Acupuncture contraindications

Original Editor - Katherine Knight

Top Contributors - Katherine Knight, Evan Thomas, Kalyani Yajnanarayan and Kim Jackson  


The safe use of acupuncture is promoted by following contraindications for it's application. The Acupuncture Association of Chartered Physiotherapists (AACP) [1]suggests that with regard to acupuncture contraindications should be thought of in two groups; 'absolute contraindications', where the use of acupuncture is forbidden and 'relative contraindications' where acupuncture can be used with careful consideration of the risk factors. The World Health Organisation Guidelines on Basic Training and Safety in Acupuncture [2] state that, "it is difficult to stipulate absolute contraindications for this form of therapy" However, they suggest that for reasons of safety, it should be avoided in pregnancy, medical and surgical emergencies, malignant tumours and bleeding disorders. The full World Health Organisation guideline can be viewed here.


The Acupuncture Association of Chartered Physiotherapists provides guidelines on contraindications aimed specifically at physiotherapists practicing acupuncture.

Absolute Contraindications

They state that absolute contraindications to be:

  • The use of points LI 4; SP 6; UB 60, 67 and sacral foraminal points B 31, 32, 33, 34 during pregnancy.
  • The use of acupuncture with patient who have uncontrolled movements.
  • The needling of and oedematous limb at risk of lymphoedma
  • Areas of spinal instability where as the result relaxation of the surrounding muscles could potentially give rise to spinal cord compression.
  • The needling of scars, keloid, recent incisional wounds or skin with sensory deficit.
  • The needling of intracapusular points if the patient is on anticoagulant therapy or is a haemophiliac.

Relative Contraindications

And relative contraindications to include:

  • Acute stroke
  • Patients with cancer
  • Areas of poor skin condition
  • Diabetic patients
  • Patients with epilepsy
  • Hemophilia or other clotting disorders [3]

Special Precautions

  • Bleeding tendency
  • Immuno-suppression,
  • Epilepsy
  • Pregnancy
  • Unclear diagnosis
  • Abnormal physical structure
  • Patient who needs to drive after acupuncture treatment
  • Strong reactors to acupuncture


  1. Acupuncture Association of Chartered Physiotherapists,, (accessed 18th July 2013)
  2. Guidelines on Basic Training and Safety in Acupuncture, World Health Organisation,, (accessed 18th July 2013)
  3. Acupuncture Association of Chartered Physiotherapists,, (accessed 18th August 2013)