Acupuncture for Rheumatoid Arthritis Pain: A Total Guide (2025)

If you live with rheumatoid arthritis (RA), an autoimmune disease, you probably already know that your body has mistaken your own healthy cells for harmful invaders. You likely know that your immune system has launched an attack on your body that has left your joints painful, stiff, and inflamed. And for sure, you know you hurt. The question is, how do you relieve that pain?

In Western medicine, the go-to treatment for calming an overactive immune system and easing joint pain is medication, primarily non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). These medicines are effective, but it could take several tries for you and your doctor to land on the right drug and dose, and you might experience some side effects along the way.

In the meantime, many people with RA also seek out natural treatments like massage therapy, herbal supplements, and acupuncture as a complement to their medications. Evidence suggests that using acupuncture together with DMARDs for RA might improve pain control, inflammation, and quality of life. If you haven’t tried acupuncture for your rheumatoid arthritis, you might wonder exactly how it works. Let’s take a closer look at what the science says.

How Does Acupuncture Work?

Acupuncture is a form of traditional Chinese medicine that’s been around for a while—3,000 years to be exact. Unlike Western medicine, which aims to treat a specific disease, the goal of acupuncture is to restore “balance” to the body overall. The idea, according to Chinese medicine philosophy, is that the body’s energy or life force, called qi (pronounced “chi”), flows through channels called meridians that run through organs and tissues. When qi gets out of balance, illness and pain result.

In Chinese medicine, RA is considered a “bi” disease, according to a report in the Chinese Journal of Integrative Medicine. Bi refers to a blockage, or a lack of blood flow, along the meridians that involve bones, joints, and muscles. The theory is that blockages—caused by exposure to factors like heat, cold, wind, or dampness—lead to pain, swelling, stiffness, and other RA symptoms.

To address these blockages, acupuncturists place very thin stainless-steel needles at points along the meridians that correlate to a buildup of energy. “We needle these points to manipulate the circulation along these pathways,” says Molly Hutto, a doctor of acupuncture and Chinese medicine (DACM) and owner of Annapolis Family Acupuncture in Arnold, MD, adding, “It’s much more complex than that, but that’s how I explain it to my new patients.”

Using Acupuncture for Rheumatoid Arthritis

Counterintuitive though it may sound, many points that acupuncturists target to treat RA pain aren’t specific to the joints causing discomfort. For instance, your acupuncturist may needle an area in the front of the leg, just below the knee. Another location where your energy may be “blocked”: Between the base of the thumb and index finger. In Chinese medicine, these are called distal points and they control the pain you might feel in other areas of your body.

“Thinking of this in terms of qi, everything is flowing within the body,” says Stephanie Cheng, M.D., assistant professor of clinical anesthesiology and medical acupuncturist at the Hospital for Special Surgery in New York City. “So if you put a needle in, even if it’s far from the site that’s hurting, it can help with everything. For example, back pain can be treated with a point in the back of the knee.”

In fact, practitioners typically avoid sticking needles into painful joints directly. “You always want to try to stay away from the affected region, particularly when it’s significantly inflamed,” says Aaron Mills, DACM, an acupuncture and integrative Chinese medicine specialist at the University of California, San Francisco. “Once that inflammation comes down, then you may be able to do further treatment with more local or adjacent points.”

Traditional acupuncture uses thin needles. Other variations of the practice stimulate pressure points in different ways:

• Acupoint injection inserts a substance like herbal extract or bee venom into the point through the acupuncture needle.

• Dry needling places a thin needle directly into a tight muscle, called a trigger point.

• Electrical acupuncture, or electroacupuncture, passes a small electric current through the needles.

• Laser acupuncture uses low-intensity energy.

• Moxibustion burns dried mugwort leaves on or near the skin to heat the acupoints.

What Are Possible Benefits of Acupuncture For RA?

How exactly acupuncture helps with RA is still a matter of debate. The prevailing theory is that placing the needles into the skin sends a message to the spinal cord and brain, triggering the release of natural painkilling chemicals called endorphins.

Acupuncture might also help with pain by bringing down inflammation. Some studies have noted a drop in inflammatory markers like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) after people received acupuncture. In several studies, people who had acupuncture reported less pain, better movement, and improved quality of life. Laser acupuncture and electroacupuncture also seem to help with rheumatoid arthritis symptoms.

Still, say experts, it’s important to go into acupuncture therapy with a realistic sense of what it can and can’t do. It won’t fix your damaged joints or cure rheumatoid arthritis. It’s more about improving your overall wellness, which is essential to managing a chronic condition like RA. “Acupuncture is really just enhancing your body’s ability to heal,” explains Dr. Cheng.

Hutto has seen noticeable symptom improvements in her patients. “A reduction in pain is the big one,” she says. She stresses that because RA is a chronic disease, acupuncture works best as part of a long-term treatment plan. Her patients come in once a week—twice a week when they’re in the middle of an active flare—and continue to receive treatment indefinitely.

What Are the Risks?

Acupuncture is safe, provided that you see a trained and licensed acupuncturist, Mills says. Some people get a little woozy from the needles, aptly called “needle shock.” If you’re needle-phobic, let your acupuncturist know before you start treatment. A few of Dr. Cheng’s patients have an unexpected emotional response to the needles. “I’ve seen people start sobbing for no reason,” she says. “Or they start giggling hysterically or feeling very euphoric.”

Other possible side effects that can accompany acupuncture include:

• Bruising

• Pain at the needle site

• Bleeding

• Worsening of symptoms

Who Should Avoid Acupuncture?

There are very few contraindications, or cases when acupuncture should be avoided. According to recent research, it’s safe for almost everyone, including babies and pregnant women, according to the experts. The rare exceptions are people who have an active infection, a blood clotting disorder, or cancer. If this applies to you, you’ll definitely want to check with your doctor first.

You also might need to avoid acupuncture with metal needles if you have a metal allergy, or you’re going to have magnetic resonance imaging (MRI) in the near future.

What Are Other Natural Treatments For RA?

Many acupuncturists also recommend herbal remedies for their patients with RA. A few herbs and other plants have shown some promise for relieving RA pain and inflammation, according to research in Medicines, including:

• Eremostachys

• Laciniata

• Chamomile

• Tripterygium wilfordii Hook F

Your acupuncturist will likely prescribe a specific mixture of herbs for you, Hutto says. The intention is to address not just the RA, but a patient’s sleep, digestion, mental health, urinary issues, and other accompanying symptoms. You can take the herbs as a capsule or mixed into tea or warm water. (Before you try any herbal remedy, always check with the doctor who treats your RA to make sure that it won’t interact with any medications you take.)

Giving Acupuncture a Try

To find a licensed and trained acupuncturist in your area, you can search the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Also, check with the medical licensing board in your state. Licensing requirements can vary from state to state.

Many private insurance companies and Medicare cover a specific number of acupuncture sessions—Hutto says about 85% of her patients pay with insurance. If your acupuncturist isn’t in-network, they might offer a discount if you purchase a package of sessions.

If you’re new to acupuncture, it’s best to give it more than a one-and-done approach. Dr. Cheng recommends trying six to eight treatments to see if you feel a difference. Acupuncture doesn’t work for everyone, so if you don’t notice a difference after multiple visits, don’t think of it as a failure. On the other hand, given the low risk of side effects, acupuncture for your RA may be worth a try.

This article was originally published August 29, 2022 and most recently updated September 6, 2022.

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