Research suggests that acupuncture may reduce back pain and improve a person’s ability to perform daily tasks. However, there is conflicting evidence.

Acupuncture involves inserting fine needles into specific areas or “acupoints” on the skin to help alleviate pain and other ailments.

This article explores whether acupuncture can help with back pain, how it works, and what to expect before, during, and after treatment.

It also discusses the risks and potential side effects of acupuncture and its financial cost.

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A 2021 systematic review and meta-analysis of 13 randomized controlled trials (RCTs) investigated the effectiveness of acupuncture for acute lower back pain (LBP). Of the 13 RCTs, 11 gave consistent, high quality results. There was an association between acupuncture and modest improvements in the following categories:

  • pain intensity
  • the ability to perform daily self-care
  • the number of pills needed to control pain

However, there was no association between acupuncture and an improved lower back — the lumbar region — function.

Further research incorporating high quality RCTs is necessary to determine the effectiveness of acupuncture for acute LBP.

A separate 2021 systematic review notes that acupuncture shows promising results for individuals with chronic LBP and may be beneficial as a first-line treatment. However, the researchers add that differences in research methods across the studies make it difficult to assess acupuncture’s effectiveness for LBP properly.

The National Center for Complementary and Integrative Health (NCCIH) states that there is low to moderate quality evidence that acupuncture may be beneficial for chronic LBP and low quality evidence that it may be beneficial for acute LBP.

Acupuncture is a part of traditional Chinese medicine (TCM) based on the belief that the body contains a vital energy called “Qi,” which flows along paths called “meridians.” Traditional acupuncture practitioners believe that acupuncture can restore the flow of Qi to help improve mental and physical health.

Today, Western practitioners may have different theories about how acupuncture alleviates pain.

A 2018 review provides insights into how acupuncture may affect LBP. According to the review, acupuncture causes microinjuries to the skin. This triggers the release of a substance called adenosine triphosphate (ATP), which breaks down into adenosine and other chemical compounds. Both ATP and adenosine block pain receptors called purinergic receptors, helping alleviate pain.

The 2018 review also explains that sham acupuncture appears almost as effective as “true” acupuncture. In sham acupuncture, the practitioner touches the needles against the acupuncture points rather than inserting them into the skin. The reviewers suggest that this may be sufficient to activate sensory nerve fibers in the skin to produce an analgesic effect.

Learn more about acupuncture.

According to the United Kingdom’s National Health Service (NHS), an initial acupuncture session typically lasts between 20 mins and 1 hour and will include the following:

The following sections describe what to expect before, during, and after acupuncture treatment.


Before treatment, the acupuncture practitioner will ask questions about a person’s general health, including any medical conditions and medications they are taking. They will also physically examine the area they intend to treat.

The practitioner will then ask the person to sit or lie down. They may also ask the person to remove certain clothing items to access the areas they need to treat.


The acupuncturist will use very fine needles measuring a few centimeters in length. The needles will be single-use and pre-sterilized to limit the risk of infection.

The acupuncturist will insert the needles just beneath the skin or into the muscle beneath the skin. They will leave the needles in place for several minutes to half an hour.

The procedure may initially cause a sensation of heaviness, numbness, or tingling. However, a person should not experience any significant pain.


A person may feel mild pain at the acupuncture site after the practitioner removes the needles.

Responses to acupuncture vary. People may feel relaxed and refreshed, energized, or sleepy. Symptoms may worsen before they improve.

How fast does acupuncture work for pain?

According to the American Institute of Alternative Medicine (AIAM), people typically notice the effects of acupuncture within 3–4 days. However, the number of acupuncture sessions and the timeframe for noticeable results can differ between individuals.

According to the NHS, acupuncture from a qualified practitioner is generally very safe, though some Individuals may experience mild, short-term side effects. These may include:

  • pain at the site of insertion
  • bleeding or bruising at the site of insertion
  • nausea
  • dizziness or lightheadedness
  • drowsiness

Serious side effects, such as an infection or punctured lung, are rare.

Acupuncture is generally safe. However, people with one or more of the following should notify the acupuncturist before receiving acupuncture:

  • a bleeding disorder, such as hemophilia
  • a metal allergy
  • a preexisting infection in the area the acupuncturist will insert needles

A person should also inform their acupuncture practitioner if they are pregnant, as certain acupuncture points are unsafe to treat during pregnancy.

Find exercises to help strengthen the lower back.

Medicare covers up to 12 acupuncture treatments for chronic low back pain. It also covers an additional eight visits if the first 12 show improvements. Medicaid coverage depends on the state in which a person lives.

Some health insurance policies cover acupuncture, while others do not. A person should check their policy to understand what it covers.

A 2019 study investigated the out-of-pocket costs of acupuncture treatments across 41 metropolitan regions within the United States using data from an online payment website.

Across the 723 clinics included in the study, the cost of a first-time acupuncture visit ranged from $15–$400, with the median cost being $112. This ranged from the lowest copayment amount to the highest out-of-pocket cost. The cost of a follow-up visit ranged from $15–$300, with the median cost being $85.

A person can discuss the costs of their acupuncture treatment with the practitioner before the initial consultation.

Learn whether Medicare covers acupuncture.

Acupuncture is a complementary therapy that involves inserting fine needles into acupoints on the skin. Research suggests it may lead to improvements in both acute and chronic lower back pain. However, further high quality studies are necessary to determine its effectiveness.

Acupuncture is generally a safe procedure, and serious side effects are rare. However, pregnant people or those with certain health conditions should consult a doctor before receiving acupuncture.