A walk that was once enjoyable may become more difficult. Sitting at work, sleeping comfortably, gardening or returning to an activity we love may require more thought. Over time, we may begin arranging our lives around what feels manageable.
If you are exploring acupuncture for chronic pain, there is some encouraging research, particularly for certain types of musculoskeletal pain. The evidence varies according to the condition, and the benefits demonstrated in clinical studies are often modest or short-term.
At Nature’s Qi Health in Forres, Moray, I offer traditional acupuncture and complementary East Asian approaches, guided by each person’s individual circumstances. My work includes an interest in movement, physical comfort and the relationships between our bodies, emotions and everyday lives.
Here I explain what the research tells us, what NICE recommends, and how I approach acupuncture when someone comes to me with concerns about pain.
What is chronic pain?
Chronic pain, sometimes called persistent or long-term pain, is pain that continues or returns for more than three months. It can affect one part of the body or several areas. Its intensity may remain fairly consistent or change from day to day.
Some people have an established medical diagnosis explaining their pain. Others experience ongoing pain without a clearly identifiable underlying cause. Both experiences are recognised in modern pain medicine. NICE distinguishes between two broad categories.
Chronic primary pain is pain for which no underlying condition adequately explains the experience or its impact. Fibromyalgia and some forms of persistent widespread pain fall within this category. Chronic secondary pain is pain associated with an identifiable condition, such as osteoarthritis, rheumatoid arthritis or another diagnosed disorder.
A person may experience both. These distinctions matter because different causes of pain require different approaches to assessment and management. You can read the definitions in the NICE guideline on chronic primary and secondary pain.
Pain involves more than one part of our lives
Pain is a complex experience involving the nervous system, our physical circumstances and many other influences. Sleep, movement, stress, previous experiences and our general health can all affect how pain is experienced. If you have lived with pain for some time, you may recognise that some days are easier than others.
An activity might be difficult one week and easier the next. Poor sleep can make everything harder. You may have lost confidence about how much movement is right for you. These observations can be useful when discussing pain with a healthcare professional.
Pain is real, even when its cause is difficult to identify. Understanding the factors that influence it can help inform a suitable care plan.
Can acupuncture help with chronic pain?
Acupuncture has been investigated in numerous clinical trials involving different types of pain. The findings are more encouraging for some conditions than others.
The UK’s Advertising Standards Authority accepts carefully qualified claims about short-term pain relief in certain circumstances, including chronic lower back pain, neck pain, tension-type headaches and some other specific conditions.
These claims have limits. Evidence of temporary improvement does not establish a permanent effect or demonstrate that acupuncture treats the underlying cause of pain. The ASA’s acupuncture guidance explains which claims it considers supportable.
What NICE recommends for chronic primary pain
The National Institute for Health and Care Excellence published guideline NG193 in 2021, covering assessment of chronic pain and management of chronic primary pain in people aged 16 and over. It recommends considering a single course of acupuncture or dry needling for chronic primary pain, subject to specified conditions concerning practitioner training, setting, treatment time and cost.
The guideline describes a course involving no more than five hours of healthcare professional time, with the number and length of sessions adapted within that limit. This is a conditional recommendation for a defined patient group. It does not mean acupuncture is recommended for every chronic pain condition.
NICE also emphasises person-centred assessment, shared decision-making, physical activity and appropriate psychological approaches to pain management. I particularly value its recognition that people should be actively involved in decisions about their care.
You can read NICE recommendation 1.2.5 on acupuncture for chronic primary pain.
Acupuncture for lower back pain
Lower back pain is one of the most frequently researched applications of acupuncture. It may be associated with muscular strain, age-related changes, particular medical conditions or other factors. Sometimes the exact cause remains uncertain.
Research has found that acupuncture can provide short-term relief for some people experiencing chronic lower back pain. However, the size and clinical importance of the benefit vary between studies. There is also an important difference between research findings, advertising guidance and NHS treatment recommendations.
Although the ASA accepts appropriately qualified claims about short-term relief of chronic lower back pain, NICE guideline NG59 does not recommend offering acupuncture for low back pain with or without sciatica. The different conclusions reflect how organisations assess evidence, compare treatments and develop recommendations.
