncture, ear acupoints; treatment cycle partly >4 weeks; vs. conventional treatment (control group)efficacy (response): improved (RR = 1.15, 95% CI = 1.09 to 1.21, p < 0.00001); stool consistency (Bristol scale): improved (SMD = 0.87, 95% CI = 0.14-1.60, p = 0.02); complete spontaneous bowel movements (CSBM): improved (SMD = 0.44, 95% CI = -0.52-0.12, p = 0.03)
79 Liu et al. 2025meta-analysis · 2,641 participantsAcupuncture (conventional and electroacupuncture); vs. Control group (not specified)Bowel sound recovery time: improved (SMD = -2.26, 95% CI [-2.97, -1.54]); Time to first flatus: improved (SMD = -2.41, 95% CI [-3.21, -1.61])
86 Ou et al. 2024systematic review · 2,459 participantsAcupuncture and moxibustion as adjunctive therapy; vs. Routine care (RC) aloneTime to first bowel sounds: improved; Time to first defecation: improved; Time to first flatus: improved

Further studies in this area: 87 106 109 111 119 123 129 136 173 194 210 217 222 231 233 256 265 274 288 306 308 312 313 321 340

Acupuncture, nausea and vomiting: human studies

After colorectal cancer surgery 123 and after laparoscopic gallbladder removal 286, nausea and vomiting occurred less frequently with acupuncture than in the control groups; a review after abdominal surgery reports fewer nausea cases 274. In addition to usual treatment, acupuncture improved complete control of acute and delayed vomiting during chemotherapy, while no difference was found for the other measures 84. Together with antiemetics, acupuncture improved the frequency and severity of nausea and vomiting in cancer patients undergoing chemotherapy 35. In combination with moxibustion, nausea and vomiting tended to occur less frequently in gastric cancer after surgery and chemotherapy 173. Electrical stimulation of acupuncture points, by needle or through the skin, reduced only moderate to severe cases of chemotherapy-induced nausea, but not the overall frequency, compared with sham stimulation 220.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
5 Xie et al. 2025meta-analysis · 9,549 participantsacupuncture, electroacupuncture, moxibustion, some with TCM/usual medicine; vs. usual medicineincidence of nausea and vomiting: improved (OR = 0.11, 95% CI: 0.03-0.45)
35 Chen et al. 2026meta-analysis · 4,133 participantsAcupuncture (body acupuncture, points ST36, PC6, CV12); vs. Sham acupuncture or conventional treatmentIncidence of vomiting: improved (RR = 0.583, 95% CI: 0.523-0.650); Vomiting severity: improved (MD = -0.839, 95% CI: -1.256 to -0.422); Vomiting episodes: improved (MD = -3.704, 95% CI: -6.256 to -1.152)
37 Zhang et al. 2023meta-analysis · 4,026 participantsAcupuncture-point stimulation (fire needle, body, auricular, electroacupuncture, moxibustion, TEAS, point embedding, wrist-ankle acupuncture); vs. Opioids aloneIncidence of nausea and vomiting: improved
67 Liu et al. 2024meta-analysis · 3,003 participantsAcupuncture, electroacupuncture, TEAS, auricular acupoint therapy; vs. MA alone; comparisons between acupuncture formsPostoperative nausea and vomiting: improved
84 Yan et al. 2023meta-analysis · 2,503 participantsAcupuncture in addition to usual care; vs. usual care alone or sham acupuncturecomplete control of acute vomiting: improved (RR, 1.13; 95% CI, 1.02 to 1.25); complete control of delayed vomiting: improved (RR, 1.47; 95% CI, 1.07 to 2.00); all other review outcomes: no difference
111 Lv et al. 2025meta-analysis · 2,031 participantsAcupuncture assisted anesthesia (AAA); vs. Control group (without AAA)Postoperative nausea and vomiting: improved (P < 0.05)
123 Qi et al. 2023meta-analysis · 1,878 participantsacupuncture (needling); vs. usual care and sham acupuncturenausea/vomiting: improved (RR 0.72, 95% CI 0.59-0.89)
129 Wang et al. 2025meta-analysis · 1,738 participantsAcupuncture (MA, EA, MOX, AI, ACE, AP, TN, TEAS) plus analgesics; vs. different acupuncture techniques compared with each other, each added to analgesicsopioid-induced nausea and vomiting: improved (SUCRA = 87.7%)

