In short
- Serious complications are rare. Minor, short-lived effects are common and usually harmless.
- Single-use sterile needles are the standard of care in the United States. They should be opened in front of you.
- Tell your practitioner about anticoagulants, pregnancy, a pacemaker or implanted device, a weakened immune system, and any lymph node surgery.
- Verify the license yourself through the California Acupuncture Board.
Common and harmless
Most people experience nothing beyond mild sensations. The effects below are frequently reported and generally settle within a day or two:
- A small bruise at a needle site, sometimes a tiny spot of blood on withdrawal.
- A dull ache, heaviness or warmth around a point during treatment.
- Feeling drowsy, relaxed or briefly light-headed afterwards.
- Mild soreness at needle sites the following day, similar to after exercise.
- A temporary flare of the symptom being treated before it settles.
Light-headedness is the most common reason a session is stopped early, and is usually managed by lying flat for a few minutes. Tell your practitioner immediately if you feel faint, clammy or nauseated. Do not try to sit it out.
The rare but serious
These are uncommon, and most relate to technique rather than to acupuncture itself:
- PneumothoraxA punctured lung: from needling too deeply over the chest or upper back. This is the most serious recognized risk. Sudden chest pain or breathlessness after treatment needs emergency assessment.
- Infection, essentially eliminated by single-use sterile needles and clean technique.
- Nerve or blood vessel injury from needling in sensitive areas.
- A retained needleRare, avoided by counting needles in and out.
- Burns from moxibustion or heat lamps.
Who should take extra care
- On anticoagulants or with a bleeding disorderGreater bruising and bleeding risk; technique should be adjusted.
- PregnantCertain points and techniques are avoided; say so before any needling.
- Pacemaker or implanted electrical deviceElectroacupuncture is generally avoided.
- Weakened immune systemFrom illness, chemotherapy or immunosuppressant medication; infection risk is higher.
- Lymph node removal or lymphoedemaNeedling in the affected limb is normally avoided.
- Poorly controlled diabetesSlower healing, particularly in the feet.
- Valvular heart disease or prosthetic valvesDiscuss with your cardiologist first.
What good practice looks like
- Sealed single-use needles, opened in your presence, and disposed of in a sharps container.
- Hands washed or sanitised, and the skin cleaned before insertion.
- A full health history taken before the first treatment, including medication.
- Needles counted in and counted out.
- You are not left unattended for long stretches, and have a way to call for help.
- Clear aftercare advice and a way to reach the clinic with concerns.
Verifying a license in California
Acupuncturists in California are licensed by the California Acupuncture Board and use L.Ac. after their name. The Board publishes a license lookup, which shows whether a license is current and whether there has been disciplinary action. California does not grant licenses on the basis of another state's license, and the national NCCAOM examination alone is not sufficient to practice here.
Checking takes a minute, and is worth doing even when a clinic looks established.
When to seek medical help after a session
Seek urgent care for chest pain or difficulty breathing after treatment, for a needle site that becomes increasingly red, hot, swollen or discharging, for a fever in the days afterwards, or for new numbness or weakness that does not resolve. These are uncommon, but they are the ones not to wait on.