"Sham Wow!!!" or The Problem with Acupuncture Research

Posted in: Acupuncture, Research | 0

You have probably heard from all the acupuncture skeptics that research proves that acupuncture doesn’t work because many studies have shown that acupuncture is no more effective than a placebo.

This is a valid point because a control group is needed in any study to compare participants that received no treatment at all, a fake treatment, or other types of treament.  A placebo is usually a fake version of the treatment, but as you can imagine, it is very difficult to give somebody a fake version of acupncture.  In studying a new drug medication it’s easy to give a sugar pill placebo and trick the participant into believing that they are taking real medication. The people giving or taking the pills have no real way of knowing which side of the study they are on, thus producing a double blinded randomized controlled trial or “the gold standard” of research. Also, it is easy to produce a pill that will have absolutely no effect on the patient. With acupuncture it is a bit trickier to produce placebos which can trick both the participant and the clinician.  Even more difficult is to produce a placebo version of acupuncture that has no effect on the patient.  Here are some of the placebos that scientists have come up with:

Fake Acupuncture Points

The first studies typically used standard acupuncture needles but inserted them into points that were not “real” acupuncture points. The problem is that it is hard to find a point on the body that is not somehow an acupuncture point.  There are about 400 classical acupuncture points. In addition, there are also ah-shi points which are acupuncture points that are not standard. Then there are the extra points which have officially been added. Acupuncture is over 3000 years old, but new points are still being discovered and new approaches or techniques are still being developed today. Also, consider that even though acupuncture is most effective if a prescribed acupuncture point is used, being “a bit off” of the exact point location is still effective and yields positive results. The drawback with using real acupuncture needles on “non-acupuncture” points is that the points could possibly be real acupuncture points after all.  Another drawback to using fake points is that it still involves inserting acupuncture needles into the body. This simple act still sets off a chain of hormonal and chemical reactions which could have a profound effect on the body.

The Fake Acupuncture Needle

There is a contraption sometimes used as a sham acupuncture that looks like a tube holding an acupuncture needle that is designed to mimic the look and feel of an acupuncture needle, but which doesn’t actually puncture the skin. The problem here is that the disguise isn’t perfect and the patient and clinician can at times tell the difference. Also, even though the needle is not puncturing the skin, there is still a sensation and a contact that could have an effect. Remember that Traditional Chinese Medicine also has a component called Tui Na Massage which involved massaging the same points and energy meridians as real acupuncture. In other words, Chinese medicine even works without the needles.

Fake Laser Acupuncture

Laser acupuncture can sometimes be used as the sham. This involves using a laser acupuncture light at an ineffective low intensity. This is a very good sham as it still tricks the patient into believing that they are being treated, thus isolating that component from the results. Most importantly it is able to appear as a real treatment without inadvertently treating.

The problem with acupuncture research is not in proving that acupuncture works.  Most studies show that acupuncture in real or sham form produces better results than no acupuncture.  The problem with acupuncture research is actually proving that acupuncture DOESN’T work. Inserting acupuncture needles into non-acupuncture points or stimulating energy meridians with fake needles often yields positive results as they are still a form of acupuncture.

The next time you read an article of how acupuncture is no better than the placebo, try to find out what type of placebo was used.  The placebo might have been acupuncture too.