How safe is Acupuncture? What are the risks?
What are the risks of Acupuncture?
1) A 2001 survey of Acupuncturists practicing in the UK reported no serious adverse events, and 43 minor events out of 34,407 acupuncture treatments. The most common of these 43 minor events were severe nausea and fainting. Three avoidable events—two patients had needles left in, and one patient had moxibustion burns to the skin—were caused by practitioners’ errors.
Practitioners also recorded 10,920 mild transient reactions occurring in 5136 treatments, 15% (14.6% to 15.3%) of the 34 407 total treatments. Some local reactions at the site of needling were reported—mild bruising in 587 (1.7%) cases, pain in 422 (1.2%) cases, and bleeding in 126 (0.4%) cases. Patients experienced an aggravation of existing symptoms after 966 (2.8%) treatments, 830 (86%) of which were followed by an improvement, possibly indicating a positive “healing crisis.” The most commonly reported mild transient reactions were “feeling relaxed” in 4098 (11.9%) cases and “feeling energised” in 2267 (6.6%) cases, symptoms that often indicate an encouraging response to treatment
2) Researcher Dieter Melchart, MD and colleagues found 7.1% minor adverse events and 5 serious ones among 97,733 acupuncture patients treated in Germany by German physicians with at least 140 hours of formal acupuncture training. The authors of this study concluded that serious adverse events seem to be rare and that acupuncture is generally a safe intervention.
Needling pain (3.28%), Hematoma (3.19%), Bleeding (1.38%), Orthostatic problems (0.46%), Forgotten needles (0.25%), Local skin irritation (0.01%), Deterioration of symptoms (0.01%), Headache (0.0033%), Fatigue (0.003%)
3) Other adverse events that are rare but happen nonetheless may include but not be limited to; pneumothorax (puncturing of the lung), injuries of the organs from needle puncture, central nervous system injuries (spinal cord and brain), peripheral nervous system injuries (damage to nerves), and scars at needling sites. Although most papers did not report the training background of the practitioner, 3 cases were reportedly treated by individuals with no medical training or license.
Before jumping into the numbers, it should be noted that in USA alone, 3.1 million American adults and 150,000 children used acupuncture in 2007. And in 2012, insurance companies reported 1 million people using Acupuncture in Germany.
 Thirteen cases of pneumothorax were reported between 2002 and 2011 (9 years) across 8 countries. Of 13 cases of pneumothorax associated with acupuncture, the USA reported 3, the UK 2, Hong Kong 2, Japan 2, Singapore 1, Germany 1, Taiwan 1, and New Zealand 1.
 Five cases of heart injury were reported between 2000 and 2011 (11 years) and include two of cardiac tamponade, one of the hemopericardium, one ventricular embolism, and one myocardial injury. Of these, two were due to the migration of embedded needles and two were due to needle insertion. Two were caused by an acupuncturist or TCM practitioner, and one by an “unauthorized acupuncturist”. The status of two practitioners was unreported. Three patients recovered; outcome was not reported in the other two cases. Of the five cases, four were reported in Korea, and one in Austria.
 There were nine cases of central nervous system injury reported between 2000 and 2011 (11 years), including five spinal cord injuries and four of brain injury.
Two of the spinal injuries were caused by migrating broken needles the others were probably the result of needling too deeply. All patients recovered after treatment.
The brain injuries were an acute intracranial hemorrhage, an injury to the medulla oblongata, a subarachnoid hemorrhage, and an intracranial hemorrhage with cerebellar infarction. Three were due to needle insertion; the medulla injury was caused by a broken needle. Three patients recovered after treatment; outcome was not given for the fourth.
Of the nine cases of CNS injury, the USA reported 2, Japan 2, Taiwan 2, Korea 2, and Iran 1.
Considering the millions of people treated in each country per year, these numbers demonstrate the extremely rare risk of any serious adverse event occurring.