Acupuncture for Neuropathy
Acupuncture and neuropathy
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord. It often starts in the feet or hands, with numbness, tingling, burning or pain. This page covers two common causes: diabetes and chemotherapy. Questions about what is causing your symptoms, and which tests and treatments fit your situation, belong with your physician or your cancer care team.
Below is a summary of what studies have found, including results that are mixed or negative. HPA helps you find licensed clinics that focus on neuropathy.
What the research says
Diabetic peripheral neuropathy
What the research shows overall. A 2025 review found low-certainty evidence that acupuncture may reduce pain from diabetic neuropathy compared with sham acupuncture.1 Major U.S. guidelines on this pain recommend certain classes of medication to reduce it and do not mention acupuncture.2,3
Pain and symptoms. The 2025 review of 14 randomized trials (1,169 participants) found that, compared with sham acupuncture, acupuncture may reduce pain by about 1.4 cm on a 10-cm pain scale. Compared with sham acupuncture or usual care, it may reduce overall nerve-symptom severity, with little to no difference in physical functioning, mental functioning or side effects. Low-certainty evidence also suggested that acupuncture may reduce pain compared with the medications amitriptyline or pregabalin. All of these findings were rated low certainty.1
Nerve function. In a 2021 trial, 180 adults with type 2 diabetes and neuropathy received 10 weekly sessions of needle acupuncture, laser acupuncture or placebo laser acupuncture. Nerve conduction measures in the legs improved significantly with needle acupuncture compared with placebo. Among patient-reported symptoms, needle acupuncture made a significant difference for heightened sensitivity and cramps. The trial's main measure was nerve conduction, not pain.4
Quality of the research. A 2024 overview of 18 meta-analyses (reviews that pool results from many trials) rated the methods of 4 as moderate quality, 7 as low and 7 as critically low. These reviews reported improvements in a "total effective rate" and in nerve conduction speed compared with conventional medications, and the authors called for stricter research and reporting standards.5
Guidelines. The American Academy of Neurology's 2022 guideline on oral and topical treatment of painful diabetic neuropathy recommends offering certain antidepressants, gabapentinoids or sodium channel blockers to reduce pain (Level B). For patients who prefer non-drug options, it lists cognitive behavioral therapy, exercise, tai chi and mindfulness (Level C). It does not mention acupuncture.2 The American Diabetes Association's Standards of Care in Diabetes—2026 recommends the same classes of medication as initial pharmacologic treatment for neuropathic pain and does not mention acupuncture.3
Chemotherapy-induced peripheral neuropathy
What the research shows overall. Several reviews report benefits, but results differ by outcome, and the one review that rated certainty found it very low.7,8,9 The American Society of Clinical Oncology (ASCO) 2020 guideline makes no recommendation on acupuncture, either to prevent or to treat this neuropathy, outside a clinical trial (evidence quality: low). For treatment, it notes that preliminary evidence suggests a potential for benefit from exercise, acupuncture and scrambler therapy, and that larger studies are needed to confirm efficacy and clarify risks.6
Reviews of many trials. A 2026 review of 18 studies (1,048 patients) reported improvements with acupuncture in neuropathy symptoms, pain, quality of life and chemotherapy-related nerve toxicity. Its authors concluded that acupuncture offered more substantial benefits than usual care, medication, vitamins or sham acupuncture. The summary of that review did not report a certainty-of-evidence rating.7 Another 2026 review of 40 randomized trials (2,496 participants) found improvements in neuropathy symptom scores and nerve conduction, but no significant effect on worst-pain scores. It rated the certainty of evidence as very low for symptom scores and the "effective rate," and said the findings should be interpreted cautiously.8
Compared with sham acupuncture. A 2022 review of five studies found that acupuncture reduced pain severity and pain's interference with daily life more than placebo acupuncture, but made no significant difference in overall neuropathy symptoms or nerve toxicity. The authors said larger studies are needed to confirm the results.9
Numbness and tingling in the hands. In a 2022 multicenter study of 168 people with this neuropathy, those who chose the treatment program received twice-weekly acupuncture, alone or with other integrative therapies, for 6 weeks. Compared with patients receiving standard care alone, they reported greater improvement in hand numbness and tingling, discomfort and physical functioning. The standard-care group was not randomly assigned.10
Research results describe groups of patients, not any one person. Acupuncture does not replace blood-sugar management, foot care or follow-up with your cancer care team. If numbness, weakness or pain is new or getting worse, see your physician.
What to expect at a visit
Acupuncture for neuropathy is used alongside your medical care, not instead of it. Before starting, let your physician know. If you are currently receiving chemotherapy, talk with your cancer care team before starting acupuncture. Tell the licensed Acupuncture Physician (AP) about all your medications and treatments. If you have diabetes, tell the AP: reduced feeling in the feet and a higher risk of infection mean extra care is needed with needling on the feet. Needling can cause minor bleeding or bruising.
In Florida, acupuncture is provided by Acupuncture Physicians (AP) licensed by the Florida Department of Health. Insurance coverage for acupuncture varies by plan — ask the clinic and your insurer before your first visit.
Clinics on HPA that focus on neuropathy
The clinic below lists this concern in its own Clinical Focus. HPA does not rank clinics.
Sources
- Acupuncture for the Management of Chronic Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PMID 40220243
- Oral and Topical Treatment of Painful Diabetic Polyneuropathy: Practice Guideline Update Summary: Report of the AAN Guideline Subcommittee. PMID 34965987
- 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes—2026. PMID 41358886
- Electrophysiologically verified effects of acupuncture on diabetic peripheral neuropathy in type 2 diabetes: The randomized, partially double-blinded, controlled ACUDIN trial. PMID 33150711
- Acupuncture treatment of diabetic peripheral neuropathy: an overview of systematic reviews based on evidence mapping. PMID 39421572
- Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update. PMID 32663120
- The efficacy of acupuncture in the treatment of chemotherapy-induced peripheral neuropathy in cancer patients: a systematic review and meta-analysis. PMID 40830723
- Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis with Trial Sequential Analysis. PMID 42780628
- The effectiveness and safety of acupuncture for chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. PMID 36262831
- Impact of acupuncture and integrative therapies on chemotherapy-induced peripheral neuropathy: A multicentered, randomized controlled trial. PMID 35960141
Prepared by Harmony Pain Alliance · Last reviewed: 2026-11-11
This page is for general information only and is not a substitute for professional medical advice.