CHICAGO - Acupuncture gets a thumbs-up for helping relieve pain from chronic headaches, backaches and arthritis in a review of more than two dozen studies the latest analysis of an often-studied therapy that has as many fans as critics.

Some believe its only powers are a psychological, placebo effect. But some doctors believe even if that's the explanation for acupuncture's effectiveness, there's no reason not to offer it if it makes people feel better.

The new analysis examined 29 studies involving almost 18,000 adults. The researchers concluded that the needle remedy worked better than usual pain treatment and slightly better than fake acupuncture. That kind of analysis is not the strongest type of research, but the authors took extra steps including examining raw data from the original studies.

The results "provide the most robust evidence to date that acupuncture is a reasonable referral option," wrote the authors, who include researchers with Memorial Sloan-Kettering Cancer Center in New York and several universities in England and Germany.

Their study isn't proof, but it adds to evidence that acupuncture may benefit a range of conditions.

The new analysis was published online Monday in Archives of Internal Medicine. The federal government's National Center for Complementary and Alternative Medicine paid for most of the study, along with a small grant from the Samueli Institute, a nonprofit group that supports research on alternative healing.

Acupuncture's use has become more mainstream. The military has used it to help treat pain from war wounds, and California recently passed legislation that would include acupuncture among treatments recommended for coverage under provisions of the nation's new health care law. That law requires insurance plans to cover certain categories of benefits starting in 2014. Deciding specifics is being left up to the states.

Some private insurance plans already cover acupuncture; Medicare does not.

In traditional Chinese medicine, acupuncture involves inserting long, very thin needles just beneath the skin's surface at specific points on the body to control pain or stress. Several weekly sessions are usually involved, typically costing about $60 to $100 per session. Fake acupuncture studied in research sometimes also uses needles, but on different areas of the body.

Scientists aren't sure what biological mechanism could explain how acupuncture might relieve pain, but the authors of the new study say the results suggest there's more involved than just a placebo effect.

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Study: Placebo or not, acupuncture helps with pain