For anyone experiencing ongoing back pain, a proper assessment remains important. Movement advice, physiotherapy, exercise and other recommended approaches may form part of care, depending on the cause.
When back pain needs medical attention
Most episodes of back pain are not caused by serious illness, but certain symptoms require urgent assessment. Seek immediate medical attention if back pain occurs with new bladder or bowel dysfunction, loss of sensation around the genitals or anus, or significant symptoms affecting both legs.
Sudden severe pain accompanied by fever or feeling very unwell also warrants urgent medical advice. The NHS back pain guide explains when to seek help. Acupuncture should never delay appropriate investigation of concerning symptoms.
Acupuncture for neck pain
Neck pain may develop gradually or follow a particular event. People sometimes notice stiffness, discomfort during movement or difficulty finding a comfortable position when working or sleeping. Research has examined acupuncture for both recent and persistent neck pain.
The ASA accepts qualified claims concerning short-term relief of neck pain, including chronic neck pain. This does not establish that acupuncture corrects structural problems in the neck or provides lasting relief. If neck pain is accompanied by progressive weakness, significant numbness, problems with balance or other neurological symptoms, medical assessment is important.
At Nature’s Qi Health, I am interested in how your physical experience relates to movement, daily activities, work and rest. The information you share helps guide our discussion about whether acupuncture is appropriate and how it might fit alongside other care.
What about knee pain, arthritis and other joint concerns?
Joint discomfort can have many causes. Osteoarthritis, inflammatory conditions, injuries and other disorders may produce symptoms that seem similar but require different management. The ASA recognises evidence supporting temporary adjunctive treatment for pain associated with knee osteoarthritis.
Adjunctive means that the approach is used alongside other appropriate care. It does not imply that acupuncture repairs cartilage, reverses arthritis or changes the underlying disease. The NICE guideline for osteoarthritis places particular emphasis on therapeutic exercise, information and appropriate management strategies.
If you have persistent swelling, warmth, restricted movement or unexplained joint pain, your GP or another qualified healthcare professional can help determine the cause.
How does acupuncture influence pain?
Traditional East Asian medicine and modern pain science describe acupuncture through different frameworks. In classical East Asian medicine, pain may be understood in relation to the movement of Qi and Blood through the meridian system.
Qi is a traditional concept sometimes translated as vital energy. Meridians are pathways described in classical medical theory. These concepts have not been established as measurable anatomical structures by modern science. Contemporary researchers investigate acupuncture through its interaction with sensory nerves and the body’s pain-processing systems.
Studies have examined changes in neural activity, endogenous pain-modulating substances and other physiological responses following needle stimulation. These are areas of ongoing research. They do not provide a complete explanation for acupuncture’s effects or establish that it works for every condition.
The traditional understanding of free flow
Within East Asian medicine, harmonious movement is an important expression of health. The concept of Xiao Yao, or free flow, describes something of this quality. I find it a helpful way to think about adaptability and change. When someone is living with persistent discomfort, movement may become restricted, routines may change and confidence in the body may be affected.
I want to understand your experience and work with what is there. Traditional theory guides my acupuncture point selection, while contemporary evidence helps inform what we can reasonably expect from treatment.
My approach to pain at Nature’s Qi Health
Every person who comes to the clinic brings a different history. Two people may describe discomfort in the same part of the body, yet their circumstances, medical diagnoses and experiences may be very different. One may have a recent injury. Another may have lived with recurring discomfort for several years.
Their daily activities, sleep, exercise, medication and priorities may also differ. I begin by listening. We discuss your health history, what you have noticed, how the discomfort affects your life and what medical advice or treatment you have already received.
I am interested in what makes things easier or more difficult, how your symptoms change and what you would like to be able to do. This information helps us consider whether acupuncture is suitable and how an individual treatment might be approached.
Choosing the acupuncture points
Traditional acupuncture involves inserting very fine, sterile, single-use needles at selected points. The points are chosen according to the traditional assessment and the acupuncture system being used. I work with several approaches, including Saam Korean acupuncture.
