In recent decades, acupuncture has gained increasing recognition within Western healthcare systems as both an alternative and complementary therapy. Originating more than 2,000 years ago within Traditional Chinese Medicine (TCM), acupuncture involves the insertion of fine needles into specific anatomical points to restore balance within the body (MacPherson et al., 2014). While its traditional foundations are rooted in the concept of Qi (pronounced “chee”), modern scientific research has sought to understand its mechanisms through neurophysiological and biochemical frameworks. Today, acupuncture occupies a unique position at the intersection of traditional healing and contemporary evidence-based medicine.
1.0 Historical and Theoretical Foundations
According to Traditional Chinese Medicine, health depends on the harmonious flow of Qi, a vital life energy that circulates through pathways known as meridians (Kaptchuk, 2000). Disruptions or imbalances in Qi are believed to result in illness, pain or dysfunction. By stimulating specific acupuncture points (acupoints), practitioners aim to rebalance Qi and restore physiological harmony.
Although the concept of Qi does not directly align with Western biomedical terminology, researchers have proposed neurobiological explanations for acupuncture’s effects. Modern theories suggest that needle insertion stimulates peripheral nerves, influencing the central nervous system and promoting the release of neurotransmitters such as endorphins, serotonin and dopamine (Zhao, 2008).
2.0 How Acupuncture Is Practised
A typical acupuncture session begins with a comprehensive assessment of the patient’s medical history, symptoms and lifestyle factors. TCM practitioners may examine the tongue and pulse to assess systemic balance (MacPherson et al., 2014).
During treatment, ultra-thin, sterile needles are inserted into selected acupoints at varying depths. Most patients report minimal discomfort, sometimes experiencing a mild sensation described as “deqi”, characterised by heaviness, warmth or tingling (White et al., 2013).
Sessions usually last between 20 and 60 minutes. While some individuals experience immediate symptom relief, others require multiple treatments for sustained benefit. Acupuncture is often integrated with herbal medicine, dietary advice and lifestyle modifications.
3.0 Acupuncture for Pain Management
One of the most extensively researched applications of acupuncture is chronic pain management. A large meta-analysis by Vickers et al. (2012), involving nearly 18,000 patients, found that acupuncture was superior to both no treatment and sham acupuncture for conditions such as back pain, osteoarthritis and headaches.
Similarly, the National Institute for Health and Care Excellence (NICE, 2021) recommends acupuncture as a treatment option for chronic primary pain in certain cases. Evidence suggests acupuncture modulates pain pathways through endogenous opioid release and changes in brain activity observed via functional MRI (Zhao, 2008).
For example, individuals suffering from chronic lower back pain may experience improved mobility and reduced reliance on analgesic medication following a course of acupuncture.
4.0 Neurological and Psychological Benefits
Beyond pain relief, acupuncture has demonstrated benefits in addressing anxiety, depression and insomnia. A systematic review by Armour et al. (2019) reported that acupuncture may reduce symptoms of generalised anxiety disorder when used alongside conventional therapy.
Mechanistically, acupuncture may regulate the hypothalamic–pituitary–adrenal (HPA) axis, thereby reducing stress hormone levels (Eshkevari et al., 2013). Additionally, serotonin modulation may contribute to improved mood regulation.
For example, patients experiencing stress-related insomnia may report improved sleep quality after several acupuncture sessions.
5.0 Acupuncture in Oncology and Supportive Care
Acupuncture is increasingly utilised in integrative oncology settings. The National Cancer Institute (2022) acknowledges its role in managing chemotherapy-induced nausea, cancer-related fatigue and pain.
Clinical trials indicate that acupuncture may significantly reduce chemotherapy-induced nausea and vomiting when used alongside antiemetic medications (Ezzo et al., 2014). Furthermore, patients often report enhanced quality of life and reduced anxiety.
6.0 Fertility and Women’s Health
Acupuncture is commonly employed in reproductive medicine, particularly in conjunction with assisted reproductive technologies. Some evidence suggests acupuncture may improve uterine blood flow and reduce stress during in vitro fertilisation (IVF) cycles (Smith et al., 2018). However, findings remain mixed, and further high-quality research is needed.
