Page last updated at 09:37 GMT, Friday, 6 June 2008 10:37 UK

So does acupuncture work?

By Simon Singh

Ever since receiving my first ever acupuncture session last month, I have been repeatedly asked whether or not it was effective.

Simon Singh
Simon decided to see if acupuncture helped

In short, did acupuncture work for me? I refuse to answer for two reasons.

First of all, the main goal of the treatment was to obtain a photo of my face full of needles to accompany an interview in BBC Focus magazine to discuss a book that I have co-authored on the subject of alternative medicine.

Second, why on earth should my personal experience be important, when we have evidence from tens of thousands of patients who have received acupuncture during carefully observed scientific trials?

These acupuncture trials have been conducted ever since the 1970s and were triggered by an article that appeared in the New York Times written by James Reston.

He had visited Peking as part of the US press corps just prior to President Nixon trip to China in 1971, and had been struck by appendicitis.

The operation was successful, but afterwards he began to suffer severe abdominal pains that were treated with acupuncture.

Reston found the treatment to be both shocking and effective in equal measure.

His subsequent article explained how the acupuncturist had inserted needles into his right elbow and just below both knees, and how these needles were then "manipulated in order to stimulate the intestine and relieve the pressure and distension of the stomach".

Placebo effect

According to Chinese philosophy, acupuncture works by acting on Ch'i, a vital energy that flows though our body via channels known as meridians.

The goal of acupuncture is to tap into the meridians at key points to rebalance or unblock the Ch'i.

I expect more of a treatment than just a placebo effect

But there is no scientific evidence to support the notion of Ch'i, so does acupuncture really work?

Perhaps Reston's recovery was due to natural healing processes that would have happened regardless of the acupuncture.

Or maybe he was also receiving conventional painkillers.

Or perhaps the recovery was due to the placebo effect, which is the psychological impact of believing that a treatment will help.

One of the first scientists to study the placebo effect was an American anaesthetist called Henry Beecher.

His interest was aroused towards the end of WWII, when a lack of morphine at a military field hospital forced him to try an extraordinary experiment.

He injected saline into a wounded soldier and suggested that it was morphine. To Beecher's surprise, the patient relaxed immediately and showed no signs of pain.

'Superficial depth'

For three decades scientific trials have sought to establish whether acupuncture is a real treatment or just a placebo.

The best trials have involved randomly dividing patients with a particular condition into two groups.

Simon Singh
'Is this going to help?'

The first group receives real acupuncture, while the second group receives sham acupuncture, which means a treatment that looks and feels like acupuncture, but which is fake.

The idea is that the both groups will benefit from a similar placebo response, because everyone thinks that they are receiving real acupuncture, but the first group will show an additional improvement if real acupuncture offers a direct impact on the patient.

In these trials, sham acupuncture is applied in three ways.

Either the needles are inserted in the wrong place, or they are inserted to only a superficial depth, or they are not inserted at all.

The third option requires a special type of needle that telescopes and collapses as it is pushed against the patient's skin.

There have now been dozens of clinical trials comparing real acupuncture against sham acupuncture and the results are not very encouraging.

'I expect more'

Even though many acupuncture clinics make claims about treating everything from addiction to diabetes, from hay fever to sexual problems, there is no convincing evidence to show that acupuncture is an effective treatment for anything except a small range of conditions.

In particular, there have been some significant positive results relating to acupuncture in dealing with some types of pain and nausea.

Next time I'm feeling ill, my first port of call will still be my GP

However, it is important to stress that - even for these conditions - the evidence is still not convincing and some new studies have questioned the value of acupuncture in treating pain.

For example, an important study was published last year in the British Medical Journal which looked at the effect of acupuncture on osteoarthritis of the knee.

In recent years, acupuncturists have argued that acupuncture is particularly effective for this condition, but this trial suggested that acupuncture is nothing more than a placebo.

And, even if acupuncture is just a placebo treatment, then maybe some people will feel that this alone justifies its use, because placebos can offer benefits.

Personally, however, I expect more of a treatment than just a placebo effect.

After all, proven treatments come with a genuine medical benefit and a placebo effect thrown in for free.

So, next time I'm feeling ill, my first port of call will still be my GP.

Simon Singh is the co-author of 'Trick or Treatment? Alternative Medicine on Trial'. He is interviewed in this month's edition of BBC Focus magazine.


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