Acupuncture Contraindications

Introduction[edit | edit source]


Acupuncture is a non-pharmacological, relatively safe and effective treatment option for a variety of symptoms and dysfunctions. [1]

It is essential that the practitioner follows a set of basic principles in order for acupuncture to be a safe treatment option. These include reducing the danger of infection transmission, maintaining adequate anatomical knowledge to enable safe needling, and receiving an orthodox medical diagnosis before beginning treatment. Past these fundamental guiding principles, there are few strict contraindications to the use of acupuncture and specific topics and situations continue to cause regular disagreement between practitioners. [2]

Most practitioners agree that acupuncture should not be utilized in the following situations "active infection, especially cutaneous, malignancy, as there might be a threat of the spread of neoplastic cells; and severe neutropenia secondary to the risk of infection". [3]Otherwise, the decision-making authority rests with the practitioner.

The safe use of acupuncture is promoted by following contraindications for it's application. The Acupuncture Association of Chartered Physiotherapists (AACP) [4]suggests that with regard to acupuncture contraindications should be thought of in two groups:

  • Absolute contraindications: The use of acupuncture is forbidden.
  • Relative contraindications: Acupuncture can be used with careful consideration of the risk factors.

The World Health Organisation Guidelines on Basic Training and Safety in Acupuncture state that, "It is difficult to stipulate absolute contraindications for this form of therapy." However, they suggest that for reasons of safety, it should be avoided in pregnancy, medical and surgical emergencies, malignant tumors and bleeding disorders. [5]

Contraindications[edit | edit source]

The Acupuncture Association of Chartered Physiotherapists provides guidelines on contraindications aimed specifically at physiotherapists practicing acupuncture.

Absolute Contraindications[edit | edit source]

They state absolute contraindications to be:

  • The use of points LI 4; SP 6; UB 60, 67 and sacral foraminal points B 31, 32, 33, 34 during pregnancy.
  • The use of acupuncture with patient who have uncontrolled movements.
  • The needling of and oedematous limb at risk of lymphoedema
  • Areas of spinal instability where as the result relaxation of the surrounding muscles could potentially give rise to spinal cord compression.
  • The needling of scars, keloid, recent incisional wounds or skin with sensory deficit.
  • The needling of intracapusular points if the patient is on anticoagulant therapy or is a haemophiliac.

Relative Contraindications[edit | edit source]

And relative contraindications to include:

Special Precautions[edit | edit source]

  • Bleeding tendency
  • Immuno-suppression,
  • Epilepsy
  • Pregnancy
  • Unclear diagnosis
  • Abnormal physical structure
  • Patient who needs to drive after acupuncture treatment
  • Strong reactors to acupuncture

References[edit | edit source]

  1. National Institutes of Health Public Health Service US Department of Health and Human Services. Acupuncture: Consensus Development Conference Report. Journal of Pharmaceutical Care in Pain & Symptom Control. 1998 Jan 1;6(4):67-90.
  2. Cummings M, Reid F. BMAS policy statements in some controversial areas of acupuncture practice. Acupuncture in Medicine. 2004 Sep;22(3):134-6.
  3. Van Hal M, Green MS. Acupuncture.
  4. Acupuncture Association of Chartered Physiotherapists,, (accessed 18th July 2013)
  5. Guidelines on Basic Training and Safety in Acupuncture, World Health Organisation,, (accessed 18th July 2013)
  6. Morar D, Tan D, Nielsen A, Anderson B, Chuang E, Connolly M, Gao Q, Gil EN, Lechuga C, Kim M, Naqvi H. www. aacp. org. uk.