Electroacupuncture is a form of acupuncture in which a small electrical current is passed between acupuncture needles after they have been inserted.

Small clips connect selected needles to an electroacupuncture unit, allowing the frequency and intensity of stimulation to be controlled. Patients usually feel a gentle pulsing, tapping or tingling sensation around the needles.

Experimental research is increasingly suggesting that the physiological effects of electroacupuncture may depend not simply on whether a needle is stimulated, but on where it is placed, the intensity of stimulation and which tissues and sensory nerves are recruited. (6).

Acupuncture needles provide sensory input to the nervous system. With electroacupuncture we can control that stimulation more precisely and maintain it for a period of time.

Different frequencies, intensities and locations of stimulation can recruit different nerve fibres and produce different physiological responses. This also makes electroacupuncture particularly interesting from a research perspective because the electrical stimulus can be described and reproduced more accurately than manual needle manipulation.

Research is increasingly showing that it isn't simply a question of whether a needle is stimulated, but where, how strongly and which tissues and nerves are being stimulated (5).

Knee osteoarthritis is one of the areas in which electroacupuncture has been particularly well studied.

Treatment may involve needling around the knee and applying electrical stimulation between selected needles. The intention isn't to reverse the structural changes of osteoarthritis, but to help with symptoms such as pain and function.

Systematic reviews and meta-analyses have reported improvements in pain and some measures of function following electroacupuncture for knee osteoarthritis, although treatment protocols and the quality of the underlying studies vary. (1,2)

Clinically, this is one of the situations where I find the sustained stimulation provided by electroacupuncture particularly useful.

Another area I find particularly interesting is the treatment of overactive or irritable bladder symptoms.

Acupuncture has historically included points on the inside of the lower leg in the treatment of urinary and pelvic problems. Modern medicine now uses a remarkably similar anatomical region for posterior tibial nerve stimulation (PTNS).

PTNS involves placing a fine needle close to the tibial nerve near the ankle and applying a small electrical current. Stimulation of the tibial nerve is thought to influence the sacral nerve pathways involved in bladder control. PTNS is now an established neuromodulation procedure and has been the subject of specific NICE guidance. (3)

You can read more about this on our Overactive Bladder page.

The history of PTNS has an interesting connection with acupuncture.

In 1983, Edward McGuire and colleagues described electrical stimulation of the tibial nerve for bladder dysfunction, with historical reviews reporting that acupuncture was part of the inspiration for the technique. The approach was subsequently developed by Marshall Stoller and evolved into the treatment now known as PTNS. (4)

The anatomical similarity is particularly striking around SP6 (Sanyinjiao), an acupuncture point on the inside of the lower leg traditionally used in the treatment of urinary and pelvic problems. Modern PTNS places a needle close to the posterior tibial nerve in essentially the same anatomical region and applies electrical stimulation. Reviews discussing the development of PTNS have specifically noted this overlap with electroacupuncture. (4)

Modern PTNS explains its effects through neuroanatomy rather than traditional Chinese medicine. What I find particularly interesting is that a treatment inspired, at least in part, by acupuncture has subsequently developed into an established medical neuromodulation technique.

There is another reason I find the PTNS literature interesting.

Acupuncture research can be difficult to interpret because different studies may use different combinations of points, different needling techniques and different treatment protocols.

PTNS is much more anatomically defined: the target is the posterior tibial nerve. This reduces some of the variation in exactly what is being stimulated and gives researchers a more consistent intervention to study.

It also fits with emerging neurophysiological research suggesting that the effects of electroacupuncture can depend upon the anatomical location, nerves and tissues being stimulated, as well as the intensity of stimulation.

Once the acupuncture needles are in position, small clips are attached to selected needles and connected to the electroacupuncture unit.

The intensity is increased gradually until a comfortable sensation is felt. Depending on the area being treated, you might notice gentle pulsing, tingling or rhythmic movement of the muscles.

The stimulation should be noticeable but comfortable and can be adjusted at any point during treatment.

Electroacupuncture isn't something I use simply because it is a more technological form of acupuncture. I use it when there is a clinical reason for wanting a controlled and sustained stimulus.

Sometimes manual acupuncture is entirely appropriate. At other times electroacupuncture gives us another way of interacting with the nervous system and the tissues being treated.

As with the other forms of acupuncture we use at Exeter Acupuncture & Osteopaths, the technique is chosen around the individual rather than trying to fit every patient to the same treatment.

You can also learn more about Five Element Acupuncture, Medical Acupuncture, Auricular Acupuncture and Traditional acupuncture, or return to our Types of Acupuncture overview.

1. Li P, Zhang Y, Li F, et al. The efficacy of electroacupuncture in the treatment of knee osteoarthritis: a systematic review and meta-analysis. Advanced Biology. 2023;7(10):e2200304.

2. Yuan SG, Chen J, Chen MX, et al. High-intensity electroacupuncture is superior to low-intensity electroacupuncture for knee osteoarthritis: a meta-analysis of randomized controlled trials. Acupuncture in Medicine. 2024;42(6):303–310.

3. NICE. Percutaneous posterior tibial nerve stimulation for overactive bladder syndrome. HealthTech Guidance HTG235. NICE HTG235

4. de Wall LL, Heesakkers JPFA. Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome. Research and Reports in Urology. 2017;9:145–157. This review discusses the development of PTNS, including McGuire's early work and the relationship with acupuncture/SP6.

5. Liu S, Wang Z, Su Y, et al. A neuroanatomical basis for electroacupuncture to drive the vagal–adrenal axis. Nature. 2021;598:641–645.