Acupressure

Our assessments of evidence for each medical benefit fall into one of these categories:

• Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
• Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
• Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
• Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
• Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
• Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

Without regard to treatment phase

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety among people with cancer treated with acupressure

• Less anxiety among people with cancer treated with acupressure compared to controls but not compared to sham acupressure in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 8 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality⁶Wang T, Tan JB et al. Effects of somatic acupoint stimulation on anxiety and depression in cancer patients: an updated systematic review of randomized controlled trials. Complementary Therapies in Clinical Practice. 2023 May;51:101735.
• Less anxiety among people with breast cancer treated with acupressure compared to usual care in a mid-sized RCT⁷Liu Q, Wang C et al. Mindfulness-based stress reduction with acupressure for sleep quality in breast cancer patients with insomnia undergoing chemotherapy: a randomized controlled trial. European Journal of Oncology Nursing. 2022 Dec;61:102219.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety among people with lung cancer treated with auricular acupressure

• Less anxiety among people with lung cancer treated with auricular acupressure compared to usual care alone in a mid-sized RCT⁸Lin L, Zhang Y et al. Auricular acupressure for cancer-related fatigue during lung cancer chemotherapy: a randomised trial. BMJ Supportive & Palliative Care. 2021 Mar;11(1):32-39.

During cancer treatment: modest evidence of less anxiety during chemotherapy among people with cancer treated with acupressure

• Less anxiety during treatment among people with advanced cancer with moderate/severe fatigue with symptoms of insomnia and/or pain treated with a 4-week patient-centered self-administered acupressure intervention compared to patient education in a small RCT⁹Cheung DST, Yeung WF et al. Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: a pilot randomised controlled trial. European Journal of Cancer Care (England). 2022 Sep;31(5):e13314.
• Lower anxiety scores during chemotherapy among people with breast cancer and insomnia treated with electroacupuncture and ear acupressure compared to wait-list controls in a small RCT¹⁰Zhang J, Qin Z et al. Electroacupuncture plus auricular acupressure for chemotherapy-associated insomnia in breast cancer patients: a pilot randomized controlled trial. Integrative Cancer Therapies. 2021 Jan-Dec;20:15347354211019103.
• Less anxiety during chemotherapy among people with breast cancer treated with 12 weeks of acupressure compared to sham acupressure in a small RCT¹¹Zhang B, Dong JN, Sun P, Feng C, Liu YC. Effect of therapeutic care for treating fatigue in patients with breast cancer receiving chemotherapy. Medicine (Baltimore). 2017 Aug;96(33):e7750.
• Less state (overt) anxiety but no evidence of an effect on trait (covert) anxiety among hospitalized people with cancer treated with 25- to 30-minute acupressure sessions, 1 session per day for 10 days, with pressure on each acupoint for 2 minutes, compared to sham acupuncture or standard care alone in a small RCT¹²Beikmoradi A, Najafi F et al. Acupressure and anxiety in cancer patients. Iranian Red Crescent Medical Journal. 2015 Mar 31;17(3):e25919.
• Fewer symptoms in a cancer-related symptom cluster of insomnia, depression, and anxiety during chemotherapy among people with self-administration of either true acupressure or sham acupressure compared to enhanced standard care in a small RCT¹³Hoang HTX, Molassiotis A, Chan CW, Vu AH, Bui PT. Pilot randomized sham-controlled trial of self-acupressure to manage the symptom cluster of insomnia, depression, and anxiety in cancer patients undergoing chemotherapy. Sleep and Breathing. 2021 Apr 14.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better hemoglobin concentrations during chemotherapy for gynecologic cancer among women treated with acupressure

• Maintained hemoglobin concentrations during a first course of chemotherapy among women with gynecologic cancer treated with acupressure 3 times per day for 6 weeks compared to decreased levels in controls in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁴Shih YW, Yang SF et al. Significant effect of acupressure in elevating blood stem cell factor during chemotherapy in patients with gynecologic cancer. Journal of Nursing Research. 2018 Dec;26(6):411-419.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less breathlessness among people with lung cancer experiencing breathlessness treated with acupressure

• Less breathlessness during chemotherapy among people with lung cancer experiencing breathlessness (dyspnea) treated with acupressure at the P6-Lu1-Lu10 acupuncture points in the hand, forearm, and chest applied 2 times a day for 4 weeks compared to standard care alone in an RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁵Doğan N, Taşcı S. The effects of acupressure on quality of life and dyspnea in lung cancer: a randomized, controlled trial. Alternative Therapies in Health and Medicine. 2020 Jan;26(1):49-56.
• Less breathlessness among people with end-stage lung cancer and and breathlessness (dyspnea) treated with auricular application of Vaccaria segetalis (a small seed) taped to the auricular location deemed specific to lung function compared to the seed taped to random auricular locations (placebo) in a small RCT¹⁶Strong RA, Georges JM, Connelly CD. Pilot evaluation of auricular acupressure in end-stage lung cancer patients. Journal of Palliative Medicine. 2016 May;19(5):556-8.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less lack of appetite during adjuvant chemotherapy among women with ovarian cancer treated with auricular acupressure

• Less lack of appetite during adjuvant chemotherapy among women with ovarian cancer treated with auricular acupressure at 4 points (Shenmen, subcortex, endocrine, and heart) for 3 minutes at a time 3 times a day for 6 weeks compared to standard care alone in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁷Tsao Y, Creedy DK. Auricular acupressure: reducing side effects of chemotherapy in women with ovarian cancer. Supportive Care in Cancer. 2019 Nov;27(11):4155-4163.

