TCM Evidence by Use: Pain, Nausea, Sleep and Other Uses
What systematic reviews and guidelines show for specific traditional Chinese medicine treatments used for pain, nausea, sleep, mood, fatigue and menopause, with the strength of each finding.
Content last updated . This page has not been medically reviewed.
Where the detail lives
Each common health concern has its own page with the studies, numbers and safety notes:- Pain: TCM for Back and Joint Pain and TCM for Headache and Migraine
- Mind and sleep: TCM for Insomnia and Sleep, TCM for Anxiety and Depression and TCM for Stress and Fatigue
- Midlife: TCM for Menopause Symptoms
- Other concerns: TCM for Nausea and Chemotherapy Side Effects, TCM for IBS and Digestive Complaints and TCM for Allergies, Asthma and Hay Fever
Pain
| Treatment | What the source found | Label |
|---|---|---|
| Acupuncture for chronic musculoskeletal, headache and osteoarthritis pain | An individual-patient meta-analysis of 39 trials (20,827 patients) found acupuncture better than sham and than no acupuncture, with differences close to 0.2 standard deviations versus sham and 0.5 versus no acupuncture. [3] | Promising to established; the gap from sham is small |
| Acupuncture for chronic low back pain | A 2025 Cochrane overview rated acupuncture as probably giving a small improvement in function over sham (moderate certainty). [4] Guidelines disagree: the American College of Physicians lists it as an initial option, while UK NICE guidance says not to offer it. [5] [6] | Mixed between guidelines |
| Cupping for chronic neck pain | A 2026 meta-analysis of 9 trials (401 people) found less pain and better function, with methodological limits in several trials. [7] NCCIH says the evidence is not very strong. [8] | Promising but limited |
| Tui na for chronic low back pain | A meta-analysis of 21 trials (1,612 people) found more pain reduction than comparison treatments, rated low certainty. [9] | Promising but limited. See Tui Na |
| Oral Chinese herbs for knee osteoarthritis | A review of 31 trials (3,115 people) found benefit, but the authors said bias in the studies means a positive conclusion cannot be drawn. [10] | Promising but limited |
| Moxibustion for neck and low back pain | A 2015 review of 75 trials said the efficacy of tui na and moxibustion was unknown because no direct evidence was found. [11] | Insufficient evidence |
Tai chi, which NCCIH says may help some pain conditions, has its own page: Tai Chi. [1]
Nausea
| Treatment | What the source found | Label |
|---|---|---|
| Stimulating the wrist point PC6 (needles or non-needle methods such as wristbands) to prevent nausea after surgery | A 2025 Cochrane network meta-analysis of 77 trials (9,847 people) found PC6 stimulation may reduce postoperative nausea compared with sham (invasive: risk ratio 0.49; non-invasive: 0.67), with low confidence. [12] | Promising but limited |
| Acupuncture for nausea and vomiting from cancer treatment | NCCIH says experts generally agree it is helpful, but this rests mainly on research done before current guidelines, so benefit alongside current treatments is uncertain. [13] | Mixed or uncertain |
See also Acupuncture for Postoperative Nausea and Other Uses.
Sleep, mood, fatigue and menopause
| Concern | What the sources found | Label |
|---|---|---|
| Chronic insomnia | A 2026 network meta-analysis of 59 trials ranked acupuncture and acupuncture plus herbs ahead of herbs alone and Western medication, with no significant difference between the two acupuncture options. [14] The American College of Physicians recommends cognitive behavioral therapy for insomnia first. [15] | Promising but limited |
| Insomnia in people with cancer | A 2025 Cochrane review of 5 small studies (402 people): versus sham, no outcome was both statistically significant and larger than the smallest meaningful difference. [16] | Insufficient evidence |
| Depression | A 2018 Cochrane review of 64 studies rated acupuncture evidence as low or very low quality. [17] | Insufficient evidence |
| Chronic fatigue | A 2026 review of 8 trials found possible benefit from acupuncture-based therapies, with small samples and moderate risk of bias. [18] | Promising but limited |
| Menopausal hot flashes | The 2023 North American Menopause Society statement did not recommend acupuncture or herbal supplements; hormone therapy remains the most effective treatment. [19] | Mixed to no good evidence of benefit |
Other uses
| Treatment | What the source found | Label |
|---|---|---|
| Moxibustion on the toe point BL67 to turn a breech baby | A 2023 Cochrane review of 13 studies (2,181 women) found moxibustion plus usual care probably reduces non-head-down position at birth (moderate certainty) but probably makes little difference to cesarean rate. [20] | Promising but limited; only with a pregnancy clinician |
| Chinese herbal products for conditions such as stroke, heart disease and colds | NCCIH says many studies were of poor quality, so no firm conclusions can be made. [1] | Insufficient evidence |
| TCM as a whole | There is no single result, because the practices differ. | Not a meaningful question |
Frequently asked questions
Does TCM work?
