Acupuncture: The Basics

Author: OncoLink Team
Content Contributor: Katherine Okonak, MSW, LSW
Last Reviewed: March 22, 2024


Acupuncture is a type of Traditional Chinese Medicine (TCM). It is used to balance the flow of life force energy, known as qi (pronounced "chee") in TCM. Qi flows through pathways (meridians) in the body. Each meridian is connected to an organ system. There are over 360 acupuncture points that affect the quality and quantity of the flow of qi (or energy) through the body and support the function of the related organ system. The acupuncture practitioner decides what acupuncture points should be used based on talking with the patient about their health concerns, personal behavior and preferences, and an exam of their pulses and tongue (color, texture).

Researchers have tried to explain how acupuncture works, but have not been very successful. Acupuncture is thought to work by affecting the nervous system, and by improving the activity of endorphins (natural pain relievers) and/or immune function (by enhancing the activity of natural killer cells and lymphocytes). There is also evidence that acupuncture affects neurotransmitters, cytokines, and neuropeptides.

How is acupuncture done?

The acupuncture practitioner puts very thin needles, ranging in length from 1/2 to 5 inches, into acupuncture points based on the goals of the session. The needles may be stimulated with energy from the practitioner, electrical stimulation, or heat (also called moxibustion). The practitioner may also rotate the needles, insert the needle further, or remove it part way, to stimulate qi. During acupuncture, you may feel a temperature change, numbness, itching, dull ache, or a grabbing or pinching feeling, which are all thought to be changes in qi. The practitioner may also notice a change in qi. The needles are left in until this occurs, which generally takes 5-30 minutes, but in some techniques, shorter needles may be left in for several days.

The practitioner should always use pre-packaged, sterile, one time use needles to prevent infection and the spread of disease. The practitioner should discuss the treatment plan (number and spacing of sessions) with you before the start of therapy.

What does treatment cost?

Ask about the cost per treatment and number of treatments before starting therapy. Currently, Medicare and Medicaid do not cover acupuncture treatments, but some private insurance policies do cover all or part of the cost. Call your insurance company to learn about your coverage.

What is acupuncture used to treat?

Acupuncture is commonly used for symptom relief, including nausea and vomiting related to chemotherapy, pain, hot flashes due to hormone therapy, and joint pain related to aromatase inhibitors (medication used in breast cancer treatment). Acupuncture may be a useful therapy alone or with standard therapies. You can read about the research that has been done on acupuncture at the National Cancer Institute.

What are the possible complications?

Acupuncture is generally safe when done by a trained acupuncturist, but there are a few concerns specific to cancer care. Patients with low white blood cell counts (or neutropenia) should be careful due to their higher risk of infection. Sterile, single-use needles should be used and the skin should be cleaned with alcohol before the needles are put in. While there is a risk for infection, acupuncture practitioners feel that acupuncture can boost immune function and may be of benefit to immune-compromised patients.

Patients with low platelet counts (thrombocytopenia) are at higher risk for bleeding and bruising so they should not have acupuncture while their platelet counts are low. There is also a concern of inserting needles into the tumor. It is recommended that this is not done to prevent spreading of the tumor, although this has not been proven to happen with acupuncture.

Other possible side effects are fainting, nausea, and increased pain. More serious issues like lung puncture (pneumothorax) are rare, and studies have found no major difference in the rates of side effects based on who was performing the therapy (professional acupuncturist, trained physician, or physiotherapist).

How is an acupuncturist certified or licensed?

In the United States, 48 states now have laws regulating acupuncture practice (SD and WY do not). Six states (AL, DE, KS, MS, ND, OK) do not license acupuncturists, but allow medical or osteopathic physicians to practice acupuncture, but not all require training in the field to do so. Some states also allow acupuncture to be done by chiropractors, dentists, podiatrists, naturopaths, and nurses. View regulations by state.

National certification is offered by the National Certification Commission for Acupuncture and Oriental Medicine, which is required by many states for licensure. The educational requirements for licensing vary from state to state. Some medical and osteopathic doctors also practice acupuncture.

How do I find a certified acupuncturist?

Ask your physician if they can recommend someone, or search for a local practitioner on the web.

Find out more about acupuncture and cancer here.

Bardia, A et al. Efficacy of complementary and alternative medicine therapies in relieving cancer pain: A systematic review. Journal of Clinical Oncology 2006; 24(34), 5457-5463.

Ezzo JM, et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database of Systematic Reviews 2006, Issue 2.

MacPherson, H et al. The York acupuncture safety study: prospective survey of 34000 treatments by traditional acupuncturists. British Medical Journal 2001; 323:486-487.

Micozzi. MS (Ed.) Fundamentals of Complementary and Alternative Medicine 3 rd ed, (2006). St. Louis, MO: Elsevier.

White, A et al. Adverse events following acupuncture: prospective survey of 32000 consultations with doctors and physiotherapists. British Medical Journal 2001; 323:485-486.

National Cancer Institute - Acupuncture

National Center for Complementary and Alternative Medicine - Acupuncture in Depth

American Academy of Medical Acupuncture

American Cancer Society - Complementary and Alternative Medicine

Related Blog Posts