One consistent theme in acupuncture research is that it has proven very difficult to show any difference between the effects of acupuncture intended to treat a symptom or disease and the effects of various kinds of fake or sham acupuncture intended as a placebo control. Often, pretending to do acupuncture (inserting needles at places not thought to be acupuncture points or just pretending to insert needles) has as much of an apparent effect as “real” acupuncture treatment. (e.g. 1, 2, 3). The evidence also strongly suggests that where one places the needles during acupuncture treatment is largely irrelevant since the effect, such as it is, will be the same.
The most reasonable interpretation of this evidence is that acupuncture functions primarily a s a placebo. It is the therapeutic ritual, and possibly some small, non-specific counterirritant effects, that influence the patient. This means that all the theorizing about points and channels and both Chinese Medicine explanations of acupuncture (Five Elements, Yin/Yang, Qi, etc.) and conventional scientific attempts to explain it (endorphins, nerve stimulation, etc.) are just rationalizations for placebo effects.
The strength of this conclusion is, as always in science, proportional to the strength of the evidence. One more small piece of evidence has recently been released that supports this understanding of acupuncture.
Carolyn Ee, MBBS; Charlie Xue, PhD; Patty Chondros, PhD; Stephen P. Myers, PhD; Simon D. French, PhD; Helena Teede, PhD; and Marie Pirotta, PhD. Acupuncture for Menopausal Hot Flashes: A Randomized Trial. Ann Intern Med. Published online 19 January 2016.
This study randomly assigned 327 women with menopausal hot flashes to either acupuncture as guided by TCM principles or fake acupuncture with non-inserted needles. The bottom line was that both groups improved about 40%, but there was no difference between targeted acupuncture treatment and fake acupuncture. This is exactly what one would expect for a placebo therapy, ,and it is consistent with the growing body of evidence indication acupuncture is no more than a placebo for most uses.