Acupuncture: A Clinical Review

Victor S. Sierpina, MD; Moshe A. Frenkel, MD


South Med J. 2005;98(3):330-337. 

In This Article

Safety and Adverse Effects

As an invasive technique, acupuncture has some risks, which include organ puncture, for example, pneumothorax, cardiac tamponade, damage to neural and vascular structures, infection, metal allergy, local pain, bruising, bleeding, or hematoma formation.[1,23,24] Serious injury is extremely rare, given the millions of acupuncture needles placed annually worldwide.[25]

A well-trained practitioner can prevent most such problems. Most of the case reports of adverse infectious effects published in the literature were preventable by using the introduction of safe needle technique with single-use, sterilized, disposable needles, and with such techniques, the risk of cross-transmission of HIV, hepatitis, or other infectious disease can be essentially eliminated. Perhaps the most common potential complication is a mild but alarming syncope or presyncope, the so-called needle shock reaction, in which the patient feels faint and diaphoretic. Removing the needles and administering smelling salts is adequate to terminate this reaction. It is more frequent on the first visit but can be minimized by close observation of the patient and performing the treatment in a recumbent rather than sitting position. Local bruising or hematoma formation may occur, though bleeding is not common with acupuncture. Delaying of conventional diagnosis and treatment when using acupuncture as part of a complete medical system (TCM) is another potential risk, as the diagnostic and therapeutic methods of TCM have not been validated by scientific studies.[1]