Evidence by Condition

What the clinical evidence supports — strength and source, plainly stated. From the BMA efficacy & safety review and guideline summaries.

De Qi — the arrival of Qi

Dull ache, heaviness, distension, tingling, warmth, or a radiating feeling around the needle — the arrival of Qi.

De qi is associated with better outcomes; it is both a clinical sign and the patient's felt experience. Twirling, lifting-thrusting, and patient feedback guide it.

Stronger 'de qi' needling is more stimulatory; gentle, brief needling tends toward sedation in modern practice (Campbell).

Chronic pain (general)

Moderate–Strong

Meta-analyses show acupuncture is superior to sham and usual care for chronic back, neck, and osteoarthritis pain, with effects persisting beyond treatment.

Source: BMA 2000; Vickers et al. meta-analyses

Chronic low-back pain

Moderate

Recommended as a non-pharmacological option; effective for short-term pain and function. Guideline-supported.

Source: BMA; NICE low-back pain guidance

Osteoarthritis of the knee

Moderate

Significant improvement in pain and function versus sham and education controls.

Source: BMA; knee-OA trials

Migraine prophylaxis

Moderate

Reduces frequency; comparable to prophylactic drugs with fewer side effects.

Source: BMA; Cochrane migraine reviews

Tension-type headache

Moderate

Reduces headache frequency and intensity for prophylaxis.

Source: Cochrane tension-type headache

Post-operative & chemotherapy nausea

Strong

P6 (PC6) stimulation is one of the best-supported indications; reduces nausea/vomiting.

Source: BMA; Cochrane P6 reviews

Nausea of pregnancy

Moderate

PC6 acupressure/needle reduces nausea; safe when LI4 and contraindicated points avoided.

Source: BMA; obstetric reviews

Neck pain

Moderate

Short-term pain relief and function improvement; results vary by technique.

Source: Cochrane neck pain

Shoulder pain (frozen shoulder/rotator cuff)

Limited–Moderate

Some benefit for pain and mobility; often combined with manual therapy.

Source: BMA; shoulder trials

Osteoarthritis of hip

Limited

Less evidence than knee OA; small trials show modest pain relief.

Source: Cochrane hip OA

Fibromyalgia

Limited

Some improvement in pain and fatigue; evidence heterogeneous.

Source: Fibromyalgia reviews

Insomnia

Limited–Moderate

Improvement in sleep quality in several trials; multi-component interventions vary.

Source: Insomnia reviews

Depression/anxiety (adjunct)

Limited

Possible adjunct benefit; not a standalone replacement for psychological care.

Source: BMA; mental-health adjunct reviews

Smoking cessation

Inconclusive

Early studies mixed; auricular protocols show variable results.

Source: BMA 2000

Asthma

Limited

Some symptom improvement; evidence insufficient to replace conventional care.

Source: BMA; asthma reviews

Evidence strength is a guide, not a verdict. Individual response varies; combine with your clinician's judgement.