| The purpose of placebo is to utilize a treatment that is indistinguishable
from genuine therapy, yet has no effect. Due to the nature of practice it
is nearly impossible to control for acupuncture. The most commonly used control therapy is that of sham acupuncture.
This involves the needling of non-traditional (non-acupoint) sites. Depth
of placement and amount of stimulation is identical to acupuncture at
traditional acupoints. However, sham acupuncture has been shown to induce
its own analgesic affect.
- Lewith and Machin (1983) showed an analgesic response of 40-50% in those
treated with sham acupuncture versus 60% response in the acupuncture
group.
- The mechanism of DNIC supports
that sham acupuncture would induce analgesia.
- Many other controlled trials have demonstrated analgesia despite whether
traditional acupoints were needled or not.
It has been suggested that in treatment of conditions other than pain, sham
acupuncture may act as a valid control.
Other methods of control include mock transcutaneous electrical nerve
stimulation (TENS) and minimal acupuncture (1-2 millimeter placement of needles
at classical acupoints with little to no stimulation). The success of
either modality as a control has not yet been established.
Streitberger and Kleenhen in 1998, however completed a study using a placebo
needle in which the needle can be placed at true acupuncture sites without
penetrating the skin. Of the 60 volunteers, 54 felt penetration with the
acupuncture needles and 34 experienced dull pain with these needles. 47
volunteers felt penetration with the placebo and 13 felt a dull pain. None of
the volunteers suspected that the needle did not penetrate the skin. They
concluded that the placebo needle is sufficient for control groups. |
