Dizziness and vertigo

Vertigo is the false sense that you or the room is moving, usually spinning; dizziness is the wider term that also covers light-headedness and unsteadiness. Both are symptoms rather than diagnoses, and the acupuncture literature splits by the cause the trial enrolled: vertigo blamed on the neck (cervical or cervicogenic vertigo), vertigo from reduced blood flow at the back of the brain (posterior circulation ischaemia), Ménière disease, benign paroxysmal positional vertigo (BPPV), and acute vertigo in an emergency department. Cochrane has not published a review of acupuncture for any of them. The reviews that exist pool trials, almost all from China, that compared acupuncture with drugs or with another hands-on treatment rather than with sham acupuncture, a control procedure built to resemble acupuncture; Sham acupuncture covers the kinds in use. This page keeps the causes and the comparisons apart.

Cervical vertigo

Hou and colleagues at Zhejiang Chinese Medical University searched seven databases to April 2016. Every trial they included compared acupuncture with medication, Western in nine trials and Chinese in one, given daily for two to four weeks. Their main outcome was the total effective rate, the share of patients a trial rated cured, markedly improved or improved on a Chinese criterion from 1994, and it favoured acupuncture with a risk ratio of 1.27. The trials most often needled GV20 (Baihui), GB20 (Fengchi), GV16 (Fengfu) and BL10 (Tianzhu). All ten trials were judged at high risk of bias, mostly for unreported randomisation, allocation concealment and blinding, and only three reported on adverse effects: one recorded a mild bruise and a skin reaction, the other two none.

Yang and colleagues at Yunnan University of Chinese Medicine compared acupuncture-based and manual treatments with one another, through a network meta-analysis, a method that ranks several treatments by combining direct and indirect comparisons. Tuina, a Chinese massage and manipulation, was the common reference. Electroacupuncture alone did better than tuina on the total effective rate (odds ratio 1.36), and combinations of electroacupuncture with tuina, moxibustion or acupotomy (needling with a small blade at the tip) ranked highest. No arm in the network was sham acupuncture, and the authors call for internationally conducted head-to-head trials with validated outcomes. Neck pain reports the evidence on the neck itself.

Vertigo from posterior circulation ischaemia

The posterior circulation is the pair of vertebral arteries and the basilar artery, which supply the brainstem and cerebellum, and the authors describe vertigo as a cardinal symptom of a stroke there. Li and colleagues at Tianjin University of Traditional Chinese Medicine pooled trials in which acupuncture, almost always added to drug treatment, was compared with drug treatment alone. The acupuncture groups had higher blood flow velocities in the basilar and vertebral arteries, measured by transcranial Doppler ultrasound, and a higher clinical effective rate (risk ratio 1.22), a composite scored on Chinese criteria that the authors note has no international standard. GB20 and GV20 recur across the trials’ prescriptions. The authors conclude that double-blind, sham-controlled trials with large samples are needed. Stroke recovery covers the wider stroke evidence.

Ménière disease

Ménière disease is an inner-ear disorder with attacks of vertigo, fluctuating hearing loss, tinnitus and a sense of fullness in the ear. Long and colleagues at the University of Leeds searched English and Chinese literature and included randomised, non-randomised and before-and-after studies; all but one study came from China. The three randomised trials compared body or scalp acupuncture with Western medicine and vitamins, and the authors argue that a placebo design would be inappropriate in this disease, because participants are almost certain to be using some medication or other means of coping. They judged the weight of evidence to point to benefit, both in an acute attack and in long-standing disease, while noting that the studies varied in quality and that the findings needed confirming outside China.

Tang and colleagues at Nanjing University of Chinese Medicine found six randomised trials, in which acupuncture alone or added to Western medicine was compared with Western medicine. The efficacy rate, another composite response score, favoured acupuncture (risk ratio 1.20) at very low certainty. Scores on the Dizziness Handicap Inventory, a questionnaire on how dizziness limits daily life, were 6.9 points better, also at very low certainty, and the three trials behind that figure disagreed widely. Pure-tone audiometry, a hearing test, was the only outcome rated moderate. One trial reported on adverse effects, and recorded none. Some trials lacked blinding or proper randomisation, and the points used most were GV20, GB20 and SI19 (Tinggong). Tinnitus covers the symptom on its own.

Acute vertigo in the emergency department

A 2015 pilot study at Changhua Christian Hospital in Taiwan offered 60 emergency patients with dizziness or vertigo, after life-threatening and central nervous system causes had been excluded, a single 30-minute session at PC06 (Neiguan) and ST36 (Zusanli), or seed patches stuck 1 cm away from those points. It was not randomised: participants chose their group, and 37 chose acupuncture. On a 10-point visual analogue scale, dizziness fell by 1.0 point with acupuncture and 0.35 with the patches after 30 minutes, and the difference held at 7 days; the Dizziness Handicap Inventory did not differ significantly at 7 days. No adverse events were reported.

An Italian 2012 trial at Tor Vergata University in Rome randomised 204 people, 124 with acute vertigo and 80 undergoing tests that stimulate the inner ear, to a pressure device on PC06 or on the back of the wrist. In the acupressure group 85% reported improvement, against 11% with the misplaced device. The improvement was significant for neurovegetative symptoms, the autonomic symptoms such as nausea that come with vertigo, and not for vertigo itself, and the device did not change eye-movement measures of the balance reflex.

BPPV and residual dizziness

BPPV is caused by crystals displaced into one of the inner ear’s canals, and is treated by a canalith repositioning procedure, a sequence of head movements that moves them back. In the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s 2017 BPPV guideline, statement 4a makes repositioning the initial treatment for posterior canal BPPV, a strong recommendation based on systematic reviews of randomised trials. Its text does not discuss acupuncture.

Some trials test acupuncture for the dizziness that can persist after a successful repositioning. A 2021 trial at Nanjing University of Chinese Medicine randomised 66 such patients to six sessions of scalp acupuncture, one every other day, or to no treatment. Dizziness scores fell more with acupuncture, and the authors also report that residual dizziness eased within two weeks in both groups. Scalp acupuncture describes the method. A trial protocol from Shandong University of Traditional Chinese Medicine, published in 2024, sets out an 84-person comparison of acupuncture with betahistine, the drug commonly given for residual dizziness.

What guidelines say

The same body’s Ménière disease guideline, published in April 2020, weighs acupuncture in its discussion of statement 8, on diet and lifestyle. It reviews two systematic reviews and one small randomised trial of acupressure, and concludes that “there is a lack of sufficient evidence at this point to recommend acupuncture”. It lists well-designed randomised trials of acupuncture and other complementary medicine among its research needs. The academy’s pages for both guidelines, read in October 2026, show no later version of either. Clinical guidelines compares other guideline bodies.

What the reviews could not settle

None of the reviews above pooled a sham-controlled trial, so none can separate an effect of needling particular points from the attention, expectation and time that come with treatment. Most trials scored success with composite effective rates on Chinese criteria rather than validated scales, and the Yang review found the evidence on the Dizziness Handicap Inventory sparse. Where the trials come from sets out what the concentration of trials in one country shows. The emergency-department evidence is one non-randomised pilot and one acupressure trial whose benefit was in nausea rather than vertigo. For BPPV, the condition with an established treatment, the acupuncture trials address only the dizziness left after it, and both groups in the one randomised trial improved.

AcuiQ’s vertigo and dizziness pages, with the related cervical vertigo and Ménière disease pages, list the protocols individual studies prescribed, each with its citation.