Acupuncture for Neck and Shoulder Pain: What the Guidance Says

Published

The NHS pages on neck pain and shoulder pain do not list acupuncture. NICE (the National Institute for Health and Care Excellence) has a recommendation on acupuncture for chronic primary pain in general, which it says to consider only under set conditions [3]. NCCIH reports a 2018 review in which acupuncture was more effective than no treatment for back or neck pain, but the same page says that in an analysis of 20 studies of people with back pain, osteoarthritis, neck pain or headaches, the beneficial effects of acupuncture continued for a year after the end of treatment for all conditions except neck pain [4].

What neck pain and shoulder pain are

Neck pain. The NHS says most neck pain only lasts a few weeks. It lists the most common causes as the neck becoming locked in an awkward position while sleeping, bad posture, a pinched nerve, and an injury such as whiplash [1].

Shoulder pain. The NHS says you can usually do things to ease shoulder pain yourself, and that it can take 6 months or longer to recover from shoulder pain. It lists possible causes that include frozen shoulder, arthritis, tendonitis, bursitis, impingement, a dislocated shoulder, a broken bone and a torn tendon, and says not to self-diagnose [2].

What the guidance and research say about acupuncture

The NHS. The NHS neck pain page lists paracetamol or ibuprofen, a low firm pillow, heat or cold packs and neck flexibility exercises, and the shoulder pain page lists staying active, exercises, pain relief, and physiotherapy. Neither page lists acupuncture [1][2].

NICE guidance (NG193, chronic pain in over 16s, published 7 April 2021). NICE's 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 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 [3]. The recommendation text does not name neck pain or shoulder pain.

NCCIH. NCCIH, part of the US National Institutes of Health, reports [4]:

  • in a 2018 review, data from 12 studies (8,003 participants) showed acupuncture was more effective than no treatment for back or neck pain, and data from 10 studies (1,963 participants) showed it was more effective than sham acupuncture
  • the difference between acupuncture and no treatment was greater than the difference between acupuncture and sham acupuncture
  • an analysis of data from 20 studies (6,376 participants) of people with painful conditions (back pain, osteoarthritis, neck pain, or headaches) showed that the beneficial effects of acupuncture continued for a year after the end of treatment for all conditions except neck pain

NCCIH's page does not report a separate result for shoulder pain.

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].

Urgent GP appointment or NHS 111 (NHS, UK) [2], for shoulder pain together with any of:

  • sudden or very bad shoulder pain
  • you cannot move your arm
  • your arm or shoulder has changed shape or is badly swollen
  • pins and needles that do not go away
  • no feeling in your arm or shoulder
  • your arm or shoulder is hot or cold to touch
  • the pain started after an injury or accident, like a fall
  • severe pain in both shoulders
  • feeling feverish or unwell

The NHS says these can be signs of something serious, like a broken or dislocated bone, or a torn (ruptured) ligament or tendon [2].

See a GP (NHS, UK):

  • neck pain or stiffness that does not go away after a few weeks [1]
  • painkillers like paracetamol or ibuprofen have not worked for neck pain [1]
  • being worried about neck pain [1]
  • other neck symptoms, like pins and needles or a cold arm, which the NHS says could be something more serious [1]
  • shoulder pain that is getting worse or does not improve after 2 weeks [2]
  • it is very difficult to move your arm or shoulder [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 neck pain that does not go away after a few weeks, or shoulder pain that does not improve after 2 weeks, 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. Neck pain. Page last reviewed 27 April 2023 (review was due 27 April 2026).
  2. NHS. Shoulder pain. Page last reviewed 22 May 2023 (review was due 22 May 2026).
  3. National Institute for Health and Care Excellence (NICE). Chronic pain (primary and secondary) in over 16s (NG193). Recommendation 1.2.5. 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.

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