Further studies in this area: 131 164 173 184 213 220 274 286 305 319

Acupuncture, gynaecology, pregnancy and fertility: human studies

In gynecology, pregnancy and fertility, several meta-analyses found advantages of acupuncture procedures: In women with polycystic ovary syndrome, the ovulation rate under body acupuncture alone was higher than under sham acupuncture and than under pharmacotherapy, as was the case under body acupuncture in combination with herbal medicine compared with pharmacotherapy 24. In women with PCOS undergoing artificial fertilization, clinical pregnancy and live birth rates increased 180; in luteinized unruptured follicle syndrome, ovulation and pregnancy rates increased compared with control groups 203. For endometriosis, acupuncture as the sole treatment reduced pain intensity in a systematic review 276. Compared with sham acupuncture, electroacupuncture in PCOS during fertility treatment increased the pregnancy rate over several attempts, but not the live birth rate 327. Before induction of labor, labor did not begin spontaneously more frequently than under sham acupuncture, but did begin more frequently than without acupuncture 56. In PCOS, acupuncture triggered ovulation about as often as clomiphene, without a reliable difference 336. The certainty of evidence is moderate; the findings apply to the variant investigated in each case, mostly body acupuncture, sometimes electroacupuncture, and many reviews examined combinations with moxibustion, herbal medicine or other procedures, so the contribution of the needles alone often remains open.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
8 Zheng et al. 2025meta-analysis · 8,147 participantsAcupuncture and related therapies (e.g., moxibustion, cupping, acupoint injection); vs. conventional treatmentTotal effectiveness: improved; IL-2: improved (61.6%); TNF-α: improved (95.8%)
14 Li et al. 2026meta-analysis · 5,937 participantsvarious acupuncture methods (incl. electro-acupuncture, acupoint catgut embedding); vs. placebo or standard treatment/medicinetestosterone levels: improved (MD: 0.69; 95% CrI [0.35, 1.03]); Ferriman-Gallwey scores (electro-acupuncture vs. placebo): improved (MD: 1.52; 95% CrI [0.50, 2.53]); pregnancy rate: improved (SUCRA = 76.6%)
17 Chen et al. 2024meta-analysis · 5,772 participants25 acupuncture-related techniques, e.g. acupuncture, moxibustion, acupoint patching; vs. oral analgesics and other acupuncture therapiesClinical effective rate: improved; Visual analogue scale (VAS): improved; Cox menstrual symptom scale (CMSS): improved
24 Wei et al. 2025meta-analysis · 4,827 participantsAcupuncture, partly combined with herbal medicine; optimal: 30 min, 29 acupoints, 3 sessions/week, 24 weeks; up to 24 weeks; vs. sham acupuncture, pharmacotherapy, or conventional therapyOvulation rate (acupuncture alone vs. sham acupuncture): improved (RR = 1.15, 95% CI: 1.04-1.27); Ovulation rate (acupuncture alone vs. pharmacotherapy): improved (RR = 1.11, 95% CI: 1.04-1.20); Ovulation rate (acupuncture plus herbal medicine vs. pharmacotherapy): improved (RR = 1.27, 95% CI: 1.12-1.43)
25 Yang et al. 2025meta-analysis · 4,579 participantsVarious acupuncture modalities, some combined with Western or Chinese medicine; vs. Comparison of acupuncture modalities with each other (network meta-analysis)Hormone regulation: improved; TCM symptoms: improved; Menopausal symptoms: improved
28 Du et al. 2026meta-analysis · 4,406 participantsAcupuncture-related therapies (12 regimens incl. acupuncture, moxibustion, electroacupuncture); vs. conventional medication and/or placeboHOMA-IR: improved (MD = 2.20, 95% CI 0.44-3.96); HOMA-IR: improved (MD = 1.06, 95% CI 0.28-1.84); Fasting insulin: improved (MD = 7.30, 95% CI 0.83-13.77)
29 Chen et al. 2025meta-analysis · 4,406 participantsAcupuncture (manual, electro) alone or with CHM/WM; vs. Western medicine or other acupuncture combinationsKupperman Index: improved (MD = -5.37); Estradiol (E2): improved (MD = 26.25); FSH and LH: improved
40 Chen et al. 2024meta-analysis · 3,903 participantsMeridian-based TCM interventions incl. acupuncture, electroacupuncture, warm needling, moxibustion, acupressure; vs. NSAIDs, waitlist, placebo, western medicine, conventional therapiesPain reduction (acupuncture vs NSAIDs): improved (SMD = -1.09, 95%CI (-1.62, -0.55)); Pain reduction (acupuncture vs waitlist): improved (SMD = -1.89, 95%CI (-3.67, -0.11)); Pain reduction (acupressure vs NSAIDs): improved (SMD = -1.51, 95%CI (-2.91, -0.12))

Further studies in this area: 43 46 56 68 91 156 171 172 175 178 180 181 203 205 219 261 270 276 293 305 327 336

Acupuncture, headache and migraine: human studies

In migraine, acupuncture reduced attack frequency and pain intensity more than preventive medication 30148 and more than sham acupuncture 260. Electroacupuncture also reduced pain intensity compared with sham electroacupuncture 144, and auricular acupuncture reduced pain intensity, attack frequency and attack duration compared with control groups 244. Compared with sham acupuncture, the advantage was not consistent: one review found it for attack frequency, pain intensity and response rate, but not for migraine days 74. In menstrual migraine, acupuncture was not superior to sham acupuncture, but was superior to medication for pain intensity 236. In chronic migraine, acupuncture was not superior to botulinum toxin A for headache and migraine days 82. The certainty of evidence is moderate; the results apply to the respective variant studied. Acupuncture together with Chinese herbal medicine reduced migraine days more than flunarizine 322; for headache originating in the cervical spine, acupuncture with tuina was among the highest-rated combinations 81.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
22 Huang et al. 2024meta-analysis · 4,880 participantsSham acupuncture (placebo) compared with other sham interventions; vs. sham rTMS, sham tDCS, sham CBT, sham nVNSmigraine days: no difference; number of migraine attacks: improved; headache frequency: improved
27 Tao et al. 2024meta-analysis · 4,426 participantsAcupuncture; vs. Tricyclic antidepressants (amitriptyline, amitriptylinoxide, clomipramine)Headache frequency: no difference (amitriptyline: mean difference [MD] -1.29, 95% CI -5.28 to 3.02); Headache intensity: no difference (amitriptyline: MD 2.35, 95% CI -1.20 to 5.78)
30 Song et al. 2023meta-analysis · 4,405 participantsAcupuncture (manual, electroacupuncture, others) vs. drugs/psychotherapy; 12-week follow-up; vs. Prophylactic drugs (calcium antagonists, beta-blockers) and psychotherapyVAS pain score: improved; migraine attack frequency: improved; headache attack days: improved
32 Song et al. 2022meta-analysis · 4,379 participantsAcupuncture-related therapies (13 different methods); vs. Network comparison of acupuncture methods against each otherVAS pain score: improved (98.0%); number of migraine days: improved (82.4%); duration of migraine: improved (99.9%)
59 Chen et al. 2024systematic review · 3,221 participantsAcupuncture (needles at acupuncture points); Follow-up up to 6 months after treatment completion; vs. Sham acupuncture, physical training, relaxation trainingResponse rate (at least 50% reduction in headache days): improved (P<0.05); Headache days: improved; Headache intensity: improved
74 Li et al. 2022systematic review · 2,725 participantsAcupuncture (needles); vs. Sham acupunctureMigraine frequency after treatment: improved (MD=-0.52, 95% CI: -0.71 to -0.34, P<0.00001); Migraine frequency at follow-up: improved (MD=-0.51, 95% CI: -0.70 to -0.32, P<0.00001); Visual Analog Scale after treatment: improved (MD=-0.72, 95% CI: -1.17 to -0.27, P=0.002)
81 Yu et al. 2026meta-analysis · 2,559 participantsAcupuncture combined with tuina and other therapies; vs. different combined treatment regimens in network comparisonefficacy (SUCRA ranking): improved; VAS pain score (SUCRA ranking): improved
82 Zheng et al. 2021meta-analysis · 2,545 participantsAcupuncture (needles); 12 weeks; vs. Topiramate, BoNT-A, or placeboReduction in monthly headache days: no difference (SMD -1.61, 95% CI: -2.35 to -0.87); Reduction in monthly migraine days: no difference (SMD -0.4, 95% CI: -0.75 to -0.04)

