SynthesisThe Permanente journal2015
Acupuncture safety in patients receiving anticoagulants: a systematic review.
Synthesis in The Permanente journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05232487 (Comparison of Swiss Versus Standard Low Back Acupuncture in Patients With Chronic Low Back Pain. A Randomized, Controlled, Single-blind, Monocentric Clinical Study), which is not on this map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Swiss Versus Standard Low Back Acupuncture in Patients With Chronic Low Back Pain. A Randomized, Controlled, Single-blind, Monocentric Clinical Study
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Acupuncture versus pharmacological conversation in treatment of atrial fibrillation in a randomized controlled trial: a systemic review and meta-analysis.European journal of medical research · 2022Pooled it
- Safety of Acupuncture: Overview of Systematic Reviews.Scientific reports · 2017Pooled it
- Advancing Safety in Acupuncture: Strategies, Best Practices, and Training for a Risk-Free Practice.Medical acupuncture · 2025Article
- Acupuncture Safety in Taiwan.Medical acupuncture · 2025Article
- Safety of dry needling in stroke patients: a scoping review.European journal of physical and rehabilitation medicine · 2024Article
- Acupuncture in cancer care: recommendations for safe practice (peer-reviewed expert opinion).Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Review
- The State of 21st Century Acupuncture in the United States.Journal of pain research · 2024Article
- Three aspects of acupuncture-related adverse events: Issues around the reporting of acupuncture-related adverse events.Integrative medicine research · 2023Article
- Dry Needling and Antithrombotic Drugs.Pain research & management · 2022Review
- Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm.Journal of pain research · 2019Article
- Safety of Acupuncture in Patients Taking Newer Oral Anticoagulants: A Retrospective Chart Review Study.Evidence-based complementary and alternative medicine : eCAM · 2018Article
- Does acupuncture increase the risk of bleeding in patients taking warfarin?Integrative medicine research · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTheoretically, acupuncture in anticoagulated patients could increase bleeding risk. However, precise estimates of bleeding complication rates from acupuncture in anticoagulated patients have not been systematically examined.
objectiveTo critically evaluate evidence for safety of acupuncture in anticoagulated patients.
methodsWe searched PubMed, EMBASE, the Physiotherapy Evidence Database, and Google Scholar.
resultsOf 39 potentially relevant citations, 11 met inclusion criteria: 2 randomized trials, 4 case series, and 5 case reports. Seven provided reporting quality sufficient to assess acupuncture safety in 384 anticoagulated patients (3974 treatments). Minor-moderate bleeding related to acupuncture in an anticoagulated patient occurred in one case: a large hip hematoma, managed with vitamin K reversal and warfarin discontinuation following reevaluation of its medical justification. Blood-spot bleeding, typical for any needling/injection and controlled with pressure/cotton, occurred in 51 (14.6%) of 350 treatments among a case series of 229 patients. Bleeding deemed unrelated to acupuncture during anticoagulation, and more likely resulting from inappropriately deep needling damaging tissue or from complex anticoagulation regimens, occurred in 5 patients. No bleeding was reported in 2 studies (74 anticoagulated patients): 1 case report and 1 randomized trial prospectively monitoring acupuncture-associated bleeding as an explicit end point. Altogether, 1 moderate bleeding event occurred in 3974 treatments (0.003%).
conclusionAcupuncture appears to be safe in anticoagulated patients, assuming appropriate needling location and depth. The observed 0.003% complication rate is lower than the previously reported 12.3% following hip/knee replacement in a randomized trial of 27,360 anticoagulated patients, and 6% following acupuncture in a prospective study of 229,230 all-type patients. Prospective trials would help confirm our findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.