Acupuncture for pain relief: How it works and what to expect – Harvard Health

If pain had a customer-service hotline, most of us would be on hold listening to the same sad elevator music:
“Your discomfort is very important to us.” Acupuncture is one of the ways people try to finally get a real human
on the lineespecially when medications aren’t enough, side effects are annoying, or the pain keeps coming back like
a sitcom reboot.

Acupuncture has been used for thousands of years and is now common in U.S. integrative medicine programs. It’s most
often discussed as a non-drug option for pain reliefincluding back and neck pain, knee pain from
osteoarthritis, headaches, and other chronic pain conditions. Research suggests it can help some people, sometimes
modestly and sometimes meaningfully, depending on the condition and the person.

What is acupuncture, exactly?

Acupuncture is a technique where a trained practitioner inserts very thin, solid needles into specific points on the
body. The points may be selected using traditional Chinese medicine (TCM) concepts (like balancing “qi” along
pathways often called meridians) and/or modern biomedical reasoning (like targeting nerves, muscles, connective
tissue, and trigger points).

The important practical takeaway: it’s not like getting a shot. Acupuncture needles are hair-thin and don’t deliver
medication. Most people describe sensations as brief pinches, dull aches, tingling, warmth, heaviness, or a
“spreading” feelingodd but not usually painful. Some people feel relaxed; others feel energized afterward.

How acupuncture may reduce pain

The honest scientific answer is: we don’t have one single “movie ending” explanation where everything ties up with a
neat bow and triumphant music. We have several plausible mechanisms that may work togetherlike a team of helpful
interns tackling pain from different angles.

1) It may nudge your nervous system to dial down pain signals

Modern explanations often focus on acupuncture’s ability to stimulate nerves and influence how pain signals are
transmitted and processed. That stimulation may affect the spinal cord and brain pathways involved in pain
perception, potentially changing how strongly pain is felt.

2) It may encourage the release of natural pain-relieving chemicals

Research discussions frequently include endogenous opioids (your body’s built-in pain-relief chemistryoften
described as endorphin-like effects) and neurotransmitters involved in pain and mood regulation. This doesn’t mean
acupuncture is a magic “happy needle.” It means the body has multiple internal levers that can influence pain, and
acupuncture may pull some of them.

3) It may reduce muscle tension and change local tissue responses

Some people seek acupuncture for tight muscles, myofascial discomfort, or “my back is basically a single knot.”
Needling can create a localized stimulus that may help relax certain muscle patterns and reduce guarding. If pain is
partly maintained by tension, stiffness, and protective movement, changing that pattern can matter.

4) It may influence stress and sleep, which feed pain (and vice versa)

Chronic pain rarely travels alone. It often brings friends: stress, poor sleep, low mood, and less movement. Many
patients report acupuncture helps them feel calmer or sleep better. That doesn’t mean the pain is “all in your head.”
It means pain and the nervous system are deeply connected, and improving the stress-sleep loop can reduce overall
pain sensitivity.

What the evidence says for pain conditions

Acupuncture research is tricky because designing a perfect placebo (“sham acupuncture”) is hard. Even light touch,
superficial needling, or needling in “non-traditional” points may still produce physiologic effects. So the question
becomes: does acupuncture outperform comparison treatments, and is the size of benefit meaningful for real life?

Overall, evidence suggests acupuncture can be helpful for several pain-related conditionsespecially certain types of
musculoskeletal pain. The strength of evidence varies by condition, and results differ across individuals.

Back and neck pain

For many people, low back pain is the headliner reason to try acupuncture. Major U.S. clinical
guidance has recommended non-drug optionsincluding acupuncturefor certain types of low back pain, particularly when
people want to avoid or minimize medications. This doesn’t mean acupuncture works for everyone; it means it’s a
reasonable, generally low-risk option to consider as part of a broader plan (movement, strengthening, posture habits,
stress management, andwhen neededmedical evaluation).

A practical example: someone with persistent low back pain who has already tried stretching and over-the-counter
medication may add acupuncture sessions while also starting a graded walking plan and core strengthening. If pain
decreases even a notch, that can make exercise easierexercise then reduces pain further. The win is often the
combination, not the needle alone.

Knee osteoarthritis and joint pain

Research suggests acupuncture may help relieve knee pain related to osteoarthritis for some people. Osteoarthritis
pain is influenced by both joint changes and nervous system sensitivity, so approaches that affect pain processing
may provide relief even when the joint itself isn’t “fixed.” Acupuncture can be paired with physical therapy, weight
management strategies (when appropriate), strength training, and supportive footwear.

Headaches and migraines

Some studies and clinical summaries suggest acupuncture may reduce headache frequency or intensity for certain people,
including tension-type headaches and migraines. People often use it as a preventive tool rather than a rescue
treatmentmeaning it’s tried over a series of sessions to see if headaches become less frequent over time.

