Acupuncture: does it really work?

By Emma Young

Alternative medicine is regularly dismissed by practitioners of Western medicine as quackery, with many scientists expressing suspicion – if not outright hostility – to the claims of therapies such as naturopathy, chiropractic and homeopathy. However there's one branch of complementary medicine that's more widely accepted in some circles: acupuncture. But not everyone is convinced that the ancient Chinese practice lives up to its promise.

Who takes acupuncture seriously?

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Acupuncture was first developed in China over 2,000 years ago. It's been in use in Western countries, on and off, for around 400 years. The ancient Chinese therapy is taught at respected universities, recommended by some GPs and the NHS has stated that there is 'some scientific evidence' that it works. Cyclist Vincenzo Nibali even credited the therapy with helping him to win the Tour de France.

What is the theory behind it?

Acupuncture is based on the theory of qi. Qi is considered to be a life force comprised of yin and yang. Acupuncture practitioners say it flows through the body along a network of invisible paths, or energy lines, known as meridians. People are thought to become ill or experience pain when the flow of qi is obstructed. The application of needles, heat or pressure to acupuncture points is designed to stimulate the circulation of qi and return the body to good health.

Is there any evidence that acupuncture works?

Unlike Western medicine, acupuncture was developed in isolation from mainstream science. It is only since the 1970s that scientists have begun to test whether it can produce any credible benefits in the treatment of ailments such as chronic pain, nausea, migraines and depression.

Of the 3,000 or so studies investigating acupuncture, the results have varied. As have the methods. Many of the trials that have produced results in favour of acupuncture have failed to use a placebo group.

Why does this matter?

For a trial to be worthwhile, it must divide patients into two groups: one receives the real treatment and the other receives a fake, or placebo. Neither doctors nor patients are supposed to know which is which. The comparison this creates is the standard way of determining whether a treatment works. Without a placebo, any 'evidence' they claim to have found that acupuncture works is likely the result of bias rather than accurate testing.

Other more respected studies have tried to overcome the difficulty of establishing a placebo by using two types of 'sham acupuncture'. The first approach involves using needles on random points of the body that have no relationship to the meridians. The second more favoured method uses retractable needles, like an onstage dagger, that prick the skin but don't puncture it. According to David Colquhoun, a pharmacologist at University College London, 'almost all experiments show no difference between real and sham acupuncture.'

Does this mean the sceptics have won?

In short, no. A group of researchers led by Ladan Eshkevari, PhD, at Georgetown University Medical Centre, published results earlier this year claiming to have found evidence that acupuncture can relieve stress in rats, Time reports. It remains questionable whether this discovery will translate to the human body, but some scientists say that the results indicate that further tests should be carried out before acupuncture is dismissed completely.