It depends on the treatment and the problem. Some practices, such as acupuncture for chronic pain, have fairly consistent trial support, while many herbal studies are too poor to judge. [1]
Is acupuncture just a placebo?
The large pain meta-analysis found acupuncture beat sham by a small margin and no-acupuncture by a larger margin, and concluded benefits are not explained by placebo alone. [3]
Is cupping proven for pain?
No. Evidence is limited and quality varies. [8]
Should I choose TCM instead of a medicine my doctor prescribed?
No. Discuss options with your doctor, and do not stop prescribed treatment on your own. [1]
Where are the study details?
Each source is listed below, and the condition pages above give the numbers. For wider study records see the Research Library.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read this page
Traditional Chinese medicine (TCM) is a collection of different practices, so research cannot say whether "TCM works". It can only say whether a specific treatment, such as acupuncture or cupping, helped a specific group of people for a specific problem, compared with something else. NCCIH puts it this way: some approaches used in TCM, such as acupuncture and tai chi, may help improve quality of life and certain pain conditions, while studies of Chinese herbal products have had mixed results. [1]
Labels used here: established, promising but limited, mixed, insufficient evidence, no good evidence of benefit, and Proper evidence not found (we looked and found nothing we could read). Most treatments below cannot be fully hidden from the person receiving them, so expectation (the placebo effect) matters. Sham-controlled trials try to account for this, though what counts as a good sham is itself debated. [2] Needling details are on What Is Acupuncture?, which owns that topic.
Safety and care first
Use of TCM should not replace or delay conventional care, and your providers should know what you use. [1] Some Chinese herbal products have been contaminated with toxic compounds, heavy metals, pesticides and microorganisms. [1] See Chinese Herbal Products: Quality, Contamination and Medicine Interactions and Moxibustion and Cupping Risks.
References
- National Center for Complementary and Integrative Health (NCCIH, US), Traditional Chinese Medicine: What You Need To Know. Read 2026-10-22.
- Lee B et al. Needling Point Location Used in Sham Acupuncture for Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis. JAMA network open 2023. PubMed 37672270. Read 2026-10-22.
- Vickers AJ et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain 2018. PubMed 29198932. Read 2026-10-22.
- Rizzo RR et al. Non-pharmacological and non-surgical treatments for low back pain in adults: an overview of Cochrane reviews. The Cochrane database of systematic reviews 2025. PubMed 40139265. Read 2026-10-22.
- Qaseem A et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of internal medicine 2017. PubMed 28192789. Read 2026-10-22.
- National Institute for Health and Care Excellence (NICE, UK), Low back pain and sciatica in over 16s: assessment and management (NG59), Recommendations. Read 2026-10-22.
- Torad AA et al. Effect of cupping therapy on chronic neck pain: A systematic review and meta-analysis of randomized controlled trials. Journal of back and musculoskeletal rehabilitation 2026. PubMed 42105092. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Cupping. Read 2026-10-22.
- Huang B et al. Tuina for chronic non-specific low back pain: A systematic review and meta-analysis of randomized controlled trials. Complementary therapies in medicine 2026. PubMed 42002161. Read 2026-10-22.
- Liang Y et al. Efficacy and Safety of Chinese Herbal Medicine for Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials. Phytomedicine : international journal of phytotherapy and phytopharmacology 2022. PubMed 35316726. Read 2026-10-22.
- Yuan QL et al. Traditional Chinese medicine for neck pain and low back pain: a systematic review and meta-analysis. PloS one 2015. PubMed 25710765. Read 2026-10-22.
- Lee A et al. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting: a network meta-analysis. The Cochrane database of systematic reviews 2025. PubMed 40938065. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Acupuncture: Effectiveness and Safety. Read 2026-10-22.
- Yang N et al. Efficacy of acupuncture, Chinese herbal medicine, combined acupuncture-herbal therapy, and western medication for adult chronic insomnia: a network meta-analysis. Frontiers in medicine 2026. PubMed 42876817. Read 2026-10-22.
- Qaseem A et al. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Annals of internal medicine 2016. PubMed 27136449. Read 2026-10-22.
- Ma Q et al. Acupuncture for insomnia in people with cancer. The Cochrane database of systematic reviews 2025. PubMed 41347621. Read 2026-10-22.
- Smith CA et al. Acupuncture for depression. The Cochrane database of systematic reviews 2018. PubMed 29502347. Read 2026-10-22.
- Li Y et al. Efficacy of acupuncture-based traditional Chinese medicine therapies for chronic fatigue syndrome: a systematic review and meta-analysis. Frontiers in neurology 2026. PubMed 42422219. Read 2026-10-22.
- The North American Menopause Society. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause (New York, N.Y.) 2023. PubMed 37252752. Read 2026-10-22.
- Coyle ME et al. Cephalic version by moxibustion for breech presentation. The Cochrane database of systematic reviews 2023. PubMed 37158339. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.