A phobia of needles is listed as an exclusion criterion in many randomized controlled trials involving acupuncture treatment. In real-world settings, individuals with a fear of needles are unlikely to seek acupuncture treatment for chronic pain. Acupressure treatment that does not involve needle use can be a suitable alternative for individuals with needle aversion.

A lack of positive engagement with providers or an explicitly negative interaction with providers is a demonstrated psychosocial barrier to acupuncture efficacy for chronic pain. While positive interactions were associated with greater pain reductions and satisfaction, neutral and negative interactions were associated with diminished pain reductions and satisfaction. Providers' beliefs about the appropriateness of acupuncture may also subsequently impact an individual’s perception of care.

Individuals who are skeptical about acupuncture as an appropriate nonpharmacologic treatment are less likely to experience the same degree of pain relief as their more optimistic counterparts and are more likely to discontinue treatment if they do not experience immediate pain relief.