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My Personal Opinion - Acupuncture and Lymphedema

It is rare that in this website I offer my own personal opinion on a treatment option. Usually I give the information for my readers to draw their own conclusions based on the evidence provided.

However, there is one treatment that is beginning to be used for lymphedema that I feel so strongly about, I must comment.

Dangers with Acupuncture and Lymphedema

1. The many holes put into your leg offers a wide open gate to potentially life threatening infection. Bacteria will have many access points to inside your lymphedema limb. Each one of these hole can become a prime septic foci for a bacterial infection.

We must remember that a limb with lymphedema is an immunodeficient limb, in others words the entire immune response mechanism in that a limb is effected.  This makes us especially susceptible to infections such as cellulitis, lymphangitis, lymphadenitis, impetigo and erysipelas.   Each infection also causes more damage to the remaining lymphatics

2. The lymphorrea (fluid) that is drained by this action has disastrous effects on your skin. The fluid is very caustic and can cause severe deterioration of the dermal layers. Skin breakdown from this fluid is a very real danger.

3. This is only a crude stop-gap treatment method. Without proper wrapping and garment use, the fluid will simply re-collect.

4. There is no uniform standard rules or laws throughout the United States that govern acupuncture. Nor are there laws regulating training, sanitation requirement or licensing. You are pretty much on your own when selecting an acupuncture therapist.

You must also have treatment and a self-management program of exercises, compression garments,  and/or compression bandages that will prevent the accumulation of fluid.

Update April 15, 2008 

It is interesting that having been challenged on the efficacy of using acupuncture for lymphedema, practioners are now claiming it is safe because the needles do not pierce the skin deeply or don't even have to be used in the area effected by lymphedema.  However, a dermal opening is still an opening whether or not it is in the lymphedematous limb..  Bacteria can still enter.

Four years after this page first came out, I stand firm in my opinion the acupuncture has no place in the treatment of lymphedema.

Finally, in the past year there have been interesting articles written, by Chinese doctors, themselves, urging a tightening up of the methodology and control.  This is the weak area of research in attempting to verify the over-all efficacy of acupuncture in the treatment of many medical conditions it claims to help.

Please before you even begin to try this treatment, consider well the consequences.

Pat O'Connor - Lymphedema People

As of this update of Jan. 3, 2012, I have yet to find additional evidence that acupuncture is  valuable (or safe in the long term) forlymphedema.  My position, therefore has remained the same as I previously stated and urge anyone considering this for their lymphedema to look carefully at what you do.  Don't be taken in by any acupuncturist site. Deman independent evidence.


The first record of Acupuncture is found in the 4,700 year old Huang Di Nei Jing (Yellow Emperor's Classic of Internal Medicine). This is said to be the oldest medical textbook in the world. It is said to have been written down from even earlier theories by Shen Nung, the father of Chinese Medicine. Shen Nung documented theories about circulation, pulse, and the heart over 4,000 years before European medicine had any concept about them.

As the basis of Acupuncture, Shen Nung theorized that the body had an energy force running throughout it. This energy force is known as Qi (roughly pronounced Chee). The Qi consists of all essential life activities which include the spiritual, emotional, mental and the physical aspects of life. A person's health is influenced by the flow of Qi in the body, in combination with the universal forces of Yin and Yang .  


Types of acupuncture 

Types of acupuncture

There are many different styles of acupuncture. Practitioners of Acupuncture Physical Medicine (APM) palpate the body (examine the body by touch) to locate reactive areas and myofascial (muscular) constrictions. Points are selected and stimulated to relieve symptomatic areas based on the relationships of meridian acupuncture theory. Practitioners trained in APM also locate and deactivate “trigger points” using an advanced needling technique. Triggers points are extremely common in pain conditions and cause referred pain and other symptoms of dysfunction in nearly everyone’s life at one time or another. 


Electro0-Acupuncture is the use of small electrical currents through th acupuncture needles. Electro-stimulation is often used in conjunction with acupuncture to enhance treatment. Electroc-acupuncture has been demonstrated to decrease pain, accelerate tissue healing and significantly reduce inflammation, edema and/or swelling.

Auricular Acupuncture

Auricular (or ear) acupuncture targets points on the outer ear, using either needles or electro acupunctoscopes to help relieve the complaint. Each acupoint on the ear, when treated, triggers electrical impulses, from the ear, via the brain, to the specific area of the body that is being treated.

