The bulk of the evidence strongly suggests that any benefits of acupuncture are purely placebo.
However, the research into the placebo effect also suggests that acupuncture is exactly the sort of thing that you would expect to induce a very strong placebo effect. Ritualistic, transgressive, personalised, slightly invasive, wrapped in fancy nonsense. And, ultimately, we don’t care that much if it’s “just” a placebo effect: a healthier patient is a healthier patient, however they got there. All too often, the placebo effect is the most effective treatment available.
As placebo-based quackery goes, acupuncture is less offensive than most. It’s unlikely to interfere with concurrent evidence-based therapies, and it’s unlikely to cause direct harm so long as basic infection control procedures are followed. The only major danger (assuming clean needles) is the possibility that patients may forego necessary treatment of serious conditions because they’re using acupuncture instead.
So where you end up is the bioethics debate about the use of placebos.
Is it okay to lie to your patients if you’re doing it for their benefit? Is it ethical to charge money for a treatment that you know to be inert? Does the answer to that question change as the price increases? Should the performers of placebo rituals be people who know that it’s just theatre, or is it better if they believe their own bullshit? What are the ethics of training clinicians in these techniques? How much consideration should we give to the value of promoting evidence-based reasoning more generally?
BTW, anyone who hasn’t seen this already would probably find it entertaining:
