Acupuncture involves the insertion of fine, sterile needles at specific anatomical points. It has been used in East Asian medical systems for centuries and is now studied in a range of clinical contexts. Research has explored its role in both physical symptoms and aspects of mental well-being, particularly where these overlap.
Physical Well-being
Pain
Acupuncture is commonly studied in the context of chronic pain conditions.
A large individual patient data meta-analysis involving over 17,000 participants found that acupuncture was associated with reductions in chronic pain compared to sham and usual care controls (Vickers et al., 2018). Conditions included low back pain, neck pain, osteoarthritis, and headache disorders.
Clinical guidelines for low back pain have included acupuncture as one of several non-pharmacological options, based on evidence of modest improvements in pain and function (Chou et al., 2012).
Other Conditions
Research has also examined acupuncture in other conditions that may influence overall function:
- Migraine: A Cochrane review reported that acupuncture was associated with a reduction in headache frequency compared to no treatment, and similar outcomes when compared with some preventive medications (Linde et al., 2016).
- Asthma: Randomised pragmatic trials have explored acupuncture as an adjunctive approach, with reported changes in symptom control and quality of life measures (Brinkhaus et al., 2017).
Findings vary depending on study design, comparator, and outcome measures.
Mental Well-being
Physical symptoms, particularly persistent pain, are often associated with changes in mood, sleep, and stress levels. Acupuncture has been studied in several mental health-related contexts, often alongside standard care.
Depression
A randomised controlled trial in primary care settings reported that acupuncture and counselling were associated with reductions in depression scores compared to usual care over time (MacPherson et al., 2013).
Anxiety
Systematic reviews have examined acupuncture in anxiety-related conditions, with some studies reporting changes in symptom scores compared to control groups (Cao et al., 2009). Methodological quality and heterogeneity remain considerations across studies.
Insomnia
Sleep disturbance has also been studied in relation to acupuncture. A systematic review of randomised trials reported that acupuncture was associated with improvements in sleep quality compared to control interventions in some studies (Cao et al., 2009).
Interaction Between Physical and Mental Health
Chronic pain, sleep disturbance, and psychological stress frequently coexist. Research programmes in primary care have examined acupuncture as part of a broader management approach for patients with both chronic pain and depression, with findings suggesting potential changes in both domains over time (Spackman et al., 2016).
Proposed Mechanisms
Several biological mechanisms have been investigated:
- Endogenous opioid release: Acupuncture has been associated with changes in endorphin activity, which may influence pain perception.
- Neurotransmitter modulation: Effects on serotonin, dopamine, and other neurotransmitters have been explored in experimental studies.
- Inflammatory pathways: Some research suggests modulation of inflammatory markers.
- Autonomic regulation: Acupuncture may influence sympathetic and parasympathetic balance, which is relevant in stress and pain responses.
These mechanisms are still being studied and may vary depending on condition and treatment parameters.
References
Brinkhaus, B., Ortiz, M., Witt, C. M., Roll, S., Linde, K., Pfab, F., Niggemann, B., Hummelsberger, J., Treszl, A., Ring, J., Zuberbier, T., Wegscheider, K., & Willich, S. N. (2017). Acupuncture in patients with allergic asthma: A randomized pragmatic trial. Journal of Alternative and Complementary Medicine, 23(4), 268–277. https://doi.org/10.1089/acm.2016.0357
Cao, H., Pan, X., Li, H., & Liu, J. (2009). Acupuncture for treatment of insomnia: A systematic review of randomized controlled trials. Journal of Alternative and Complementary Medicine, 15(11), 1171–1186. https://doi.org/10.1089/acm.2009.0041
Chou, R., et al. (2012). Diagnosis and treatment of low back pain: A joint clinical practice guideline. Annals of Internal Medicine, 147(7), 478–491. https://doi.org/10.7326/0003-4819-147-7-200710020-00006
Linde, K., et al. (2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews, 6, CD001218. https://doi.org/10.1002/14651858.CD001218.pub3
MacPherson, H., et al. (2013). Acupuncture and counselling for depression in primary care: A randomised controlled trial. PLoS Medicine, 10(9), e1001518. https://doi.org/10.1371/journal.pmed.1001518
Spackman, E., et al. (2016). Acupuncture for chronic pain and depression in primary care: A programme of research. NIHR Journals Library. https://doi.org/10.3310/pgfar05030
Vickers, A. J., et al. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. Journal of Pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005