Prospective studies of the safety of acupuncture: a systematic review

Purpose: The objective of this review was to determine the incidence of adverse events associated with acupuncture. Subjects and methods: A search for prospective surveys of the safety of acupuncture was conducted using computerized databases (Medline, Embase, the Cochrane Library, and CISCOM), inquiries to acupuncture organizations, and our own files. Data on sample, size, types of patients duration of study, types of acupuncture, definition of adverse events, method of evaluation, and findings were extracted systematically from the retrieved reports. Results: Nine surveys were located and included in the review. Their results were not uniform. The most common adverse events were needle pain (1% to 45%) from treatments, tiredness (2% to 41%), and bleeding (0.03% to 38%). Feelings of faintness and syncope were uncommon, with an incidence of 0% to 0.3%. Feelings of relaxation were reported by as many as 86% of patients. Pneumothorax was rare, occurring only twice in nearly a quarter of a million treatments. Conclusions: Although the incidence of minor adverse events associated with acupuncture may be considerable, serious adverse events are rare. Those responsible for establishing competence in acupuncture should consider how to reduce these risks.