Joint pain has many causes. For osteoarthritis, one of them, NICE (the National Institute for Health and Care Excellence) says: "Do not offer acupuncture or dry needling to manage osteoarthritis." [3] A 2019 American College of Rheumatology and Arthritis Foundation guideline, as reported by NCCIH, conditionally recommends acupuncture for osteoarthritis of the knee, hip or hand [4]. The NHS lists immediate warning signs for joint pain (see below) [1].
What joint pain is
The NHS says joint pain is common, especially as you get older. It lists knee, shoulder, hip, foot (including ankle and toes), hand (including wrist and fingers), elbow and arm, and neck pain as common types. You might feel pain in one joint or more than one at the same time [1].
The NHS says it might be caused by an injury or a longer-lasting problem such as arthritis, and that perimenopause and menopause can also cause aching and painful joints due to lowered levels of oestrogen. Its advice is not to self-diagnose and to see a GP if you're worried [1].
The NHS pairs symptoms with possible causes [1]:
- pain, swelling or bruising after intense or repetitive exercise: sprain or strain
- pain that's worse when walking and stiffness after activity (usually over the age of 45): osteoarthritis
- a warm, swollen joint that's more painful when you move it or press on it: bursitis
- pain and stiffness on both sides of the body that's worse after not moving: rheumatoid arthritis
- a hot, swollen toe joint with very bad pain that comes on suddenly, often overnight: gout
- a hot, swollen joint that's difficult to move and a high temperature, or feeling hot or cold and shivery: joint infection (septic arthritis)
Osteoarthritis. The NHS describes osteoarthritis as a condition that causes joints to become painful and stiff, and the most common type of arthritis in the UK. It most often causes problems in the knees, hips and small joints of the hands. It is a long-term condition that cannot be cured, but the NHS says it does not necessarily get any worse over time and can sometimes gradually improve [2].
What the guidance and research say about acupuncture
NICE guidance (NG226, osteoarthritis in over 16s). NICE's recommendation 1.3.8 reads: "Do not offer acupuncture or dry needling to manage osteoarthritis." [3] This guideline covers osteoarthritis in general, not one joint. NICE names "dry needling" alongside acupuncture; the sources used for this page do not define it.
The NHS. The NHS says treatment for joint pain depends on what is causing it, and that sometimes the pain may go away without treatment. It lists strong painkillers, antibiotics if you have an infection, physiotherapy, steroid injections, referral to hospital for an X-ray, scan or specialist treatment (such as surgery), and advice about lifestyle changes such as doing more exercise. Acupuncture is not on that list [1]. For osteoarthritis it lists regular exercise, losing weight if overweight, suitable footwear, painkillers and a structured exercise plan with a physiotherapist [2].
NCCIH. NCCIH, part of the US National Institutes of Health, reports [4]:
- a 2018 review of 10 studies (2,413 participants) found acupuncture more effective than no treatment for osteoarthritis pain, and an analysis of 9 studies (2,376 participants) found it more effective than sham (simulated) acupuncture; the difference between acupuncture and no treatment was greater than the difference between acupuncture and sham acupuncture
- most participants in those studies had knee osteoarthritis, but some had hip osteoarthritis
- a 2018 review of 6 studies (413 participants) of acupuncture for hip osteoarthritis found that, in the two studies comparing acupuncture with sham acupuncture, there was little or no difference in effects on pain
- a 2019 guideline from the American College of Rheumatology and the Arthritis Foundation conditionally recommends acupuncture for osteoarthritis of the knee, hip or hand, and states that the greatest number of studies showing benefits have been for knee osteoarthritis
- acupuncture "may also help relieve joint pain associated with the use of aromatase inhibitors, which are drugs used in people with breast cancer"; a 2017 review of 5 studies (181 participants) concluded that 6 to 8 weeks of acupuncture "may help reduce the pain", though the individual studies were small and difficult to compare
NICE and the American guideline were produced by different bodies and reach different conclusions. This page does not decide between them.
Acupuncture in Malaysia
What acupuncture is. NCCIH, part of the US National Institutes of Health, describes acupuncture as a technique in which practitioners insert fine needles into the skin. The needles may be manipulated by hand or stimulated with small electrical currents (electroacupuncture). Acupuncture originated from traditional Chinese medicine [4].
