Is Acupuncture “Just Placebo”? The 5 Best Studies to Read Before You Decide
If you’ve ever wondered whether acupuncture is real medicine or “just placebo,” you’re not alone. Skepticism is healthy — and honestly, the acupuncture world needs more of it.
The good news is that we don’t have to guess. We now have large, high-quality studies comparing real acupuncture to sham (placebo) acupuncture. Sham acupuncture uses fake needles or non-therapeutic needling designed to feel convincing. If real acupuncture still outperforms sham, that’s strong evidence there’s something happening beyond belief alone.
Below are five of the strongest studies you can look at if you want a science-based answer.
Quick Nav: Find the Studies That Match Your Concern
Jump to the topic that matters most to you:
Chronic pain (back pain, neck pain, headaches, arthritis) → Study #1 and #2
Knee arthritis / joint pain → Study #3
Migraines / frequent headaches → Study #4
Post-surgery nausea, gut upset, or “objective outcomes” → Study #5
Keywords you can search on this page:
back pain, arthritis, osteoarthritis, headache, migraine, nausea, vomiting, placebo, sham acupuncture, chronic pain, knee pain
The Five Studies
Study #1 — The “biggest and best” pain analysis: real acupuncture beats sham
Best for: chronic pain, arthritis, tension headaches, neck/back pain
Why it matters: huge sample size + top-tier methods
A landmark analysis pooled individual patient data from the best randomized trials — nearly 18,000 people total. These were not loose or “alternative-medicine style” studies. They were rigorous, sham-controlled clinical trials.
What it found:
Real acupuncture outperformed sham acupuncture across common chronic pain conditions. The advantage over sham was modest but consistent — and statistically extremely unlikely to be random.
What that means in plain English:
Even when the “fake acupuncture” feels real, real acupuncture still works a bit better.
Citation: Vickers et al., Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis (2012).
Study #2 — The updated version confirms the result and shows it lasts
Best for: chronic pain; people worried effects are short-lived
Why it matters: replication + durability
The same research group repeated the analysis years later with more trials and long follow-ups.
What it found:
The real-over-sham advantage still showed up, and benefits stayed for months after treatment ended.
Why skeptics often pause here:
Placebo effects can be real — but they tend to fade quickly when treatment stops. These improvements persisted, which supports a genuine treatment signal.
Citation: Vickers et al., Acupuncture for Chronic Pain: Updated IPD Meta-analysis (2017/2018).
Study #3 — Knee osteoarthritis: real acupuncture outperforms sham
Best for: knee pain, osteoarthritis, aging-related joint issues
Why it matters: classic high-profile trial in a mainstream medical journal
This trial compared:
real acupuncture
sham acupuncture
usual care/education
What it found:
Real acupuncture improved pain and function more than sham — and both acupuncture groups beat usual care.
Plain English:
For knee arthritis, acupuncture wasn’t just “a good experience.” The real treatment had an extra measurable edge.
Citation: Berman et al., Effectiveness of Acupuncture as Adjunctive Therapy in OA of the Knee (Annals of Internal Medicine, 2004).
Study #4 — Migraine prevention: real acupuncture beats sham and lasts 6 months
Best for: migraines, recurring headaches
Why it matters: migraines are strongly placebo-sensitive — beating sham here is a high bar
A large trial evaluated acupuncture for preventing migraines and followed participants for half a year.
What it found:
Real acupuncture reduced migraine frequency and migraine days more than sham, and the benefit held up at 6 months.
Plain English:
Migraines are one of the easiest conditions for placebo to “look good” in. Yet real acupuncture still did better.
Citation: Zhao et al., Acupuncture for Migraine Prophylaxis (JAMA Internal Medicine, 2017).
Study #5 — Post-op nausea/vomiting: less actual vomiting vs sham
Best for: nausea, recovery after surgery, people who want “objective” outcomes
Why it matters: vomiting isn’t just a feeling — it’s a measurable bodily event
A conservative Cochrane review looked at RCTs using point PC6 (Neiguan) for postoperative nausea and vomiting.
What it found:
PC6 acupuncture/stimulation reduced nausea and vomiting more than sham controls across many trials.
Plain English:
This isn’t just “people saying they feel better.” They had less real vomiting, which is hard to explain away as belief alone.
Citation: Cochrane Review on PC6 stimulation for postoperative nausea/vomiting.
“Okay… but why isn’t the effect huge?”
This is a fair question, and the science actually gives a fair answer.
Sham acupuncture isn’t an inert sugar pill.
Even fake or off-point needling can stimulate nerves, skin receptors, and brain pathways. So sham acupuncture often acts like a weaker form of acupuncture, which makes the real treatment look less different than it might compared to a truly inactive placebo.
That’s why the most honest summary is:
Acupuncture consistently outperforms sham by a modest margin, and both outperform usual care in many conditions.
Not magic. Not nothing. A real, repeatable clinical effect — with a strong context effect layered on top.
If You’re Still Unsure, Here’s the Most Reasonable Take
You don’t have to “believe in acupuncture.”
You just have to be open to evidence that:
Real acupuncture beats credible placebo controls in major studies, especially for pain and migraine.
Physiology changes too (brain networks, stress hormones, endogenous opioids), which supports plausibility.
Effects are often moderate, not miraculous — and that’s exactly what we see in many legitimate therapies.