Ear acupuncture for pain: does it work?

Ear acupuncture, known in the field as auricular acupuncture, is a Traditional Chinese Medicine (TCM) practice that stimulates specific points on the ear to promote healing. Each acupuncture point corresponds to a different area of the body and helps provide pain relief.

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In TCM, the human ear represents a microsystem of the human body. This means that certain spots on the ear correlate to specific areas of the body. Those points can then be used to heal their corresponding body parts. 

Ear acupuncture is a practice dating back over 2,500 years that uses extremely thin, thread-like needles to stimulate specific acupuncture points. According to the theory of TCM, this increases the flow of blood or qi (pronounced “chee”) to different areas to facilitate healing. 

The acupuncture points commonly used today came from the work of French physician Dr. Paul Nogier in the 1950s. Known as the father of modern auricular acupuncture, Dr. Nogier noted that the human ear resembled an upside-down fetus. This realization led him to create the “inverted fetus map” of the ear, which is still used for diagnosis and treatment today (Hou, 2015). 

Multiple studies have shown that when used as a complementary therapy, auricular acupuncture can provide significant pain relief, help with pain management, and decrease the amount of prescription drugs needed––all without the serious negative side effects of pain medications (Yeh, 2014). 

Promising studies have also shown that the practice alleviates and manages many different types of pain—like chronic pain and discomfort related to pregnancy, cancer treatments, and migraines—which we’ll take a closer look at below.

Also, if sticking tiny needles in your ear sounds too close for comfort, there is a steadily growing foundation of evidence supporting traditional (whole-body) acupuncture for treating pain as well (Yin, 2017). 

Chronic pain

A 2019 study analyzed the effects of a combination treatment focused on hand and ear acupuncture for chronic lower back pain. Compared to traditional acupuncture and standard treatments (like massage, restorative exercise, strength training, or painkillers), acupuncture, in general, had longer-lasting positive effects on pain management.

Hand-ear acupuncture was more effective than standard acupuncture, especially for long-term pain relief. This type of acupuncture also reduced the need for pain medications among study participants (Yong, 2019). 

Another study found that auricular acupuncture reduced chronic pain in patients with musculoskeletal disorders. Patients who received ear acupuncture saw a pain reduction of 80% during the study and a 60% reduction 15 days after treatment (Moura, 2019). 

While some skeptics attribute the benefits of acupuncture to the placebo effect (basically the idea that if you believe you’re being treated, you’ll see an improvement in symptoms), research has shown that the benefits of acupuncture are more than just placebo.

A large review compared the effects of acupuncture on chronic pain and compared the treatment group to a group receiving no treatment and another group receiving acupuncture in “sham” spots (basically, they stuck the needles in the wrong places). The results indicated that acupuncture was more effective at treating chronic pain than the sham and non-acupuncture treatment methods, providing further support that pain relief wasn’t due to the placebo effect (Vickers, 2012). 

Auricular acupuncture has been increasingly researched by the military and Veterans Health Association (VHA) as a complementary therapy to provide pain relief to soldiers and veterans. These therapies are now recognized by the Department of Defense and Pain Management Taskforce as effective complementary treatments that also help reduce the need for opioids in patients with pain (Niemtzow, 2018).

There’s even a specific protocol (Battlefield Acupuncture (BFA) which involves inserting acupuncture needles at specific points around the ear and has been shown to manage chronic pain and PTSD in veterans (Zeliadt, 2020). 

Cancer-related pain 

Both cancer and the various treatments available can leave patients with extensive and unmanageable pain, decreasing patients' quality of life. 

Research has found that acupuncture can be effective for alleviating pain in patients undergoing cancer treatment (Chiu, 2016). One study found ear acupuncture coupled with drug therapy was more effective than medication alone for relieving pain in patients with cancer (Yang, 2020).

Pregnancy-related pain

Pelvic pressure, lower back pain, abdominal discomfort, and joint aches are just a few symptoms that can come with pregnancy. Current research indicates that acupuncture helps relieve pain in the pelvic and lower back regions that is common before and after delivery. 

One small study compared ear acupuncture and standard obstetric care methods like patient education, posture modification, strength training, stretching exercises, and pain medications.  The research found that auricular acupuncture significantly reduced the intensity of back and pelvic pain in 80% of patients—all without the side effects that can come with the use of common pain-relieving medications. 

At the end of treatment, ear acupuncture in combination with standard obstetric care was nine times more effective than standard care alone, and the benefits were still seen in women evaluated a year later (Vas, 2019).  

Over 100 million Americans deal with chronic pain daily. As healthcare providers and patients search for solutions, the rampant and uncontrolled use of prescription opioids has led to an epidemic of opioid use. 

In 2019, opioids were involved in over 70% of all drug overdose deaths in the United States. That amounts to almost 50,000 lives lost to painkillers (Mattson, 2021). As the opioid crisis continues, identifying less harmful treatment methods for alleviating pain is crucial. 

The traditional Chinese practice of acupuncture helps reduce pain and decreases the need for prescription pain medications (He, 2019). Used as a complementary pain management tool,  ear acupuncture could play a role in reducing the use of opioid medications. 

Eastern medicine has used the pain-relieving effects of auricular acupuncture for thousands of years, but current research allows us to gain a deeper understanding of the biological mechanism of how acupuncture works.

Dr. Nogier hypothesized that the relationships between auricular acupuncture points and their corresponding areas of the body were due to the vagus nerve—a large nerve in the autonomic nervous system that runs from the brain to the gut that’s also connected to the ear and other structures (Hou, 2015). The autonomic nervous system is responsible for things that we don’t consciously control (like our heart rate, blood pressure, and digestion).

The autonomic nervous system plays an important role in both pain perception and pain regulation, and current research supports this idea that the autonomic nervous system may be affected by vagus nerve stimulation using auricular acupuncture (Butt, 2019). 

Studies have shown that stimulation of the vagus nerve can help to stop the sensation of pain and elicit the pain-relieving effects of opioids (Couck, 2014). Research also indicates that ear acupuncture can help to activate a pathway (called the descending pain pathway) that functions to stop the pain signal traveling to the brain, essentially decreasing the overall sensation of pain (Moura, 2019). 

Overall, alternative medicine is becoming less alternative. More people are seeking out holistic ways to manage pain instead of or in addition to over-the-counter or prescription drugs. 

But as with any treatment, acupuncture is not right for everyone. Pay attention to what your body responds to and what gives you relief. To learn more about whether acupuncture is right for you, consult a licensed acupuncturist who can help you determine if you can benefit from the treatment. 

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Current version

June 29, 2021

Written by

Regina Paskoff

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.