Saam often uses four carefully selected points, commonly on the arms and legs. It is a distinctive traditional Korean system that has become an important part of my practice. Using only a few points suits the way I like to work: simply, and with care.
The use of fewer needles does not necessarily mean greater effectiveness. Each approach has its own traditional principles, and research comparing different systems remains limited. You can learn more in Saam Korean Acupuncture: The Gentle Four-Needle Approach.
Other approaches I may use
My background includes Tuina, acupressure, massage and other complementary techniques. Depending on the individual, I may discuss:
- Tuina: Traditional East Asian massage involving pressure and movement.
- Acupressure: Manual pressure applied to selected points.
- Cupping: A technique using suction cups on the skin.
- Gua Sha: Repeated strokes using a smooth-edged tool.
- Moxibustion: Traditional application of warmth using processed mugwort.
- Movement guidance: Discussing activity and appropriate ways to remain mobile.
These techniques have different evidence bases and safety considerations. Their use should be discussed individually, and they should not be assumed to treat the underlying cause of pain. We choose what is appropriate together, with your comfort and preferences guiding each step.
The relationship between pain, stress and sleep
Living with persistent pain can be tiring. It may affect concentration, sleep, relationships and the activities that give us enjoyment. Pain can also be influenced by emotional experiences and stress, although this does not mean that pain is imaginary or caused solely by emotions.
Modern pain care increasingly recognises the importance of understanding these relationships. NICE recommends asking how pain affects a person’s daily life and how different aspects of life may influence the pain. This includes sleep, physical and psychological wellbeing, work, relationships and previous experiences.
I find this consistent with the attention traditional East Asian medicine gives to the whole person. If you are interested in these connections, you may find my article on acupuncture for stress and emotional wellbeing helpful. Persistent sleep problems or significant emotional distress also deserve appropriate medical or psychological care.
Movement, rehabilitation and living well with pain
When we experience discomfort, it can be tempting to avoid movement. Sometimes rest is appropriate, particularly following certain injuries or during acute illness. For many persistent pain conditions, however, remaining physically active within suitable limits is an important part of recommended care.
The type and amount of activity depend on the individual and any underlying diagnosis. Walking, swimming, strength exercises or a carefully planned rehabilitation programme may be appropriate. A physiotherapist or other qualified healthcare professional can help with individual exercise advice.
Listening to the body’s response
One of the ideas I value in my practice is learning to notice how our bodies respond. What happens after an activity? How do we feel the following morning? Is a particular movement becoming easier or more difficult? These observations can be useful when discussing activity and rehabilitation with an appropriate professional.
The aim is to develop an informed relationship with movement, recognising that abilities and needs can change over time. I also draw on the traditional concept of Yang Sheng, or Nourishment of Life. Yang Sheng considers how food, movement, rest, environment and daily habits contribute to our experience of wellbeing.
It encourages attention to the ordinary things that sustain us.
What happens at your first acupuncture appointment?
If you are considering acupuncture for chronic pain in Forres, your first appointment begins with a conversation. We discuss your symptoms, relevant medical history, medication, previous investigations and treatments, and any factors that may influence safety.
I explain the approach I am considering and invite your questions. Acupuncture needles are much finer than those used for injections, although you may feel tingling, heaviness, warmth or a brief ache. Minor bleeding, bruising or soreness can occur. Rare serious complications are possible, which is why practitioner training and appropriate safety procedures matter.
Please tell me about anticoagulant medication, bleeding disorders, pregnancy, recent surgery, implanted medical devices or other relevant health conditions. Your consent and comfort are important throughout.
How many appointments might be needed?
There is no single course suitable for everyone. NICE’s recommendation for chronic primary pain describes a defined, time-limited course under particular circumstances. It should not be interpreted as a general recommendation for unlimited treatment.
At Nature’s Qi Health, we review your experience and discuss whether further appointments are appropriate. I would always sooner reassess than assume the same approach should carry on indefinitely. For more practical details, read What to Expect at Your First Acupuncture Appointment in Forres.
