Acupuncture for Chronic Pain: Separating Fact From Fiction

Acupuncture is an evidence-based treatment for chronic pain conditions like low back pain, arthritis, and migraines, supported by major medical organizations and high-quality research. Despite growing clinical evidence, myths about acupuncture persist, preventing many people with chronic pain from exploring this option. A naturopathic doctor and acupuncturist at University Hospitals Connor Whole Health breaks down five common misconceptions that may be holding you back from relief.

Does Acupuncture Actually Hurt?

The biggest myth about acupuncture is that the needles cause pain. In reality, acupuncture needles are nothing like the ones used for injections or blood draws. "Acupuncture needles are solid, flexible and extremely thin," explains Jacob Wolf, ND, a naturopathic doctor and acupuncturist at University Hospitals Connor Whole Health. "They're designed more to push tissue to the side rather than cut through it like an injection." The needles are only about as thick as a piece of hair.

Most people feel only a brief sensation when the needle enters the skin, and that feeling typically fades within seconds. If a muscle is activated—like with a trigger point—you might feel a stronger sensation, but that also tends to fade quickly. If anything feels uncomfortable, your acupuncturist can adjust or remove the needle. For people who are very nervous, practitioners can use different needle types, including some that are only fractions of a millimeter long and held in place with stickers.

Is Acupuncture Just a Placebo Effect?

Another common misconception is that acupuncture only works because people believe it will. While some studies on acupuncture have had mixed findings, this doesn't mean the benefits are purely psychological. The challenge with studying acupuncture is that creating a true control group is difficult. Unlike prescription medication studies where one group gets the drug and another gets a placebo pill, acupuncture studies can't easily blind participants and providers to whether real treatment is happening.

Despite these research challenges, high-quality studies do show that acupuncture is more effective than placebo. "Strong research supports using acupuncture to help manage conditions like low back pain, migraines, headaches, knee arthritis, and nausea and vomiting after surgery or with chemotherapy," says Dr. Wolf. The American College of Physicians has been recommending acupuncture as a first-line therapy for acute, sub-acute, and chronic low back pain since 2017, based on evidence that it's an effective non-invasive treatment.

What Conditions Can Acupuncture Actually Treat?

Research on acupuncture has focused heavily on its use for both acute and chronic pain. The bulk of evidence centers on specific conditions where acupuncture has proven effective:

• Low Back Pain: The most extensively researched application, with strong evidence supporting its use as a first-line therapy for acute, sub-acute, and chronic cases.
• Arthritis and Joint Pain: Osteoarthritis of the knee and hip respond well to acupuncture treatment, making it valuable for managing chronic inflammation.
• Headaches and Migraines: Both tension headaches and migraines show significant improvement with acupuncture therapy.
• Post-Surgical and Chemotherapy Nausea: Acupuncture effectively reduces nausea and vomiting after surgery and during chemotherapy treatment.
• Neck Pain: Similar to low back pain, neck pain responds well to acupuncture as a non-invasive treatment option.

How Much Does Acupuncture Cost, and Is It Covered?

Many people assume acupuncture treatments are expensive, but costs are usually moderate. For self-paying patients, a first acupuncture session typically costs between $100 to $200, though it can be as low as $15. Follow-up visits are cheaper, with a 2019 study citing an average of $60 to $80 for follow-up sessions.

Insurance coverage varies significantly. Certain health insurance plans or health savings accounts (HSA) and flexible spending accounts (FSA) may cover acupuncture treatment, though coverage depends heavily on your individual plan. For example, Medicare only covers acupuncture for chronic low back pain. If cost is a concern, group sessions at community-based clinics can help keep costs low and may charge on a sliding scale. "Group acupuncture is equally as effective as private acupuncture and allows more patients to access treatment," says Dr. Wolf.

Is Acupuncture Safe for Everyone?

"Acupuncture is, overall, a very safe therapy," says Dr. Wolf. "It's safe to perform with most health conditions and medications." However, not everyone is an ideal candidate. Working with a well-trained and experienced provider is essential for safety. In Ohio, practitioners must complete a master's course in acupuncture, become certified by the National Certification Board for Acupuncture and Herbal Medicine (NCBAHM), and become licensed by the state. Acupuncturists must also take and pass a Clean Needle Technique course, which trains providers in safe handling and disposal of acupuncture supplies. All acupuncture needles are sterile and single-use only.

Certain conditions require caution or make acupuncture unsuitable. While patients on blood thinners can receive acupuncture without significant added risk, it's not considered safe for people with extremely low platelets or low neutrophil counts, which are primarily seen in cancer treatment. Acupuncture is also not performed on open wounds or compromised skin, though it could potentially be done in other unaffected areas of the body. If you have a pacemaker or are pregnant, tell your practitioner, since acupuncture with electrical pulses may interfere with pacemaker devices and certain acupuncture points may increase the risk of early labor.

Most patients begin seeing benefits that last longer than a few days after about four to six sessions. Once a patient experiences lasting benefits, their acupuncturist will work with them to spread out treatments if possible, making it a sustainable long-term option for managing chronic pain.