Category Archives: Acupuncture Research

Practice, practitioner, or placebo? A multifactorial, mixed-methods randomized controlled trial of acupuncture 2012

This article was published in the journal ‘Pain’ in 2012 by Peter White, Felicity L. Bishop, Phil Prescott, Clare Scott, Paul Little, George Lewith et al.
PAIN, Volume 153, Issue 2, February 2012, Pages 455-462

Here is the abstract:
The nonspecific effects of acupuncture are well documented; we wished to quantify these factors in osteoarthritic (OA) pain, examining needling, the consultation, and the practitioner. In a prospective randomised, single-blind, placebo-controlled, multifactorial, mixed-methods trial, 221 patients with OA awaiting joint replacement surgery were recruited. Interventions were acupuncture, Streitberger placebo acupuncture, and mock electrical stimulation, each with empathic or nonempathic consultations. Interventions involved eight 30-minute treatments over 4 weeks. The primary outcome was pain (VAS) at 1 week post treatment.
Face-to-face qualitative interviews were conducted (purposive sample, 27 participants). Improvements occurred from baseline for all interventions with no significant differences between real and placebo acupuncture (mean difference −2.7 mm, 95% confidence intervals −9.0 to 3.6;P = .40) or mock stimulation (−3.9, −10.4 to 2.7; P = .25). Empathic consultations did not affect pain (3.0 mm, −2.2 to 8.2; P = .26) but practitioner 3 achieved greater analgesia than practitioner 2 (10.9, 3.9 to 18.0; P = .002). Qualitative analysis indicated that patients’ beliefs about treatment veracity and confidence in outcomes were reciprocally linked.
The supportive nature of the trial attenuated differences between the different consultation styles. Improvements occurred from baseline, but acupuncture has no specific efficacy over either placebo. The individual practitioner and the patient’s belief had a significant effect on outcome. The 2 placebos were equally as effective and credible as acupuncture. Needle and non-needle placebos are equivalent. An unknown characteristic of the treating practitioner predicts outcome, as does the patient’s belief (independently). Beliefs about treatment veracity shape how patients self-report outcome, complicating and confounding study interpretation.

Plantar Fasciitis relief

I have personal experience of this awful foot pain that takes ages to go away and prevents walking and running for up to 6 months. This journal article suggest the use of electro-acupuncture for the relief of the condition in short time.

painful feetElectro-acupuncture (EA) coupled with conventional treatment is more effective than conventional treatment for plantar fasciitis, according to a pilot study carried out in Thailand. Thirty patients with chronic refractory plantar fasciitis were randomly assigned to two groups. Subjects in the control group received five weeks of conventional treatment, including stretching exercises, shoe modification and analgesics. Subjects in the acupuncture group received the same treatments plus ten twice-weekly sessions of electro-acupuncture. At the end of treatment, visual analogue scale (VAS) pain scores were found to have decreased significantly in both the acupuncture and control groups. However, Foot Function Index (a measure of the impact of foot pathology on foot function in terms of pain, disability and activity restriction) decreased significantly in the acupuncture group only. With successful treatment defined as a minimum 50% decrease in VAS, subjects in the acupuncture group experienced significantly higher success rates than those in control group (80% versus 13.3%, respectively), which were maintained at six-week follow-up. (Efficacy of electro-acupuncture in chronic plantar fasciitis: a randomized controlled trial. Am J Chin Med. 2012;40(6):1167-76).

Nausea and vomiting during chemotherapy

Many patients undergoing chemotherapy experience nausea and vomiting (Gralla 1999; Hesketh 1998). The symptoms can be severe, impairing a patient’s quality of life (Osoba 1997), causing emotional distress (Love 1989), and aggravating cancer-related symptoms such as cachexia, lethargy and weakness (Griffin 1996; Roscoe 2000).

This article reviews the research evidence for the effectiveness of acupuncture in these circumstances.

