Acupuncture Explained: What It Is, What to Expect, and What the Evidence Says
Acupuncture is the part of Chinese medicine that made it to the West. Most people in Britain have at least a rough idea of what it involves, many know someone who's tried it, and it's available on the NHS in some circumstances. What far fewer people know is that in China, acupuncture is one half of a pair, and arguably the smaller half. This article covers what acupuncture actually is, what a session involves, what the evidence currently supports, and where it sits alongside the herbal tradition.
What Acupuncture Is
Acupuncture involves inserting very fine needles into specific points on the body. The needles are considerably thinner than the ones used for injections or blood tests, typically around the width of a couple of human hairs, which is why insertion is usually described as a brief prick or nothing much at all rather than as pain.
The practice is documented in Chinese medical texts going back more than two thousand years, including the Huangdi Neijing, the foundational classic we've referenced in several other entries. Traditional theory describes a network of channels called meridians through which Qi circulates, with specific points along them where that circulation can be influenced. There are around 360 classical points on the main meridians, though a practitioner uses only a handful in any given session.
What a Session Actually Involves
A first appointment usually begins with a long conversation. A traditional practitioner will ask about sleep, digestion, energy, temperature preferences and a range of things that seem unrelated to why you came, then examine your tongue and take your pulse at both wrists. This is the diagnostic framework we described in our entry on tongue diagnosis, and it's what determines which points get used.
Needling itself is quick. Points are selected, needles inserted to varying depths, and left in place typically for 20 to 30 minutes while you rest. Many people describe a distinctive sensation at the point, a dull ache, heaviness or spreading tingle, which the tradition calls de qi and regards as a sign the point has been engaged correctly. It's a strange sensation rather than a painful one.
Practitioners often use moxibustion alongside, a technique involving burning dried mugwort near the skin to warm specific points. It smells distinctive and is a standard part of traditional practice rather than an add-on.
What the Evidence Says
This deserves a straight answer, since "does acupuncture work" is one of the most searched questions about it.
The evidence base is genuinely mixed and it varies a lot by condition. The strongest support is in chronic pain and headache: in the UK, NICE guidance includes acupuncture as an option for chronic primary pain and for migraine prevention, which reflects a body of clinical evidence rather than tradition alone. For many other conditions the evidence is weaker, inconsistent, or absent.
There's also an ongoing scientific debate about mechanism. Trials comparing real acupuncture against sham acupuncture, using retractable needles or non-points, often find both perform better than no treatment, with a smaller gap between them than between either and nothing. Researchers disagree about what that means, and it's a genuinely unresolved question rather than a settled one in either direction.
The honest summary: acupuncture has meaningful evidential support for some specific uses, particularly chronic pain, considerable uncertainty around mechanism, and a strong safety record when practised competently. Anyone telling you it's proven for everything, or that it's definitively nothing, is going further than the evidence allows.
Finding a Practitioner in the UK
Acupuncture isn't statutorily regulated in the UK, which means anyone can technically practise. In practice, look for membership of a recognised professional body such as the British Acupuncture Council, whose members meet defined training standards and carry insurance. Physiotherapists and some GPs also practise a Western-style medical acupuncture, which uses needles within a conventional medical framework rather than a traditional diagnostic one, and both approaches are legitimate.
Side effects are generally minor and short-lived, mild bruising or brief tiredness being the most common. Tell your practitioner if you're pregnant, have a bleeding disorder, or take blood-thinning medication.
The Other Half: Herbal Medicine
Here's the thing most Western audiences don't realise. In China, acupuncture and herbal medicine are two distinct disciplines within one tradition, and herbal medicine is by many measures the larger of the two. Practitioners often specialise in one or the other, hospitals have separate departments, and the classical literature devoted to herbal formulas dwarfs that on needling.
Acupuncture travelled to the West more successfully for practical reasons rather than because it was the more important half. It's visually distinctive, easy to demonstrate, needs no supply chain, and doesn't run into the regulatory complexity that imported herbs do.
What both share is the same underlying framework: the same diagnostic approach, the same concepts of Qi, Yin and Yang, and the same aim of restoring balance. A practitioner assessing you for acupuncture and one selecting a herbal formula are reading the same picture, then working with different tools. This is why the classical formulas we've written about, from Ba Zhen Tang to Liu Wei Di Huang Wan, are built on exactly the concepts an acupuncturist works from.
If acupuncture is your entry point into this tradition, the herbal side is the larger room next door.
Frequently Asked Questions
Does acupuncture hurt?
Usually not. The needles are far finer than injection needles. Most people report a brief prick at most, followed by a dull, heavy or tingling sensation at the point.
Does acupuncture actually work?
Evidence is strongest for chronic pain and migraine prevention, and NICE includes it as an option for both. For many other conditions the evidence is weaker or inconclusive, and the mechanism remains debated.
How many sessions do I need?
Practitioners typically suggest a course rather than a single session, often around six, with a review afterwards. It varies by practitioner and by what you're seeking help with.
Is acupuncture available on the NHS?
In some circumstances and in some areas, particularly for chronic pain, though availability varies considerably. Your GP can advise on local provision.
What is moxibustion?
A traditional technique using burning dried mugwort to warm specific points, often used alongside needling as part of the same session.
How do I find a qualified practitioner?
Acupuncture isn't statutorily regulated in the UK, so look for membership of a recognised body such as the British Acupuncture Council, or for a regulated healthcare professional practising medical acupuncture.
Acupuncture and herbal medicine are two halves of one tradition. Explore the formulas built on the same principles in the Aura range.
