ACUPUNCTURE AND THE PLACEBO RESPONSE

A recent study comparing real acupuncture, laser acupuncture, and sham laser acupuncture with no treatment for knee arthritis showed that real acupuncture, laser acupuncture, and sham laser acupuncture all resulted in decrease in pain. In the media this study has been presented as evidence that acupuncture does not work and that any decrease in pain associated with acupuncture is the result of the placebo effect.

In reality the story is more complicated than that. First of all, the study was small, with fewer than 20 patients in each treatment group. Second, treatment was only administered for three months, which is rarely long enough to bring about lasting improvement in a condition that has, in most cases, developed over the course of decades. And third, the discussion of this study in the mainstream media and scientific circles ignores the fact that EVERY medical or surgical treatment relies quite heavily on the placebo response, whether we are talking about prescription medication, herbal medicine, acupuncture, or surgery.

Placebo response — “all in your head” or a valuable tool?

For reasons that we do not yet understand, receiving treatment from a person who we perceive to be an expert (whether a physician writing us a prescription, a surgeon cutting on us, or an acupuncturist needling us) often elicits a cascade of responses that results in the body healing itself. This is the much maligned placebo response. But isn’t stimulating the body to heal itself a GOOD thing? If a treatment is low-risk and results in a person feeling better, by whatever means, shouldn’t that be something that people are encouraged to try? Particularly when the other options (for instance long term use of anti-inflammatory drugs or joint replacement surgery) carry serious risks?

Is acupuncture a placebo?

I remain convinced, on the basis of over ten years of clinical experience, as well as the available scientific evidence (including evidence from animals and small children, who are not subject to the placebo response), that acupuncture is more than a placebo. On the other hand, I do not dismiss the value of the placebo response. If a portion of the relief that my patients experience is the result of a self-healing response elicited by our interaction with one another, then I am thrilled for my patients to benefit from that. The bottom line is that they feel better and that is what counts.