The Most Commonly Treated Acupuncture Indications in the United States: A Cross-Sectional Study
Wang et al. · The American Journal of Chinese Medicine · 2018
Evidence Level
MODERATEOBJECTIVE
Investigate the 99 conditions most commonly treated with acupuncture in the United States
WHO
419 licensed acupuncturists with more than 3 years of practice
DURATION
Survey conducted between September 2015 and May 2016
POINTS
List of 189 indications based on WHO literature and clinical experience
🔬 Study Design
Trained in China
n=249
Acupuncturists with traditional Chinese training
Trained in the US
n=170
Acupuncturists trained in American schools
📊 Results in numbers
Low back pain (most treated condition)
Depression (most common in the top 99)
Insomnia
Anxiety
Percentage highlights
📊 Outcome Comparison
Top 10 most treated conditions
This study mapped, for the first time, which conditions are most commonly treated with acupuncture in the US. It found that, in addition to pain (especially low back pain), acupuncture is highly sought out for mental health concerns such as depression, anxiety, and insomnia, demonstrating its potential as an integrative mind-body treatment.
Article summary
Plain-language narrative summary
This nationwide cross-sectional study represents the first comprehensive mapping of the conditions most commonly treated with acupuncture in the United States. Conducted between September 2015 and May 2016, the survey involved 419 licensed acupuncturists from 46 states, revealing key information about the current landscape of Chinese medicine in the country. The results show that low back pain leads as the most frequently treated condition, reported by 50% of practitioners. Surprisingly, when analyzing the 99 most common conditions, depression emerged as the absolute leader, treated by 92% of acupuncturists, followed by insomnia (90%).
This finding reveals a significant demand for mental health care, positioning acupuncture as an important modality in integrative mind-body treatment. The study identified six main categories: pain management (25 different conditions), mental health, immunologic disorders, gynecology, neurology, and internal medicine. The demographic analysis revealed interesting differences among practitioners: acupuncturists trained in China tend to treat a broader spectrum of conditions (64.6 indications on average) compared with those trained in the US (56.4 indications). Female acupuncturists treat more gynecologic cases and mood disorders, while male acupuncturists focus more on urologic issues and traumatology.
Geographically, Florida stands out in treating geriatric conditions, New York in stress- and work-related problems, and California in lifestyle issues. The study developed innovative Commonality (CI) and Specialty (SI) indices to evaluate the specialization potential of each indication. Conditions such as low back pain, depression, anxiety, allergies, and female infertility showed greater potential for development of subspecialties within acupuncture. The findings have important implications for professional education, suggesting that the curriculum should consolidate fundamentals for common conditions and develop specializations for specific areas.
For the healthcare system, the study highlights the growing role of acupuncture as a non-pharmacological alternative, especially relevant in the context of the opioid crisis. The high demand for mental health treatment with acupuncture suggests opportunities for interdisciplinary collaboration with psychologists and psychiatrists. Limitations include the predominantly Chinese sample due to the distribution method via WeChat, although this allowed valuable comparisons among different educational backgrounds. The study provides, for the first time, an epidemiologic profile of conditions treatable by acupuncture in the US, serving as a fundamental reference for patients, healthcare professionals, educators, and health policy makers.
Strengths
- 1First comprehensive national survey on acupuncture indications in the US
- 2Large representative sample of 419 licensed practitioners
- 3Development of innovative indices for evaluating specialization potential
- 4Detailed demographic analysis revealing regional and educational patterns
Limitations
- 1Predominantly Chinese sample due to the distribution method
- 2Lack of data on the actual efficacy of reported treatments
- 3Possible selection bias due to voluntary participation
- 4Absence of acupuncturists trained in other Asian countries
Expert Commentary
Dr. Marcus Yu Bin Pai
MD, PhD · Pain Medicine · Physical Medicine and Rehabilitation · Medical Acupuncture
▸ Clinical Relevance
This nationwide US survey offers the clinician an epidemiologic snapshot of real demand for acupuncture in a Western context — and the numbers have direct implications for those working in pain and rehabilitation services in Brazil. The leadership of low back pain among the most frequent indications confirms what any physiatry service already observes day to day, but the most operationally relevant data point is in mental health: depression in 92% and insomnia in 90% of surveyed acupuncturists. This signals that the demand for acupuncture extends far beyond musculoskeletal pain, encompassing a patient profile with neuropsychiatric comorbidities who frequently seeks non-pharmacological alternatives. For the physician who integrates acupuncture into the therapeutic armamentarium, the data reinforce the relevance of screening for depressive symptoms and sleep quality in any patient with chronic pain — populations that overlap considerably and that can benefit from a systematized mind-body approach.
▸ Notable Findings
The hierarchical inversion in the data is the most notable finding: low back pain leads when asking about the single most treated condition (50%), but when the analysis expands to the 99 most common conditions, depression takes first place (92%) and insomnia takes second (90%). This suggests that pain rarely arrives alone in the acupuncture clinic — it comes accompanied by a significant neuropsychiatric substrate. Another relevant finding is the difference in the spectrum of indications by training: practitioners trained in China treat an average of 64.6 distinct indications versus 56.4 for those trained in the US, raising questions about how the breadth of the curriculum translates into clinical scope. The creation of the Commonality and Specialty indices represents a useful methodological contribution for identifying where the development of acupuncture subspecialties — such as pain, integrative oncology, or reproductive medicine — has a sustainable practical base.
▸ From My Experience
In my practice at the pain service, the overlap among chronic low back pain, insomnia, and depression is the rule, not the exception — and it was precisely this triad that led me, years ago, to systematize mood and sleep screening before defining the acupuncture protocol. Patients with this combination tend to respond more slowly: while a low back pain patient without neuropsychiatric comorbidity may show functional improvement in three to four sessions, the patient with associated depression often needs six to eight sessions before any gain is perceptible and sustainable. I usually combine acupuncture with supervised physical activity and, when there is moderate to severe depression, I do not hesitate to maintain pharmacotherapy in parallel — acupuncture enhances, but does not replace. The profile that responds best, in my observation, is the patient with chronic low-intensity pain, fragmented sleep, and low mood without an established major depressive episode: precisely the subgroup in which polypharmacy carries more risk than benefit.
Full original article
Read the full scientific study
The American Journal of Chinese Medicine · 2018
DOI: 10.1142/S0192415X18500738
Access original articleScientific Review
Marcus Yu Bin Pai, MD, PhD
CRM-SP: 158074 | RQE: 65523 · 65524 · 655241
PhD in Health Sciences, University of São Paulo. Board-certified in Pain Medicine, Physical Medicine and Rehabilitation, and Medical Acupuncture. Scientific review and curation of every entry in this library.
Learn more about the author →Medical disclaimer: This content is for educational purposes only and does not replace consultation, diagnosis, or treatment by a qualified professional. Some information may be assisted by artificial intelligence and is subject to inaccuracies. Always consult a physician.
Content reviewed by the medical team at CEIMEC — Integrated Centre for Chinese Medicine Studies, a reference in Medical Acupuncture for over 30 years.
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