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Sat Jun 13 13:27:31 BST 2009

At the risk of inviting trouble, surely the question is whether the
"sham-acupuncture" is actually a placebo and therefore there is no
difference between the placebo and the treatment. Sham acupuncture does
involve applying pressure to the skin in a particular place and may not be a
genuine placebo, as we don't know what it is about accupuncture that is
meant to be therapeutic designing a true placebo becomes difficult. I'd ask
similar questions of cholesterol lowering drugs that lower cholesterol
relative to an olive oil placebo.

My anatomy lecturer at medical school was convinced that acupuncture works -
there are small FMRI studies showing that acupuncture generates activity in
the periaquaductal grey matter which is a region involved in mediating
analgesia. Additionally studies in people with nerve damage, doing
accupuncture in insensate areas produced no benefit. Unfortunately having
graduated from medical school I can no longer get hold of the references,
but it would seem perfectly reasonable to me that mildly stimulating
nocireceptors could produce some inhibition of stronger pain signals.
Afterall perception of pain can be influenced by an enormous number of other
factors (fear, anxiety etc.).

 I suspect accupuncture may end up being something like phantom limb pain,
allodinya or RSD that was treated as nonsense for years but once the
mechanism is understood suddenly becomes reasonable.

Dr. Thomas Riley
FHO
Derriford Hospital, Plymouth.

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