Acupuncture for Fibromyalgia

Acupuncture for fibromyalgia (FM) has become more common over the years, especially since more and more research has shown the benefits of this treatment. One in five people with fibromyalgia seek acupuncture treatment within two years of diagnosis. Because fibromyalgia is a difficult condition to treat and many people with it have trouble tolerating drugs and even supplements, complementary and alternative treatments like acupuncture are especially appealing and represent a potential way to relieve fibromyalgia symptoms.

How Does Acupuncture Work?

The medical use of acupuncture goes back about 2,500 years. It is a traditional Chinese medicine practice that involves placing hair-thin needles at strategic points around the body. In many cases, the needle is twisted until the practitioner feels something called the needle grasp. That part is believed to be important in producing a pain-relieving effect.

Acupuncture points are located on meridians; however, modern acupuncture may also be performed on myofascial trigger points, which are tight areas of connective tissue that can radiate pain.

Most people—even those with fibromyalgia—report no pain or just a momentary twinge when the needles are inserted and upon needle grasp. During and after treatments, it’s common to feel relaxed.

The ancient explanation of acupuncture’s benefits was that it enables the flow of a life energy called qi throughout the body. The theory held by Western medicine is that acupuncture stimulates or activates several mechanisms in the body, including the:  

• Peripheral and central nervous systems
• Spinal glial (white matter) cells
• Immune system’s inflammatory response
• Endogenous opioid system (a natural pain-relieving mechanism in the nervous system)
• Pain inhibition system in the central nervous system (which is believed to be dysfunctional in fibromyalgia)

Benefits for Fibromyalgia

Acupuncture has many potential health benefits for fibromyalgia, including:

• Lower pain levels
• Better sleep
• Possible immune system stimulation
• Enhanced relaxation
• Better overall health

Acupuncture therapy has several advantages over conventional fibromyalgia treatments, such as:

• Low risk
• No negative interactions with drugs or supplements
• No need for regular laboratory tests

Acupuncture Research

Research using functional magnetic resonance imaging (fMRI) shows that acupuncture has real effects on brain structures involved in pain. Larger and longer-term high-quality studies are needed to draw firm conclusions, but so far, acupuncture appears to be a safe and effective treatment for fibromyalgia.

Studies also support a variation of the ancient treatment called electroacupuncture (EA), which uses an electronic device to deliver a small current between pairs of needles. Some studies have even shown it to be especially effective for FM.

A Cochrane research review concluded that EA appears to be better than standard acupuncture for fibromyalgia when it comes to improving:

• Pain 
• Stiffness 
• Sleep 
• Fatigue 
• Overall well-being

While not all researchers agree on the strength of the current evidence for this intervention, a 2019 review stated that acupuncture therapy is an effective and safe treatment for patients with FM, and this treatment can be recommended for the management of FM. It concluded that acupuncture was more effective in the short and long term than conventional FM medications and that no serious side effects had been found. Even so, the researchers stated that more large-scale, long-term studies need to be performed.

Research is beginning to look into why acupuncture relieves FM symptoms. A 2018 trial suggested that acupuncture causes changes in the levels of two neurotransmitters (brain chemicals) that are key to FM:

• Serotonin: Involved in pain processing, the sleep/wake cycle, alertness, appetite, sex drive, mood, and digestion. Activity is believed to be low in FM.
• Substance P: Released when nerve cells detect painful stimuli and is related to the pain threshold (how sensitive you are to pain). Levels are believed to be elevated in FM. 

The authors wrote that acupuncture appears to increase serotonin and decrease substance P, which can improve fibromyalgia symptoms.

Acupuncture for Related Conditions

Acupuncture may benefit many of the conditions that commonly occur alongside fibromyalgia, including:

• Myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS)
• Myofascial pain syndrome
• Headaches and migraines
• Irritable bowel syndrome
• Menstrual cramps
• Low back pain
• Anxiety
• Depression
• Insomnia
• Irritable bladder
• Arthritis
• Immune system problems

Possible Side Effects

The most common side effects of acupuncture include: 

• Tiredness
• Pain at insertion site
• Headache
• Bruising, bleeding, and soreness at insertion site

In one study, about 10% of people experienced at least one of the above effects. Somewhat more significant side effects included:

• Nausea
• Dizziness and fainting
• Exacerbation (worsening) of symptoms

More serious side effects are extremely rare, especially if you’re going to a licensed acupuncturist. They include:

• Organ puncture
• Infection from unsterile needles
• Convulsions
• Nerve damage

Warnings and Precautions

You shouldn’t replace recommended treatments with acupuncture without first discussing it with your healthcare provider. Acupuncture is generally considered a complementary treatment option, meaning it’s done along with other treatments.

Acupuncture may not be safe for you if you have a bleeding disorder. Those who take blood-thinning medications, such as Coumadin (warfarin), Xarelto (rivaroxaban), and Eliquis (apixaban) should exercise caution.

You shouldn’t have electroacupuncture if you have a:

• Cardiac pacemaker
• Infusion pump
• Other implanted electrical devices

Finding an Acupuncturist

Your doctor, other medical practitioners, or pain clinics in your area may be able to recommend a qualified acupuncturist. When looking for a practitioner, be sure you find someone who’s licensed and certified in your state.

Most states require acupuncturists to complete a licensing process and pass an exam given by the National Certifications Commission for Acupuncture and Oriental Medicine (NCCAOM). You can check practitioner credentials through the NCCAOM directory.

Once you’ve found a provider, ask about their experience in treating fibromyalgia and other pain conditions. Also, ask what kind of results you should expect and how many sessions it may take to see a difference. Keep the lines of communication open as you notice improvements or side effects so your practitioner knows what is or isn’t working for you.

A Word From Verywell

Fibromyalgia is notoriously hard to treat, and the symptoms can be difficult to manage. It’s common for people experiencing fibromyalgia to look into complementary and alternative treatments. Acupuncture has more research backing it than many other such treatments, so it may be a good place to start. Be sure to discuss your decision to try acupuncture with your healthcare provider and find a qualified acupuncture practitioner.