Further studies in this area: 95 108 118 143 144 148 154 155 167 185 225 236 244 260 322

Acupuncture, smoking and addiction: human studies

For smoking cessation, a meta-analysis found that more people remained smoke-free with acupuncture than in the control groups 237. The certainty of evidence is moderate. It remains open whether acupuncture is as effective for smoking cessation as medication.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
60 Xu et al. 2026meta-analysis · 3,174 participantsAcupuncture (unspecified); vs. conventional rehabilitationCraving reduction: unclear
237 Tahiri et al. 2012meta-analysis · 823 participantsAcupuncture (variant not specified); Outcomes at 6 or 12 months; vs. Control groups of included trialsSmoking cessation (point prevalence or continuous abstinence): improved (odds ratio [OR], 3.53; 95% confidence interval [CI], 1.03-12.07)

Acupuncture: further outcomes in studies

Further meta-analyses found advantages over control groups in chronic urticaria 124, mouth ulcers 158, tic disorders in children under scalp acupuncture 151 and COPD under electroacupuncture 199. Most of these meta-analyses themselves rate the certainty of their findings as low to moderate. Mostly body acupuncture was studied, as well as electroacupuncture, auricular acupuncture, laser acupuncture and acupuncture with moxibustion, sometimes as an addition to other treatments. It remains open which acupuncture variant and which comparison (sham acupuncture, usual care, waiting list) support the results in each case.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
1 Lu et al. 2022systematic review · 138,995 participantsAcupuncture therapies (various modalities); vs. Randomised controlled trials in meta-analysesNumber of systematic reviews on acupuncture: unclear (120 SRs); Number of included RCTs: unclear (1402 RCTs); Number of participants: unclear (138 995 participants)
5 Xie et al. 2025meta-analysis · 9,549 participantsacupuncture, electroacupuncture, moxibustion, some with TCM/usual medicine; vs. usual medicineKPS score: improved (MD = 2.12, 95% CI: 0.43-3.80); incidence of dizziness: improved (OR = 0.29, 95% CI: 0.09-0.90)
10 Fang et al. 2026meta-analysis · 7,791 participantsvarious acupuncture therapies; short-term and long-term; vs. conventional medication, sham acupuncture, other interventionsadverse events: no difference (99 adverse events were reported (5.59%))
11 Chi et al. 2021systematic review · 7,113 participantsEye acupuncture, needles around the orbit (horizontal outer orbital edge); small needles (φ0.25 × 13 mm), retained ≤30 min, mostly without manipulation; vs. 45 RCTs, 5 CCTs, 31 case series; controls not further reportedquality of life and mental health: improved
15 Gui et al. 2026meta-analysis · 5,864 participantsManual or electroacupuncture, alone or as an adjunct to SSRIs; short-term, including four weeks; vs. sham acupuncture, waitlist, psychotherapy, or SSRIstreatment-related adverse events: improved; quality of life: improved
16 Yang et al. 2026meta-analysis · 5,797 participantsAcupuncture (manual, electro, warm-needle moxibustion), sometimes combined with Tuina/acupotomy/manipulation; vs. Tuina alone or other acupuncture/manual therapy combinationsOverall response rate (OR): improved (OR = 1.53; 95% CI: 1.23-1.89); Evaluation Scale for Cervical Vertigo (MD): improved (mean difference = 12.52; 95% confidence interval: 8.51-16.54); Dizziness Handicap Inventory (SMD): improved (standardized mean difference = 2.04; 95% confidence interval: 1.49-2.58)
18 Luo et al. 2025systematic review · 5,492 participantsAcupuncture vs inserted and non-inserted sham acupuncture vs no treatment; vs. sham acupuncture (inserted/non-inserted) and no treatmentproportion of natural history/regression to the mean effect: unclear (0.335 (95% confidence interval [CI], 0.255-0.415)); proportional contextual effect of acupuncture: unclear (0.639 (95% CI, 0.567-0.710)); proportional contribution of the placebo effect: unclear (0.191)
19 Hu et al. 2025meta-analysis · 5,362 participantsElectroacupuncture, mostly as complementary therapy; vs. Control group (usual care/sham)Adverse reactions: improved (RR = 0.54, 95% CI [0.35, 0.83])

