Does acupuncture really work?

Helen Cowan

Useful for virtually every condition afflicting mankind or no more than a powerful placebo? Does acupuncture work? Helen Cowan takes a look at case studies and clinical trials to consider this controversial question

What is acupuncture?

As traditional acupuncturist Heather Davidson explains, it’s a treatment that involves using extremely fine needles to stimulate points on the skin that connect and activate the various systems in the body (for example, the nervous system or hormone system). The primary objective is to correct imbalances in the body that underlie symptoms and disease; treatments are tailor-made to each individual.

She explained that there are nearly no side effects except that you may feel tired after treatment and may get a tiny bruise. Treatment should be sought through a practitioner registered with the British Acupuncture Council or other professional body.

 

Does it work?

Heather has seen acupuncture help with everything from aches and pains to painful periods, migraine, insomnia, menopause and depression.

Whilst individual case studies are compelling, do clinical trials agree? Are the narratives repeated in larger numbers? It seems so. When it comes to period pain, a small Australian study involving 74 women showed that acupuncture halved the severity of period pain in half of the women for up to a year after treatment; small studies (and patient stories) show that acupuncture may also reduce cancer pain and associated nausea.

So why do some doctors still say no to needling (though an increasing number of GPs now refer for it)?

A quick trip to the online Cochrane Library (a resource where research results are summarised) suggested a reason. Studies seeking to answer whether acupuncture ameliorates a range of disorders (such as depression, fibromyalgia, osteoarthritis, shoulder pain and acute stroke) have revealed promising, but incomplete, conclusions. For the studies, and the effects seen, have often been too small to be helpful.

What’s more, several studies fail to answer the most common argument against acupuncture: do some patients feel better after acupuncture because of the placebo effect and not because of the needles themselves? Do patients get better because their brain convinces their body that it’s better? This, of course, can also happen with medication: receiving sham painkillers in a clinical trial can sometimes relieve pain almost as effectively as a promising new drug.

 

Testing the placebo effect

Some trials use sham needles that do not penetrate the skin but collapse on contact. Harvard Medical School recently reported that acupuncture is superior to sham for various types of pain relief.

The acupuncturist, however, remains aware when the active treatment is being given, and when it is not, and may find it difficult to act without bias; pressure, meanwhile, is still exerted on the skin, possibly activating nerves in a similar way to acupuncture.

More confusing still, it’s possible that patients get better on their own, but attribute it to the acupuncture. Mind you, the same can be said when taking some medication. How, for example, can you be sure that a short course of antibiotics, rather than your own immune system, has fought your infection?

 

If it works for you

So what’s the advice when it comes to acupuncture? I’ve decided to approach it with an open mind, but not to put all my apples in one basket. As for puzzling over the placebo problem, and agonising over how acupuncture works, the jury is still out.

Acupuncture may one day be a weapon in my armour to fight disease, along with a healthy lifestyle and prescribed drugs. It may work for me, it may not. But then again, drugs don’t always work for all people either.