Is there a contraindication to getting acupuncture after having a stroke?

Acupuncture After Stroke: Safety and Efficacy

Acupuncture is not contraindicated after stroke and is actually recommended by the World Health Organization as an alternative and complementary strategy for stroke rehabilitation. 1

Evidence Supporting Acupuncture After Stroke

• Acupuncture has been used for thousands of years in Asia to treat stroke and is widely employed to improve motor, sensory, speech, and other neurological functions in post-stroke patients 1
• The World Health Organization has specifically recommended acupuncture as an alternative and complementary strategy for stroke and post-stroke rehabilitation 1
• Numerous clinical trials and meta-analyses have indicated the efficacy of acupuncture in improving balance, reducing spasticity, and increasing muscle strength and general well-being after stroke 1
• Basic studies have demonstrated that acupuncture is effective at facilitating ischemic stroke rehabilitation and reducing post-stroke infarct volume and neurological deficits 1

Mechanisms of Action

• Acupuncture promotes neurogenesis and cell proliferation in the central nervous system 2
• It helps regulate cerebral blood flow and reduces blood-brain barrier permeability 2
• Acupuncture has anti-apoptotic effects and regulates neurotransmitters 2
• It improves neuronal synaptic function and stimulates neuroplasticity 2, 3
• Acupuncture can stimulate neurogenesis, activate axonal regeneration and sprouting, and improve the structure and function of synapses 3

Specific Applications in Post-Stroke Care

• Acupuncture has shown positive effects on motor recovery, with specific acupuncture points including GV20, GB20, LI4, ST36, SP6, LI11, GB39, and motor scalp area 2
• For cognitive dysfunction, points GV20 and EX-HN-1 are commonly used 2
• For dysphagia treatment, points GV20, GV16, and CV23 are frequently utilized 2
• A randomized controlled trial found that acupuncture treatment in addition to standard rehabilitation provided superior clinical efficacy compared to rehabilitation alone 4

Clinical Guidelines and Recommendations

• The 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines note that there is insufficient evidence to recommend for or against acupuncture for depression following stroke (neither for nor against recommendation) 1
• Multiple countries have positive recommendations for acupuncture use in various post-stroke conditions including rehabilitation, dysphagia, shoulder pain, motor recovery, walking, balance, spasticity, upper limb extremity impairment, post-stroke pain, cognitive disorder, depression, and sleep problems 5

Long-Term Benefits

• A one-year follow-up study showed that patients who received acupuncture in the subacute stage of stroke had significantly better outcomes than control groups in motor function, activities of daily living, and social situation 6
• The acupuncture group continued to improve more than the control group during the follow-up year, suggesting long-term benefits 6

Practical Considerations

• The most commonly used acupuncture points for ischemic stroke include GV 20, ST 36, LI 11, GV 26, GV 14, and LI 4 1
• Treatment protocols typically involve sessions lasting 30 minutes, administered 3-5 times weekly for several weeks 4, 6
• Acupuncture should be performed by qualified practitioners with specific training in post-stroke acupuncture techniques 2

While there are no specific contraindications to acupuncture after stroke mentioned in the guidelines, standard acupuncture contraindications would still apply (e.g., bleeding disorders if on anticoagulants). However, these would be relative contraindications requiring professional judgment rather than absolute contraindications to the procedure itself.