Solid science proves acupuncture is an effective and safe pain-reliever. Now, research is closing in on how it works.

A major study released by Memorial Sloan-Kettering Cancer Center in 2012 that looked at almost 18,000 patients confirms the ancient therapy relieves chronic back, neck, and shoulder pain; osteoarthritis, and recurring headaches. Additionally, proponents claim needle treatment can ease allergies and anxiety among other health problems.

But acupuncture is still controversial in the U.S. One big reason: It’s rooted in centuries-old concepts of health and illness in contrast to measurable and reproducible clinical data.

“Acupuncture is based on the ancient Chinese belief that energy called Qi flows throughout the body along meridians—or channels—to create balance and health,” says Marcos Hsu, an acupuncturist at the University of Maryland Center for Integrative Medicine.

As the traditional theory goes, physical pain and illness occur when energy slows or stops flowing in a particular body zone. Inserting tiny needles into related acupuncture points (there are 350 of them) releases the energy and helps the body heal itself.

Hsu continues: “Any blockage or stagnation of energy can cause pain and lead to illness. Each acupuncture point along the meridians is related to a specific body system or function that can be stimulated by inserting fine needles to restore health. The goal of acupuncture is to promote the body’s innate ability to heal by correcting imbalances of energy flow.”

So, how does modern research explain the healing powers of acupuncture? Even though its mechanism of action isn’t clear-cut, multiple studies confirm the ancient therapy unleashes good-for-you chemicals throughout the body.

“Many acupuncture studies show beneficial changes in blood circulation and levels of neurochemicals such as endorphins and serotonin that may produce an analgesic effect and suppress pain,” Hsu says.

“Other scientists suggest pain relief occurs when acupuncture blocks pain signals from reaching the brain via specific nerve fibers. Additionally, some propose the therapy stimulates a localized release of endorphins at the injury site. Regardless of the explanation, research consistently shows that acupuncture relieves pain.”

People respond differently to acupuncture but the treatment is safe and effective, with minimal adverse effects for most patients. That said, individuals with 1) heart problems, 2) metal allergies, 3) skin conditions, 4) bleeding disorders, 5) low immunity, or 6) who are taking anticoagulants should consult their doctor or acupuncturist prior to receiving an initial treatment, Hsu says.

With acupuncture drifting into the medical mainstream, more insurance companies are covering the treatment in medical centers and private clinics across the country. To find a practitioner, contact your health insurance carrier for a list of approved providers or consult your doctor for a referral.

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