Acupuncture

Acupuncture has a traditional explanation involving meridians and qi, and a physiological one that has been studied for decades. We work from the physiological one.

• Local chemistry at the needle

  Inserting and gently manipulating a needle causes a small, controlled tissue response — adenosine release and local changes in blood flow — which dampens the firing of nearby pain fibres.

• Signals into the spinal cord

  The needle stimulates deep sensory nerves. Those signals reach the spinal segment serving the painful area and reduce how readily pain messages are passed upward — the same gate-control principle that makes rubbing a knock help.

• Release of the body's own opioids

  Needling activates descending pathways from the brainstem and triggers release of endorphins and related chemicals. This is measurable: the effect is partly reversed by drugs that block opioid receptors.

• The antiemetic point

  Stimulation at the inner wrist (P6) has the most replicated evidence of any acupuncture use — it reduces nausea and vomiting through pathways into the brainstem vomiting centres. It is the basis of the anti-sickness wristbands sold in pharmacies.

• Autonomic and inflammatory tone

  Sessions shift the balance toward parasympathetic activity and appear to modulate inflammatory signalling — the likely route for effects on hot flushes, sleep and general arousal.

This is the therapy where we can be most specific about who benefits, because the trials exist. Strongest first.

• Chemotherapy-induced nausea and vomiting

  As an addition to anti-sickness medication, not a replacement. The best-supported use of acupuncture in cancer care, particularly for the nausea that persists after standard drugs.

• Joint and muscle pain from aromatase inhibitors

  The stiffness and aching that make people want to stop their hormone tablets. Recommended in integrative oncology guidelines, and one of the clearest wins we see.

• Chronic musculoskeletal pain

  Back, neck, shoulder and osteoarthritic pain, including pain from long periods in bed or from altered posture after surgery.

• Hot flushes

  From hormone therapy, chemotherapy-induced menopause, or androgen deprivation — a symptom where good drug options are limited.

• Chemotherapy-induced peripheral neuropathy

  Numbness, burning and tingling in hands and feet. Evidence is moderate rather than strong, but options are so few that a trial of six to eight sessions is often reasonable.

• Dry mouth after head and neck radiotherapy

  Studied for radiation-induced xerostomia with modest benefit — worth trying when saliva substitutes are not enough.

• Fatigue and insomnia

  Smaller and less consistent effects than for the above, but frequently reported as a secondary benefit by people attending for something else.

Especially worth considering if

• Your anti-sickness medicines are already maximised and nausea is still winning.
• You are considering stopping a hormone therapy because of joint pain.
• Pain medicines are limited by side effects, drowsiness or kidney function.
• You have neuropathy, and have been told there is not much to offer.

Acupuncture is safe in trained hands, but it breaks the skin — which makes blood counts, clotting and infection risk genuinely decisive. Nothing here is a formality. Bring a recent blood count if you have one.

Stop — clearance needed first

Do not start until your medical team has confirmed it is safe for you.

• Neutropenia (low white cells)

  Any break in the skin is an infection risk when neutrophils are low. We do not needle during a neutropenic period; sessions are timed to the recovered part of your chemotherapy cycle.

• Low platelets or a bleeding disorder

  Bleeding and bruising risk rises as platelets fall. Below the threshold your haematologist sets, we do not needle at all; in the range above it we use fewer, shallower needles and prolonged pressure afterwards.

• Fever, active infection, or sepsis risk

  No needling while an infection is being treated or investigated. This includes an unexplained temperature.

• Prosthetic heart valves or a history of endocarditis

  Any procedure that breaks skin needs a cardiology opinion first because of the risk of seeding an infection onto a valve.

• Severe lung disease, emphysema, or a single functioning lung

  Needling over the chest and upper back carries a small pneumothorax risk that becomes serious in these situations. Points are then restricted to the limbs.

• Pregnancy

  Several points are traditionally avoided in pregnancy. Tell us before, not during.

• Uncontrolled arrhythmia or recent cardiac event

  Needs medical sign-off before any session, and rules out electroacupuncture.

