Another systematic review looked at the effect of acupuncture on many chronic pain conditions, which included low back pain, tension-type headache, migraine, knee osteoarthritis, fibromyalgia, abdominal scar pain, postoperative pain, and procedural pain during colonoscopy. This review compared the response in groups treated with true acupuncture, sham acupuncture, and no acupuncture found a small but statistically significant difference between true acupuncture and sham acupuncture when used to treat various types of chronic pain conditions in favor of true acupuncture. However the effect of placebo acupuncture varied significantly, and there was a great amount of heterogeneity when comparing placebo acupuncture to no acupuncture.4
A meta-analysis
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The mechanisms of the placebo effect include expectations, conditioning, anxiety reduction, and social support.3 The repeated sessions, close contact with the acupuncturist, and invasive nature of both sham acupuncture and true acupuncture (as compared to simply giving a pill) can be interpreted by patients as very meaningful. This “meaning response” may contribute to the reduction of pain seen in both verum and sham acupuncture groups when compared with control groups.5 It could also be argued that the slightly greater improvement seen in the true acupuncture groups compared to the sham acupuncture groups is due to a combination of the placebo effect as well as true physiological …show more content…
Furthermore, this research was limited by the access to certain literature that required a subscription or payment. If this study had the resources to access all of this literature and was able to review a larger sample size of available studies, the results could have been very different. Further research is needed to investigate the physiological effects of needling the skin, to determine if it has effects independent of location or depth. This could be furthered by further study Emerging research methods are making it possible to perform sham acupuncture without actually piercing the skin, while still keeping the participants blinded as to which treatment group they are in.2 This may serve to ameliorate the aforementioned criticism regarding the similarity of previous sham acupuncture techniques to true acupuncture techniques. Finally, pain is a subjective complaint and can be difficult to measure quantitatively and objectively. If researchers can identify an objective way to measure pain (such as change in brain activity on neuroimaging), this can be used to measure response to treatment, which may help further understand what the physiologic effects of acupuncture