Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis

Abstract

Acupuncture has gained increasing attention in the treatment of chronic pain. The lack of a satisfying placebo method has made it impossible to show whether needling is an important part of the method or whether the improvement felt by the patient is due to the therapeutic setting and psychological phenomena. Also, the effectiveness of acupuncture has not been demonstrated sufficiently. We treated 52 sportsmen with rotator cuff tendinitis in a randomised single-blind clinical trial using a new placebo-needle as control. Patients were treated for 4 weeks. The primary endpoint of the trial was the change in the modified Constant-Murley-score from the baseline. Assessment of the treatment outcome was made by experienced orthopaedists not informed of the treatment allocation. Acupuncture with penetration of the skin was shown to be more effective than a similar therapeutic setting with placebo needling in the treatment of pain. The acupuncture-group improved 19.2 Constant-Murley-score points (SD 16.1, range from -13 to 50), the control-group improved 8.37 points (SD 14.56, range from -20 to 41), (P=0.014; C.I. 2.3;19.4). This study showed that needling is an important part of the acupuncture effect in the treatment of chronic shoulder pain in athletes. No conclusions can be derived from this study concerning the importance of choosing points and the rules of Traditional Chinese Medicine. Using the new placebo method as control for other ailments could improve the evidence of specific acupuncture effects beyond pain treatment.

Subacromial corticosteroid injection or acupuncture with home exercises when treating patients with subacromial impingement in primary care – a randomized clinical trial

“…Hay et al 9 reported similar efficacy for subacromial corticosteroid injection and a mix of PT intervention and it is common in clinical practice to combine for example acupuncture with exercises as a treatment for patients with SIS. 5,10 Electro 11 and manual acupuncture 12 alone or combined with home exercises 13 are reported as being probably effective, but the treatment strategies and inclusion criteria of different trials has varied. Overall, the evidence of efficacy seems inconclusive, especially over the long-term.…”

A combined [11C]diprenorphine PET study and fMRI study of acupuncture analgesia

“…Sham / placebo acupuncture administration-Placebo treatment used a validated sham acupuncture needle (Streitberger placebo) [16,17,19,28,31,37,40] and was identical to active manual acupuncture except that the needle was not inserted into the skin and the acupuncturist held and rotated the needle more gently. The sham needles differed from regular needles by possessing blunt and retractable tips.…”

Acupuncture for the treatment of obesity: a review of the evidence

“…69 This placebo needle was shown to be perceived by volunteers as similar to the true penetrating acupuncture needle (also held in place via bandaid and ring), 69 and, appropriately, the placebo was significantly less effective in reducing tendinitis pain and discomfort. 70 With or without appropriate blinding and placebo controls, expectations about the credibility (usefulness and efficacy) of unconventional methods such as acupuncture may influence outcome. 71 Such moderating variables may obscure real differences between groups especially in small samples.…”