Acupuncture: How it Works, Uses, Benefits, and Risks

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Acupuncture is a modality that is now being used in Western medicine to treat pain and is one of the many skills employed within physiotherapy as part of an integrated approach to the management of pain, inflammation, hot flushes, OAB and general wellbeing. Physiotherapists have been using acupuncture for almost 40 years and are the largest providers of acupuncture within the NHS, usually learning their skills with a post graduate CPD provider. Physiotherapists base their treatments on scientific research and clinical evidence and although there are many research studies undertaken on acupuncture, further research is required. Whilst a number of studies are prone to method bias, as is the case in other areas of Physiotherapy-related research, there is a growing evidence base with stronger methods and thus, reduced bias potential.

There are several techniques for applying acupuncture and these are described below:

Conventional Acupuncture

Inserting Acupuncture Needles

Conventional acupuncture involves the use of single-use, pre-sterilised disposable needles of varying widths, lengths and materials that pierce the skin at the acupuncture points. The physiotherapist will determine the locations of these points on the basis of an assessment of the cause of the imbalance. A number of needles may be used during each treatment, and these are typically left in position for between 20 and 30 minutes before being removed.
Trigger point acupuncture may also be used to facilitate relaxation in specific muscles following traumas, for longer-term unresolved muscle pain, or as a means of increasing muscle length in order to aid stretch and rehabilitation. In the latter case, the needle is inserted into the affected muscle until the tissue is felt to relax under the needle, which is then removed. Trigger point needling often produces an effect much more quickly, and therefore, does not require the 20–30-minute treatment time.



In acupressure treatment, physiotherapists use their hands to activate acupuncture or trigger points in order to relieve muscle tightness, or to stimulate Qi flow and balance the body. It is a healing art in which the fingers are applied to key acupuncture points. The amount of pressure used varies according to the condition and requires trained, sensitive hands. It is often used to treat patients who are sensitive, those with a phobia of needles, children and frail people.

Laser Acupuncture

Laser is an acronym of "light amplification by stimulated emission of radiation", and the use of these beams in treatment is known as low-level laser therapy (LLT). Laser stimulation may be used to perform any acupuncture treatment for which needles are typically used. It is particularly suited for nervous patients, children, sports injuries, sensitive areas and ears. This form of acupuncture may be available from physiotherapists who are fully trained in the correct application of this treatment and its contraindications

Moxabustion and Cupping

Moxabustion and cupping are techniques used to introduce warmth into the acupuncture points, either at the end of the acupuncture needle in the case of moxabustion, or to areas that require increased stimulation of Qi flow in the case of cupping. These enhancements have the effect of increasing the circulation, removing waste products, and reducing muscle spasm and pain.
Moxabustion and cupping may also be used as precursors to the physiotherapist stretching the damaged tissue or mobilising a joint. Conditions treated with these techniques include osteoarthritis, areas of poor Qi flow and cold conditions.

Electro Acupuncture

Following a detailed physiotherapy assessment, inserted needles can be coupled to the electrodes of an electroacupuncture machine. These units are designed to deliver variable amplitudes and frequencies of electrical impulses. Low-frequency electroacupuncture is intended to contribute to the mechanism of pain reduction, especially by stimulating chemicals in the brain that aid analgesia, relaxation and sleep.
This technique is particularly useful in chronic pain problems and solid research to supports its use. Your physiotherapist may use transcutaneous electrical nerve stimulation (TENS) machines over specific acupuncture points in order to help this mechanism and enhance pain modulation.


Safety first!

“Needles can kill people but cannot save dead peoples’ lives”. This quote was historically used to promote safe needling practices and highlight the importance of TCM technique and theory. Like any form of medical treatment it's important to think of patient safety. Hence all patients should be screened for the need for special precautions and Contraindications.



The Acupuncture Association of Chartered Physiotherapists provides guidelines on contraindications aimed specifically at physiotherapists practicing acupuncture.

Absolute Contraindications

They state that absolute contraindications to be:

The use of points LI 4; SP 6; UB 60, 67 and sacral foraminal points B 31, 32, 33, 34 during pregnancy.
The use of acupuncture with patient who have uncontrolled movements.
The needling of and oedematous limb at risk of lymphoedma
Areas of spinal instability where as the result relaxation of the surrounding muscles could potentially give rise to spinal cord compression.
The needling of scars, keloid, recent incisional wounds or skin with sensory deficit.
The needling of intracapusular points if the patient is on anticoagulant therapy or is a haemophiliac.

Relative Contraindications

  • Acute stroke
  • Patients with cancer
  • Areas of poor skin condition
  • Diabetic patients
  • Patients with epilepsy
  • Hemophilia or other clotting disorders

Special Precautions

  • Bleeding tendency
  • Immuno-suppression,
  • Epilepsy
  • Pregnancy
  • Unclear diagnosis
  • Abnormal physical structure
  • Patient who needs to drive after acupuncture treatment
  • Strong reactors to acupuncture

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