Ear acupuncture treats points on the outer ear, read as a map of the whole body rather than as stops along the channels. A 2015 review by Hou and colleagues lists the ways the ear is stimulated: needles, seeds, magnets, lasers, ultrasound, bloodletting, moxibustion, electrical current and pressure by hand. This page sets out where the map came from, how its points are named, two fixed ear protocols, NADA and battlefield acupuncture, and what reviews of those trials counted.
Where the map came from
The Hou review traces the oldest Chinese record of treatment at the ear to the Huang Di Nei Jing, compiled around 100 BC, which describes blowing into the ear to revive an unconscious patient. A 2007 history by Luigi Gori and Fabio Firenzuoli notes that Chinese medicine used points on the ear without linking them to a map of the body. The map came from Paul Nogier, a physician in Lyon, who presented his observations to the Congress of the Mediterranean Society of Acupuncture in February 1956, and Gérard Bachmann published them in German in 1957. Nogier described the ear as an inverted fetus: the Hou review sets out the arrangement, with the earlobe standing for the head and brain; the antihelix for the spine; the scaphoid fossa for the arms; the upper and lower crura for the legs; and the concha, the hollow around the ear canal, for the internal organs.
Chinese acupuncturists read Nogier’s article in translation in 1958 and 1959, and a research team of the Nanjing army tested the map on more than 2,000 patients, according to both histories. Chinese and European maps have differed since; the Hou review records that numerous differences between them remain.
How ear points are named
Ear points are named in China’s GB/T 13734-2008, the World Federation of Acupuncture-Moxibustion Societies’ STANDARD-002:2012, and a partial list adopted by a WHO working group in Lyon in 1990. Most papers number ear points by region in the anatomical order those standards use. AcuiQ numbers them alphabetically within each region, so the same region prefix can carry a different number here; TF4 is not a point sets out the collisions and publishes a crosswalk, and Reading a point code explains the catalogue’s prefixes. Every ear point in the catalogue is listed under auricular points.
Needles, press tacks and seeds
Press tacks and intradermal needles, which stay in place for days, are covered under Press needles. Ear seeds do without a needle: a 2016 review of the NADA protocol by Stuyt and Voyles describes practitioners taping Vaccaria seeds or magnetised metal beads to the points, which the patient presses between visits. Trials call that auricular acupressure. Bloodletting at the ear is covered under Bloodletting, and current through ear needles or electrodes under Electroacupuncture.
AcuiQ records how each protocol was delivered as its modality, separately from the points, so an ear prescription delivered by needle, press tack or seed is filed as needling, press needles or acupressure. Reading a protocol explains the field.
The NADA protocol
The Stuyt and Voyles review traces the protocol of the National Acupuncture Detoxification Association (NADA) to Lincoln Hospital in the South Bronx, New York, where Michael Smith refined it by trial and error over several years. The work began with Hsiang-Lai Wen, a neurosurgeon in Hong Kong, who found in 1972 that ear needles placed as an anaesthetic before surgery eased withdrawal from opium. Smith and others founded NADA in 1985 to train clinicians in it. The protocol uses three to five fixed points in the ear and is usually given to a group of patients sitting together; in most of the trials the review tabulates, a session lasted 30 to 45 minutes. NADA estimates that about 25,000 people have been trained in it. Both authors are NADA trainers, and Stuyt was president of its board when the review was published.
| Point | AcuiQ |
|---|---|
| Sympathetic | IAC03 |
| Shenmen | TF10 |
| Kidney | CYC11 |
| Liver | CYC08 |
| Lung | CVC02 |
A 2002 trial led by Arthur Margolin at Yale randomised 620 adults dependent on cocaine, at six US clinics, to ear acupuncture, a needle-insertion control or relaxation, five times a week for eight weeks. Cocaine use fell in all three groups and did not differ between them, and the authors concluded that their trial did not support ear acupuncture as a stand-alone treatment for cocaine addiction. A 2006 Cochrane review by Simon Gates and colleagues pooled seven trials with 1,433 participants, most comparing ear acupuncture with needles at other ear sites, and found no evidence that it is effective for cocaine dependence, on evidence it described as not of high quality and inconclusive. A 2016 review by Baker and Chang found four randomised trials of the NADA protocol for opioid use disorder, and reported that it may not reduce acute craving or withdrawal but may keep people in treatment longer and lower methadone doses; the authors call these conclusions tentative. Stuyt and Voyles recommend that trials compare the protocol added to standard treatment with that treatment alone, rather than test it on its own.
