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Acupuncture (from Latin, ‘acus’ (needle) + ‘punctura’ (to puncture)[1]) is a form of alternative medicine[2] and a key component of traditional Chinese medicine (TCM)[3] involving inserting thin needles into the body at acupuncture points.[4] It can be associated with the application of heat, pressure, or laser light to these same points.[4] Acupuncture is commonly used for pain relief,[5][6] though it is also used for a wide range of conditions.[3] Clinical practice varies depending on the country.[7] It is rarely used alone but rather as an adjunct to other forms of treatment.[8] TCM theory and practice are not based upon scientific knowledge,[9] and acupuncture is described as a type of pseudoscience.[10][11]

The conclusions of many trials and numerous systematic reviews of acupuncture are largely inconsistent.[12] Cochrane reviews found acupuncture is not effective for a wide range of conditions.[12] An overview of high-quality Cochrane reviews suggests that acupuncture may alleviate certain kinds of pain.[13] A systematic review of systematic reviews found that for reducing pain, real acupuncture was no better than sham acupuncture.[n 1][5] The evidence suggests that short-term treatment with acupuncture does not produce long-term benefits.[15] Some research results suggest acupuncture can alleviate pain, though other research consistently suggests that acupuncture’s effects are mainly due to placebo.[7] A systematic review concluded that the analgesic effect of acupuncture seemed to lack clinical relevance and could not be clearly distinguished from bias.[16]

Acupuncture is generally safe when done by an appropriately trained practitioner using clean technique and single-use needles.[17][18] When properly delivered, it has a low rate of mostly minor adverse effects.[4][17] Between 2000 and 2009, at least ninety-five cases of serious adverse events, including five deaths, were reported to have resulted from acupuncture.[5] Since serious adverse events continue to be reported, it is recommended that acupuncturists be trained sufficiently to reduce the risk.[5] A meta-analysis found that acupuncture for chronic low back pain was cost-effective as an adjunct to standard care,[19] while a systematic review found insufficient evidence for the cost-effectiveness of acupuncture in the treatment of chronic low back pain.[20]

Scientific investigation has not found any histological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points.[n 2][24][25] Many modern practitioners no longer support these concepts[26][27] and have abandoned the concepts of qi and meridians.[28][29] Acupuncture is currently used widely throughout China and many other countries, including the United States.[17][30] It is uncertain exactly when acupuncture originated or how it evolved, but it is generally thought to derive from ancient China.[31] In the early 19th century, an interest arose both in the US and Europe.[7] Acupuncture is identified by Chinese people globally as part of their intangible cultural heritage.[32]