Does Acupuncture Hurt? A Retrospective Study on Pain and Satisfaction during Pediatric Acupuncture

Pain is one of the main concerns that keeps children and adolescents away from acupuncture, even when this therapy could provide significant benefits for the treatment of chronic painful conditions. Many parents, patients, and even clinicians avoid considering pediatric acupuncture because of concerns that needles will cause additional discomfort to children who are already suffering with pain. Although studies demonstrate the safety and efficacy of acupuncture in children for various types of pain, including chronic pain, migraines, and sickle cell pain, few works have specifically investigated how much the application of needles actually bothers young patients during the procedure.

The main aim of this study was to investigate the real-world experience of children and adolescents during acupuncture sessions, with particular focus on pain caused by needle insertion, while also assessing levels of satisfaction, relaxation, and anxiety reduction. The researchers also wanted to understand whether the number of acupuncture sessions influenced these perceptions over time. To this end, they retrospectively analyzed data from 230 unique patients (ages 8 to 21 years) who took part in a total of 1,380 acupuncture sessions at a pediatric pain clinic between 2009 and 2013. All patients were treated with the Kiiko Matsumoto style of Japanese acupuncture, known for being a gentler technique that uses very fine needles inserted superficially.

After each session, patients completed standardized questionnaires evaluating needling pain with the Faces Pain Scale-Revised, plus questions on overall satisfaction, relaxation, and anxiety reduction on 1-to-10 scales.

The results were surprisingly positive and reassuring. The mean pain related to needle insertion was just 1.3 on a 0-to-10 scale, with 57.7% of patients reporting absolutely no pain during their first acupuncture session. Another 28% reported only mild pain (score 2 out of 10). This means that approximately 87% of young patients experienced minimal or no pain during the procedure.

In addition, patients showed high satisfaction with treatment, with a mean score of 8.4 out of 10, felt relaxed (mean 8.2 out of 10), and experienced significant anxiety reduction (mean 7.7 out of 10). About 68% of patients reported that acupuncture helped decrease their existing pain, while only 3.1% reported no pain reduction.

For patients and clinicians, these findings have very important practical implications. First, they refute the myth that acupuncture is painful for children, providing concrete evidence that the vast majority of young patients do not experience significant pain during treatment. This may encourage more families to consider acupuncture as part of an integrated treatment plan for pediatric chronic pain. The study also revealed that patients who completed more sessions (four or more) reported even higher levels of satisfaction, relaxation, and anxiety reduction, suggesting that the benefits of acupuncture may increase over time.

Importantly, needling-related pain remained consistently low regardless of the number of sessions, and only one mild adverse event was recorded throughout the study period. For clinicians, these data provide confidence to recommend acupuncture as a safe and well-tolerated therapeutic option, especially given the growing need for non-pharmacological alternatives for pain management in children.

The study presents some limitations that should be considered in interpreting the results. Because it is a retrospective analysis of clinical data, there is the possibility of selection bias, since patients dissatisfied with their first sessions probably did not return for additional treatments. In addition, the results apply specifically to the Kiiko Matsumoto style of Japanese acupuncture, which uses gentler techniques, and may not generalize to all types of acupuncture. The study also included only children aged 8 years and older, since this is the minimum age for reliable pain self-report.

Despite these limitations, the findings are consistent and based on a large and diverse sample of patients with different types of chronic pain. The researchers suggest that future studies include randomized controlled trials with control groups and comparisons with other integrative therapies. In conclusion, this study provides robust evidence that pediatric acupuncture is a well-tolerated, essentially painless, and highly satisfactory intervention for children and adolescents, and may be a valuable tool in the multidisciplinary management of pediatric chronic pain.