Written by Karen Pilkington, Edzard Ernst and the CAM-Cancer Consortium.
Updated July 14, 2015

Acupuncture for breathlessness

Is it safe?

Adverse events

In about 8-10% of all patients, acupuncture causes mild, transient adverse effects such as pain, haematoma or bleeding at the site of needling.16,17 In addition, in rare cases complications due to tissue trauma, pneumothorax, cardiac tamponade or infection are on record.18 Risk of cross-infection of blood borne disease, particularly hepatitis B, is minimised by the use of sterile disposable needles, and immunisation of acupuncturists. Rare cases of fatalities after acupuncture treatment have been reported although causality was not confirmed in many of these reports.19


Professional bodies for acupuncture vary somewhat in defining contraindications, particularly in relation to pregnancy.1,20 Bleeding abnormalities and anticoagulant treatment, oedema, epilepsy, pregnancy and needle phobia are among those conditions that have been suggested as relative, or in some cases absolute, contra-indications. Some points are considered ‘forbidden’ or not to be used for acupuncture needling.


None known, except for electro-acupuncture where the electrical current might interfere with pacemakers and is used with caution in epilepsy.20


Strict asepsis and use of sterile disposable needles are mandatory to avoid infections. Some patients faint during acupuncture and should thus be treated lying down.

Citation Karen Pilkington, Edzard Ernst, CAM-Cancer Consortium. Acupuncture for breathlessness [online document]. http://ws.cam-cancer.org/The-Summaries/Mind-body-interventions/Acupuncture-for-breathlessness. July 14, 2015.


  1. BAcC (British Acupuncture Council) website: Ten Top Things to Know, accessed 17th April 2015.
  2. Filshie, J., Cummings, M. Western medical acupuncture. In: Ernst, E., White, A.  (Eds). Acupuncture: A Scientific Appraisal. 1999. Butterworth-Heinemann, Oxford. pp 31-59.
  3. White A; Editorial Board of Acupuncture in Medicine. Western medical acupuncture: a definition. Acupunct Med. 2009 27(1):33-5.
  4. White A, Ernst E. Introduction. In: Ernst, E., White, A. (Eds). Acupuncture: A Scientific Appraisal. 1999. Butterworth-Heinemann, Oxford. pp1-10.
  5. Birch S, Kaptchuk T. History, nature and current practice of acupuncture: an East Asian perspective. In: Ernst, E., White, A.  (Eds). Acupuncture: A Scientific Appraisal. 1999. Butterworth-Heinemann, Oxford. pp 11-30.
  6. Ahn AC, Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM, Langevin HM. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics. 2008 29(4):245-56.
  7. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008; 84(4):355-375.
  8. Molassiotis A, Browall M, Milovics L, Panteli V, Patiraki E, Fernandez-Ortega P. Complementary and alternative medicine use in patients with gynecological cancers in Europe. Int J Gynecol Cancer. 2006 16 Suppl 1:219-24.
  9. Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AM, Platin N, Kearney N, Patiraki E. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol. 2005 16(4):655-63.
  10. Ben-Aharon I, Gafter-Gvili A, Paul M et al. Interventions for alleviating cancer-related dyspnea: a systematic review. J Clin Oncol 2008; 26: 2396-404.
  11. Bausewein C, Booth S, Gysels M et al. Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database Syst Rev 2008; 2: CD005623.
  12. Vickers AJ, Feinstein MB, Deng GE et al. Acupuncture for dyspnea in advanced cancer: a randomized, placebo-controlled pilot trial. BMC Palliat Care 2005; 4: 5.
  13. Filshie J, Penn K, Ashley S et al. Acupuncture for the relief of cancer-related breathlessness. Palliat Med 1996; 10: 145-50.
  14. Jobst K, Chen JH, McPherson K et al. Controlled trial of acupuncture for disabling breathlessness. Lancet 1986; 2: 1416-9.
  15. Lewith GT, Prescott P, Davis CL. Can a standardized acupuncture technique palliate disabling breathlessness: a single-blind, placebo-controlled crossover study. Chest 2004; 125: 1783-90.
  16. Coyle ME, Shergis JL, Huang ET, Guo X, Di YM, Zhang A, Xue CC. Acupuncture therapies for chronic obstructive pulmonary disease: a systematic review of randomized, controlled trials. Altern Ther Health Med. 2014; 20(6):10-23.
  17. White A, Hayhoe S, Ernst E. Survey of Adverse Events Following Acupuncture Acupunct Med. 1997; 15:67-70.
  18. Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, Willich SN. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed. 2009 Apr;16(2):91-7.
  19. White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004; 22(3):122-123.
  20. Ernst E. Deaths after acupuncture: a systematic review. Int J Risk Safety 2010; 22(3):131-136.
  21. BMAS (British Medical Acupuncture Society): Code of Practice & Complaints Procedure. Version 9 December 2009, accessed 21st July 2015.