Modest evidence of less depression among people with cancer treated with acupressure

• Less depression among people with cancer treated with acupressure compared to controls but not compared to sham acupressure in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 6 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality¹⁸Wang T, Tan JB et al. Effects of somatic acupoint stimulation on anxiety and depression in cancer patients: an updated systematic review of randomized controlled trials. Complementary Therapies in Clinical Practice. 2023 May;51:101735.
• Less depression during chemotherapy among people with breast cancer treated with 12 weeks of acupressure compared to sham acupressure in a small RCT¹⁹Zhang B, Dong JN, Sun P, Feng C, Liu YC. Effect of therapeutic care for treating fatigue in patients with breast cancer receiving chemotherapy. Medicine (Baltimore). 2017 Aug;96(33):e7750.
• Lower depression scores among people with breast cancer treated with acupuncture 5 times a week and auricular acupressure on each side once every 4 days for 8 weeks compared to 20 mg fluoxetine hydrochloride once a day in a small RCT²⁰Xiao B, Liu ZH. [Efficacy on depression in breast cancer treated with acupuncture and auricular acupressure]. Zhongguo Zhen Jiu. 2014 Oct;34(10):956-60. Chinese.

Acupressure as a whole: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less fatigue among people with cancer treated with acupressure

• Less fatigue among people with chronic lymphocytic leukemia treated with acupressure targeting the SP6 point for 10 minutes twice a day for 4 weeks compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²¹Parizad N, Hassanpour A, Goli R, Khalkhali H, Nozad A. Comparing the impact of acupressure and reflexology on fatigue in chronic lymphocytic leukemia patients: a randomized controlled trial with three arms. European Journal of Oncology Nursing. 2024 Jun;70:102573.
• Less fatigue among people with stage 3 or 4 cancer receiving palliative care treated with 20 minutes of acupressure once a day, 2 days a week for 4 weeks compared to controls in a mid-sized RCT²²Utli H, Dinç M, Utli MDA. The effect of acupressure or reiki interventions on the levels of pain and fatigue of cancer patients receiving palliative care: a randomized controlled study. Explore (NY). 2023 Jan-Feb;19(1):91-99.
• Less fatigue among people with breast cancer treated with acupressure compared to usual care in a mid-sized RCT²³Liu Q, Wang C et al. Mindfulness-based stress reduction with acupressure for sleep quality in breast cancer patients with insomnia undergoing chemotherapy: a randomized controlled trial. European Journal of Oncology Nursing. 2022 Dec;61:102219.
• Less cancer-related fatigue during or after cancer treatment among people treated with acupressure compared to controls, with moderately more benefit from auricular acupressure compared to body acupressure in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 15 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial²⁴Chou HC, Tsai HY, Sun TC, Lin MF. [The effectiveness of acupressure in reducing cancer-related fatigue: a systematic review and meta-analysis]. Hu Li Za Zhi. 2022 Aug;69(4):75-87. Chinese.
• Less cancer-related fatigue among people treated with acupressure compared to controls, with greater benefits among males, in a meta-analysis of 14 RCTs²⁵Hsieh SH, Wu CR et al. The effect of acupressure on relieving cancer-related fatigue: a systematic review and meta-analysis of randomized controlled trials. Cancer Nursing. 2021 Nov-Dec 01;44(6):E578-E588.
• A weak trend toward less cancer-related fatigue among people treated with acupressure compared to controls in a meta-analysis of 4 RCTs and controlled trials²⁶Duong N, Davis H et al. Mind and body practices for fatigue reduction in patients with cancer and hematopoietic stem cell transplant recipients: a systematic review and meta-analysis. Critical Reviews in Oncology/Hematology. 2017 Dec;120:210-216.

Auricular acupressure: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less cancer-related fatigue among people with lung cancer treated with auricular acupressure

• Less cancer-related fatigue among people with lung cancer treated with auricular acupressure compared to usual care in a mid-sized RCT²⁷Lin L, Zhang Y et al. Auricular acupressure for cancer-related fatigue during lung cancer chemotherapy: a randomised trial. BMJ Supportive & Palliative Care. 2021 Mar;11(1):32-39.

