Acupressure

Classical framework and the age claim

Modern reviews present acupressure as a form of acupoint massage that rests on the meridian and acupoint framework of Chinese medicine. A 2025 descriptive review refers to the Huangdi Neijing (Yellow Emperor's Internal Classic) as foundational and says the practice goes back more than 5,000 years. It gives no dated textual evidence for the longer figure, so that age is best read as a traditional claim and not as an established date.

A paper on tuina by Ming Cheng, held in a Middlesex University repository, says that no one knows exactly when or how tuina originated and that there is very little record of it before the Qin dynasty. It says the Huangdi Neijing, compiled between the Qin and Han dynasties, describes tuina as a therapeutic method, and that a specialised Qin or Han book on massage did not survive. The paper is undated and concerns tuina, a related but separate practice.

Later development in China

The same paper says that in the Tang dynasty the central imperial government appointed tuina therapists of different grades, that tuina was applied to paediatrics in the Ming and Qing dynasties, and that since 1959 it has been a major subject in traditional Chinese medicine education in China. These statements are the author's summary and were not checked against specialist historical scholarship.

Related forms and what is not established

The 2025 review lists acupressure alongside shiatsu, auricular acupressure, therapeutic Thai acupressure and foot reflexology, and dates two developments in related forms: Nogier's work on auricular therapy in the 1950s and Eunice Ingham's adaptation of foot reflexology in 1930. The sources reviewed do not trace acupressure as a practice distinct from tuina and acupuncture through time, and do not date the self-applied or wristband forms used in modern trials.

Acupressure within acupoint massage

The 2025 review uses acupoint massage as the wider heading and lists acupressure as one of five forms. In that review acupressure means pressure applied to acupoints across the body with varied manipulations, whereas shiatsu is described as stationary, sustained finger pressure that relies mainly on body weight and tends to be more holistic in orientation, with acupressure giving more weight to particular acupoints. Auricular acupressure is described as light to moderate pressure on ear reflex zones.

Acupressure, acupuncture and tuina

The Cochrane review of wrist-point stimulation classes needle acupuncture as an invasive technique and acupressure wristbands as a noninvasive one, so in that research acupressure denotes pressure without skin penetration. Cheng describes tuina as manipulation of parts of the body and acupuncture points, and lists pressing, rubbing, grasping, pushing and kneading among the methods described in early texts, which makes it a broader manual therapy within Chinese medicine. Acupuncture, shiatsu and tuina are separate practices and are not described further here.

Point names and trial vocabulary

The Cochrane review of wrist stimulation carried the label P6 in the titles of its earlier versions and PC6 in 2025, and the 2025 version refers to the PC6 acupoint on the wrist. Trials use further terms. Zick and colleagues distinguish relaxing from stimulating acupressure as two types of self-administered acupressure, and a later trial compares true with sham self-acupressure, the sham being a comparison condition and not a form of the practice. The abstracts do not specify which points define each type.

Pressure and sensation

The 2025 review describes acupressure as pressure applied to acupoints with varying methods and strength, and notes a term, De Qi, for therapeutic sensations of soreness, numbness and distension. Wristband forms work differently: in the UK ANCHoR trial the wristbands pressed the P6 point on the anterior surface of the forearm, and the Cochrane review of wrist stimulation counts acupressure wristbands among noninvasive techniques.

Self-applied programmes in trials

In the breast cancer survivor trial, women practised relaxing or stimulating acupressure on themselves daily for six weeks. In a 2026 trial in ovarian cancer survivors, participants learned true or sham self-acupressure from a mobile app and used it for six weeks, with follow-up to week 24. These are research protocols and do not describe a typical session.

Practitioner-led sessions

The sources reviewed do not describe a standard practitioner-led acupressure session, including its length, intake or the usual number of visits. Cheng's paper on tuina says that explicit consent should be obtained before treatment and that a chaperone may be present if the person requires; that guidance concerns tuina. A person receiving any hands-on therapy can ask what contact to expect and can ask the practitioner to stop.

Application areas listed in reviews

The 2025 review lists acupoint massage applications in pain (labour pain, dysmenorrhoea, chronic low back pain, knee osteoarthritis and cancer pain), in mental health (depression and anxiety), in sleep problems, in gastrointestinal problems including constipation and nausea and vomiting in pregnancy and with chemotherapy, and in cancer-related fatigue. The list records where studies have been done and does not show benefit in each area; the same review calls the evidence for some sleep conditions insufficient.

Nausea and vomiting

The Cochrane review of wrist stimulation starts from the observation that antiemetic drugs are only partly effective in preventing postoperative nausea and vomiting, and treats stimulation of the PC6 acupoint as an alternative approach. The UK chemotherapy trial similarly describes nausea as difficult to manage and asks whether wristbands could add to standard antiemetic drugs. Early pregnancy is a third setting in which acupressure has been tried.

Labour, menstrual pain and fatigue

Reviews of randomised trials have tested acupressure for pain in labour, for primary dysmenorrhoea (period pain) and for fatigue in people who have had cancer. The findings for each are reported in the next section and apply only to the populations and comparisons studied.