Five-Element Acupuncture

Five-Element Acupuncture is an ancient form of acupuncture that treats the mind, body, heart, and spirit. The five elements are fire, earth, metal, water and wood, which correspond to emotions that must remain in balance in order to maintain health. A practitioner using this technique assesses factors such as skin color, vocal sound, body odor, emotional state, and pulse, using the information gathered to diagnose and treat the imbalance.

Japanese Acupuncture

Japanese acupuncture is a form of acupuncture in which a practitioner uses touch to diagnose ailments and to find the exact location of the relevant acupuncture point. Once the correct points are located, the practitioner uses a guiding tube to shallowly insert very thin needles. Japanese acupuncture is often accompanied by direct moxibustion, the warming of acupoints by burning moxa, a substance derived from the wormwood plant.

Korean Acupuncture

Korean acupuncture is a form of acupuncture that integrates techniques from traditional Chinese acupuncture, Japanese acupuncture, and five-element acupuncture. Practitioners make a diagnosis by assessing your "basic constitution," or body type. In Korean hand acupuncture, a subtype of Korean acupuncture generally, the hand is seen as a microcosm of the body, and practitioners can assess and address conditions anywhere on a patient's boy simply by applying treatment to the hands.

Traditional Chinese Acupuncture

Traditional Chinese acupuncture is the form of acupuncture in which the plurality of practitioners are trained, and it remains the most widely practiced form. According to traditional Chinese medicine, the human body is filled with lines or channels through which the energy of the body flows. These channels function as points of entry into the body, called acupuncture points. Acupuncture is the practice of inserting fine sterile stainless steel needles into these points to remove blockages and imbalances in the body's energy flow. Removing these blockages allows energy and blood to circulate smoothly throughout the body, stimulating the body to heal itself.

Trigger Point Acupuncture Needle Types

Trigger point acupuncture is a form of acupuncture that targets tight or knotted muscles, also known as trigger points. The practitioner uses touch to locate muscular tightness, then inserts an ultra-thin, single-use acupuncture needle into the suspect muscle and gently probes. This produces localized involuntary twitching, which fatigues the tight muscle and reduces tightness. 
The Health Professsional Directory (Different types) 

Needle Types

The nine needles used in ancient China had a variety of uses including puncturing, surgical incision and massage. These ancient needles are similar in shape to their modern, stainless-steel counterparts. Only the surgical needle is not used in acupuncture practice today. Six of the nine ancient needles can be compared to today's filiform needle. Used for superficial insertion into the skin, these needles now vary in thickness from 0.12 to 0.40 mm and in length from 13 to 125 mm. The remaining needles are a blunt massaging needle and a three-edged needle used for bleeding. Needles also used today include the plum blossom needle -- shaped like a small, plastic hammer -- for stimulating blood flow and semipermanent ear needles, which can be left in for several days.


What is Acupuncture?

It is an ancient Chinese form of medicine that the technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms. It is a type of complementary and alternative medicine.

Acupuncture as defined by the National Center for Complementary and Alternative Medicine  is the practice of inserting thin needles into specific body points to improve health and well-being. It originated in China more than 2,000 years ago. American practices of acupuncture use medical traditions from China, Japan, Korea and other countries. In the United States, the best-known type involves putting hair-thin, metallic needles in your skin.

With lymphedema patients, it also is used as a method of draining the accumulated fluids in a lymphovenous limb.



Question Corner

From July-September 1998 NLN Newsletter
Addressed by Judith Casley-Smith, PhD, MD

Q: In February 1998, I had a lumpectomy with lymph node removal. When necessary, I have used acupuncture successfully for the past 15 years. I have been told not to do this anymore, but I'm not sure I understand why, since the acupuncturist washes down the area with alcohol, uses sterile needles which are then discarded and washes the area a second time after treatment. I get the feeling my doctor just doesn't believe in acupuncture and this might be the reason for his feel-feelings on the subject. Is acupuncture really contraindicated for lymphedema patients and, if so, why?

A: This question brings another question to mind. Have you been having the acupuncture in the affected limb? If the acupuncture has been in the affected limb, then we would advise a patient to stay away from any potential needle sticks in spite of the best-intended sterile technique. If the needle stick of the acupuncture is in a remote part of the body, then the likelihood of infection to the affected limb certainly lessens, but does not completely go away. I would say acupuncture is contraindicated for lymphedema patients - certainly in the affected limb - and alternate modes of therapy should be tried before subjecting oneself to acupuncture generally when lymphedema is present. Those few patients who have tried it have reported no benefit or reduction in the lymphedema.