Self administration of acupressure: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less cancer-related fatigue treated with acupressure by themselves or caregivers

• Apparently lower severity and level of cancer-related fatigue (without a clear statement of significance) among elderly people treated with acupressure on 3 acupuncture points on the hands and legs (LI4, SP6, and ST36) by themselves or caregivers for 3 minutes twice a day for 4 weeks compared to controls in a small RCT²⁸Özdemir Ü, Taşcı S. Acupressure for cancer-related fatigue in elderly cancer patients: a randomized controlled study. Alternative Therapies in Health and Medicine. 2023 May;29(4):57-65.
• Less fatigue among people with cancer-related fatigue treated with self acupressure once a day, 5 times a week for 4 weeks compared to sham acupressure in a mid-sized RCT²⁹Shu J, Ren W, Chen S, Li L, Zhu H, Jin A. Effect of somatosensory interaction transcutaneous electrical acupoint stimulation on cancer-related fatigue and immunity: a randomized controlled trial. American Journal of Clinical Oncology. 2022 Jul 1;45(7):316-324.
• Less fatigue among people with cancer experiencing moderate to severe fatigue taught to massage/press acupressure points daily for 2 weeks on their own compared to sham acupressure in a small RCT³⁰Molassiotis A, Sylt P, Diggins H. The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: a randomised controlled trial. Complementary Therapies in Medicine. 2007 Dec;15(4):228-37.

Constipation: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less constipation among people with cancer treated with acupressure, including during chemotherapy or after surgery

• Less constipation among people with cancer with opioid-induced constipation treated with 8 minutes of acupressure from the Zhongwan (CV12), Guanyuan (CV4), and Tianshu (ST25) acupoints once a day for 4 weeks compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects³¹Yildirim D, Kocatepe V, Talu GK. The efficacy of acupressure in managing opioid-induced constipation in patients with cancer: a single-blind randomized controlled trial. Supportive Care in Cancer. 2022 Jun;30(6):5201-5210.
• Less constipation during chemotherapy among people with breast cancer treated with auricular acupressure at 7 auricular acupoints for 6 weeks using vaccaria seeds compared to usual care in a small RCT³²Shin J, Park H. Effects of auricular acupressure on constipation in patients with breast cancer receiving chemotherapy: a randomized control trial. Western Journal of Nursing Research. 2018 Jan;40(1):67-83.
• Less constipation after lung cancer surgery among people treated with auricular points treatment combined with acupoints application therapy compared to routine care in a mid-sized RCT³³Li Y, Qi D et al. Effect of auricular points treatment combined with acupoints application in patients with constipation after lung cancer surgery. Journal of Cancer Research and Therapeutics. 2017;13(5):844-848.

Diarrhea: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less diarrhea during the second and third cycles of intensive chemotherapy among children with acute lymphoblastic leukemia treated with acupressure

• Less diarrhea during the second and third cycles of intensive chemotherapy, but no evidence of an effect during the first cycle, among children (7 to 15 years old) with acute lymphoblastic leukemia treated with acupressure in addition to antiemetic medication compared to antiemetic medication alone in a small RCT³⁴Essawy MA, Abohadida RM, Abd-Elkader WM, Fathy HM, Hassab HM. Comparing the effect of acupressure and ginger on chemotherapy gastrointestinal side-effects in children with leukemia. Complementary Therapies in Medicine. 2021 Aug;60:102730.

Nausea and vomiting

Acupressure as a whole: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less nausea and vomiting during chemotherapy among people, including children, treated with acupressure

• Greater relief of chemotherapy-induced nausea and vomiting, mainly delayed nausea and vomiting, among people treated with acupressure added to antiemetics compared to antiemetics alone in meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 19 RCTs³⁵Chen L, Wu X, Chen X, Zhou C. Efficacy of auricular acupressure in prevention and treatment of chemotherapy-induced nausea and vomiting in patients with cancer: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2021 Aug 3;2021:8868720.
• Less nausea and vomiting during intensive chemotherapy among children (7 to 15 years old) with acute lymphoblastic leukemia treated with acupressure in addition to antiemetic medication compared to antiemetic medication alone in a small RCT³⁶Essawy MA, Abohadida RM, Abd-Elkader WM, Fathy HM, Hassab HM. Comparing the effect of acupressure and ginger on chemotherapy gastrointestinal side-effects in children with leukemia. Complementary Therapies in Medicine. 2021 Aug;60:102730.
• Less severe acute and delayed chemotherapy-induced nausea, but no evidence of an effect on the incidence or frequency of vomiting, among people treated with acupressure compared to controls in a meta-analysis of 12 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial of varying quality³⁷Miao J, Liu X et al. Effects of acupressure on chemotherapy-induced nausea and vomiting-a systematic review with meta-analyses and trial sequential analysis of randomized controlled trials. International Journal of Nursing Studies. 2017 May;70:27-37.

Wrist acupressure: good evidence of less nausea and vomiting during chemotherapy among people treated with wrist acupressure

• Lower incidence and severity of acute and delayed nausea and vomiting during chemotherapy but no evidence of an effect of the duration of nausea or vomiting among people with cancer treated with PC6 acupressure compared to controls in meta-analyses of 10 RCTs³⁸Xiao C, Qin M et al. Effects of PC6 acupressure on acute and delayed nausea and vomiting induced by chemotherapy in patients with malignant neoplasm: a meta-analysis. Supportive Care in Cancer. 2023 Aug 7;31(9):510.
• Less nausea during treatment with cisplatin among people treated with acupressure to Pericardium-6 and Heart-7 on each wrist for 3 minutes per point twice a day for 3 days starting on the second day of chemotherapy in addition to antiemetics compared to antiemetics alone in a small controlled trial³⁹Augustine A, Devi ES, Latha T. Effectiveness of acupressure on chemotherapy induced nausea and vomiting and the functional status among cancer patients receiving cisplatin as radiosensitizer chemotherapy in Kasturba hospital Manipal. International Journal of Nursing Education. 2015;7:32.

Acupressure wrist bands: modest but somewhat conflicting evidence of less nausea or vomiting during chemotherapy among people wearing acupressure wristbands

• No evidence of an effect on the severity of acute or delayed nausea or vomiting during highly emetic chemotherapy among children 4 to 18 years old treated with standard antiemetic agents plus acupressure wrist bands (Sea-Bands®) compared to sham bands in a mid-sized RCT⁴⁰Dupuis LL, Kelly KM et al. Acupressure bands do not improve chemotherapy-induced nausea control in pediatric patients receiving highly emetogenic chemotherapy: a single-blinded, randomized controlled trial. Cancer. 2018 Mar 15;124(6):1188-1196.
• Less severe early nausea but no evidence of an effect on the incidence of acute nausea or vomiting (emesis) 24 hours after highly emetogenic chemotherapy among people treated with acupressure with bilateral stimulation of P6 via a Sea-Band worn for 5 days after chemotherapy treatment compared to a placebo band in a mid-sized RCT⁴¹Said Z, Hussein A, Alkaissi A. Acupressure for chemotherapy induced nausea and vomiting in breast-cancer patients: a randomized, placebo-controlled clinical trial. Advances in Life Science and Technology. 2016 Feb;41.
• No evidence of an effect on acute or delayed nausea, vomiting, or use of antiemetic medication during chemotherapy among women with breast cancer experiencing nausea in previous treatment cycles treated with acupressure wrist bands compared to sham bands or no bands in a small RCT⁴²Roscoe JA, Matteson SE et al. Acustimulation wrist bands are not effective for the control of chemotherapy-induced nausea in women with breast cancer. Journal of Pain and Symptom Management. 2005 Apr;29(4):376-84.
• Less delayed vomiting and less intense nausea but no evidence of an effect on acute nausea or vomiting during a second or third cycle of chemotherapy among women with breast cancer experiencing nausea during previous cycles treated with a wrist device applying pressure to P6 point compared to pressure to SI3 point (placebo) or usual care in a mid-sized RCT⁴³Dibble SL, Luce J et al. Acupressure for chemotherapy-induced nausea and vomiting: a randomized clinical trial. Oncology Nursing Forum. 2007 Jul;34(4):813-20.
• Lower incidence and distress of nausea, vomiting, and retching among people treated with acupressure with bilateral stimulation of P6 via a Sea-Band worn for 5 days after chemotherapy treatment compared to controls in a small RCT⁴⁴Molassiotis A, Helin AM, Dabbour R, Hummerston S. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complement Ther Med. 2007 Mar;15(1):3-12.
• Less nausea on the day of chemotherapy treatment but no evidence of an effect on delayed nausea or vomiting among people treated with acupressure bands compared to controls in a large RCT⁴⁵Roscoe JA, Morrow GR et al. The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Journal of Pain and Symptom Management. 2003 Aug;26(2):731-42.

Auricular acupressure: preliminary evidence of less nausea, vomiting, or retching during chemotherapy among people treated with auricular acupressure

• Higher complete response rates of chemotherapy-induced nausea and vomiting (CINV) and lower incidence and severity of acute CINV, but not anticipatory CINV, among people with breast cancer treated with either auricular acupressure or sham auricular acupressure in addition to standard antiemetic treatment and care compared to standard care alone in a mid-sizedRCT⁴⁶Tan JY, Molassiotis A et al. Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary randomized controlled trial. BMC Complementary Medicine and Therapies. 2022 Mar 24;22(1):87.
• Lower nausea and retching during chemotherapy among people with colorectal cancer treated with auricular acupressure compared to placebo (non-acupressure stickers) in a small controlled trial⁴⁷Shin N, Park J. Effect of auricular acupressure on nausea, vomiting, and retching in patients with colorectal cancer receiving chemotherapy. Korean Journal of Adult Nursing. 2018;30:227-234.
• Lower frequency and intensity of both acute and delayed vomiting and nausea during chemotherapy among women with breast cancer treated with standard medication and ear (auricular) acupuncture compared to standard medications only in a small controlled trial⁴⁸Eghbali M, Yekaninejad MS et al. The effect of auricular acupressure on nausea and vomiting caused by chemotherapy among breast cancer patients. Complementary Therapies in Clinical Practice. 2016 Aug;24:189-94.

After surgery: no evidence of an effect on nausea and vomiting after a subtotal gastrectomy among people treated with acupressure

• No evidence of an effect on nausea and vomiting after a subtotal gastrectomy among people treated with acupressure at acupoints of Neiquan (P6) and Zusanli (ST36) for 3 consecutive days compared to standard care alone in a small RCT⁴⁹Hsiung WT, Chang YC, Yeh ML, Chang YH. Acupressure improves the postoperative comfort of gastric cancer patients: a randomised controlled trial. Complementary Therapies in Medicine. 2015 Jun;23(3):339-46.