Further studies in this area: 20 21 23 27 33 36 37 38 42 44 48 50 51 52 53 54 57 58 59 60 61 64 65 67 70 71 72 77 80 83 89 93 94 95 96 98 99 101 104 108 110 111 113 114 115 116 118 119 120 123 124 125 126 134 135 147 148 149 150 151 158 159 162 163 164 165 166 167 169 172 173 174 177 179 182 183 184 185 186 187 191 192 194 195 196 198 199 201 202 204 208 212 213 214 215 218 221 223 227 228 230 233 234 236 238 239 240 241 242 245 248 254 258 261 262 264 265 266 270 271 272 273 274 277 278 280 282 283 284 285 287 289 297 299 302 311 314 315 318 319 323 324 325 326 327 330 331 333 336 337 338 339 341 342

4. How is Acupuncture used? Procedure, frequency and duration in studies

The studies investigated mainly body acupuncture, as well as electroacupuncture, ear acupuncture, laser acupuncture and acupuncture with moxibustion. Acupuncture was often used in addition to other treatments, such as medication, rehabilitation or herbal medicine. The results apply in each case to the variant and preparation investigated; the doses are shown in the table.

Preparation or formDoseDurationStudy
Standard acupuncture (SA) or SA plus maintenance (EA), added to usual careSA: 8-15 sessions over 12 weeks; EA: plus 4-6 maintenance sessions12 weeks treatment, follow-up up to 12 months296
Acupuncture plus atlantoaxial bone-setting (group A), acupuncture alone (group B), tiapride (group C)—2 months of treatment297
Acupuncture by licensed acupuncturists plus usual carein the ED and twice weekly in follow-up clinic1 month298
Acupuncture plus breathing exercises—3 months299
Electroacupuncture (EA) vs. sham acupuncture (SA)3 sessions per week for 6 weeks6-week treatment, 30-week follow-up300
ElectroacupunctureSessions over 4 weeks4 weeks treatment, 4 weeks follow-up301
Acupuncture (body acupuncture) versus sham acupuncture20 sessions over 8 weeks8 weeks treatment, 24 weeks follow-up302
Manual acupuncture (MA)36 sessions over 12 weeks12 weeks treatment, 24 weeks follow-up303
Electro-acupuncture or auricular acupuncture—10 weeks treatment, endpoint week 12304
Active or sham acupuncture, 30 minutes daily; doxylamine-pyridoxine or placeboAcupuncture 30 minutes daily; doxylamine-pyridoxine dose not reported14 days305
Electroacupuncture—8 weeks treatment, effects up to 24 weeks308
Electroacupuncture (EA), three intensities: strong, weak, shamstrong EA > 2 mA, weak EA < 0.5 mA, sham EA at non-acupoints5 sessions per week for 2 weeks309
Verum acupuncture (body acupuncture)10 sessions over 14 days14 days310
Acupuncture (needles) vs. massageweekly for 10 weeks, then monthly boosters up to 26 weeks26 weeks follow-up311
Acupuncture (15 sessions) vs. sham acupuncture with blunt-tipped needles at non-acupoints15 sessions over 6 weeks6 weeks treatment, 12 weeks follow-up (18 weeks total)312

5. Is Acupuncture safe? Side effects in studies

The studies report predominantly mild and temporary side effects such as local reactions at the insertion sites. In several papers, adverse events under acupuncture were less frequent than under comparison treatments 192742. Under acupuncture in addition to antipsychotics, adverse events were less frequent than under antipsychotics alone 33. Serious adverse events related to acupuncture were not reported 26. Details are shown in the table.

StudyReported side effects
2 Li et al. 2026Acupuncture decreased adverse reactions
3 Yeo et al. 2022Safety was an aim, but no specific adverse events reported
5 Xie et al. 2025constipation, nausea/vomiting, dizziness reported as outcomes
7 Wan et al. 2025Adverse event rates comparable among sham acupuncture groups
10 Fang et al. 202699 adverse events (5.59%), no significant differences
11 Chi et al. 202118 studies (22.2%) reported adverse events
15 Gui et al. 2026fewer treatment-related adverse events with adjunctive acupuncture
16 Yang et al. 2026Safety assessed, no specific data reported
19 Hu et al. 2025Adverse reactions less frequent with electroacupuncture (RR = 0.54)
21 Wan et al. 2025No differences in adverse events versus sham acupuncture or Western medication
23 Lixia et al. 2026described as safe
26 Liu et al. 2025No serious adverse events related to acupuncture reported

6. What remains open: limits of the evidence

  • Many studies examined only short periods; long-term effects are contradictory.
  • The comparison differs between studies: sham acupuncture, usual treatment, waiting list or medication.
  • Combinations of several procedures were often investigated, so the contribution of the needles alone remains open.
  • The acupuncture variant was not consistently named in all papers.
  • The transferability to individual acupuncture variants is limited.

