A needle-thin solution for a widespread problem
Imagine a world where the simple act of breathing through your nose becomes a daily struggle, punctuated by relentless sneezing, itching, and congestion. For the over 400 million people worldwide suffering from allergic rhinitis (AR), this is not imagination but reality 6 . AR, an inflammatory condition of the nasal passages triggered by allergens like pollen and dust mites, has been called the "epidemic of the 21st century," affecting individuals of all ages and peaking during adolescence 5 .
Allergic rhinitis affects approximately 10-25% of the global population, with some studies suggesting up to 40% of children may be affected 5 .
While conventional treatments such as antihistamines and nasal corticosteroids offer relief to many, they frequently come with limitations including side effects like drowsiness, diminished effectiveness over time, and poor symptom control for some patients 3 5 . In search of alternatives, increasing numbers of patients and healthcare providers are turning to an ancient practice reevaluated through modern scientific rigor: acupuncture.
Allergic rhinitis represents a chronic inflammatory disease of the nasal mucosa mediated by Immunoglobulin E (IgE) after exposure to environmental allergens in susceptible individuals 5 . The condition manifests through a constellation of symptoms that significantly impact quality of life:
Resulting from hyperemia and swelling of the nasal mucosa.
Watery nasal discharge caused by overactive nasal mucosal glands.
Triggered by hypersensitivity of nerve endings in the nasal cavity.
Linked to the release of inflammatory mediators like histamine 3 .
Global prevalence range of allergic rhinitis
Annual AR-related costs worldwide
The global prevalence of AR varies widely, ranging from 10% to 25% of the population, with some studies suggesting up to 40% of children may be affected 5 . The economic impact is substantial, with annual AR-related costs reaching approximately $20 billion worldwide, including direct healthcare expenses and indirect costs from reduced productivity and absenteeism 5 6 .
Acupuncture has been practiced in China for over 3,000 years as a fundamental component of Traditional Chinese Medicine (TCM) 5 . This medical practice spread to Europe and the United States between the 16th and 19th centuries, with research into its mechanisms beginning in the eighteenth century 5 .
According to TCM theory, acupuncture works by stimulating specific points on the skin to regulate the flow of Qi (the body's internal energy) and blood through pathways called meridians 5 . The sensation of soreness, numbness, fullness, or heaviness felt during acupuncture—known as "Deqi"—is considered essential to its therapeutic effect 5 .
Years of acupuncture practice
Modern scientific investigations have revealed that acupuncture's mechanisms involve complex interactions with the neuroendocrine immune system 6 . The mechanical stimulation at acupoints generates electrical signals that travel to the central nervous system, triggering various descending pathways that regulate immune responses and control the secretion of inflammatory factors 5 .
In recent years, numerous randomized controlled trials (RCTs) and meta-analyses have evaluated acupuncture's efficacy for allergic rhinitis.
Published in Chinese Medicine
Examined 39 studies with 3,433 participants, comparing various acupuncture methods against sham acupuncture and conventional treatments . The analysis demonstrated that all acupuncture types were superior to sham acupuncture in reducing nasal symptoms measured by the Total Nasal Symptom Score (TNSS) and improving quality of life assessed by the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) .
Published in European Journal of Medical Research
Corroborated these findings, concluding that acupuncture may have advantages over no intervention and sham acupuncture for improving nasal symptoms and quality of life in adults with AR 4 . The analysis, which included 30 trials with 4,413 participants, found the effects of acupuncture and conventional antihistamines (cetirizine or loratadine) to be similar 4 .