Gastrointestinal function after surgery: preliminary evidence of earlier passing of gas (flatus) but no evidence of an effect on bowel movements (defecation) after surgery among people treated with acupressure

• Earlier flatus passage and time to liquid intake but no evidence of an effect on solid food intake or defecation after abdominal surgery among people with colorectal cancer treated with ST-36 acupressure in a 3-minute cycle 3 times a day during the 5 days after surgery compared to sham acupressure in a small RCT⁵⁰Chao HL, Miao SJ et al. The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer. Oncology Nursing Forum. 2013 Mar;40(2):E61-8.
• Shorter time to first flatus but no evidence of an effect on time to first bowel movement (defecation) after a subtotal gastrectomy among people treated with acupressure at acupoints of Neiquan (P6) and Zusanli (ST36) for 3 consecutive days compared to standard care alone in a small RCT⁵¹Hsiung WT, Chang YC, Yeh ML, Chang YH. Acupressure improves the postoperative comfort of gastric cancer patients: a randomised controlled trial. Complementary Therapies in Medicine. 2015 Jun;23(3):339-46.

Unspecified acupressure: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less pain among people with cancer treated with acupressure

• Less pain and analgesic use among people with stage 3 or 4 cancer receiving palliative care treated with 20 minutes of acupressure once a day, 2 days a week for 4 weeks compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵²Utli H, Dinç M, Utli MDA. The effect of acupressure or reiki interventions on the levels of pain and fatigue of cancer patients receiving palliative care: a randomized controlled study. Explore (NY). 2023 Jan-Feb;19(1):91-99.
• Less pain immediately after each session but no evidence of an effect on long-term pain among people with leukemia treated with 12 acupressure sessions in addition to standard care compared to standard care alone in a mid-sized RCT⁵³Sharif Nia H, Pahlevan Sharif S et al. Effect of acupressure on pain in Iranian leukemia patients: A randomized controlled trial study. International Journal of Nursing Practice. 2017 Apr;23(2).

Hand acupressure: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately less pain among people with cancer treated with hand acupressure

• Moderately less pain among people with cancer treated with hand acupressure compared to  controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 2 RCTs⁵⁴Zhang Y, Wang S et al. Massage therapy can effectively relieve cancer pain: a meta-analysis. Medicine (Baltimore). 2023 Jul 7;102(27):e33939.

Auricular acupressure: good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less cancer-related pain among people treated with auricular acupressure

• Less pain among people with stage 3 or 4 cancer receiving palliative care treated with acupressure compared to controls in a mid-sized RCT⁵⁵Utli H, Dinç M, Utli MDA. The effect of acupressure or reiki interventions on the levels of pain and fatigue of cancer patients receiving palliative care: a randomized controlled study. Explore (NY). 2023 Jan-Feb;19(1):91-99.
• Less intense cancer pain and use of analgesics among people with cancer treated with  conventional analgesic and auricular acupressure, either with or without manual acupuncture, compared to analgesic alone in a meta-analysis of 17 RCTs⁵⁶He Y, Guo X et al. Clinical evidence for association of acupuncture and acupressure with improved cancer pain: a systematic review and meta-analysis. JAMA Oncology. 2020 Feb 1;6(2):271-278.
• Fewer arm symptoms (pain, swelling or difficult movement) or breast symptoms (pain, swelling, oversensitivity, or skin problems) during chemotherapy among people with breast cancer treated with crystal pellets applied to six acupoints in the outer ear (shen men, kidney, stomach, cardia, brainstem and endocrine) with instructions to moderately press the site for five minutes, three times a day: morning, afternoon and night compared to controls treated with micropore® application in the same acupoints in a small RCT⁵⁷Vallim ETA, Marques ADCB et al. Auricular acupressure in the quality of life of women with breast cancer: a randomized clinical trial. Revista da Escola de Enfermagem da USP. 2019 Dec 2;53:e03525. Portuguese, English, Spanish.

Refreshing versus stimulating acupressure: preliminary evidence of less severe pain among women with breast cancer treated with relaxing acupressure, but less pain interference among those treated with stimulating acupressure

• Less severe pain among women with breast cancer treated with relaxing acupressure, but less pain interference with function among those treated with stimulating acupressure compared to usual care in a mid-sized RCT⁵⁸Zick SM, Sen A. Impact of self-acupressure on co-occurring symptoms in cancer survivors. JNCI Cancer Spectrum. 2018 Nov 1;2(4): pky064.