Contraindications for Acupuncture from Memorial Sloan-Kettering Cancer Center

  • Neutropenia, thrombocytopenia, or history of endocarditis
    Acupuncture may increase risk of infection and bleeding. Use with caution.
  • Pregnancy
    Pregnant women should inform practitioners before seeking acupuncture treatment
  • Lymphedema
    Needles should not be placed in the limbs of patients with lymphedema.
  • Pacemakers
    Electrical stimulation is contraindicated for patients wearing electronic medical devices.


    Safety Aspects of Acupuncture in Palliative Care

    Jacqueline Filshie


    Acupuncture can mask symptoms of cancer and tumour progression. It is not safe to use such a therapy without full knowledge of the clinical stage of the disease, and the current status of orthodox therapy.

    Contraindications to acupuncture needling include an unstable spine, severe clotting disorder, neutropenia and lymphoedema. Whilst semi-permanent needles are used increasingly in symptom control and pain management they should not be used in patients with valvular heart disease or in vulnerable neutropenic patients.

    Acupuncture has an increasing role in support for pain and symptom management, but patients should not be advised to abandon conventional treatments in favour of complementary or alternative therapies alone, and should not have their hopes raised inappropriately, or have any guilt projected on to them for the cause of their cancer.

    Key Words
    Acupuncture, palliative medicine, adverse events, safety.

    Jacqueline Filshie, Consultant in anaesthetics and pain management
    Royal Marsden Hospitals, London & Surrey
    Honorary senior lecturer, Institute of Cancer Research



    A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphoedema.

    Sept 2011

    Cassileth BR, Van Zee KJ, Chan Y, Coleton MI, Hudis CA, Cohen S, Lozada J, Vickers AJ.


    Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New York, NY 10021, USA.



    Lymphoedema is a distressing problem affecting many women after breast cancer surgery. There is no cure and existing treatments are marginally beneficial, rarely reducing arm swelling in any meaningful way. Needling and even lifting of objects using the affected arm has been prohibited, but our clinical experience and that of others suggested that acupuncture was safe and that it might be a useful treatment for lymphoedema.


    We sought to conduct a pilot study of the safety and effectiveness of acupuncture in women diagnosed with chronic lymphoedema for at least 6 months and less than 5 years.


    Women with chronic lymphoedema (affected arm with >2 cm circumference than unaffected arm) after breast cancer surgery received acupuncture twice a week for 4 weeks. Response was defined as at least a 30% reduction in the difference in size between the affected and unaffected arms. Monthly follow-up calls for 6 months following treatment were made to obtain information about side effects.


    Study goals were met after nine subjects were treated: four women showed at least a 30% reduction in the extent of lymphoedema at 4 weeks when compared with their respective baseline values. No serious adverse events occurred during or after 73 treatment sessions. Limitations This pilot study requires a larger, randomised follow-up investigation plus enquiries into possible mechanisms. Both are in development by our group.


    Acupuncture appears safe and may reduce lymphoedema associated with breast cancer surgery. 

    *Editor's Note:  There still needs to be more research on the long terms results and its effect onlymphedema and any complilcations that arise from using it. Pat O'Connor


    Current situations about studies on the evaluation of clinical efficacy of acupuncture 

    Feb 2011

    Zhen Ci Yan Jiu. 

    ang FR, Ren YL, Tang Y.

    Chengdu University of Chinese Medicine, Chengdu 610075, China.

    To evaluate the efficacy of acupuncture scientifically and objectively is a major issue for the development of acupuncture medicine. Although some progresses have already been gained in the research of the evaluation of clinical therapeutic effects of acupuncture at present, some problems as empirical evaluation method, following evaluation indexes of Western medicine, poorer quality of evaluation studies, etc. still exist. Thus, it is urgent to establish a reasonable evaluating system for acupuncture clinical efficacy which accords with the theory of acupuncture, embodies the characteristics and advantages of acupuncture clinic, perfecting the clinical evaluation method, and improving the quality of clinical efficacy evaluation and accelerating the sustainable development of acupuncture clinic. Through reasonable analysis on the current situations about the clinical evaluation research of acupuncture and combining some new concepts and methods, the authors of the present paper hold that the new evaluation system should embody the characteristic of the theory and clinical practice of acupuncture and fully make use of the methods of evidence-based medicine and some measuring scales. They also advocate trying to establish an "evidence-based-goal-attainment scale" method by combining standardized population evaluation with individualized diagnosis-treatment evaluation so as to enhance the international development of acupuncture.

