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The short answer is, we are not exactly sure! To the best of our current understanding, it works by eliminating blockages in the subtle energy (or meridian) system of the body, rather like "clot-busting" drugs dissolve clots in blood vessels.
Somehow, when we combine our intention to heal with the transmission of kinetic energy down the meridians through the tapping, and we pay attention to the dynamic nature of your experience, we facilitate a change in your experience of the issue.
But just as you can benefit from having a car and using it to get from Point A to Point B without being able to tear down and reassemble the engine, you can benefit from tapping without knowing exactly how it works. Thousands of people already have!
What about the placebo effect?
Is it possible that tapping may be working by using the placebo effect? Yes, for all we know. But if you get relief that you weren't able to get before, without the use of drugs, surgery, years in treatment modalities that don't work, unpredictable side-effects, and without having to leave the comfort of your own home, isn't that a wonderful outcome?
Whether your current belief system predisposes you to accept the existence of the subtle energy body or not, we know from today's understanding of quantum physics that everything is energy. Even things that appear solid to our five senses are, when you get down to it, mostly the empty space between the nuclei of atoms and their surrounding electrons.
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