Proceed, with changes

These do not rule the therapy out. They change how it is delivered — tell us so we can adapt it.

• Lymphoedema, or a limb at risk after node clearance

  No needles in that arm or leg — ever, including for blood pressure cuffs and injections. Tell us which side, every visit, even if you told us last time.

• Anticoagulants and antiplatelets

  Warfarin, DOACs, heparin, clopidogrel and even long-term aspirin all raise bruising. Sessions still go ahead in most cases: fine needles, superficial insertion, firm pressure afterwards. Expect more bruising than other people get.

• Pacemakers, defibrillators and neurostimulators

  Standard needling is fine. Electroacupuncture is not used near the device, and usually avoided entirely.

• Peripheral neuropathy or reduced sensation

  If you cannot reliably feel the area, you cannot warn us that something is wrong. We needle shallowly and check the skin closely.

• Diabetes

  Slower healing and higher infection risk at needle sites, especially in the feet. Foot points are often avoided altogether.

• Skin in a radiotherapy field, or any broken or infected skin

  Points are moved away from irradiated, ulcerated, inflamed or recently operated skin.

• Fainting, needle phobia, severe anxiety

  Vasovagal fainting is the most common acupuncture side effect. First sessions are done lying down, with fewer needles.

• Directly over a tumour, or over an implanted port

  Never needled. Nearby points are chosen instead.

Medicines, devices and interactions

Bring your full medication list, including anything bought without a prescription.

• Blood thinners — bruising, not danger

  The interaction is mechanical, not chemical. It changes technique and pressure time; it rarely cancels the session.

• Insulin and diabetes medication

  Deep relaxation and a missed meal before a session can drop blood sugar. Eat something beforehand and bring your usual treatment for a hypo.

• Sedatives, opioids, blood pressure medicines

  Increase the chance of feeling faint or drowsy on standing. Get up slowly; arrange a lift home after your first session.

• Immunosuppressants and steroids

  Raise infection risk and thin the skin. Strict sterile technique and fewer points; sometimes a delay is safer.

• No effect on drug levels

  Acupuncture does not alter how your medicines are absorbed or cleared. It never replaces an anti-sickness or pain medicine — it is added to them.

Before

• A full history: diagnosis, treatment schedule, medicines, recent blood counts, surgery and which side had lymph nodes removed.
• Eat something light within a couple of hours. Arriving hungry is the commonest reason people feel faint.
• Wear loose clothing — many points are below the knee and elbow, and you usually stay dressed.

During

• Needles are single-use, sterile, and roughly the width of a hair. Between four and twelve is typical.
• Insertion feels like a small tap. Then a dull, heavy, spreading ache at the point — that sensation is the intended one, not a problem.
• You rest with the needles in for 15–25 minutes. Most people become very relaxed; some sleep.
• Tell the practitioner immediately about sharp pain, a burning feeling, light-headedness, sweating or nausea. A needle can be removed in one second.

After

• Pinprick bruises at some points, especially on blood thinners. They fade over a few days.
• Deep relaxation and sometimes drowsiness for an hour or two.
• A brief flare of the treated symptom in the first day happens to some people, and usually settles before it recurs.
• Occasionally a session or two of feeling unusually emotional or unusually energetic.

Acupuncture is measurable, so measure it. Pick the one symptom you came for, score it out of ten daily for a week before you start, and keep scoring. Impressions blur; a diary does not.

Signs it is helping

• Nausea: fewer vomiting episodes, or less rescue anti-sickness medication used in the days after chemotherapy.
• Pain: a drop of two or more points out of ten, or the same score with less breakthrough medication.
• Aromatase-inhibitor joint pain: easier mornings, less stiffness on standing, and — the real endpoint — being able to keep taking the tablet.
• Hot flushes: fewer per day, or the same number but less drenching and less disruptive at night.
• Neuropathy: better balance, fewer night-time burning episodes, less trouble with buttons and cutlery.
• Benefit that lasts longer after each session than it did after the last one — the pattern to watch for.

