Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 2003 Aug;49:985–989.

Adverse effects of acupuncture. Which are clinically significant?

Ainee Chung 1, Luke Bui 1, Edward Mills 1
PMCID: PMC2214278  PMID: 12943357

Abstract

OBJECTIVE: To review potentially serious adverse events associated with acupuncture. QUALITY OF EVIDENCE: Studies in the medical literature primarily provide level II evidence from retrospective reviews, case reports, and prospective surveys of practitioners. MAIN MESSAGE: Both the general public and physicians are becoming more interested in the ancient Chinese medical practice of acupuncture. This paper discusses the basic philosophy of acupuncture and describes adverse events that might be associated with acupuncture treatment. Some events, such as nausea and syncope, can be mild and transient, but rare events, such as septicemia and hepatitis C infection, can be fatal. As the role of acupuncture in today's multidisciplinary clinics increases, the complications of acupuncture, although infrequent, cannot be overlooked. CONCLUSION: Responsible clinicians practising acupuncture and seeing patients who use acupuncture should be aware of the adverse events associated with it.

Full Text

The Full Text of this article is available as a PDF (152.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astin J. A., Pelletier K. R., Marie A., Haskell W. L. Complementary and alternative medicine use among elderly persons: one-year analysis of a Blue Shield Medicare supplement. J Gerontol A Biol Sci Med Sci. 2000 Jan;55(1):M4–M9. doi: 10.1093/gerona/55.1.m4. [DOI] [PubMed] [Google Scholar]
  2. Braverman S. E. Acupuncture education and integration in the physical medicine and rehabilitation residency. Phys Med Rehabil Clin N Am. 1999 Aug;10(3):755-65, xi. [PubMed] [Google Scholar]
  3. Bullock Milton L., Kiresuk Thomas J., Sherman Robert E., Lenz Scott K., Culliton Patricia D., Boucher Tacey A., Nolan Christopher J. A large randomized placebo controlled study of auricular acupuncture for alcohol dependence. J Subst Abuse Treat. 2002 Mar;22(2):71–77. doi: 10.1016/s0740-5472(01)00217-3. [DOI] [PubMed] [Google Scholar]
  4. Cassidy C. M. Chinese medicine users in the United States. Part I: Utilization, satisfaction, medical plurality. J Altern Complement Med. 1998 Spring;4(1):17–27. doi: 10.1089/acm.1998.4.1-17. [DOI] [PubMed] [Google Scholar]
  5. Ceccherelli Francesco, Rigoni Maria Teresa, Gagliardi Giuseppe, Ruzzante Leonardo. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain. 2002 May-Jun;18(3):149–153. doi: 10.1097/00002508-200205000-00003. [DOI] [PubMed] [Google Scholar]
  6. Corbin Winslow Lisa, Shapiro Howard. Physicians want education about complementary and alternative medicine to enhance communication with their patients. Arch Intern Med. 2002 May 27;162(10):1176–1181. doi: 10.1001/archinte.162.10.1176. [DOI] [PubMed] [Google Scholar]
  7. Dong H., Lüdicke F., Comte I., Campana A., Graff P., Bischof P. An exploratory pilot study of acupuncture on the quality of life and reproductive hormone secretion in menopausal women. J Altern Complement Med. 2001 Dec;7(6):651–658. doi: 10.1089/10755530152755207. [DOI] [PubMed] [Google Scholar]
  8. Drivdahl C. E., Miser W. F. The use of alternative health care by a family practice population. J Am Board Fam Pract. 1998 May-Jun;11(3):193–199. doi: 10.3122/15572625-11-3-193. [DOI] [PubMed] [Google Scholar]
  9. Eisenberg D. M., Davis R. B., Ettner S. L., Appel S., Wilkey S., Van Rompay M., Kessler R. C. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998 Nov 11;280(18):1569–1575. doi: 10.1001/jama.280.18.1569. [DOI] [PubMed] [Google Scholar]
  10. Ernst E., White A. R. Prospective studies of the safety of acupuncture: a systematic review. Am J Med. 2001 Apr 15;110(6):481–485. doi: 10.1016/s0002-9343(01)00651-9. [DOI] [PubMed] [Google Scholar]
  11. Ernst E., White A. Life-threatening adverse reactions after acupuncture? A systematic review. Pain. 1997 Jun;71(2):123–126. doi: 10.1016/s0304-3959(97)03368-x. [DOI] [PubMed] [Google Scholar]
