Anxiety and Stress

Introduction

Feeling anxious or stressed is something most people experience from time to time. For some, these feelings become overwhelming and start to affect sleep, concentration, and daily life. While there are established ways to manage anxiety, some people are also curious about what other approaches might offer. This page looks at what researchers have explored about acupuncture in this context, based on information from the British Acupuncture Council.

How Acupuncture May Help

Acupuncture involves inserting very fine needles into specific points on the body. Some researchers have explored whether this might influence areas of the brain involved in the body’s stress response, though exactly how this works — and whether it directly relates to anxiety — is not yet clear (Hui et al., 2010; Almeida & Cavalca, 2022). In traditional practice, acupuncture is used holistically, meaning the practitioner considers your overall wellbeing rather than looking at symptoms in isolation. It is important to understand that acupuncture is not a replacement for medical or psychological treatment for anxiety.

What the Research Says

Research into acupuncture for anxiety has produced mixed findings. Several reviews have explored whether acupuncture might be associated with reduced anxiety symptoms, but researchers agree the quality of evidence needs improvement before firm conclusions can be drawn (British Acupuncture Council, n.d.).

A key challenge is that much of the research has looked at anxiety alongside other conditions — such as before surgery, during cancer treatment, or alongside fertility treatment — rather than generalised anxiety on its own. This makes the findings harder to apply broadly.

The American Society of Clinical Oncology includes acupuncture in supportive care recommendations for people with breast cancer who are experiencing anxiety (Carlson et al., 2023). European guidelines for breast cancer supportive care also include acupuncture for symptoms such as nausea and hot flushes (Cardoso et al., 2024). These recommendations apply to specific patient groups and do not extend to anxiety in the general population.

Studies on generalised anxiety disorder

A 2021 systematic review examined 20 clinical trials involving 1,823 people diagnosed with generalised anxiety disorder. All of the trials were conducted in China. The review reported that acupuncture was associated with reduced anxiety scores compared with control conditions. However, the researchers noted that more high-quality studies are needed before any firm conclusions can be drawn (Yang et al., 2021).

A 2023 review of 37 trials looked at electroacupuncture — acupuncture delivered with a mild electrical current — for anxiety across a range of conditions including insomnia, irritable bowel syndrome, and situational anxiety (Hong et al., 2023). The authors reported reductions in anxiety scores, though the studies varied widely in the conditions they covered and the quality of evidence was moderate at best.

Reviews of the overall evidence base

An overview of 10 systematic reviews in 2019 found that while most reviews reported the acupuncture group did better than the control group, the overall quality of evidence was low and the methodological quality of the reviews themselves needed improvement (Li et al., 2019). A 2018 review of electroacupuncture noted similar challenges with varied study populations (Amorin et al., 2018). An integrative review in 2016 described acupuncture as an interesting area of study but highlighted that better research methods are needed (Goyatá et al., 2016).

Auricular (ear) acupuncture

Some studies have looked at ear acupuncture for situational anxiety, such as before an operation. A 2022 review of 13 studies found auricular acupuncture was associated with reduced anxiety compared with placebo (Vieira et al., 2022). Another 2022 review of 15 studies involving 1,603 patients looked at ear acupuncture before surgery and reported similar findings, though the authors noted that more research is needed to clarify how reliable these findings are (Usichenko et al., 2022).