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Acupuncture (PDQ®)

Adverse Effects

Serious adverse effects of acupuncture are rare. Reported accidents and infections appear to be related to violations of sterile procedure, negligence of the practitioner, or both.[1,2] A systematic review of case reports on the safety of acupuncture, involving 98 papers published in the English language from 22 countries during the period from 1965 to 1999, found only 202 incidents. The number of incidents appeared to decline as training standards and licensure requirements were enhanced. Among the 118 (60%) reported incidents involving infection, 94 (80%) involved hepatitis, occurring mainly in the late 1970s and early 1980s. Very few hepatitis or other infections associated with acupuncture have been reported since 1988, when widespread use of disposable needles was introduced and national certification requirements for clean-needle techniques were developed and enforced as an acupuncture licensure requirement.[3,4] Because cancer patients who are undergoing chemotherapy or radiation therapy are immunocompromised, precautions must be taken and strict clean-needle techniques must be applied when acupuncture treatment is given.[5]

Minor adverse effects of acupuncture, such as pain at needling sites, hematoma, tiredness, lightheadedness, drowsiness, and localized skin irritation, have been reported.[6-10] These minor adverse effects can be minimized by appropriate patient management, including local pressing and massage at the needling site after treatment.[11,12] Acupuncture in children has not been studied extensively. However, adverse effects appear to be rare and limited to the same effects as observed in adults.[13,14]


  1. Lao L: Acupuncture techniques and devices. J Altern Complement Med 2 (1): 23-5, 1996. [PUBMED Abstract]
  2. MacPherson H: Fatal and adverse events from acupuncture: allegation, evidence, and the implications. J Altern Complement Med 5 (1): 47-56, 1999. [PUBMED Abstract]
  3. Lao L, Zhang G, Wong RH, et al.: The effect of electroacupuncture as an adjunct on cyclophosphamide-induced emesis in ferrets. Pharmacol Biochem Behav 74 (3): 691-9, 2003. [PUBMED Abstract]
  4. National Commission for the Certification of Acupuncturists: Clean Needle Technique for Acupuncturists: A Manual: Guidelines and Standards for the Clean & Safe Clinical Practice of Acupuncture. 3rd ed. Washington, DC: National Commission for the Certification of Acupuncturists, 1989.
  5. Shen J, Wenger N, Glaspy J, et al.: Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial. JAMA 284 (21): 2755-61, 2000. [PUBMED Abstract]
  6. Brattberg G: Acupuncture treatment: a traffic hazard? Am J Acupunct 14 (3): 265-7, 1986.
  7. Ernst E, White AR: Prospective studies of the safety of acupuncture: a systematic review. Am J Med 110 (6): 481-5, 2001. [PUBMED Abstract]
  8. White A, Hayhoe S, Hart A, et al.: Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ 323 (7311): 485-6, 2001. [PUBMED Abstract]
  9. MacPherson H, Thomas K, Walters S, et al.: The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. BMJ 323 (7311): 486-7, 2001. [PUBMED Abstract]
  10. Yamashita H, Tsukayama H, Tanno Y, et al.: Adverse events related to acupuncture. JAMA 280 (18): 1563-4, 1998. [PUBMED Abstract]
  11. Cheng X, ed.: Chinese Acupuncture and Moxibustion. Beijing, China: Foreign Languages Press, 1987.
  12. O'Connor J, Bensky D, eds.: Acupuncture: A Comprehensive Text. Chicago, Ill: Eastland Press, 1981.
  13. Jindal V, Ge A, Mansky PJ: Safety and efficacy of acupuncture in children: a review of the evidence. J Pediatr Hematol Oncol 30 (6): 431-42, 2008. [PUBMED Abstract]
  14. Ladas EJ, Rooney D, Taromina K, et al.: The safety of acupuncture in children and adolescents with cancer therapy-related thrombocytopenia. Support Care Cancer 18 (11): 1487-90, 2010. [PUBMED Abstract]
  • Updated: February 25, 2015