Positive Health Online

Abstract

WHITE and co-workers, Complementary Medicine Research Unit, Mail Point OPH, Royal South Hants Hospital, University of Southampton, Brintons Terrace, Southampton, UK, pjw1@soton,ac,uk, have asked the question whether the placebo needle is a valid and convincing control for use in acupuncture trials.

Background

The issue of what constitutes an effective and realistic acupuncture placebo control has been a long-standing problem in acupuncture research. The control procedure must be convincing, visible and should mimic in all respects, apart from the physiological effect, the real treatment. The 'Streitberger needle' might fulfil these criteria, and in this study was tested in that regard.

Methodology

In this single-blinded, randomized, crossover pilot study, 37 patients were recruited from the orthopaedic hip and knee joint replacement waiting list. Intervention consisted of either 2 weeks of treatment with real acupuncture followed by treatment for 2 weeks with placebo needling, or vice versa. The outcome measure was a needle sensation questionnaire.

Results

No significant differences between groups or needle types were found for any of the sensations measured. Most patients were unable to discriminate between the needles by penetration. Nearly 40% of patients were able to detect a difference in treatment type between needles. No major differences in treatment outcomes between real and placebo needling could be found.

Conclusion

The fact that nearly 40% of patients did not find that the two treatments were similar raises some concern over the use of this instrument as a standard placebo control for acupuncture. Further research on inter-tester reliability and standardization of technique is highly recommended.

References

White P, Lewith G, Hopwood V, Prescott P. The placebo needle, is it a valid and convincing placebo for use in acupuncture trials? A randomised, single-blind, cross-over pilot trial. Pain 106 (3): 401-409, Dec 2003.