7. Bottom line: what is established about Acupuncture

Acupuncture is a procedure from traditional Chinese medicine in which fine needles are placed at defined skin points. Studies in humans show improvements for several areas of application, most clearly for pain, sleep disorders, nausea and vomiting as well as for stroke and the nervous system. The findings come predominantly from meta-analyses, many of which rate the certainty of their own results as low. The results apply in each case to the variant investigated and the respective comparison; many studies examined combinations of several procedures, and contradictory results are available on long-term effects.

Frequently Asked Questions

How well has Acupuncture been studied in humans?

We evaluated 343 human studies on Acupuncture, including 44 randomised controlled trials and 294 meta-analyses or systematic reviews; the controlled studies include 11,913 participants in total. As of 30 September 2026.

Does Acupuncture help with back, neck and joint pain? What the studies show

We evaluated 84 meta-analyses or systematic reviews, 13 controlled studies and 2 further studies; the controlled studies include 4,876 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 4567

Does Acupuncture help with sleep, anxiety and depression? What the studies show

We evaluated 77 meta-analyses or systematic reviews, 10 controlled studies and one further study; the controlled studies include 1,529 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 391015

Does Acupuncture help with stroke and nervous system? What the studies show

We evaluated 43 meta-analyses or systematic reviews, 6 controlled studies and one further study; the controlled studies include 2,062 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 2133644

Does Acupuncture help with stomach and gut? What the studies show

We evaluated 27 meta-analyses or systematic reviews, 5 controlled studies and one further study; the controlled studies include 1,453 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 5202137

Does Acupuncture help with nausea and vomiting? What the studies show

We evaluated 16 meta-analyses or systematic reviews and 2 controlled studies; the controlled studies include 592 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 5353767

Does Acupuncture help with gynaecology, pregnancy and fertility? What the studies show

We evaluated 27 meta-analyses or systematic reviews and 3 controlled studies; the controlled studies include 442 participants in total. Result of the controlled studies: mostly no difference. Strength of evidence under our published rules: moderate. Sources: 8141724

What is acupuncture and how is it examined in studies?

Acupuncture is a procedure from traditional Chinese medicine in which fine needles are placed at defined points on the skin. In studies, it is usually compared with sham acupuncture, usual treatment or a waiting list. This comparison determines what a result means.

For which complaints do studies in humans show benefits?

Improvements were shown, among other things, for neck and pelvic pain 51137153, after cesarean section 79, for sleep disorders 344966112168193, for anxiety disorders 152176 as well as for nausea and vomiting 123286. After a stroke, acupuncture improved cognitive function 117128196303 and swallowing function 114170310. The results apply in each case to the variant investigated.

Are there also results without a difference?

Yes, in several areas studies found no differences. For chronic back pain, electroacupuncture was mostly not superior to manual acupuncture in a systematic review 235. In cancer patients, acupuncture differed hardly from sham acupuncture for sleep quality and insomnia severity 280; in fibromyalgia, it did not reliably improve sleep quality 201. In menstrual migraine, acupuncture was not superior to sham acupuncture for frequency, duration and severity of attacks 236.

How well tolerated is acupuncture?

The studies report predominantly mild and temporary side effects such as local reactions at the insertion sites. In several papers, adverse events under acupuncture were less frequent than under comparison treatments 192742. Under acupuncture in addition to antipsychotics, adverse events were less frequent than under antipsychotics alone 33. Serious adverse events related to acupuncture were not reported 26.

What limitations do the studies have?

Many studies examined only short periods, and contradictory results are available on long-term effects. The comparison differs between studies: sham acupuncture, usual treatment, waiting list or medication. Combinations of several procedures were often investigated, so the contribution of the needles alone remains open. The acupuncture variant was not consistently named in all papers.

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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.

International Health Research · https://ih-research.com/en/knowledge/acupuncture/ · Last updated: 2026-10-15