Acupuncture for Trauma and PTSD in Denver

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Design

Blinded randomized trial at one VA medical center in Long Beach, California, comparing acupuncture with a control treatment using minimal needling. The main measure was the clinician-rated CAPS-5.

Result

Acupuncture showed a large effect (Cohen d 1.17) and the control treatment a moderate effect (d 0.67). The difference between groups was 7.1 points (P = .005). Fear extinction, measured by startle response, improved in the acupuncture group but not the control group.

Limit

The control group also improved a good deal. The group was 85 men and 8 women aged 18 to 55, so results may not apply to everyone.

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Design

Randomized trial. One group received usual PTSD care plus eight 60-minute acupuncture sessions, twice weekly. The other received usual care alone. Outcomes were measured through 12 weeks.

Result

At 12 weeks, PTSD severity improved more with acupuncture (PCL change 19.8 versus 9.7, P<0.001; CAPS change 35.0 versus 10.9, P<0.0001). Depression, pain, and physical and mental health functioning also improved more.

Limit

Small sample. The comparison was usual care alone, so the trial cannot separate the needling from the effect of added care.

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Design

A meta-analysis of acupuncture against psychological or drug treatment, an analysis of the acupoints used, and a summary of mechanism research. Searched to November 2022.

Result

Acupuncture outperformed drug treatment in improving CAPS, HAMA, HAMD, PCL-C and SCL-90 somatization scores, and outperformed psychotherapy in improving CAPS, PCL-C and HAMD scores. The authors conclude that acupuncture has promising potential for PTSD.

Limit

The abstract gives no effect sizes, sample sizes or certainty ratings. The mechanism findings come partly from animal studies, so I do not treat them as proof of benefit in people.

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Design

Meta-analysis of randomized trials in adults with PTSD, searched in January 2016. Certainty was rated with the GRADE method.

Result

PTSD symptoms were lower with acupuncture than with comparators after treatment (SMD -0.80, 6 trials) and at longer follow-up (SMD -0.46, 4 trials). Serious adverse events were uncommon, with minor to moderate pain, superficial bleeding and bruising at needle sites.

Limit

Certainty was very low after treatment and low at follow-up. The confidence interval for the first result barely excluded no effect (-1.59 to -0.01), and anxiety and sleep showed no clear difference.

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Design

Systematic review. Of 136 articles found, 4 randomized and 2 uncontrolled trials were reviewed.

Result

One high-quality trial found acupuncture better than a waiting list, with effects similar to cognitive behavioral therapy. One trial found no statistical difference between acupuncture and SSRIs. One trial favored acupoint stimulation plus CBT over CBT alone.

Limit

The authors call the evidence encouraging but not cogent and say further qualified trials are needed. Only a handful of trials met the criteria, and the review is more than a decade old.

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Design

Systematic review of ear acupuncture for trauma-related mental disorders after large-scale disasters. Of 10 studies analyzed, 3 were randomized trials.

Result

Ear acupuncture improved overall PTSD-related symptoms. For insomnia, a randomized trial found improvement in a few subscales of the Pittsburgh Sleep Quality Index, but the sleep diary, actigraph and Insomnia Severity Index did not improve. No serious adverse events were reported.

Limit

The quality of the randomized trials was generally low. Because of the small number of studies and their differences, the authors could not draw conclusions about effectiveness and safety.

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Design

A summary of the 2023 VA and DoD clinical practice guideline. Experts graded the evidence with the GRADE method and made 34 recommendations.

Result

Six treatment recommendations were rated strong. It recommends manualized psychotherapies over medication (prolonged exposure, cognitive processing therapy or EMDR), and the medicines paroxetine, sertraline or venlafaxine. It recommends against benzodiazepines and cannabis products.

Limit

The abstract does not mention acupuncture. I read it as a statement of the core treatments, not as a verdict on acupuncture.

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Design

Randomized pilot trial of people with PTSD, assigned to acupuncture, group cognitive behavioral therapy or a waiting list. The main measure was self-reported PTSD symptoms.

Result

Compared with the waiting list, acupuncture had a large effect (Cohen d 1.29, p < 0.01), similar to group therapy (d 1.42). The difference between acupuncture and group therapy was small (d 0.29), and the reductions held at 3 months.

Limit

A pilot trial with self-reported symptoms, compared with a waiting list. The authors called for larger trials with additional controls.

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Design

A secondary analysis of the 2024 veterans trial, looking at anxiety, depression and sleep after the same twice-weekly course.

Result

Anxiety improved with a large effect in the acupuncture group (d = 1.3) and a moderate effect in the control group (d = 0.9). Depression and insomnia symptoms showed a similar pattern.

Limit

There was no statistical difference between acupuncture and the control treatment on these measures, so the extra benefit seen for PTSD severity did not carry over to them.

The research is encouraging but limited. In a 2024 trial of 93 combat veterans, PTSD severity fell 7.1 points more with acupuncture than with a control treatment, measured on the clinician interview used to rate PTSD. Reviews rate the certainty as very low to low, and the control group also improved. I treat acupuncture as an add-on to trauma-focused therapy, not a replacement, and I make no promises.

The 2024 veterans trial allowed up to 24 one-hour sessions over 15 weeks, twice a week, and 71 of 93 people completed it. A 2014 trial gave eight one-hour sessions, twice a week. The other studies I read do not state a session count. After your first visit I give you my estimate, and we check progress together after five visits.

Yes. The 2023 VA and DoD guideline recommends trauma-focused psychotherapies such as prolonged exposure, cognitive processing therapy and EMDR, and the medicines paroxetine, sertraline and venlafaxine. Its summary does not list acupuncture, so I offer it as a complement. I do not provide trauma therapy. Please keep taking your medication and keep your therapy appointments.

No. In the 2024 trial the control group also improved, and a 2025 analysis found no difference between the two groups for anxiety, depression or insomnia. Trauma-focused therapy has the strongest guideline support for PTSD. Acupuncture may help some people feel calmer while they do that work, and I will tell you if I do not think it is helping.

See your doctor first for any thoughts of harming yourself or ending your life (call or text 988 right away, or call 911 if you are in immediate danger), severe flashbacks, dissociation or panic that make it hard to function or stay safe, a crisis with alcohol or drug use or withdrawal, or violent thoughts toward others. If you have any of these symptoms and have not already told your doctor, please let them know.

At The Subtle Point a 90-minute first visit is $150 and follow-ups are $60 for 30 minutes of acupuncture, $95 for 60 minutes of acupuncture with Tuina massage, or $130 for 90 minutes of acupuncture with Tuina massage and cupping. HSA and FSA cards work, and you receive a superbill for your insurer.

Rarely, and never the way an injection does. Acupuncture needles are about the width of a human hair. Most people feel a brief tap, then a dull, heavy or warm sensation that fades in a few seconds. If any point feels sharp, tell me and I will adjust or remove it.