Wrist and knee acupuncture: preliminary evidence of less pain after a subtotal gastrectomy among people with stomach cancer treated with acupressure

• Less pain after a subtotal gastrectomy among people with stomach cancer treated with acupressure at acupoints of Neiquan (P6) and Zusanli (ST36) for 3 consecutive days compared to standard care alone in a small RCT⁵⁹Hsiung WT, Chang YC, Yeh ML, Chang YH. Acupressure improves the postoperative comfort of gastric cancer patients: a randomised controlled trial. Complementary Therapies in Medicine. 2015 Jun;23(3):339-46.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better quality of life during or after completing cancer treatment among people with cancer treated with acupressure

• Better quality of life during chemotherapy among people with lung cancer experiencing breathlessness (dyspnea) treated with acupressure at the P6-Lu1-Lu10 acupuncture points in the hand, forearm, and chest applied 2 times a day for 4 weeks compared to standard care alone in an RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶⁰Doğan N, Taşcı S. The effects of acupressure on quality of life and dyspnea in lung cancer: a randomized, controlled trial. Alternative Therapies in Health and Medicine. 2020 Jan;26(1):49-56.
• Better quality of life at least 12 months after completing cancer treatment among people with breast cancer treated with relaxing acupressure for 6 or 10 weeks but no evidence of an effect of stimulating acupressure compared to controls in a mid-sized RCT⁶¹Zick SM, Sen A et al. Investigation of 2 types of self-administered acupressure for persistent cancer-related fatigue in breast cancer survivors: a randomized clinical trial. JAMA Oncology. 2016 Nov 1;2(11):1470-1476.

Without regard to treatment phase: strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep quality among people with cancer treated with acupressure without regard to cancer treatment phase

• Better sleep quality among people with leukemia treated with acupressure to the SP6 point twice a day for 10 minutes for 4 weeks compared to standard care in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶²Parizad N, Hassanpour A, Goli R, Khalkhali H, Nozad A. Comparing the efficacy of acupressure and foot reflexology on sleep quality in patients with leukemia: a comparative clinical trial. Integrative Cancer Therapies. 2024 Jan-Dec;23:15347354241261356.
• Less self-reported sleep disturbance among people with cancer treated with acupressure compared to enhanced supportive care in a network meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 24 RCTs⁶³Cheung DST, Xu X et al. Invasive or noninvasive? A systematic review and network meta-analysis of acupuncture and acupressure to treat sleep disturbance in cancer patients. Worldviews on Evidence-Based Nursing. 2022 Dec 21.
• Better sleep scores among people with breast cancer treated with acupressure compared to usual care or mindfulness based stress reduction (MBSR), and better sleep efficiency, sleep latency, total sleep time, and wake after sleep onset with acupressure either alone or combined with MBSR compared to MBSR alone in a mid-sized RCT⁶⁴Liu Q, Wang C et al. Mindfulness-based stress reduction with acupressure for sleep quality in breast cancer patients with insomnia undergoing chemotherapy: a randomized controlled trial. European Journal of Oncology Nursing. 2022 Dec;61:102219.
• Better sleep scores (9 studies), lower sleep disturbance rates (2 studies), and less sleep medicine usage (2 studies) among people with lung cancer treated with auricular acupressure compared to usual care, sham acupressure, or placebo in meta-analyses of RCTs⁶⁵Lu HB, Ma RC, Yin YY, Song CY, Yang TT, Xie J. Auricular acupressure for improving sleep quality in patients with lung cancer: a systematic review and meta-analysis. Holistic Nursing Practice. 2022 Jul-Aug 01;36(4):E27-E37.

During chemotherapy: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep quality during chemotherapy among people with cancer treated with acupressure

• Less disturbed sleep during adjuvant chemotherapy among women with ovarian cancer treated with auricular acupressure at 4 points (Shenmen, subcortex, endocrine, and heart) for 3 minutes at a time 3 times a day for 6 weeks compared to standard care alone in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁶⁶Tsao Y, Creedy DK. Auricular acupressure: reducing side effects of chemotherapy in women with ovarian cancer. Supportive Care in Cancer. 2019 Nov;27(11):4155-4163.
• Better sleep quality during chemotherapy among women with ovarian cancer treated with auricular point acupressure and sleep hygiene practices compared to sleep hygiene practices alone in a small RCT⁶⁷Kuo HC, Tsao Y, Tu HY, Dai ZH, Creedy DK. Pilot randomized controlled trial of auricular point acupressure for sleep disturbances in women with ovarian cancer. Research in Nursing & Health. 2018 Oct;41(5):469-479.
• Better sleep quality during chemotherapy among people with breast cancer treated with 12 weeks of acupressure compared to sham acupressure in a small RCT⁶⁸Zhang B, Dong JN, Sun P, Feng C, Liu YC. Effect of therapeutic care for treating fatigue in patients with breast cancer receiving chemotherapy. Medicine (Baltimore). 2017 Aug;96(33):e7750.
• Fewer symptoms in a cancer-related symptom cluster of insomnia, depression, and anxiety during chemotherapy among people self-treating with either true acupressure or sham acupressure compared to enhanced standard care in a small RCT⁶⁹Hoang HTX, Molassiotis A, Chan CW, Vu AH, Bui PT. Pilot randomized sham-controlled trial of self-acupressure to manage the symptom cluster of insomnia, depression, and anxiety in cancer patients undergoing chemotherapy. Sleep and Breathing. 2021 Apr 14.

