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Are Acupuncture Placebo Needles Truly Only Placebos?

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womanandacuUsage of the scientific method to conclude whether acupuncture really works — or if its observed effects are strictly due to placebo effect – is a relatively recent phenomenon.
Before acupuncture reached the West, its effectiveness in the treatment of various conditions was accepted based upon centuries of observations. If needling a particular point caused a sensation along a specific line, or if it produced a specific effect, and the same sensation and effect was noted by numerous patients and doctors, it became accepted over time what the effects of needling a specific point were.
In the West, this method of reasoning is not accepted as valid by the scientific community. While the number of acupuncturists throughout the West has exploded over the past four decades, and the general public has grown increasingly more eager to try acupuncture both for wellness and the treatment of health conditions, clinical research is still in its infancy.
During the pioneer days of acupuncture, much of the clinical research involved the use of “sham” acupuncture (needle insertion on a place on the body that is not considered to be an acupoint). This obviously poses many problems because some may argue that there are acupoints all over the body, and if the needle is inserted it is acupuncture.
In 1998, a placebo needle was created to look and feel like an acupuncture needle by becoming shorter when it is supposedly “inserted” by the acupuncturist. But is a placebo needle really a better alternative to sham acupuncture? Will it help increase the quality of acupuncture research? Let’s examine the research on placebo needles.
The scientists who developed the placebo needle conducted their own study which used 60 volunteers. Fifty-four felt a penetration with acupuncture and forty-seven felt it with the placebo (even though nothing penetrated the skin). Thirty-four patients described feeling a “de qi” sensation with acupuncture and thirteen felt “de qi” with the placebo. The researchers concluded based on those results that a placebo needle is “sufficiently credible” to be used in clinical trials.
A slightly more sophisticated study of the placebo needle was conducted in 2003. Thirty-seven patients who were on the waiting list to receive a joint, hip, or knee replacement were given 2 weeks of acupuncture treatment followed by 2 weeks of placebo needle treatment, and vice versa.
There were no significant differences in the needle sensation described by patients using a questionnaire, although 40% were able to detect a difference in treatment type. There was no difference in treatment outcome. The researchers concluded that more studies need to be conducted to test inter-tester reliability and standardization of technique.
The 2003 study is more informative than the 1998 study, but the results raise a variety of questions. One could make a hasty conclusion that acupuncture treatment for joint, hip, and knee replacement patients was no more effective than placebo. Another person could say that the wrong set of acupoints were used, or pattern diagnosis was not taken into account.
Another person may conclude that the placebo acupuncture actually is acupuncture because it is actually stimulating the acupoint. (Some methods of acupuncture even prescribe non-insertion techniques and the stimulation of the acupoints with moxa instead of needles.) Having experienced the healing benefits of acupuncture both as a patient and as a clinician, I’m more apt to believe the latter explanation.


Sources: article/pii/S0304395903003750

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