Registration. Malaysia's Traditional and Complementary Medicine Act 2016 (Act 775) defines traditional and complementary medicine to include traditional Chinese medicine [5]. Under section 25 of the Act, in force since 1 March 2021, a person who is not a registered practitioner shall not practise traditional and complementary medicine services [5][6]. A registered practitioner must hold a valid practising certificate, which is valid for not more than twelve months and must be displayed at the place of practice (section 26) [5].
Referral. Section 30 of the Act requires a registered practitioner to refer a patient to a medical or dental practitioner if the patient has an acute medical emergency, or if the condition is beyond the practitioner's skill, competency or expertise [5]. Under section 30(3) the practitioner must explain this duty to the patient, or the patient's guardian or representative, so that they can make an informed decision about whether to refuse being referred. Section 30(4) says that if the patient, guardian or representative gives written notice consenting not to be referred, the practitioner is not obliged to refer [5].
NCCIH's guidance is not to use acupuncture to postpone seeing a health care provider about a health problem [4].
Safety. According to NCCIH, relatively few complications from acupuncture have been reported, but complications have resulted from nonsterile needles and improper delivery. When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs and injury to the central nervous system [4]. The NHS lists two situations in which acupuncture may not be safe: taking blood-thinning medicine or being at increased risk of bleeding, and having a skin condition or skin infection [7].
When the sources say to get medical help
Each source below sets its own level of urgency. Malaysia's emergency line is 999 [8]. The regulator's numbering plan also lists 112 as the code for mobile phones routed to emergency services [9].
Call 999 or go to A&E (NHS, UK) [1], for joint pain with any of:
- very bad joint pain after a fall or injury
- being unable to walk or put weight on a joint
- a joint that has moved out of place
- any tingling, or no feeling in the area around the joint after an injury
Urgent advice from NHS 111 (NHS, UK) [1]: "Ask for an urgent GP appointment or get help from NHS 111 if":
- you have joint pain and the skin around it is swollen and feels hot
- you have joint pain and feel generally unwell, have a high temperature or feel hot, cold or shivery
See a GP (NHS, UK) [1], if:
- joint pain is stopping you doing normal activities or affecting your sleep
- the pain or swelling is getting worse or keeps coming back
- the pain has not improved after treating it at home for 2 weeks
- your joints are stiff for more than 30 minutes after waking up
- your child has joint problems
The NHS also says persistent symptoms of osteoarthritis should be seen by a GP so they can confirm the diagnosis and prescribe any necessary treatment [2].
In Malaysia (Ministry of Health portals). Klinik Kesihatan Kuala Lumpur, a government health clinic, lists outpatient (Pesakit Luar) services. It lists its service hours as 8.00am to 5.00pm Monday to Friday, with extended hours on weekday evenings and on weekends and public holidays, and says it is closed on some festival days [10]. Hospital Kuala Lumpur's emergency department says it provides 24-hour emergency medical services to people in Kuala Lumpur [11].
Find a clinic
The NHS's suggested next step for joint pain that has not improved after 2 weeks of home treatment is to see a GP [1]. The clinic directory lists acupuncture and traditional Chinese medicine clinics across Malaysia by state and town.
Sources
- NHS. Joint pain. Page last reviewed 26 February 2026.
- NHS. Osteoarthritis. Page last reviewed 20 March 2023 (review was due 20 March 2026).
- National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management (NG226). Recommendation 1.3.8. Published 19 October 2022.
- National Center for Complementary and Integrative Health (NCCIH), US National Institutes of Health. Acupuncture: Effectiveness and Safety. Last updated October 2022.
- Laws of Malaysia. Traditional and Complementary Medicine Act 2016 (Act 775), English text published by the Ministry of Health Malaysia. Sections 3, 25, 26 and 30.
- Federal Government Gazette P.U. (B) 118, 23 February 2021. Appointment of date of coming into operation, Traditional and Complementary Medicine Act 2016.
- NHS. Herbal medicines and complementary therapies. Page last reviewed 1 May 2026.
- Malaysia.gov.my (MyGovernment portal). Malaysia Emergency Response Services (MERS) 999. Page updated 25 September 2025.
- Malaysian Communications and Multimedia Commission. Numbering and Electronic Addressing Plan, issued 26 January 2006. Schedule D.
- Kuala Lumpur and Putrajaya State Health Department, Ministry of Health Malaysia. Klinik Kesihatan Kuala Lumpur.
- Hospital Kuala Lumpur, Ministry of Health Malaysia. Kecemasan & Trauma.