"Possibly, the devices elicit a response," Kaptchuk said. But he added that the elaborate ritual of needling may explain why fake acupuncture provides even greater relief than sugar pills. "There's a large placebo effect when treating pain with acupuncture," he said.
Weidenhammer, who specializes in alternative medicine at Technische University in Munich, Germany, said that his team tried to eliminate some of this confusion by borrowing standardized methods from both ancient and modern medicine.
The study, published today in the British Medical Journal, randomized 270 patients with severe tension headaches to three treatment groups. Some received traditional acupuncture, which utilizes 25 needles at key points until an irradiating feeling is reached, known as "de qi." The second group received smaller needles in their arms, legs and back. The third group went without any form of acupuncture. All patients were allowed to take medicine if they suffered a headache.
Over an eight-week period, those receiving traditional acupuncture experienced seven fewer days of headaches—almost half of what those who weren't stuck with needles had. However, the group that had smaller needles stuck in them at random spots were not far behind. They experienced 6.6 fewer days of headaches.
While headache relief may be a matter of mind over body instead of the acupuncture itself, Weidenhammer said that smaller and fewer needles could still have a role, regardless if practitioners follow the original Chinese designs.
"It was still acupuncture and we cannot exclude certain physiological effects leading to pain relief," he said.
