Acupuncture is superior to sham for painful conditions
- 1Primary Care, Peninsula Schools of Medicine and, Dentistry, Plymouth University, Plymouth, UK
- 2Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
- Correspondence to: Dr Adrian White
Peninsula Schools of Medicine and, Dentistry, Plymouth University, Tamar Science Park, Plymouth PL68BX, UK;
Commentary on: Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture Trialists’ Collaboration. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 2012;172:1444–53.
Acupuncture is controversial. Even if one assumes its overall effectiveness, common explanations for its causal impact are biologically implausible. Hence acupuncture is often dismissed as ‘no more than a placebo’, and this allegation is difficult to disprove as placebo-controlled trials are problematic. ‘Placebo’ needles stimulate sensory nerves and are possibly a less active treatment, ‘sham’ rather than ‘placebo’.1 Small differences between treatments require large sample sizes, as achieved by meta-analysis. Previous meta-analyses concentrated on finding all trials, but poor quality limited the conclusions.
This is a systematic review of randomised controlled trials (RCTs) of chronic headache and musculoskeletal conditions that had unambiguous allocation concealment and were assessed for risk of bias from blinding. The authors …