This week’s issue of Newsweek magazine, features an interesting article by Sharon Begley describing the power of placebo. The article mentions a study by Daniel Cherkin of Group Health Center for Health Studies (Seattle, WA, USA), just published in the Archives of Internal Medicine, which randomised 638 patients with lower-back pain to individualized acupuncture, standardized acupuncture, simulated acupuncture, or usual care. Ten treatments were provided over 7 weeks by experienced acupuncturists.
Remarkably, both the participants receiving real or simulated acupuncture did better than those receiving usual care.
Thus, although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient or even penetration of the skin appear to be unimportant in eliciting therapeutic benefits.
This finding suggests that the “placebo effect” of acupuncture (whether real or sham) is more powerful than conventional treatment and certainly raises doubts about the supposed mechanism of action of acupuncture. After all if the success of acupuncture for back pain has nothing to do with actually using the right points or even using real needles (tooth picks were used for some of the sham treatments), then one must wonder about how important the placebo effect of this treatment really is.
As students of obesity are well aware, acupuncture has also been suggested as a treatment for obesity. This was addressed in a randomised controlled trial just published this month in the International Journal of Obesity.
In this small but carefully conducted study, Nourshahi and colleagues from the Shahid Beheshti University, Tehran, Iran, randomised 27 obese women to 3 groups receiving diet and exercise with or without acupuncture for 8 weeks or to no intervention at all. Both diet and exercise groups lost the same amount of weight, with no indication of any additional benefit of acupuncture.
So apparently the “placebo effect” of acupuncture that works for back pain does not work for weight loss. But even if the acupuncture patients had lost more weight, in light of the back pain study, I’d be wondering about the mechanism of this effect.
Truly placebo effects never fails to intrigue me - to find out how little we know about how placebos actually work (and believe me, there is more science around this than you may suspect), I strongly recommend Begley’s article in Newsweek!
AMS,
New Orleans, LA
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