Pause and tell us if

• Pain reliably increases after sessions rather than easing.
• Bruising is large, spreading, or slow to fade — stop and have your platelets and clotting checked.
• Any needle site becomes red, hot, swollen or discharges — that needs same-day medical review.
• Breathlessness or chest pain in the hours after needling of the chest or upper back — that is an emergency, go to hospital.
• You repeatedly faint despite lying down and eating beforehand.
• Six to eight sessions have produced no change on your own diary.

Length of a session

45–60 minutes for the first appointment, 30–40 minutes after that, with needles in place for 15–25 minutes.

Initial course

Once or twice weekly for six to eight sessions. Nausea protocols are timed to your chemotherapy days rather than to a fixed weekly slot.

Continuing

If it worked: every two to four weeks, or a short burst of sessions when a symptom returns. Hot flushes and joint pain often need maintenance; pain from a single injury often does not.

When we review it

At eight sessions, and again after any change in blood counts, blood thinners, or treatment plan.

• Bring a recent full blood count

  Platelets and neutrophils decide what is safe on the day. Without them we work conservatively or postpone — with them, you get the session you came for.

• Time it to your chemotherapy cycle

  Blood counts fall to their lowest around 7–14 days after most regimens. Sessions are safest and most useful in your recovered window; tell us your cycle dates and we will build the schedule around them.

• Name the lymphoedema side every single visit

  Practitioners change; notes get missed. This is the one thing worth repeating even when you are certain we already know.

• Eat before you come

  A light meal within two hours. Fainting during acupuncture is almost always low blood sugar plus lying still, not the needles.

• Only ever see a qualified practitioner using single-use needles

  Sterile, individually packaged, opened in front of you, disposed of in a sharps bin. Serious complications in the literature come almost entirely from untrained practice.

• Keep it in your medical notes

  Tell your oncologist you are having acupuncture. If your nausea improves enough to change your anti-sickness prescriptions, that is a decision for them, not for you or us.

• Say no to open moxibustion and cupping if your skin is fragile

  Burns and blistering are a real risk with radiotherapy skin, steroid-thinned skin, neuropathy or diabetes. Needles alone are safer.

• Expect gradual, cumulative change

  Unlike massage, one session rarely settles anything for long. The pattern is small improvements that hold a little longer each time.

Acupuncture has the strongest evidence base of any therapy on this site, though it is uneven across uses. It is recommended in mainstream integrative oncology guidance for aromatase-inhibitor joint pain and as an addition to standard anti-emetics for chemotherapy-induced nausea and vomiting, where the P6 point evidence is extensive. Evidence is moderate for chronic musculoskeletal pain, hot flushes and radiation-induced dry mouth, and weaker but reasonable for chemotherapy-induced neuropathy, fatigue and insomnia. Whether the specific point locations matter as much as tradition claims remains genuinely debated — sham-needle comparisons often narrow the gap. There is no evidence acupuncture affects tumour growth or survival, and we do not offer it on that basis.

Sources informing this page

• Society for Integrative Oncology / ASCO — clinical practice guidelines on integrative approaches to pain and to anxiety and depression in cancer
• Cochrane reviews — acupuncture and acupressure for chemotherapy-induced nausea and vomiting, and for chronic pain
• US National Center for Complementary and Integrative Health (NCCIH)
• WHO — safety guidance and training standards for acupuncture practice

Named for transparency about where our position comes from. Specific study references are added by our clinical team at review.

Take these to your doctor before you start. They are the questions that change what is safe for you specifically.

• “What are my current platelet and neutrophil counts, and what threshold should acupuncture stop below?”
• “Where in my chemotherapy cycle is it safest to book sessions?”
• “I am on a blood thinner — is there any reason I should not have needling at all?”
• “Which limb must never be needled because of lymph node surgery or radiotherapy?”
• “Is there any reason to avoid needling my chest or upper back?”
• “If my nausea improves, how do you want me to adjust or report my anti-sickness medicines?”