One of the main arguments that has been hitherto used to dismiss acupuncture as just placebo is based on studies that found that ‘true’ acupuncture (a.k.a. ‘doing it properly’) is not much better than ‘sham’ acupuncture (a.k.a. ‘doing it almost properly’ – with the needles inserted into the body slightly away from actual acupuncture points). Both the true and the sham acupuncture in these trials tended to be effective, which leads professional sceptics to shout loud from the rooftops that ‘it doesn’t matter where you put the needle’. However, a meta-analysis by an excellent team of UK-based researchers, involving 29 good quality trials and tens of thousands of acupuncture treatments has shown that acupuncture is significantly superior to the controls with which it is typically compared – irrespective of the type used. This analysis included patients with headache and migraine, osteoarthritis and back, neck and shoulder pain. The controls with which ‘true’ acupuncture was compared included ‘sham’ needles (as described above), non-penetrating sham (i.e. ‘false-dagger’ type) needles, and routine care. Acupuncture was found to be significantly superior to all of these controls. True to form, where penetrating needles were used as a sham control, true acupuncture was found to have smaller effect sizes. Larger effect sizes were found where acupuncture was compared with routine care.
The take home message here? There are a few. Firstly, acupuncture is effective for illnesses involving pain. Secondly, there is no such thing as ‘sham’ acupuncture; wherever you insert a needle into the body it produces important therapeutic physiological activity. And finally, it’s back to the drawing board with for many acupuncture researchers, as many of the trials conducted up to this point really aren’t fit for purpose as evidence.