The best evidence for acupuncture’s effectiveness is with postoperative nausea and vomiting (PONV) (Ezzo 2006a). The latest systematic review, based on 40 trials and nearly 5,000 patients, found acupuncture to be significantly better than sham treatment and at least as good as anti-emetic drugs, with minimal side-effects (Lee 2009). Trials published since this review gathered its data have also been consistently positive: acupressure at P6 (Soltani 2010), acupoint injection of droperidol at P6 (Zhu 2010), 24-hour acupoint stimulation (Frey 2009), acupuncture at several points (Ayoglu 2009), acupuncture at P6 (Puyang 2009, Frey 2009) and ear acupuncture (Sahmaddini 2008). There is one less consistently favourable review but that looked specifically at caesarean delivery under neuraxial anaesthesia (6 trials only): (Allen 2008).


For chemotherapy-induced nausea and vomiting, there is also substantial evidence supporting acupuncture and associated procedures, although it is not as consistent as that for PONV. The latest systematic review (Ezzo 2006b) is now several years old. It found that electro- (but not manual) acupuncture reduced the incidence of acute vomiting and self-administered acupressure appears to have a protective effect for acute nausea and can readily be taught to patients. Subsequent individual trials of acupuncture or electroacupuncture (Yang 2009; You 2009; Sima 2009; Gottschling 2008) have all reported significant benefits, while those for acupressure applied using a wristband have been mixed (Jones 2008; Molassiotis 2007; Shin 2006).

Intense acupuncture for Bells Palsy

This interesting article, published in the CMAJ, discusses the results of a new research project from China that compares treatments for Bells Palsy. The traditional Chinese theory of acupuncture emphasizes that the intensity of acupuncture must reach a threshold to generate de qi, which is necessary to acheive the best therapeutic effect. De qi is an internal compound sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints. However, the notion that de qi must be acheived for maximum benefit has not been confirmed by modern scientific evidence. This article discusses the importance of de qi in Bells Palsy treatement.
Reuters health


Depression is a common condition for acupuncturists to work with. Often people visit a local acupuncturist when bio-medical treatments are not helping them to get better and remain healthy. Click here for a Fact Sheet on Depression from BAcC.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional wellbeing.

Studies indicate that acupuncture can have a specific positive effect on depression by altering the brain’s mood chemistry, increasing production of serotonin (Sprott 1998) and endorphins (Wang 2010). Acupuncture may also benefit depression by acting through other neurochemical pathways, including those involving dopamine (Scott 1997), noradrenaline (Han 1986), cortisol (Han 2004) and neuropeptide Y (Pohl 2002).

Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain which is responsible for anxiety and worry (Hui 2010). Stress-induced changes in behaviour and biochemistry may be reversed (Kim 2009).

Full research details are contained in the Fact Sheet.

Acupuncture for Irritable Bowel Syndrome

Evidence of efficacy of acupuncture in this BAcC Fact Sheet on IBS

There is consistent evidence that a course of acupuncture improves IBS symptoms and general wellbeing (Anastasi 2009, Trujillo 2008, Reynolds 2008, Schneider 2007b, Xing 2004, Lu 2000), though there are arguments about the extent to which the effect is placebo-related (Lembo 2009, Schneider 2007a, Lim 2006, Forbes 2005). As yet there is no satisfactory placebo/sham intervention for acupuncture so this is still a matter for conjecture. There are plausible physiological explanations for acupuncture’s effects (see above) and it can promote mechanisms not seen with sham treatments (Schneider 2007b).

World Health Organisation supports Acupuncture

WHO have recently compiled a list of conditions for which significant controlled trials have demonstrated that acupuncture is effective. Go to the WHO website for details of significant success with:

Adverse reactions to radiotherapy and/or chemotherapy
Allergic rhinitis (including hay fever)
Depression (including depressive neurosis and depression following stroke)
Facial pain (including craniomandibular disorders)
Low back pain
Nausea and vomiting
Neck pain Pain in dentistry (including dental pain and temporomandibular dysfunction)
Rheumatoid arthritis