Battlefield acupuncture
Battlefield acupuncture was devised by Richard Niemtzow, a US Air Force physician, as a rapid treatment for pain that could go with troops on deployment. In a 2020 account he dates its final form to August 2002 and lists its five points, needled in each ear in this order: cingulate gyrus, thalamus, omega 2, Shenmen and point zero. Of those, AcuiQ’s catalogue holds Thalamus as CVC10 and Shenmen as TF10. The needles are semi-permanent gold darts under 2 mm long, of a type Nogier designed, which stay in for about three to four days until they fall out. According to the same account, $5.4m from a Joint Incentive Fund paid to spread the technique through the US Department of Defense and Veterans Administration and trained thousands of clinicians.
A 2021 review led by Juan Yang at the Mayo Clinic found nine randomised trials of adults in pain and pooled five of them, with 344 participants. Against no treatment, usual care, sham battlefield acupuncture or delayed treatment, it found no significant improvement in pain, and it rated the trials poor in methodological quality. A 2017 review of ear acupuncture in emergency departments, by Jan and colleagues, with Niemtzow as an author, pooled four randomised trials with 286 patients, most of them using battlefield acupuncture, and found pain scores about 2.5 to 2.8 points lower out of 10 than in control groups, while noting significant bias. A 2026 review by the Mayo group of seven emergency-department trials with 758 patients, each adding battlefield acupuncture or a modified form of it to standard care, found positive results in 71% of them and no serious adverse events; most of the trials were at high risk of bias.
What reviews of ear acupuncture report
| Review | Question | Trials, participants | Comparison | What it found |
|---|---|---|---|---|
| Asher 2010 | Pain of any kind | 17 trials | Sham, placebo or standard care | Lower pain intensity (standardised mean difference 1.56, 8 trials); less analgesic use after surgery (5 trials). Authors call for larger trials. |
| Yeh 2014 | Pain of any kind | 22 trials; 13 pooled, 806 participants | Sham or other controls; 7 of the 22 trials used a sham | Pooled effect favoured ear therapy, with very high heterogeneity (I² 95%). |
| Zhou 2025 | Pain around surgery | 21 trials, 1,527 | Sham, placebo, usual treatment or none | Pain 0.44 points lower out of 10 and less analgesic use; evidence rated low in quality. |
| Usichenko 2022 | Anxiety before surgery | 15 trials, 1,603 | Sham; no treatment; benzodiazepines | Less anxiety than sham (8 trials, 701 patients, moderate certainty) and than no treatment (very low certainty); no difference from benzodiazepines (3 trials, 158 patients, very low certainty). |
| White 2014, Cochrane | Stopping smoking | 14 trials of continuous ear stimulation, 1,155 | Sham | More people abstinent in the short term (risk ratio 1.69), an effect seen with continuous ear acupressure (7 trials) and not with indwelling needles (6 trials); at six months or more, 5 trials with 570 people could not exclude no effect. |
| Luo 2026 | Primary insomnia | 25 trials, 2,106 | Other ear methods, eszopiclone, sham or usual care | Ear acupressure, and electrical stimulation of the ear’s branch of the vagus nerve through the skin, each improved sleep-quality scores more than controls; authors say the small number of trials means the ranking of methods needs confirming. |
AcuiQ’s pages for smoking cessation, opioid dependence, preoperative anxiety and insomnia list the protocols individual studies prescribed, each with its citation.
Reported adverse events
A 2014 review by Tan and colleagues collected adverse events of ear therapy from 32 randomised trials, seven other trials and four case reports. With needles, the events reported most were tenderness or pain where the needle went in, dizziness, local discomfort, minor bleeding and nausea. With seeds or pellets, they were skin irritation and discomfort, mild tenderness and dizziness; ear bloodletting produced minor infections. The review found no serious events and called most of those it found transient and mild. The large survey of needling reported in After a treatment left out studies limited to ear points, so its rates do not cover them.
What the sources cannot tell you
The map itself is not settled. The Hou review cites a double-blind study by Andersson and colleagues of 25 people with chronic pain that found the ear map did not correspond to the painful parts of the body. The sham in many ear trials, including most of those in the cocaine review, is needling at other points on the same ear, so a trial that finds no difference cannot tell whether the treatment did nothing or the sham did something too; Sham acupuncture sets out that problem. And because European and Chinese maps differ and published codes carry no scheme, a point list read from one paper may not mean the same points in the next.