Postoperative pain and other pain contexts

Evidence summaries also discuss acupuncture for postoperative pain and certain other pain scenarios. The key phrase
here is “may help.” If you’re considering acupuncture around surgery or a complex medical condition, coordinate with
your clinician so timing, safety, and expectations are clear.

Bottom line: acupuncture is not a cure-all, but it is a credible option for some pain problemsespecially
musculoskeletal painand is often used alongside standard care rather than instead of it.

What to expect at an acupuncture appointment

If your only reference is a movie scene where someone gets “mysteriously healed” in 30 seconds, let’s reset the
expectations to something more realisticand less cinematic.

Step 1: A detailed intake (yes, they’ll ask questions)

A first visit often includes a thorough health history: where the pain is, what makes it better or worse, sleep,
stress, digestion, medications, prior injuries, and goals. Some practitioners use TCM-style assessments (like looking
at the tongue or feeling pulses), while others focus more on musculoskeletal testing. Either way, the point is to
understand patternsnot just point to a spot and say “fix this.”

Step 2: The needling

During treatment, you typically lie on a table while the practitioner inserts a small number of needlesoften just a
handful. Harvard Health describes a common approach of inserting roughly four to 10 needles and
leaving them in place for about 10 to 30 minutes while you rest. You might nap, meditate, or stare
at the ceiling and wonder why ceiling tiles are suddenly fascinating.

Sensations vary. You may feel:

• a tiny prick or tap as the needle goes in
• a dull ache, warmth, tingling, or heaviness near the point
• little to nothing at all (which is also normal)

Step 3: Optional add-ons

Depending on the practitioner and your needs, they may use:

• Electroacupuncture (a gentle electrical stimulation through certain needles)
• Heat (sometimes used to enhance relaxation and circulation)
• Cupping or soft tissue techniques (common in integrative settings)

If you have a pacemaker or specific medical devices, mention itespecially before electroacupuncture is considered.

Step 4: A treatment plan (acupuncture is usually a series)

Acupuncture is often tried as a course of treatments rather than a single visit. Harvard Health notes a typical
course might involve six to 12 sessions over about three months. Some people notice improvement
quickly; others need a few sessions before changes show up. And some won’t notice meaningful benefit at allwhich is
why it’s smart to set a “re-evaluate” point with your practitioner.

Is acupuncture safe? Risks and side effects

In the U.S., acupuncture is generally considered safe when performed by a trained, licensed professional using
sterile, single-use needles.

Common side effects

• mild soreness
• minor bleeding or bruising at needle sites
• temporary lightheadedness or fatigue (less common)

Rare but serious risks

Serious complications are uncommon, but can occurmost notably infection if sterile technique is not used, or injury
if needles are inserted too deeply (for example, near the lungs). These risks are why choosing a qualified
practitioner matters.

Who should be extra cautious?

Tell your practitioner (and, when appropriate, your clinician) if you:

• take blood thinners or have a bleeding disorder
• have a compromised immune system or active infection
• are pregnant (some points/approaches may be avoided)
• have implanted electrical devices (especially if electroacupuncture might be used)

How to choose an acupuncture practitioner

The best needle in the world can’t overcome sketchy training. (Also, “my cousin watched three YouTube videos” does
not count as a credential.)

What to look for

• Licensure in your state (requirements vary)
• National certification when applicable (for example, credentials verified through recognized U.S. certifying bodies)
• Clean, professional setting with single-use, disposable needles
• Clear communication about what they’re treating, how they’ll measure progress, and when to reassess

Smart questions to ask

• What’s your training and licensure?
• How many sessions do you recommend before we evaluate results?
• What changes should I look forpain score, function, sleep, medication use?
• Do you coordinate with physical therapy or medical care when needed?

What acupuncture feels like (and what it doesn’t)

Acupuncture is not supposed to feel like torture. If you feel sharp, persistent pain, tell your practitioner right
away. The goal is a tolerable, often subtle sensationnot a “braveheart” audition.

Many people report one of two “after” feelings:

• Relaxed and sleepy (like you just got a calming massage for your nervous system)
• Light and energized (like your body finally unclenched a jaw you didn’t know you were clenching)

Mild soreness can happen, especially early on. Hydrating, taking it easy after the first session, and paying
attention to how your body responds can help you decide whether acupuncture fits you.

Costs and insurance: the practical reality

Coverage varies widely. Some private plans cover acupuncture for certain diagnoses; others don’t. Medicare
specifically covers acupuncture for chronic low back pain under defined limits (with a set number of
sessions and continuation based on improvement). If cost is a concern, ask about package pricing, community
acupuncture clinics, or integrative health programs that may offer lower-cost options.

