Acupuncture is mainly used to relieve pain in a variety of chronic conditions such as arthritis or migraine. Most studies show some benefit in around 60% of patients, suggesting it is more than simply a placebo (which usually improves about 30%). The shorter the duration of the pain the better the response.

Acupuncture has been used to relieve pain in terminal malignant disease. It is a time-consuming procedure, but can sometimes reduce opioid analgesic requirements.

The mechanism of action may be release of endogenous opioids, which inhibit the central transmission of pain. (Acupuncture analgesia can be reversed by naloxone.) An early study showed cerebrospinal fluid (CSF) from rabbits receiving acupuncture could raise the pain threshold of normal rabbits after intra-ventricular injection. Recent studies using specific antisera to encephalins (in order to abolish their specific effects) suggest high frequency electro-acupuncture (100Hz to 200Hz) maybe mediated by dynorphin, and low frequency electro-acupuncture (2Hz to 6Hz) by metenkephalin. 5HT levels (in brain and CSF of experimental animals) also rise after acupuncture, and 5HT is known to inhibit transmission of pain in the spinal cord.

Traditional Chinese acupuncture (acu = needle) practiced for over 4,000 years is based on the theory that needle insertion alters the flow of energy (Chi) along certain lines (meridians) on the surface of the body. This is said to restore the balance of positive and negative forces (Yin and Yang) in the internal organs, resulting in cure of pain or disease. Modern acupuncture also uses electrical stimulation or laser stimulation in addition to needles. Many Western practitioners believe in focal points rather than the meridian theory.

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