If you need to rebuild strength, balance or movement after an injury or surgery, physical therapy usually leads the plan. Acupuncture is an option for pain management alongside that work. You may benefit from one or both, depending on what is limiting you and how treatment helps you function.
Dr Deb Ma, PhD, LAc, OMD · 1640 Valencia St, San Francisco
Pain relief and rehabilitation overlap. A physical therapist treats pain as well as movement; an acupuncturist may address sleep and other symptoms that accompany it.
| Acupuncture | Physical therapy | |
|---|---|---|
| What it is | Fine needles placed at selected points. Treatment may also include cupping, heat or electrical stimulation through the needles, depending on the condition. | An assessment and treatment plan using exercise, education and, where appropriate, hands-on care to improve pain, strength, movement and function. |
| What it treats | At Puzzle, pain and symptoms involving sleep, digestion and women's health. The evidence and goals differ by condition. | Movement, mobility and function: recovery after surgery or a stroke, back and joint pain, balance and walking. |
| A first visit | 75 minutes at Puzzle for a history, examination and treatment. Follow-up visits track symptoms and what you can do more comfortably. | An evaluation of movement, strength and range of motion, then a plan and exercises to start at home. |
| Who does it | A licensed acupuncturist, after a state exam. | A licensed physical therapist. New US entrants complete a Doctor of Physical Therapy degree; experienced clinicians may hold an earlier qualifying degree. |
Sources: California Business and Professions Code sections 2620, 4927, 4937 and 4938; APTA, Becoming a PT; the Physical Therapy Board of California's March 2026 oversight paper; the clinic's published practice.
Dr Deb may also use cheek acupuncture or FSN needling. These techniques are distinct from the acupuncture used in the knee trial below.
The useful question is whether acupuncture adds enough relief to make daily life or rehabilitation easier. The answer varies by condition and study.
A 2024 Beijing trial included 110 people with knee osteoarthritis in its analysis. At 12 weeks, 82 percent in the acupuncture-plus-exercise group met the study's threshold for improvement in pain and function, compared with 50 percent with exercise alone and 54 percent with acupuncture alone.
Share of knee osteoarthritis patients who improved, by treatment
A meaningful gain in pain and function, week 4 and week 12, Beijing, 2024
Liu et al., Journal of Pain Research, 2024. Participants were aged 45 to 70; treatment lasted four weeks, followed by eight weeks of observation. Of 120 enrolled, 110 were included in the analysis.
This was a small study without a sham-acupuncture group. Its result does not mean combined treatment is always better: another knee osteoarthritis trial found no extra improvement in its main pain outcome at six or twelve months when acupuncture was added to advice and exercise. A trial of treatment should have an agreed goal and a point at which you reassess it.
After surgery or a stroke, rehabilitation involves practising movement and progressing the work as you recover. A physical therapist can measure that progress, adjust exercises and help you return to daily activities. Acupuncture cannot replace that training, even when it helps with pain.
California access rules are set out in the Physical Therapy Practice Act, section 2620.1. Referral requirements are explained in the FAQ below.
Dr Deb worked alongside rehabilitation clinicians at Beijing United Family Hospital and can coordinate with your physical therapist here. Bring the exercise plan and explain which tasks still hurt, rather than judging progress only by how you feel on the treatment table.
| The problem | Usual first stop | What the other adds | What to tell each clinician |
|---|---|---|---|
| Stroke, first weeks | The hospital and neurology, then rehab once you are stable. | Discuss any acupuncture with the stroke team. It should fit around, and never delay, the rehabilitation plan. | The discharge plan, current medicines and the skills you are working to recover. |
| Low back pain, sudden | An assessment if pain is severe, unusual or limiting activity. A therapist can help you find tolerable movement. | Acupuncture is an option for pain relief if appropriate after assessment. | Which movement helps and which makes it worse. |
| Knee osteoarthritis | An exercise plan matched to your strength, symptoms and goals. | Consider acupuncture for additional symptom relief, then assess whether it helps walking, stairs or exercise. | Which exercises you can do and how the knee feels afterwards. |
| After knee replacement | The surgeon and the physical therapist, for strength work. | Discuss acupuncture for pain with the surgical team, including timing, healing and medicines. | The surgery date and the weight-bearing rules. |
| Neck pain from screens | Physical therapy if recurring pain limits movement or work; acupuncture is another option for symptom relief. | Pain management alongside changes to movement, exercise and work habits. | What brings the pain on, what eases it and how long you can work comfortably. |
Sources: the studies above, and the clinic's practice.
Yes. Acupuncture and physical therapy can run in the same weeks. Tell each clinician what the other is doing and how you feel afterwards so they can adjust timing and treatment intensity.
Yes. With your permission, Dr Deb can share her findings with your therapist and fit treatment around the rehabilitation plan. Tell both clinicians about changes in pain, movement and your ability to do the exercises.
You can start either without a referral. In California, physical therapy beyond 45 calendar days or 12 visits, whichever comes first, requires an examination and approval of the plan by a physician or a podiatrist acting within their scope. Insurance may have separate referral requirements. Puzzle's free consult needs no referral.
Less than most people expect. You may feel a brief prick, aching or heaviness. Tell Dr Deb if anything feels sharp or uncomfortable so she can adjust it. Temporary soreness or a small bruise can occur.
The first consult is free. A new patient visit is $255 for 75 minutes and follow ups are $205 for 60 minutes. Current rates are on the pricing page. Insurance is not required to cover physical therapy visits that start without a referral, and acupuncture coverage varies by plan; ask each office before the first visit.
The consult is free. Dr Deb goes through your history, current medicines and exercises, then discusses whether acupuncture could help with the symptoms that are limiting your progress.