Health & Wellbeing — Traditional Medicine Series
What it is, how it works, what the evidence says.
Every year, millions of people around the world lie on treatment tables while a practitioner places slender needles at precise points on their skin. For some it brings relief from chronic pain. For others it is a bridge between their cultural heritage and modern medicine.
Acupuncture is a therapeutic practice that originated in China. Since there is no documentation on the development of Chinese medicine from its inception to the establishment of the theoretical system, it is impossible to provide an accurate account of the historical timeline of Chinese medicine. According to archaeological relics, there is historical evidence that stone needles have been used as medical tools longer than the Neolithic Age — about 10,000 to 4,000 years ago. The theoretical system of traditional Chinese medicine originated during the Warring States Period (BC 475–221), more than 2,500 years ago. Today it involves inserting very fine, sterile needles into specific points on the body — called acupoints — to influence health and treat or prevent disease.
In its classical form, acupuncture is part of Traditional Chinese Medicine (TCM), a comprehensive system that views the body as a network of energy pathways called meridians. According to this framework, a vital life force called qi (pronounced "chee") flows through these meridians. Illness arises when that flow is disrupted; needling restores balance.
Modern, evidence-based acupuncture does not rely on the concept of qi. Instead, researchers study its measurable biological effects: stimulation of nerves and connective tissue, release of endorphins, changes in blood flow, and modulation of the nervous system's pain-signalling pathways. Both frameworks — traditional and biomedical — can coexist in practice, and many practitioners draw on both.
Back, neck, knee, and shoulder pain are among the most evidence-supported uses. Major systematic reviews find meaningful benefit over sham acupuncture and no treatment.
Guidelines in several countries (including Germany and the UK) now list acupuncture as an option for migraine prevention, comparable to drug therapies for some patients.
Evidence supports acupuncture for pain and function in knee osteoarthritis, and it is included in clinical guidelines from several rheumatology bodies.
Stimulation of the Neiguan (P6) point on the wrist has the strongest evidence base of any acupuncture indication — recognised by oncology and anaesthesia guidelines for chemotherapy-related nausea.
Research on acupuncture is substantial but nuanced. Over 3,000 randomised controlled trials and numerous large meta-analyses have been published. The picture that emerges is not a simple yes or no.
For chronic pain, the evidence is the strongest. A landmark 2017 individual patient data meta-analysis — pooling data from nearly 18,000 patients — found that acupuncture produced statistically and clinically significant pain relief beyond both sham controls and usual care. Effects persisted at 12 months.
For other conditions the picture is more mixed, partly due to the genuine difficulty of designing valid controls (a convincing "placebo needle" is hard to create). Some researchers argue that even sham acupuncture has physiological effects, which may mean that current trials underestimate the true treatment effect rather than overestimate it.
Acupuncture deserves neither uncritical celebration nor reflexive dismissal. It is a practice with genuine therapeutic value for a meaningful range of conditions, a remarkable safety record when performed correctly, and a tradition that has been refined over millennia.
Speak with your GP first, especially if you have a bleeding disorder, take blood thinners, are pregnant, or have a pacemaker. Acupuncture is generally safe for most people but your full medical history matters.