Postoperative nausea and vomiting

A 2025 Cochrane network meta-analysis (searches to June 2025) included 77 randomised trials, run between 1986 and 2022, with 9,847 participants, and compared PC6 stimulation techniques, antiemetic drugs and sham. Against sham, noninvasive PC6 stimulation such as wristbands may reduce postoperative nausea (risk ratio 0.67, 95% confidence interval 0.58 to 0.76) and vomiting (0.58, 0.49 to 0.70), but the certainty was low. High risk of bias came mainly from selective reporting.

Nausea in chemotherapy and pregnancy

The ANCHoR trial randomised 500 people starting chemotherapy at 14 UK cancer units to P6 wristbands, sham wristbands or standard antiemetic care alone. Nausea in the first cycle did not differ significantly between the arms (primary data for 361 participants), nor did vomiting, anxiety or quality of life. Women responded more favourably to sham wristbands than men, which the authors read as suggesting a placebo effect, and they drew no clear conclusion.

For early pregnancy, a 2015 Cochrane review of 41 trials (5,449 women) judged the evidence for P6 and auricular acupressure limited. A 2023 meta-analysis of 11 trials (1,378 women) found lower symptom scores than with sham (mean difference -1.33, -2.06 to -0.61) but no benefit over sham for preventing nausea and vomiting (risk ratio 0.83, 0.50 to 1.38).

Labour and menstrual pain

A 2020 Cochrane review of 28 trials (3,960 women) included 15 on acupressure for labour pain, none at low risk of bias on all domains. Against sham acupressure the effect on pain intensity was uncertain (very low-certainty evidence), though caesarean section was probably reduced (risk ratio 0.44, 0.27 to 0.71; moderate certainty). Against a combined control, pain was probably slightly reduced (standardised mean difference -0.42, -0.65 to -0.18; two trials).

A 2025 meta-analysis of 20 trials in primary dysmenorrhoea reported lower menstrual pain than with placebo acupressure, oral medication or usual treatment, and its authors rated the evidence low quality.

Cancer-related fatigue

In a trial of 288 breast cancer survivors with persistent fatigue, six weeks of daily relaxing or stimulating self-acupressure was compared with usual care. At week 6, 66.2%, 60.9% and 31.3% respectively had normal fatigue scores, and the two acupressure arms did not differ. A 2026 trial of 171 ovarian cancer survivors found fatigue improved more with true self-acupressure than usual care (adjusted mean difference -1.23, -2.17 to -0.29), while sham self-acupressure did not differ significantly from usual care or from true.

A meta-analysis of 14 trials (776 participants, searches to July 2020) reported lower general and physical fatigue with acupressure than with controls (Hedges g -0.87 for each) and a smaller effect on mental fatigue (-0.37). Risk of bias and certainty were not assessed for this page.

Sham and usual-care comparators

Trials differ in what acupressure is compared against. Usual care cannot separate the effect of pressure from attention, expectation and time spent on a self-care task. Where sham comparators were used the results complicate interpretation: in ANCHoR sham wristbands did not differ significantly from real ones, and in the 2026 ovarian cancer trial the true and sham arms did not differ significantly. Neither finding shows that acupoint pressure has no effect; both suggest that benefits may partly reflect non-specific factors.

Risk of bias, heterogeneity and certainty

The 2025 acupoint massage review reports variation in acupoint selection between studies, suboptimal blinding, modest sample sizes and possible publication bias, and notes no improvement in children given highly emetogenic chemotherapy. The 2015 pregnancy review could not pool most outcomes because trials differed, and the dysmenorrhoea review rated its evidence low quality.

Gaps in the sources reviewed

PubMed searches for this entry covered Cochrane reviews, labour, pregnancy, chemotherapy, fatigue, pain, adverse events and history. Evidence on low back pain, insomnia, anxiety and other uses was not appraised, and no source reviewed compares practitioner-delivered with self-applied pressure. Absence of appraisal is not evidence of absence.

Adverse events reported in studies

The 2025 Cochrane review found no serious or long-term complications; 39 studies (5,334 participants) reported minor effects such as skin irritation, redness and swelling, with very uncertain evidence. In ANCHoR, transient tightness, discomfort and minor swelling at the wristband were reported (six people). In the breast cancer survivor trial one woman withdrew because of bruising at the acupoints, and the 2026 trial reported no adverse events. Reporting methods differ, and an absence of reports does not show that none occurred.

Suitability and precautions

No source reviewed gives a contraindication list specific to acupressure. Cheng's paper on tuina lists open soft tissue injuries, bleeding, fractures, skin infections, a haemorrhagic tendency, acute infectious disease and pregnancy among contraindications for tuina, which should not be assumed to apply to light self-applied pressure. Trials in pregnancy, labour and cancer care were run within clinical settings and cannot be applied to individual decisions. Acupressure should not delay or replace necessary medical assessment or treatment.

Training and regulation

No source reviewed addresses training standards, professional registers or regulation specific to acupressure, and no statutory regulation or training standard specific to it was found. Titles and qualifications may differ by country and were not checked.