NICE’s guideline NG84 counts pharyngitis and tonsillitis as acute sore throat, which it describes as self-limiting and often set off by a viral infection of the upper airways, with symptoms that can last about a week. Trials of acupuncture and related methods ask three separate questions: whether treatment eases an acute sore throat, whether it helps chronic pharyngitis, the persistent form, and whether stimulating points around an operation prevents the sore throat that a breathing tube leaves behind. The Cochrane review of lidocaine for postoperative sore throat reports that between 30% and 70% of patients have one after tracheal intubation.
Is there a Cochrane review of acupuncture for sore throat?
No. Cochrane has published no review of acupuncture, acupressure or acupoint stimulation for sore throat, pharyngitis or postoperative sore throat. Its nearest, a 2012 review of Chinese medicinal herbs by Huang and colleagues, included 12 trials with 1,954 participants, judged ten of them methodologically poor, and could not recommend any herbal formulation. The 2015 lidocaine review by Tanaka and colleagues included 19 trials with 1,940 adults and rated the evidence for a lower risk of sore throat low quality; it covers drugs only.
Acute sore throat and tonsillopharyngitis
The only meta-analysis is a 2023 review by Zhang and colleagues at Heilongjiang University of Chinese Medicine, searched to October 2022. It included 19 randomised trials with 1,701 patients, 17 of them run in China, one in Germany and one in the United States. Fourteen tested bloodletting, pricking points such as LU11 (Shaoshang), the ear tips or the throat to let blood; four tested manual needling and one ear acupuncture. The review counts 17 trials as comparisons with antibiotics, given alone or added to the same antibiotics, and two as comparisons with sham acupuncture.
Against antibiotics, the review reported a higher response rate, each trial’s own share of patients judged improved (16 trials, 1,513 patients, odds ratio 4.18, I² 0%), and lower pain scores and a shorter sore throat, with I² of 84% and 90% for those two. Against sham, the two trials showed no difference in pain. Seventeen of the 19 trials did not say whether the people assessing outcomes were blinded, no trial reported an adverse event from acupuncture, and the review graded the certainty of none of its findings. The authors asked for their conclusions to be read with caution. The trials most often used LI04 (Hegu), LI11 (Quchi) and LU11.
The German sham-controlled trial, by Fleckenstein and colleagues in 2009, gave 60 people with acute tonsillitis or pharyngitis one needling session along the large intestine meridian between LI08 (Xialian) and LI10 (Shousanli), or sham laser acupuncture over the same stretch. Pain on swallowing fell in both groups 15 minutes later, the difference between them was not statistically significant (P = 0.12), and the trial stopped early for lack of suitable patients. The American trial, by Moss and Crawford in 2015, added battlefield acupuncture, small needles placed at set points on the ear, to standard treatment for 54 adults and reported lower pain for 24 hours and fewer doses of pain medication up to 48 hours; the trial was unblinded. Common cold gives both trials in more detail.
A 2026 review of battlefield acupuncture in emergency departments, by Yang and colleagues at the Mayo Clinic, found seven trials with 758 patients, acute sore throat among the conditions treated. It judged most trials at high risk of bias, did not pool them, and reported no severe adverse events. Han and colleagues at Kyung Hee University reviewed PubMed papers from 1992 to 2015 in 2016: seven controlled trials and eight case series, with no pooled analysis. Their abstract reports acupuncture effective for acute and chronic sore throat and calls for more trials with objective outcomes, such as temperature or painkiller use.
Chronic pharyngitis
No systematic review of acupuncture for chronic pharyngitis is indexed in PubMed or Europe PMC. Li and Wang at Beijing University of Chinese Medicine surveyed the Chinese literature in the CNKI and VIP databases in 2010. They found combined treatment the most common, especially acupuncture with Chinese herbs, and that research quality, diagnostic criteria and the standards used to judge efficacy all needed improving. One later trial, from Tianjin in 2019, randomised 42 patients to four six-day courses of daily needling at an extra point, Qianlianquan, and the eight confluent points on the hands and feet, among them PC06 (Neiguan), or to a Chinese patent medicine, Qinghou Liyan granules. It reported a total effective rate of 90.5% against 81.0%; its abstract describes no sham and no blinding. Among its results, the Cochrane herb review reports one herbal treatment for children with chronic pharyngitis, with no acupuncture arm.
