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The Economist Asked 'Does Acupuncture Work?' Here's What They Got Wrong

Updated: 7 hours ago

The Economist just published a three-minute explainer on acupuncture, and I want to be fair: they got some things right. There is strong evidence for pain. The 2018 Journal of Pain meta-analysis covering nearly 21,000 patients is real, it's solid, and the benefits held up a year out. That part? Accurate.

But the way they framed everything else — and what they left out — is the kind of lazy science journalism that genuinely misleads patients. And that matters, because when people read "the jury's out on everything else," some of them quietly decide not to pursue a treatment that could have changed their life.

The Sham Acupuncture Trap

The article cites a 2020 JAMA Internal Medicine paper showing "no significant difference in pain relief between true and sham acupuncture" — and uses it to imply the whole thing might be placebo. This is one of the most persistently misused findings in the acupuncture debate, and it drives me absolutely crazy.

Sham acupuncture is not a sugar pill. It involves inserting needles — just shallower, or at non-traditional points. It still penetrates skin. It still activates mechanoreceptors and connective tissue. Decades of research, including work from NIH-funded researcher Helene Langevin (who the article actually cites!), has shown that needle insertion — wherever it happens — causes measurable fascial and neurological responses.

So when a study shows that "sham" acupuncture performs similarly to "real" acupuncture, it doesn't prove that acupuncture is placebo. It raises the possibility that both are doing something real. That is a wildly different conclusion, and collapsing these two things is not a minor error.

They Cited the Mechanism and Then Ignored It

Here's what's maddening: the article mentions Langevin's research. Her work shows needles twist connective tissue, pull on nerve endings, and trigger a cascade that reduces pain. That is a proposed biological mechanism — not a belief system, not a vibe. And then, in the very next paragraph, the article pivots straight to placebo.

You can't have it both ways. If there's an identifiable tissue-level mechanism, you don't get to conclude "maybe it's all in your head." Pick a lane.

The Edzard Ernst Problem

The article's primary skeptic is Edzard Ernst, an emeritus professor from the University of Exeter whose career has been built on debunking complementary medicine. His quote — "any therapy comes automatically with a placebo effect" — is used to cast doubt on acupuncture's results. Which, fine, it's technically true. Every therapy has a placebo component. Antidepressants. Physical therapy. Surgery.

We don't use that fact to dismiss those treatments. We don't look at the data showing antidepressants outperform placebo by modest margins and conclude they're fake. We have an adult conversation about clinical effect size, patient outcomes, and risk-benefit ratios. Acupuncture deserves the same standard.

What's Actually Missing from the Story

The 2022 review they reference — the one that analyzed 862 systematic reviews — showed benefits for post-operative nausea comparable to antiemetics, migraines, tension headaches, cancer-related fatigue, female infertility (in conjunction with reproductive medicine), and chronic pelvic pain. That is a meaningful list of conditions affecting millions of people. The article breezed past it to focus on the 86 conditions where evidence was insufficient.

What they didn't mention at all: the neuroimaging data showing acupuncture changes brain activity in specific, measurable ways. The 2021 Nature study identifying a neuroanatomical pathway — the vagal-adrenal axis — that is activated by acupuncture at specific points but not others. Not "acupuncture is magical," but "specific needle placement produces specific physiological effects." That's the opposite of placebo.

They also didn't mention that the VA, DoD, and NICE in the UK actively recommend acupuncture for specific conditions. These are not fringe organizations swayed by ancient mysticism.

Why This Matters Beyond Being Annoying

Patients with anxiety, fertility challenges, chronic fatigue, digestive disorders, or headaches will read this article and conclude that acupuncture is probably a pain-only tool. Some of them will make decisions based on that. They'll pursue pharmaceutical options with documented side effect profiles, when they might have done well with a treatment that has an exceptionally clean safety record and growing mechanistic evidence.

That's not a small thing. That's the actual public health impact of sloppy framing from a prestigious outlet.

Here's what I'd tell any patient who read that piece: the science is more interesting — and more promising — than a three-minute summary can capture. Acupuncture is not magic. It doesn't work for everything. But dismissing it as an elaborate placebo in 2026, after two decades of neuroimaging research and mechanism studies, isn't skepticism. It's just not keeping up.

The British Acupuncture Council published their own response to The Economist article — worth a read: acupuncture.org.uk/news/bacc-response-to-the-economist-article-does-acupuncture-work/

Courtney Zeller is the primary practitioner at GoodMedizen, an integrative acupuncture and functional medicine clinic in downtown Seattle. She has been practicing since 2011 and holds a QSI Detoxification Certification alongside her acupuncture license.

 
 
 

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