7.0 Safety and Regulation
When performed by trained and licensed practitioners using sterile, single-use needles, acupuncture is generally considered safe (White et al., 2013). Adverse events are rare but may include minor bruising or temporary soreness.
In the United Kingdom, practitioners are often regulated by professional bodies such as the British Acupuncture Council, ensuring adherence to hygiene and safety standards.
However, individuals with bleeding disorders, compromised immune systems or implanted medical devices should consult healthcare professionals before initiating treatment.
8.0 Complementary Versus Alternative Medicine
Acupuncture may function as either an alternative therapy—used instead of conventional treatment—or more commonly as a complementary therapy, integrated alongside biomedical care.
The integrative model is increasingly favoured within modern healthcare systems. According to the World Health Organization (2019), traditional medicine, including acupuncture, plays an important role in global health, particularly when integrated responsibly with conventional medical practices.
For example:
- A patient with chronic migraines may use prescribed medication while also receiving acupuncture to reduce frequency and severity.
- An individual undergoing physiotherapy for musculoskeletal injury may incorporate acupuncture to enhance pain relief.
9.0 Scientific Debate and Evidence Limitations
Despite promising evidence, acupuncture remains subject to scientific debate. Critics argue that some benefits may be attributed to placebo effects or contextual healing factors (Colquhoun and Novella, 2013). Designing appropriate placebo controls in acupuncture trials presents methodological challenges.
Nonetheless, high-quality systematic reviews continue to demonstrate statistically significant benefits beyond placebo for certain conditions, particularly chronic pain (Vickers et al., 2012).
10.0 Holistic and Patient-Centred Care
One notable strength of acupuncture lies in its holistic, patient-centred approach. Practitioners typically allocate substantial time to patient assessment, fostering therapeutic rapport. This relational aspect may enhance treatment outcomes and patient satisfaction.
By addressing lifestyle, stress and emotional wellbeing alongside physical symptoms, acupuncture aligns with broader principles of integrative medicine.
Acupuncture represents a compelling example of how traditional healing systems can coexist with modern biomedical practice. Rooted in the concept of Qi and meridian pathways, yet increasingly understood through neurophysiological mechanisms, acupuncture offers evidence-based benefits particularly in pain management, stress reduction and supportive care.
While not a substitute for conventional medical treatment in serious conditions, acupuncture can serve as a valuable complementary therapy, enhancing symptom relief and overall wellbeing. Continued rigorous research will further clarify its mechanisms and optimal clinical applications.
As healthcare increasingly embraces integrative approaches, acupuncture stands as a bridge between ancient wisdom and contemporary science.
References
Armour, M. et al. (2019) ‘Acupuncture for depression and anxiety’, BMJ Open, 9(6), e023543.
Colquhoun, D. and Novella, S.P. (2013) ‘Acupuncture is theatrical placebo’, Anesthesia & Analgesia, 116(6), pp. 1360–1363.
Eshkevari, L. et al. (2013) ‘Acupuncture modulates cortisol levels’, Journal of Endocrinology, 217(2), pp. 147–155.
Ezzo, J. et al. (2014) ‘Acupuncture for chemotherapy-induced nausea’, Journal of Clinical Oncology, 32(28), pp. 3204–3210.
Kaptchuk, T.J. (2000) The Web That Has No Weaver. 2nd edn. New York: McGraw-Hill.
MacPherson, H. et al. (2014) Acupuncture Research: Strategies for Establishing an Evidence Base. Edinburgh: Elsevier.
National Cancer Institute (2022) Acupuncture in cancer care. Available at: https://www.cancer.gov.
National Institute for Health and Care Excellence (2021) Chronic pain management guidance. London: NICE.
Smith, C.A. et al. (2018) ‘Acupuncture for IVF’, Cochrane Database of Systematic Reviews, Issue 5.
Vickers, A.J. et al. (2012) ‘Acupuncture for chronic pain’, Archives of Internal Medicine, 172(19), pp. 1444–1453.
White, A. et al. (2013) Western Medical Acupuncture. 2nd edn. Edinburgh: Churchill Livingstone.
World Health Organization (2019) WHO global report on traditional and complementary medicine. Geneva: WHO.
Zhao, Z.Q. (2008) ‘Neural mechanism underlying acupuncture analgesia’, Progress in Neurobiology, 85(4), pp. 355–375.
