Acupuncture in the UK: what it is used for, safety, who should take care and how practitioners are regulated

Fine needles are inserted into the skin at specific points and may be stimulated by hand or with a small electrical current. NCCIH says the practice comes from traditional Chinese medicine and has been used for at least 2,500 years.

How it works is not fully understood. Research summarised by NCCIH suggests effects on the nervous system, direct effects on tissue near the needles, and non-specific or placebo effects, and notes that benefits in some studies extended beyond comparison with sham acupuncture. Cancer Research UK describes the stimulation of nerves and release of endorphins and serotonin as one proposed explanation.

NCCIH describes the most robust support for pain conditions. Back and neck pain outcomes were comparable to non-steroidal anti-inflammatory drugs, knee osteoarthritis improved more than with sham treatment, migraine frequency fell with moderate-quality evidence, and postoperative pain and opioid use were reduced. Other uses with some support include seasonal allergies, stress incontinence in women, nausea and vomiting from cancer treatment, and asthma symptoms though not lung function.

The quality of evidence differs by condition. Some findings are described as moderate quality, others as low to moderate or insufficient for firm conclusions. The NHS osteoarthritis page, for its part, says that acupuncture and aromatherapy are tried by some people who find them helpful, but there is a lack of medical evidence to suggest they are effective and they are generally not recommended by NICE.

The NHS says it may offer acupuncture for long-term pain, migraine-type headaches and severe hiccups, and its migraine page lists acupuncture among the treatments to prevent attacks. Availability depends on local commissioning, so ask your GP or specialist.

Cancer Research UK says most people pay privately, though acupuncture is being used more within the NHS. Because services differ by area, confirm who delivers the treatment and what their qualification is before starting.

NCCIH says complications are relatively few when acupuncture is delivered properly, but improper delivery can cause infections, punctured organs and injury to the central nervous system. In the US, needles are regulated as sterile single-use medical devices. Cancer Research UK reports minor bleeding or bruising in 1% to 10% of treatments, and serious effects such as a punctured lung or infection in fewer than 1 in 10,000 treatments.

The NHS lists two groups for whom acupuncture may not be safe: people taking blood-thinning medicines or at increased risk of bleeding, and people with an active skin condition or infection. Tell the practitioner about every medicine you take and any bleeding disorder.

The NHS states that complementary therapists other than osteopaths and chiropractors do not need to be registered by law, and recommends checking registers accredited by the Professional Standards Authority. Cancer Research UK names the British Acupuncture Council, the British Medical Acupuncture Society and the Acupuncture Association of Chartered Physiotherapists as routes to qualified practitioners.

It also advises avoiding high street shops, and looking for proper training and experience in using acupuncture for people with cancer where relevant. The CNHC register covers microsystems acupuncture only, which is a specific form, so a CNHC listing should not be read as covering all acupuncture.

• Ask which register they belong to and how to verify it.

• Ask whether they use single-use sterile needles.

• Ask about their experience with your condition and what outcome they would review after a few sessions.