Summary:
This study was a systematic review and meta-analysis of randomised controlled trials (RCTs) that evaluated the effectiveness of manual acupuncture vs sham acupuncture for reducing anxiety symptoms. Anxiety is a common condition that can significantly impact functioning and quality of life, and there is growing interest in non-pharmacological treatment options such as acupuncture. Manual acupuncture is when which fine needles are inserted into specific anatomical points on the body, with the intention of eliciting physiological effects. In contrast, sham acupuncture is used as a control condition in clinical trials and is designed to mimic the procedure without providing a full therapeutic effect. Studies were included if they involved participants with anxiety and twenty RCTs including 1,462 participants were analysed. Compared with sham acupuncture, manual acupuncture resulted in a significant reduction in anxiety symptoms following treatment, and similar improvements were observed when compared with usual care. These effects remained significant at follow-up when compared with sham acupuncture. Most included studies were assessed as having a low risk of bias, although some had limitations related to blinding and allocation. Reported adverse events were mild, including minor bleeding, localised pain, and temporary discomfort, with no serious adverse events recorded. Overall, this study found that manual acupuncture may reduce anxiety symptoms in the short term, with some sustained effects when compared with sham treatment. Acupuncture appears to be a safe and minimally invasive intervention for anxiety.
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Abstract:
Objective: This systematic review and meta-analysis aim to evaluate the efficacy of acupuncture in reducing anxiety by synthesizing evidence from randomized controlled trials (RCTs). Methods: A comprehensive search was conducted across six databases—AMED, CINAHL, CENTRAL, Embase, Ovid MEDLINE, and PubMed—for RCTs published in English up to January 22, 2025. Eligible studies included patients with anxiety complications and compared RCTs comparing manual acupuncture (MA) with sham acupuncture (SA) or usual care or wait list control (UC/WLC) were included if anxiety was assessed as the primary outcome using validated measures. SMDs with 95% CIs were calculated using a random-effects model, and heterogeneity was assessed using I² and REML. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 (RoB 2) tool. Results: A total of 20 RCTs with 1462 participants were included. MA significantly reduced anxiety at post-treatment compared to SA (SMD = −1.06, 95% CI: −1.74 to −0.39, p = 0.0005, I² = 94%) and UC/WLC (SMD = −1.35, 95% CI: −2.26 to −0.44, p = 0.00006, I² = 59%). The effect was maintained at follow-up when compared to SA (SMD = −0.78, 95% CI: −1.21 to −0.35, p < 0.00001) but not significant compared to UC/WLC (SMD = −0.60, 95% CI: −1.68 to 0.49, p = 0.12). RoB assessment showed low risk in 14 studies, while others had unclear allocation concealment and blinding issues. Seventy-nine adverse events were reported, mainly transient discomfort, minor bleeding, or localized pain, with no severe events. Conclusion: MA effectively reduces anxiety symptoms in the short term, with effects sustained at follow-up when compared to SA but not UC/WLC. Further research is needed to confirm long-term efficacy and standardize methodologies. Acupuncture remains a promising, safe, and minimally invasive therapy for chronic anxiety.
Article Publication Date: 29/12/2025
DOI: 10.1002/jclp.70079Digital Object Identifier (DOI)