How to get the most out of acupuncture for pain relief

Acupuncture tends to work best when it’s part of an overall pain strategybecause pain is rarely a one-cause problem.
Consider these evidence-friendly habits alongside treatment:

• Track outcomes: pain levels, function (walking, sitting, lifting), sleep, and stress
• Keep moving: gentle activity often helps pain more than prolonged rest
• Pair with rehab: physical therapy, strengthening, and mobility work can amplify gains
• Address the “pain loop”: stress management and sleep support can lower pain sensitivity

A helpful mindset: acupuncture is not always a “pain eraser.” For many people, it’s a “pain volume knob.” Even a
small reduction in pain can improve function, which improves fitness, which improves painlike a positive domino
effect.

When to call your clinician instead of (or in addition to) an acupuncturist

Acupuncture is not a substitute for urgent medical care. Seek medical evaluation promptly if you have pain with:

• fever, unexplained weight loss, or severe night pain
• new weakness, numbness, or bowel/bladder changes
• chest pain, shortness of breath, or sudden severe headache
• significant trauma (fall, accident) or suspected fracture

Think of acupuncture as one tool in the toolboxnot the entire hardware store.

Real-world experiences: what people commonly notice (about )

Below are realistic, composite-style experiences based on commonly reported patterns in clinical settings and patient
education from U.S. medical and integrative health sources. They’re not promises, and they’re not a guarantee your
body will respond the same waypain relief is personal.

Experience #1: “I came for back pain… and stayed for the nap”

A typical first-timer arrives skeptical but hopeful, often after months of low back pain that flares with sitting.
The intake feels surprisingly thorough: the practitioner asks about sleep, stress, work posture, and what the pain
stops them from doing (like lifting groceries without turning into a human question mark). During the needling, the
person feels a few quick pinches, then a heavy, warm sensation in the hips and legs. The surprising part isn’t pain
it’s quiet. Ten minutes in, their nervous system seems to stop arguing with gravity. Many people describe leaving
the session feeling “looser,” not necessarily “fixed.” Over a few visits, they might notice that mornings are less
stiff or that a flare-up fades faster. The most meaningful win can be functional: they can walk longer, tolerate a
car ride, or restart physical therapy exercises with less fear.

Experience #2: “My knee didn’t become 22 again, but it stopped being so dramatic”

Someone with knee osteoarthritis might come in expecting a miracle and learns to aim for something better: progress.
The practitioner sets expectations earlyacupuncture may reduce pain sensitivity and improve comfort, but it won’t
reverse cartilage changes. After a couple sessions, the person may report fewer “sharp zings” on stairs or less
aching at night. On good weeks, they’re able to do strengthening work more consistently (which is a big deal for knee
OA). On not-so-good weeks, acupuncture still helps them recover from activity without needing to completely shut down.
Many people find that even a modest change in pain makes movement feel safer, and movement is where long-term knee
outcomes often improve.

Experience #3: “My headaches didn’t vanish, but my calendar stopped revolving around them”

For headaches or migraines, people often try acupuncture as a preventive strategy. They don’t always walk out of the
first session headache-freeand that’s normal. What they watch for is frequency and intensity over time. Some report
that headaches still show up but hit less hard, or that the “warning signs” are calmer and easier to manage. Others
notice better sleep or less neck tension, which indirectly reduces headache triggers. The biggest quality-of-life
shift is when headaches stop being the main character of the week: fewer canceled plans, fewer “I can’t look at
light” days, and less reliance on rescue meds (when medically appropriate).

Experience #4: The small surprisessleep, stress, and the “reset” feeling

Many people go in for pain and come out noticing something else: deeper sleep, a calmer mood, or a body that feels
less “on edge.” That matters because chronic pain and stress are noisy roommates. If acupuncture helps lower that
background alarm, pain can feel more manageable. Some people feel sleepy after sessions and plan them later in the
day. Others feel clear-headed and schedule them before work. Over a series, the most realistic outcome is often a
quieter nervous system and better functionnot a superhero transformation.

If you try acupuncture, give it a fair test: agree on a short trial period (for example, several sessions), define
what “success” means (less pain, more function, better sleep, fewer flare-ups), and reassess. The goal is not to
collect wellness hobbies like trading cards. The goal is to feel and function better.

Conclusion

Acupuncture for pain relief sits at a practical intersection of ancient practice and modern research. It may help
reduce certain types of painespecially musculoskeletal pain like low back pain or knee osteoarthritisand it tends
to be low risk when performed by qualified professionals using sterile needles. The best approach is a smart,
measured trial: know what to expect, track outcomes, and use acupuncture as part of a broader plan that supports
movement, sleep, stress reduction, and appropriate medical care.