    PMID: 18386648 [PubMed - in process]


    Acupuncture clinical studies and evidence-based medicine--an update

    Zhen Ci Yan Jiu. 2008 Feb

    Lao LX.

    Center for Integrative Medicine, Department of Family Medicine, University of Maryland, Baltimore, MD 21207, USA.

    Acupuncture has been widely used in the West in recent years and demand has been growing for scientific evaluation of its clinical efficacy. The practice of evidence-based medicine has brought new challenges in the design of acupuncture research, and publication of randomized clinical trials on acupuncture has significantly increased. While systematic reviews of these trials have advanced our current knowledge, they have exposed deficiencies in research design and revealed that one design can not answer all research questions. Few clinical studies conducted in China have been published in the West, and most published in Chinese suffer from methodological design flaws that render the results unreliable and unconvincing. Such flaws include inadequate or no randomization, inadequate control, unsatisfactory outcome measurements, lack of proper concealment, insufficient follow-up, and improper statistical analysis. To foster high quality acupuncture clinical research in China, we must cultivate innovation and creativity in research design. It is unwise to simply follow or copy the research methodology of Western pharmaceutical studies. Acupuncture and traditional Chinese medicine (TCM) must be evaluated using rigorous scientific methods that preserve the essence of TCM concepts, so that acupuncture and TCM, these ancient healing arts, can continue to play an important role in the health care systems of modern societies.

    PMID: 18386647 [PubMed - in process]


    Discussion on randomized controlled trials about clinical researches of acupuncture and moxibustion medicine 

    2007 Jul

    Zhongguo Zhen Jiu. 

    Li N, Wang DL, Wang CW, Wu B.

    Section of Acupuncture & Moxibustion, West China Hospital of Sichuan University, Chengdu 610041, China.

    The characteristics of clinical tests of acupuncture and moxibustion were analyzed by studies of the literature about clinical evidence-based trials of acupuncture and moxibustion medicine at present and on the basis of full analysis on the cause of insufficient evidence of clinical researches of acupuncture and moxibustion, in combination with the authors' experiences of clinical studies, and it is put forward that future clinical researches of acupuncture and moxibustion medicine should actively search for new research methods, insist evidence-based acupuncture and moxibustion medical researches, pay attention to retaining own researching characteristics of the acupuncture and moxibustion medicine, accumulate experiences, gradually establish and perfect the assessment system conforming with clinical research methods of acupuncture and moxibustion medicine, elevate the position of acupuncture and moxibustion medicine and develop the acupuncture and moxibustion medicine.

    PMID: 17722836 [PubMed - indexed for MEDLINE


    External Links:

    Assessing the feasibility of using acupuncture and moxibustion to improve quality of life for cancer survivors with upper body lymphoedema. Sept 2011

    Keywords: Breast cancer; Head and neck cancer; Oncology; Lymphoedema; Acupuncture; Moxibustion; Survivorship; Symptom burden; Quality of life


    Observation on 27 elderly women in britain with lymphedema syndrome treated by acupuncturecombined with medicine 

    Jul 2009


    Adverse Reactions after Acupuncture: A Review

    Palle Rosted MD
    Consultant Medical Acupuncturist
    Clinical Lecturer Sheffield University
    Weston Park Hospital
    Sheffield S10 2SJ (UK)


    Lymphedema risk from acupuncture?


    Be Wary of Acupuncture, Qigong, and "Chinese Medicine"

    Stephen Barrett, M.D.


    Acupuncture: Can it help? - Mayo Clinic


    An Introduction to Acupuncture - National Center for Complementary and Alternative Medicine


    Acupuncture - Clinical


    Acupuncture and Acupressure






    Benzopyrones Treatment

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    Diuretics are not for Lymphedema 

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    Lymphedema Treatments are Poorly Utilized


    Lymphedema Treatment Programs Canada

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    Compression Bandages for Lymphedema

    Short Stretch Bandages are for Lymphedema

    Compression Garments Stockings for Lymphedema

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    Aqua Therapy for Postsurgical Breast Cancer Arm Lymphedema

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