A rigorous review has found that acupuncture outperforms both traditional treatment and fake acupuncture in relieving arthritis and migraines, as well as chronic neck, back and shoulder pain. The solid findings led chief author Dr. Andrew J. Vickers to conclude, “We think there’s firm evidence supporting acupuncture for the treatment of chronic pain.”

These results will likely come as no surprise to many of the three million estimated Americans who use the age-old therapy each year. Acupuncture involves the insertion of needles into the skin to stimulate specific spots called acupoints on the body. A key part of traditional Chinese medicine, it is used to restore and maintain health, in addition to alleviating pain and stress.

The high quality study clearly reveals the effectiveness of acupuncture.

In a quest to answer questions about acupuncture’s efficacy, the researchers conducted a six-year painstakingly detailed analysis of studies involving 18,000 adults. Published in the Archives of Internal Medicine, the review found what authors refer to as “the most robust evidence to date” that the needle therapy is a viable option for treatment of pain.

Prior to any treatment, participants were required to rate their pain on a scale of 0 to 100. The average baseline pain rating was 60; the rating reduced to an average of 30 in those who received acupuncture and 35 in those who received fake acupuncture. Interestingly, those who received standard treatment of over-the-counter medications and physical therapy had an average rating of only 45, which revealed acupuncture was more effective. And what’s more, this superior effectiveness did not involve side effects, which are typically associated with many drugs.

Is fake acupuncture really phony?

Fake acupuncture, sometimes called sham acupuncture, is the insertion of needles into the skin at random spots on the body at more superficial depths than that of real acupuncture. The fact that the participants received more pain relief from the fake acupuncture than from standard treatment could indicate one of two factors is involved: either part of acupuncture’s benefit stems from a placebo effect or the benefit received from the fake treatment is actually real.

Some experts believe the so-called “fake” treatment may be beneficial. One of these is Rick Hecht, MD, research director at the Osher Center for Integrative Medicine at the University of California, San Francisco, who speculates that even though the needles are not targeting the acupoints, the treatment could be relieving pain through factors unknown at this time. This hypothesis is supported by Robert Duarte, MD, director of the Pain Center at the Cushing Neuroscience Institute in Great Neck, N.Y., who points out that the terms “fake” or “sham” may be misleading. He explains that these terms imply phoniness, but in actuality, it may provide true relief. “Maybe the traditional acupuncture points are not as important as once thought,” he says.

The bottom line is that since the new review was more rigorous than many prior studies, the conclusions are more robust, opines Dr. Andrew Avins, researcher with the University of California at San Francisco and Kaiser-Permanente. Acupuncture is generally safe and a lack of understanding of how it works should not prevent doctors from recommending it to their patients struggling with pain, he states.