Focus on Intranasal Acupuncture Therapy (IAT)
Found significant benefits compared to both sham acupuncture and antihistamines 1 . The analysis of 21 RCTs with 1,889 participants showed IAT was associated with better quality of life and reduced nasal symptoms, with no serious adverse events reported 1 .
| Acupuncture Method | Key Findings | Quality of Evidence |
|---|---|---|
| Manual Acupuncture | Similar efficacy to antihistamines; improves quality of life | Moderate |
| Moxibustion | Ranked most effective for reducing nasal symptoms | Moderate |
| Intranasal Acupuncture | Significant improvement in TNSS vs. sham acupuncture | Moderate |
| Electroacupuncture | Effective for symptom relief; modulates immune markers | Low to Moderate |
| Manual Acupuncture + Conventional Medicine | Most effective for improving quality of life | Moderate |
One particularly promising approach involves acupuncture targeting the sphenopalatine ganglion (SPG), also known as the "butterfly palate point" 8 . A randomized controlled trial conducted by Bao Jiaying explored the effects of modified acupuncture at this location in 80 patients with allergic rhinitis 3 .
| Outcome Measure | Acupuncture Group | Control Group (Budesonide) | Statistical Significance |
|---|---|---|---|
| Total Effective Rate | 92.5% | 72.5% | P < 0.05 |
| Recurrence Rate | 13.5% | 44.8% | P < 0.01 |
| TNSS Reduction | Significant improvement | Moderate improvement | P < 0.01 |
| Quality of Life (RQLQ) | Significantly better | Moderate improvement | P < 0.01 |
These results are particularly noteworthy because they suggest that acupuncture may not only relieve symptoms but also potentially modify the underlying disease process, resulting in more sustained benefits and reduced recurrence. The sphenopalatine ganglion, located in the pterygopalatine fossa, serves as an important neural crossroads influencing nasal function, and its stimulation through acupuncture appears to modulate autonomic nervous system activity and inflammatory responses 8 .
Contemporary research has revealed that acupuncture exerts its therapeutic effects on allergic rhinitis through several interconnected biological mechanisms:
Emerging research suggests acupuncture may influence the composition and function of microbiota, which play a role in immune regulation and inflammatory processes 3 .
| Mechanism | Biological Effects | Research Evidence |
|---|---|---|
| Immune Regulation | Modulates IgE, cytokines (IL-4, IL-10, IL-33); reduces inflammatory cells | Multiple RCTs showing immunological changes 3 6 |
| Neural Modulation | Influences autonomic nervous system; regulates nasal gland secretion | Sphenopalatine ganglion studies 8 |
| Inflammation Control | Activates cholinergic anti-inflammatory pathway; reduces inflammatory mediators | Basic science and clinical studies 5 8 |
| Microbiota Influence | Potentially modulates immune-relevant microbiota | Preliminary mechanistic studies 3 |
One of the most significant advantages of acupuncture for allergic rhinitis is its favorable safety profile. A comprehensive systematic review and meta-analysis of randomized controlled trials examining acupuncture safety in oncological patients—a particularly vulnerable population—found that acupuncture was not associated with an increased risk of serious adverse events compared to sham acupuncture, active controls, or treatment as usual 2 .
While there was a noted increase in nonserious adverse events compared to treatment as usual, this finding was not robust against potential selection bias in the studies, and the overall safety picture remains reassuring 2 . Commonly reported minor adverse events may include temporary discomfort, minor bleeding, or bruising at needle insertion sites.
No serious adverse events reported in studies
The 2025 systematic review of intranasal acupuncture therapy specifically reported that no serious adverse events were documented across the included studies, though the authors noted that safety reporting was sometimes incomplete 1 .
To conduct rigorous research on acupuncture for allergic rhinitis, scientists utilize specific assessment tools and materials:
Specialized needles or devices that mimic real acupuncture without actual skin penetration, or that stimulate non-acupoints, serving as critical controls for distinguishing specific from non-specific treatment effects 4 .
The accumulating evidence from numerous randomized controlled trials and meta-analyses suggests that acupuncture represents a valuable therapeutic option for patients with allergic rhinitis. While the quality of evidence varies and further rigorously designed studies are needed, the current research indicates that acupuncture:
As research continues to refine our understanding of optimal acupuncture techniques, treatment parameters, and mechanisms of action, this ancient practice appears poised to play an increasingly important role in the comprehensive management of allergic rhinitis. For the millions suffering from this condition, acupuncture offers a potentially effective complementary approach that bridges traditional wisdom with modern scientific validation.