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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 …
Competing interests AW receives fees as the editor of the journal Acupuncture in Medicine.