Acupuncture

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Indications

Primary Indications

Chronic low back pain, neck pain, shoulder painKnee osteoarthritis pain and functionHeadache disorders (tension-type, migraine prevention)Postoperative and chemotherapy-induced nausea/vomitingAnxiety, stress, and insomnia (adjunctive)

Mechanism

From a biomedical perspective, acupuncture modulates peripheral and central nociceptive processing via A-delta and C-fiber stimulation, increases endogenous opioid peptides (e.g., endorphins, enkephalins), engages descending inhibitory pathways (serotonin, norepinephrine), and influences limbic/autonomic networks (HRV improvements). Locally, it impacts neuroimmune signaling and microcirculation. In TCM theory, acupuncture regulates Qi and blood by harmonizing meridians and organ systems to restore homeostasis.

Protocol

Preparation

Clinical evaluation and goal setting; identification of target patterns (TCM) or myofascial/segmental targets (medical acupuncture); informed consent; positioning and skin antisepsis.

Procedure

Insertion of sterile, single-use filiform needles at individualized acupoints (commonly 6–20 points/session).
Manual stimulation or electroacupuncture applied for 10–30 minutes as indicated.
Needles retained typically for 20–40 minutes; reassess symptoms and adverse effects post-session.

Frequency: 1–2 sessions per week initially; adjust based on response.

Duration: 4–8 weeks for an initial course; maintenance or booster sessions as needed.

Total Treatment Time: Varies by condition; many chronic pain protocols use 6–12 sessions.

Treatment Variants

Expected Outcomes

Immediate

Relaxation, reduced muscle tension, transient analgesia

Short Term

Improved pain scores, sleep, and stress within 2–4 weeks

Long Term

Sustained pain/function gains with periodic maintenance in responders

Side Effects

common

Minor bleeding or bruising
Transient soreness or fatigue
Lightheadedness

uncommon

Vasovagal reaction
Worsening of symptoms for 24–48 hours (usually self-limited)

rare

Infection from poor asepsis
Pneumothorax with inappropriate chest wall needling
Nerve injury

Contraindications

absolute

Active skin infection at intended needle sites
Patient refusal

relative

Anticoagulation/bleeding diathesis (use superficial techniques, avoid deep needling)
Pregnancy: avoid strong stimulation and specific contraindicated points (e.g., LI4, SP6, BL60/67)
Pacemaker/implanted stimulators (avoid or take precautions with electroacupuncture)
Severe neutropenia (infection risk; avoid needling)

special considerations

Chest and upper back needling requires proper angle/depth to avoid pneumothorax.
Use pediatric-appropriate protocols and parental consent for children.

Patient Selection

ideal candidates

Individuals with chronic musculoskeletal pain seeking nonpharmacologic options
Patients preferring integrative care for headaches, insomnia, or anxiety
Oncology and perioperative patients for nausea/vomiting support

screening required

Bleeding risk assessment and medication review
Pregnancy status when applicable
Infection/skin integrity check at planned sites

Integration Support

Concurrent Therapies

Physical therapy and exercise
Cognitive behavioral therapy for pain and insomnia
Pharmacologic pain management (dose-sparing goal)
Mindfulness and relaxation training

Cost Considerations

typical session cost: $60–$150 per session (varies by region and practitioner)

total treatment cost: Initial course often 6–12 sessions; maintenance as needed

insurance coverage: Coverage varies; many plans cover for chronic low back pain and other indications

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Clinical Notes

Evidence supports acupuncture over sham for chronic pain with small-to-moderate effect sizes; benefits may persist beyond treatment.
Electroacupuncture can enhance analgesic effects in some conditions.
Expectations and therapeutic alliance influence outcomes (context effects).
Use strict sterile technique; single-use needles are standard of care.

This treatment information is for educational purposes only. Treatment decisions should be made in consultation with qualified healthcare professionals based on individual circumstances, symptoms, and medical history. Do not attempt treatment without professional guidance.

Interested in this treatment?

This information is for educational purposes. Always consult with a qualified healthcare provider before starting any new treatment.

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