A group from Southampton randomised 221 patients awaiting joint replacements because of osteoarthritis into receiving real acupuncture or placebo-acupuncture (non-penetrating needles) or mock electrical stimulation.
Each group was further divided into either empathetic or non-empathetic consultations. The treatment period lasted four weeks. The results demonstrated that the placebo treatments were as effective (or ineffective) and equally creditable as real acupuncture. Patients’ belief in acupuncture was a determinant of the clinical outcome.
This is the most recent in a long list of trials suggesting that acupuncture is, in fact, nothing more than an elaborate placebo. It also is (to my knowledge) the third study that shows the consultation to be the important bit of an acupuncture session.
I can already hear the acupuncturists arguing: this only shows that acupuncture is a complex intervention which cannot be taken apart; it must be evaluated as a whole. My answer to this has always been that most, if not all medical, surgical or psychological treatments are complex – even prescribing an aspirin usually requires a consultation - and, with good doctors, this should always be empathetic. My point is simple: the fact that some treatments generate non-specific (or context) - effects cannot be a good reason for treating our patients with placebos.
Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter
Reference
White P, Bishop FL, Prescott P, Scott C, Little P, Lewith G. Practice, practitioner, or placebo? A multifactorial, mixed-methods randomized controlled trial of acupuncture. Pain 2011; Dec 12. [Epub ahead of print].