Sore throat after a breathing tube
Jau and Chang at Taipei City Hospital published the only meta-analysis in 2022, from searches covering January 2000 to August 2020. It included four randomised trials and one non-randomised study with 1,478 adults, comparing point stimulation by capsicum plaster, needles, electrical pads or a patch with no stimulation or sham, pooled together. Five studies with 1,148 participants gave the incidence at 24 hours: risk ratio 0.32 (95% CI 0.18 to 0.55, I² 0%). Two trials with 121 participants gave severity, a standardised mean difference of −2.79. The review judged most trials to have some concerns over bias, found no significant adverse events, and did not grade the certainty of its findings. The table gives the trials that compared a sham or no treatment, with later ones the review did not cover.
| Trial | People and surgery | Stimulation | Control | Reported |
|---|---|---|---|---|
| Park and colleagues 2004, Seoul | 150 women, hysterectomy | Capsicum plaster at K-A20, a Korean hand acupuncture point | Plaster at non-points, or placebo tape | Moderate to severe sore throat at 24 hours in 0%, against 16% with sham and 19% with tape; no difference in the recovery room |
| Esmaeili and colleagues 2013, Tehran, not randomised | 228, mixed surgery | Needling at PC06 | No treatment | Sore throat in 24 hours in 14% against 29.8%; severe sore throat needing treatment no different |
| Wang and colleagues 2017, Hangzhou | 100, thyroid lobectomy | Transcutaneous electrical acupoint stimulation (TEAS), current through skin pads, at LI04 and PC06 | Same pads, no current | Lower incidence at 1, 6 and 12 hours; at 24 hours 14% against 28%, not significant |
| Yue and colleagues 2021, Beijing | 60, gastrointestinal surgery | Pricking at LU11, electroacupuncture at LU05 (Chize) and LI04 | Routine anaesthesia | Lower incidence and severity at 12 and 24 hours |
| Liu and colleagues 2025, Lanzhou | 112, gynaecological or general surgery | Herbal patch at CV22 (Tiantu), PC06, ST36 (Zusanli) and KD01 (Yongquan) | Sham patch, same points | Sore throat in 24.5% against 44.2% at 24 hours and 5.7% against 28.8% at 48 hours |
| Li and colleagues 2025, Hefei | 72, day-case thyroidectomy | Wrist-ankle acupuncture, needles under the skin of the wrist | Standard care alone | Lower throat pain at 9 and 27 hours |
| Zou and colleagues 2026, Wenzhou and Taizhou | 88, lung surgery with a double-lumen tube | Cheek acupuncture, micro-needles at points on the cheek, for 30 minutes before surgery ended | Sham acupuncture, same points | Sore throat within 48 hours in 34.1% against 65.9% (risk ratio 0.52) |
Park’s and Liu’s trials were described as double-blind. Nausea after surgery and Postoperative pain report the wider trials of point stimulation around operations.
What guidelines say
NICE’s NG84, Sore throat (acute): antimicrobial prescribing, was published on 26 January 2018 and is current, with minor changes since, the latest in October 2026. For self-care it recommends considering paracetamol or ibuprofen and adequate fluids, and says medicated lozenges may reduce pain by a small amount; it does not mention acupuncture. It tells clinicians to advise seeking medical help if symptoms worsen rapidly or significantly, do not start to improve after a week, or the person becomes systemically very unwell. It recommends referral to hospital for a sore throat with a severe systemic infection or a severe suppurative complication, such as quinsy, an abscess beside the tonsil.
The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guideline, published in April 2012, recommends ibuprofen or paracetamol for symptoms and states that the evidence for herbal treatments and acupuncture in sore throat is inconsistent. Neither guideline covers chronic pharyngitis or sore throat after anaesthesia. Clinical guidelines lists what other guidelines say about acupuncture.
What the reviews could not settle
None of the reviews graded the certainty of its evidence, so no finding here carries a GRADE rating. For acute sore throat, the two sham-controlled trials in Zhang’s review found no difference in pain, while the trials reporting benefit compared bloodletting with antibiotics, mostly in China and without described blinding. For chronic pharyngitis there is no review and no sham-controlled trial to pool. For sore throat after intubation, Jau’s review pooled sham and no-treatment controls, rested its severity estimate on two trials, and predates the later sham-controlled trials of patches and cheek acupuncture; no two of those trials tested the same method at the same points.
AcuiQ’s sore throat, chronic pharyngitis and sore throat after surgery pages list the protocols individual studies prescribed, each with its citation.