  12. Goldszmidt M., Levitt C., Duarte-Franco E., Kaczorowski J. Complementary health care services: a survey of general practitioners' views. CMAJ. 1995 Jul 1;153(1):29–35. [PMC free article] [PubMed] [Google Scholar]
  13. Halvorsen T. B., Anda S. S., Naess A. B., Levang O. W. Fatal cardiac tamponade after acupuncture through congenital sternal foramen. Lancet. 1995 May 6;345(8958):1175–1175. doi: 10.1016/s0140-6736(95)91004-2. [DOI] [PubMed] [Google Scholar]
  14. Johnstone Peter A. S., Polston Gregory R., Niemtzow Richard C., Martin Peter J. Integration of acupuncture into the oncology clinic. Palliat Med. 2002 May;16(3):235–239. doi: 10.1191/0269216302pm540oa. [DOI] [PubMed] [Google Scholar]
  15. Kaptchuk Ted J. Acupuncture: theory, efficacy, and practice. Ann Intern Med. 2002 Mar 5;136(5):374–383. doi: 10.7326/0003-4819-136-5-200203050-00010. [DOI] [PubMed] [Google Scholar]
  16. Lao L., Bergman S., Hamilton G. R., Langenberg P., Berman B. Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial. Arch Otolaryngol Head Neck Surg. 1999 May;125(5):567–572. doi: 10.1001/archotol.125.5.567. [DOI] [PubMed] [Google Scholar]
  17. MacPherson H. Fatal and adverse events from acupuncture: allegation, evidence, and the implications. J Altern Complement Med. 1999 Feb;5(1):47–56. doi: 10.1089/acm.1999.5.47. [DOI] [PubMed] [Google Scholar]
  18. MacPherson H., Thomas K., Walters S., Fitter M. The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. BMJ. 2001 Sep 1;323(7311):486–487. doi: 10.1136/bmj.323.7311.486. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. McCormick W. F. Sternal foramena in man. Am J Forensic Med Pathol. 1981 Sep;2(3):249–252. doi: 10.1097/00000433-198109000-00011. [DOI] [PubMed] [Google Scholar]
  20. Moritz Carneiro N. M., Li S. M. Acupuncture technique. Lancet. 1995 Jun 17;345(8964):1577–1577. doi: 10.1016/s0140-6736(95)91128-6. [DOI] [PubMed] [Google Scholar]
  21. Pierik M. G. Fatal Staphylococcal septicemia following acupuncture: report of two cases. Occurrence of Staphylococcal septicemia following acupuncture emphasizes need for thorough medical evaluation before such procedures. R I Med J. 1982 Jun;65(6):251–253. [PubMed] [Google Scholar]
  22. Sarel A., Borkan J., Carasso R. L., Bernstein J., Rozovsky U. [Attitudes of family physicians to alternative medicine]. Harefuah. 1998 Aug;135(3-4):101-4, 167. [PubMed] [Google Scholar]
  23. Tramèr M. R., Moore R. A., Reynolds D. J., McQuay H. J. Quantitative estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain. 2000 Mar;85(1-2):169–182. doi: 10.1016/s0304-3959(99)00267-5. [DOI] [PubMed] [Google Scholar]
  24. Verhoef M. J., Sutherland L. R. Alternative medicine and general practitioners. Opinions and behaviour. Can Fam Physician. 1995 Jun;41:1005–1011. [PMC free article] [PubMed] [Google Scholar]
  25. Verhoef M. J., Sutherland L. R. General practitioners' assessment of and interest in alternative medicine in Canada. Soc Sci Med. 1995 Aug;41(4):511–515. doi: 10.1016/0277-9536(94)00351-s. [DOI] [PubMed] [Google Scholar]
  26. Wang B., Tang J., White P. F., Naruse R., Sloninsky A., Kariger R., Gold J., Wender R. H. Effect of the intensity of transcutaneous acupoint electrical stimulation on the postoperative analgesic requirement. Anesth Analg. 1997 Aug;85(2):406–413. doi: 10.1097/00000539-199708000-00029. [DOI] [PubMed] [Google Scholar]
  27. White A., Hayhoe S., Hart A., Ernst E. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. BMJ. 2001 Sep 1;323(7311):485–486. doi: 10.1136/bmj.323.7311.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Yamashita H., Tsukayama H., White A. R., Tanno Y., Sugishita C., Ernst E. Systematic review of adverse events following acupuncture: the Japanese literature. Complement Ther Med. 2001 Jun;9(2):98–104. doi: 10.1054/ctim.2001.0446. [DOI] [PubMed] [Google Scholar]
  29. Zaza C., Sellick S. M., Willan A., Reyno L., Browman G. P. Health care professionals' familiarity with non-pharmacological strategies for managing cancer pain. Psychooncology. 1999 Mar-Apr;8(2):99–111. doi: 10.1002/(SICI)1099-1611(199903/04)8:2<99::AID-PON340>3.0.CO;2-K. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES