Research on the safety of acupuncture can largely be found by database searching for the keyword ‘adverse’ or ‘adverse events’. There are several different types of study

  • Individual case reports of adverse events
  • Systematic reviews of numbers/types of case reports in the literature (Xu et al 2013)
  • Prospective surveys of adverse events recorded in normal practice. These may be practitioner reports (MacPherson 2001) or patient reports (MacPherson 2004; Witt 2010). While the former tend to underestimate, the latter may record spurious incidents that are either not adverse or not related to the acupuncture treatment
  • Experimental studies; for example, anatomical information about safe needling depths at different points
  • Reports of any adverse events seen in trials, especially those comparing acupuncture to other interventions or to no treatment.

Although case reports give invaluable warnings of what can happen in certain circumstances they are not useful estimators of normal practice incidences of adverse events, i.e. they don’t give you a quantitative idea of the risk. For this, you need (very large) prospective surveys, as in the studies cited above.


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):486-7
Macpherson H, Scullion A, Thomas KJ, Walters S. Patient reports of adverse events associated with acupuncture treatment: a prospective national survey. Qual Saf Health Care. 2004 Oct;13(5):349-55
Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, Willich SN. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed. 2009 Apr;16(2):91-7
Xu S, Wang L, Cooper E, Zhang M, Manheimer E, Berman B, Shen X, Lao L. Adverse events of acupuncture: a systematic review of case reports. Evid Based Complement Alternat Med. 2013;2013:581203