After completing chemotherapy: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep quality after completing cancer treatment among people with breast cancer treated with relaxing acupressure for 6 weeks but no evidence of an effect of stimulating acupressure

• Better sleep quality at least 12 months after completing cancer treatment among people with breast cancer treated with relaxing acupressure for 6 weeks but no evidence of an effect of stimulating acupressure compared to controls in a mid-sized RCT; the benefit on sleep quality was not evident at 10 weeks⁷⁰Zick SM, Sen A et al. Investigation of 2 types of self-administered acupressure for persistent cancer-related fatigue in breast cancer survivors: a randomized clinical trial. JAMA Oncology. 2016 Nov 1;2(11):1470-1476.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better urinary function after radical hysterectomy among people with cervical cancer treated with acupressure

• Shorter time for ureter retention and less residual urine volume after grade III radical hysterectomy among people with cervical cancer treated with acupressure at positive points [liniao point and Qihai (RN6)] combined points by syndrome typing [Guanyuan (RN4) , Zhongji (RN3) , Shenshu (BL23) , Zusanli (ST36), Sanyinjiao (SP6), and Taixi (K13)] compared to sham acupressure or standard care alone among people with urinary retention in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷¹Wang HF, Wang DB, Chen YH, Zhou MY. [Relief of urinary retention after radical hysterectomy for cervical cancer patients by acupressure: a randomized controlled trial]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2015 Apr;35(4):425-8. Chinese.

Acupressure with acupuncture: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep onset latency, total sleep time, sleep efficiency, anxiety, depression, and quality of life at 24 weeks of follow-up among people with breast cancer with chemotherapy-associated insomnia treated with acupuncture and acupressure

• Better sleep onset latency, total sleep time, sleep efficiency, anxiety, depression, and quality of life at 24 weeks of follow-up but no evidence of an effect on sleep scores after only 6 weeks among people with breast cancer with chemotherapy-associated insomnia treated with 15 sessions of active acupuncture regimen combining needling into body acupoints and acupressure on auricular acupoints for 18 weeks compared to sham acupuncture in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷²Zhang J, Qin Z et al. Acupuncture for chemotherapy-associated insomnia in breast cancer patients: an assessor-participant blinded, randomized, sham-controlled trial. Breast Cancer Research. 2023 Apr 26;25(1):49.

Acupressure antinausea wristbands and guided mind-body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self-hypnosis): preliminary evidence of less anxiety and fatigue among women with breast cancer undergoing initial surgery using a self-care toolkit

• Less anxiety, fatigue among women with breast cancer undergoing initial surgery using a self-care toolkit of audio-files of guided mind-body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self-hypnosis) and acupressure antinausea wristbands compared to usual care in a mid-sized RCT⁷³Stoerkel E, Bellanti D et al. Effectiveness of a self-care toolkit for surgical breast cancer patients in a military treatment facility. Journal of Alternative and Complementary Medicine. 2018 Sep/Oct;24(9-10):916-925.

Acupressure and reflexology: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less breathlessness among people with advanced cancer treated with acupressure and reflexology

• Less breathlessness, with relief for a few weeks to months, among people with advanced cancer treated with acupressure and reflexology in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 29 RCTs of low quality⁷⁴Gupta A, Sedhom R et al. Nonpharmacological interventions for managing breathlessness in patients with advanced cancer: a systematic review. JAMA Oncology. 2021 Feb 1;7(2):290-298.

Acupressure with magnets: preliminary evidence of less severe pain during bone marrow aspiration and biopsy but no evidence of an effect on median pain among people with cancer treated with magnetic acupressure

• Less severe pain during bone marrow aspiration and biopsy but no evidence of an effect on median pain among people with cancer treated with magnetic acupressure to the large intestine 4 (LI4) acupoint compared to a sham site in a small RCT⁷⁵Bao T, Ye X et al. The analgesic effect of magnetic acupressure in cancer patients undergoing bone marrow aspiration and biopsy: a randomized, blinded, controlled trial. Journal of Pain and Symptom Management. 2011 Jun;41(6):995-1002.

Acupressure wrist bands and relaxation recording: preliminary evidence of lower peak chemotherapy-induced nausea among people with breast cancer expecting nausea when treated with acupressure wrist bands and a relaxation MP3 recording

• Lower peak chemotherapy-induced nausea during doxorubicin treatment (but not other treatment) among people with breast cancer expecting nausea when treated with acupressure wrist bands and a relaxation MP3 recording compared to usual care in a mid-sized RCT⁷⁶Peoples AR, Culakova E et al. Positive effects of acupressure bands combined with relaxation music/instructions on patients most at risk for chemotherapy-induced nausea. Supportive Care in Cancer. 2019 Dec;27(12):4597-4605.
• Lower peak chemotherapy-induced nausea among people with breast cancer who had high pretreatment anxiety and were expecting nausea when treated with acupressure wrist bands and a relaxation MP3 recording compared to usual care in a mid-sized RCT⁷⁷Peoples AR, Culakova E et al. Positive effects of acupressure bands combined with relaxation music/instructions on patients most at risk for chemotherapy-induced nausea. Supportive Care in Cancer. 2019 Dec;27(12):4597-4605.

