Pain is not always simple
Pain can appear for many different reasons. Sometimes there is an obvious injury. Sometimes it develops gradually through degeneration or repetitive strain. Sometimes pain continues long after an injury has healed, and sometimes investigations do not reveal a clear cause at all.
That difference matters.
Acute pain behaves differently from persistent pain. Pain from osteoarthritis is different from pain after an injury. Long-standing back or neck pain often involves different factors again, including movement, sleep, stress, workload, recovery and how the nervous system processes pain.
At Nurturing Life, acupuncture appointments look at more than simply where it hurts. We spend time understanding when the pain started, what aggravates or relieves it, how it affects your movement and daily life, and what else may be contributing to the overall picture.
Different types of pain
People seek acupuncture for many different pain presentations, including:
- acute pain following an injury or strain
- persistent or chronic pain
- back and neck pain
- joint and musculoskeletal pain
- pain associated with osteoarthritis or degenerative change
- headaches and migraine
- repetitive strain and overuse
- pain that fluctuates with stress, workload or fatigue
- pain where the underlying cause remains unclear despite investigation
Acute pain
Acute pain usually appears relatively suddenly, often following an injury, strain, procedure or flare-up.
If you are experiencing acute pain from an unknown, especially if it is severe it is recommended to first seek support from a GP to get further medical investigation.
If you are experiencing acute pain that is familiar to you (you have experienced it before) and just want some assisstance with pain reduction then acupuncture can be a great choice.
Chronic and persistent pain
Pain lasting for months or years can become much more complicated than the original injury or diagnosis.
Persistent pain can be influenced by tissue changes, sensitivity within the nervous system, movement patterns, poor sleep, stress, reduced activity and the understandable changes people make when they are trying to avoid aggravating their symptoms.
Research into acupuncture for chronic pain has produced more substantial evidence than for many other acupuncture applications. Large reviews have found modest improvements in some chronic pain conditions, particularly low-back pain, neck pain, osteoarthritis-related knee pain and headache.
Pain from injury or overuse
Not all injuries happen in one dramatic moment.
Pain can develop gradually through repetitive work, training load, prolonged positions or doing more than the body has had time to adapt to.
During an appointment we can look at the location of your pain, how it changes with movement, what you are repeatedly asking that area to do, and whether factors such as recovery, activity levels or workload need to be addressed alongside acupuncture.
Where appropriate, I may also recommend assessment from another health professional if your presentation requires investigation, rehabilitation or care outside my scope.
Degenerative pain and osteoarthritis
Degenerative changes become increasingly common with age, but imaging findings do not always correspond neatly with how much pain a person experiences.
To be clear, acupuncture does not reverse degenerative diseases, but it may assist with the symptoms and pain associated with the degeneration. We can also look at different lifestyle factors which may be contributing to the ongoing decline.
Acupuncture can form one useful part of managing pain and maintaining function alongside appropriate movement, strengthening, medical care and other strategies.
When there is no clear cause
One of the most frustrating experiences is being in pain while scans, tests or investigations fail to provide a simple explanation.
A lack of a clear structural cause does not mean the pain is not real.
Pain is produced through a complex interaction between the body and nervous system. Tissue health matters, but so can previous injury, sensitivity, sleep, stress, activity levels and many other factors.
Acupuncture is often used as part of the management of persistent pain even when there is not one obvious structure that can be identified as the cause.
More than needles
For pain, I rarely think the useful conversation ends with acupuncture.
Depending on your situation, we may also discuss:
- movement and activity
- pacing and gradual return to activity
- sleep and recovery
- repetitive movements or workload
- stress and nervous system load
- heat or other simple self-management strategies
- daily routines that may be aggravating or supporting your symptoms
- diet choices that may be increasing inflammation (and thus pain)
For long-standing pain, these factors often matter because what happens during the rest of your week is considerably more important than what happens during one appointment.
What does the research say about acupuncture for pain?
Pain is one of the more extensively researched areas of acupuncture.
Evidence is not identical across every pain condition, but research suggests acupuncture may be helpful for several types of pain, including chronic low-back pain, neck pain, knee osteoarthritis and some headache disorders.
For chronic low-back pain specifically, a Cochrane review found acupuncture performed better than no treatment for pain and function, although differences compared with sham acupuncture were not considered clinically meaningful. Other systematic reviews have reported modest short-term improvements.
For headache and migraine, reviews have found acupuncture may reduce headache frequency, although some of the observed benefit may be related to nonspecific treatment effects.
Appointments include time to understand how the pain developed, how it is affecting you and what other factors may need attention alongside acupuncture.
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Chronic low-back pain — Asano et al., 2022.Effectiveness of Acupuncture for Nonspecific Chronic Low Back Pain: A Systematic Review and Meta-Analysis. The review found acupuncture was associated with improvements in pain and disability, while also noting variation in study quality.
View on PubMedChronic low-back pain — 2023 systematic review/meta-analysis. This review included 14 randomised controlled trial comparisons and found reductions in pain and disability in some comparisons, although outcomes differed depending on what acupuncture was compared against.
View on PubMedChronic neck pain — 2024 systematic review/meta-analysis. Acupuncture used as an adjunct was associated with sustained pain improvement at follow-up and improved functional outcomes. Importantly, pain relief was not statistically superior to sham acupuncture in the pooled sham-controlled comparison.
View on PubMedKnee osteoarthritis — Mei et al., 2023.Acupuncture for knee osteoarthritis: A systematic review and meta-analysis. This review assessed acupuncture for pain and functional outcomes in knee osteoarthritis.
View on PubMedKnee osteoarthritis — 2024 systematic review/meta-analysis. This review included 10 RCTs and 3,221 participants and reported that improvements in pain and function could persist for several months after treatment in some comparisons, though durability varied by comparator.
View on PubMedMigraine — Guo et al., 2023.Acupuncture for the Treatment of Migraine: An Overview of Systematic Reviews. This paper examined the body of systematic-review evidence for acupuncture in migraine and also assessed the methodological quality of that evidence.
View on PubMedAcute migraine — Wang et al., 2023.Acupuncture for acute migraine attacks in adults: a systematic review and meta-analysis.