Acupuncture for Fibromyalgia and Myofascial Pain: What the Guidance Says

Published

The sources used for this page report no guidance or research on acupuncture for muscle strains or pulled muscles. They do cover long-term muscle-related pain: fibromyalgia and myofascial pain syndrome. NICE (the National Institute for Health and Care Excellence) says to "Consider a single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system, for people aged 16 years and over to manage chronic primary pain", but only if the course meets set conditions [3]. NICE defines chronic pain as pain that "persists or recurs for more than 3 months", and chronic primary pain as pain in which no underlying condition adequately accounts for the pain or its impact. It says fibromyalgia is a type of chronic primary pain [3]. The NHS says of acupuncture for long-term pain: "Acupuncture can reduce pain and improve the quality of life in some people with long-term pain. But its effects have only been shown to last up to 3 months, and any longer-term benefits it may have are unknown. It may also not be available in your area." [12]

What the conditions are

This page covers fibromyalgia and myofascial pain syndrome, and also gives the NHS advice for a muscle strain, for which the sources report no acupuncture research.

Strains. The NHS describes a strain as an overstretched or torn muscle (also known as a pulled muscle), most common in the feet, legs and back. It lists muscle spasms or cramping, "where your muscles painfully tighten on their own", among the symptoms of a sprain or strain. It says that after 2 weeks most sprains and strains will feel better, and that severe ones can take months to get back to normal [1].

Fibromyalgia. The NHS describes fibromyalgia as a long-term condition that causes pain all over the body. Other symptoms include increased sensitivity to pain and muscle stiffness. It says there is currently no cure, but there are treatments to help relieve some of the symptoms [2].

What the guidance and research say about acupuncture

NICE guidance (NG193, chronic pain in over 16s). Recommendation 1.2.5 reads: "Consider a single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system, for people aged 16 years and over to manage chronic primary pain, but only if the course:" [3]

  • "is delivered in a community setting"
  • "and is delivered by a band 7 (equivalent or lower) healthcare professional with appropriate training"
  • "and is made up of no more than 5 hours of healthcare professional time (the number and length of sessions can be adapted within these boundaries)"
  • "or is delivered by another healthcare professional with appropriate training and/or in another setting for equivalent or lower cost."

NICE says: "Fibromyalgia (chronic widespread pain) is a type of chronic primary pain." [3] The recommendation text does not name strains or other muscle injuries, and NICE says chronic pain with an underlying condition that adequately accounts for it is managed in line with the NICE guideline for that condition [3].

The NHS. For fibromyalgia, the NHS Treatment page has an Acupuncture heading with the sentences quoted at the top of this page [12]. The NHS fibromyalgia overview and the NHS sprains and strains page do not name acupuncture [1][2]. For strains, the NHS lists PRICE therapy for the first 2 to 3 days (protection, rest, ice, compression, elevation), speaking to a pharmacist about painkillers, and physiotherapy for a sprain or strain that is taking longer than usual to get better [1]. For fibromyalgia, it says treatment tends to be a combination of lifestyle changes such as exercise programmes and relaxation techniques, talking therapies such as CBT and ACT, and medicine such as antidepressants. It says exercise has important benefits, including helping to reduce pain [2].

NCCIH. NCCIH, part of the US National Institutes of Health, reports:

  • a 2019 review of 12 studies (824 participants) of people with fibromyalgia indicated that acupuncture was significantly better than sham acupuncture for relieving pain, "but the evidence was of low-to-moderate quality" [4]
  • myofascial pain syndrome is a common form of pain derived from muscles and their related connective tissue (fascia), involving tender nodules called "trigger points" [4]
  • a combined analysis of a small number of studies of acupuncture for myofascial pain syndrome showed that acupuncture applied to trigger points had a favourable effect on pain intensity (5 studies, 215 participants), "but acupuncture applied to traditional acupuncture points did not (4 studies, 80 participants)" [4]
  • in many studies the benefit of acupuncture was greater when compared with no treatment than when compared with sham (simulated) acupuncture [4]

The sources used for this page do not report research on acupuncture for muscle strains.

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], after an injury, if:

  • you heard a crack when you had your injury
  • the injured body part has changed shape or is pointing at an odd angle
  • the injured body part is numb, tingling or has pins and needles
  • the skin around the injury has changed colour, such as looking blue or grey, or is cold to touch

The NHS says you may have broken a bone and will need an X-ray. It says: "Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance." [1]

Urgent advice from NHS 111 (NHS, UK) [1], after an injury, if:

  • it's very painful, or the pain is getting worse
  • there's a large amount of swelling or bruising, or the swelling or bruising is getting worse
  • you cannot put any weight on it or walk more than a few steps
  • it feels very stiff or is difficult to move
  • it's not feeling any better after treating it yourself
  • you also have a very high temperature, or feel hot, cold or shivery, which the NHS says could be an infection

See a GP (NHS, UK):

  • you think you have a sprain or strain and it's getting worse or not feeling better after treating it yourself [1]
  • you think you have fibromyalgia [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 a strain that is getting worse or not feeling better after self-treatment, or for suspected fibromyalgia, is to see a GP [1][2]. The clinic directory lists acupuncture and traditional Chinese medicine clinics across Malaysia by state and town.

Sources

  1. NHS. Sprains and strains. Page last reviewed 23 April 2024.
  2. NHS. Fibromyalgia. Page last reviewed 12 October 2022 (review was due 12 October 2025).
  3. National Institute for Health and Care Excellence (NICE). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NG193). Recommendation 1.2.5 and terms used in the guideline. Published 7 April 2021.
  4. National Center for Complementary and Integrative Health (NCCIH), US National Institutes of Health. Acupuncture: Effectiveness and Safety. Last updated October 2022.
  5. 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.
  6. Federal Government Gazette P.U. (B) 118, 23 February 2021. Appointment of date of coming into operation, Traditional and Complementary Medicine Act 2016.
  7. NHS. Herbal medicines and complementary therapies. Page last reviewed 1 May 2026.
  8. Malaysia.gov.my (MyGovernment portal). Malaysia Emergency Response Services (MERS) 999. Page updated 25 September 2025.
  9. Malaysian Communications and Multimedia Commission. Numbering and Electronic Addressing Plan, issued 26 January 2006. Schedule D.
  10. Kuala Lumpur and Putrajaya State Health Department, Ministry of Health Malaysia. Klinik Kesihatan Kuala Lumpur.
  11. Hospital Kuala Lumpur, Ministry of Health Malaysia. Kecemasan & Trauma.
  12. NHS. Fibromyalgia: Treatment. Page last reviewed 12 October 2022 (review was due 12 October 2025).

Chest pain, trouble breathing, sudden weakness or another emergency: call 999 (112 from a mobile) or go to the nearest hospital emergency department.