To the Editor In their Editorial, Drs Briggs and Shurtleff1 cited the decision of the German health authorities and insurance companies to provide reimbursement for acupuncture treatment of low back pain as evidence for its efficacy. In fact, 2 of the trials cited (references 5 and 7) found no significant difference between traditional acupuncture and sham acupuncture controls. The decision to provide reimbursement for acupuncture treatments was apparently based on considerations other than efficacy, including a permissive attitude toward the use of placebos.2 In 2011 the German Medical Association issued a report on placebos in medicine that endorsed their use under certain conditions.2 The lead author of the report commented, “Every good doctor should have a couple of white or blue sugar pills handy.”2 The literature on acupuncture trials is conflicting, but the best evidence is that traditional acupuncture provides no clinically meaningful relief of pain compared with sham acupuncture controls.3- 5 The trials also demonstrated that the use of acupuncture points provides no unique benefits compared with controls that stimulate the skin and superficial tissues at a variety of locations.3- 5 At this time, it would be preferable to abandon the preoccupation with acupuncture in favor of a broader perspective on the neuroscience of nonpharmacologic approaches to relief of pain.
Donald M. Marcus. Acupuncture and Sham Acupuncture for Pain Relief. JAMA. 2017;318(15):1502–1503. doi:10.1001/jama.2017.13390