Transcutaneous electrical acupoint stimulation and auricular acupressure: preliminary evidence of less fatigue during chemoradiotherapy among people with head and neck cancer treated with transcutaneous electrical acupoint stimulation and auricular acupressure

• Less fatigue during chemoradiotherapy among people with head and neck cancer treated with transcutaneous electrical acupoint stimulation and auricular acupressure for 6 weeks compared to standard care in a small RCT⁷⁸Chou YH, Wang YJ, Yeh ML, Lin CY. [Effects of an acupoint intervention on improving fatigue and heart rate variability in head and neck cancer patients receiving concurrent chemoradiotherapy]. Hu Li Za Zhi. 2019 Jun;66(3):46-58. Chinese.

Psychotherapy communication intervention, traditional Chinese medicine lifestyle coaching, self-acupressure guidance, and mindfulness practice: weak evidence of lower anxiety, depression, insomnia, fatigue, and fear of cancer recurrence scores among people with colorectal cancer treated with a psychotherapy communication intervention, traditional Chinese medicine lifestyle coaching, self-acupressure guidance, and mindfulness practice

• Lower anxiety, depression, insomnia, fatigue, and fear of cancer recurrence scores at 6 weeks among people with colorectal cancer treated with a psychotherapy communication intervention, traditional Chinese medicine lifestyle coaching, self-acupressure guidance, and mindfulness practice compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design⁷⁹Sun L, Pang Y et al. Effect of traditional Chinese medicine combined group psychotherapy on psychological distress management and gut micro-biome regulation for colorectal cancer survivors: a single-arm phase I clinical trial. Supportive Care in Cancer. 2023 Nov 15;31(12):698.

Nausea and vomiting: modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower incidence of nausea and vomiting after surgery among people treated with acupressure

• Lower risk of vomiting after abdominal surgery with general anesthesia among people treated with acupressure compared to placebo in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 20 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of varying quality⁸⁰Fu C, Wu T, Shu Q, Song A, Jiao Y. Acupuncture therapy on postoperative nausea and vomiting in abdominal operation: a Bayesian network meta analysis. Medicine (Baltimore). 2020 Jun 5;99(23):e20301.
• Moderately lower incidence of nausea and vomiting and less need for rescue antiemetics after surgery among people treated with acupressure compared to sham acupressure or antiemetics in a meta-analysis of 59 RCTs or comparison trials of low quality⁸¹Lee A, Chan SK, Fan LT. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database of Systematic Reviews. 2015 Nov 2;2015(11):CD003281.

Pain: insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of less pain after surgery among people treated with acupressure

• No change in pain scores or opioid use for 2 days after surgery among people treated with acupressure compared to sham acupressure or no intervention in a mid-sized RCT⁸²Noll E, Shodhan S et al. Efficacy of acupressure on quality of recovery after surgery: randomised controlled trial. European Journal of Anaesthesiology. 2019 Aug;36(8):557-565.
• Less pain and more comfort after gallbladder removal (cholecystectomy) among people treated with acupressure compared to controls in a small RCT⁸³Topdemir EA, Saritas S. The effect of acupressure and reiki application on patients’ pain and comfort level after laparoscopic cholecystectomy: a randomized controlled trial. Complementary Therapies in Clinical Practice. 2021 May;43:101385.

Recovery after surgery: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on recovery time, length of hospital stay, or return to normal physical activities among people undergoing major laparoscopic procedures treated with acupressure devices in a preliminary study

• No evidence of an effect on recovery time, length of hospital stay, or return to normal physical activities among people undergoing major laparoscopic procedures with acupressure devices 30 to 60 minutes before beginning anesthesia compared to a sham acustimulation device in a mid-sized RCT⁸⁴White PF, Zhao M, Tang J, Wender RH, Yumul R, Sloninsky AV, Naruse R, Kariger R, Cunneen S. Use of a disposable acupressure device as part of a multimodal antiemetic strategy for reducing postoperative nausea and vomiting. Anesthesia & Analgesia. 2012 Jul;115(1):31-7.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better sleep latencythe length of time to transition from full wakefulness to sleep and sleep efficiencythe ratio of total sleep time to time in bed but no evidence of an effect on sleep quality scores among family caregivers of patients with advanced cancer reporting sleep disturbance self-administering acupressure

• Lower sleep latency and better sleep efficiency but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on sleep quality scores among family caregivers of patients with advanced cancer reporting sleep disturbance self-administering acupressure at the Baihui (GV20), Fengchi (GB20), Neiguan (PC6), and Shenmen (HT7) points over a 12-week period compared to sleep hygiene education in a controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial⁸⁵Lee KC, Chao YC, Lin YP, Wang HC. Effectiveness of self-administered acupressure for family caregivers of advanced cancer patients with insomnia: a randomized controlled trial. Cancer Nursing. 2022 Jan-Feb 01;45(1):E1-E9.

Preliminary evidence of better sleep quality index scores among family caregivers of women with ovarian cancer when the people with cancer were treated with acupressure to relieve symptom severity

• Better sleep quality index scores at 4 and 6 weeks among family caregivers of women with ovarian cancer when the people with cancer were treated with acupressure to relieve symptom severity compared to baseline in a small controlled trial⁸⁶Wu TT, Pan HW et al. Concomitant benefits of an auricular acupressure intervention for women with cancer on family caregiver sleep quality. Cancer Nursing. 2021 Sep-Oct 01;44(5):E323-E330.