The Difference Between “Sham Acupuncture” and “True Acupuncture” Must be Clarified.

As acupuncture and Eastern Medicine become more mainstream, more misleading research is appearing in the news. It is important to clarify any possible mistakes.

In an attempt to create a placebo group for acupuncture trials, researchers have been needling nonspecific acupuncture points in what is called, the “sham” acupuncture group, and needling specific acupuncture points in the “True Acupuncture” group. John Amaro, LAc, Dipl. Ac. (NCCAOM), FIAMA, DC’s latest article in this month’s Acupuncture Today goes over some specific trials where this took place. He describes the process of “Sham” and “True” acupuncture.

In this research, studies were categorized by use of wrong points, nonpoints, and normal insertion and stimulation versus superficial insertion or minimal stimulation. The researchers obviously discounted superficial stimulation, as in various forms of Japanese acupuncture, as a valid treatment despite its thousand-plus year history. They further discounted any acupuncture points as invalid or wrong other than those which are illustrated on the human acupuncture mannequin or a typical acupuncture chart.

Not surprising, both acupuncture groups improved.

Why do both groups improve?

The reason both groups improve is because in both groups, needles are placed in the pain area, for example, low-back, arm, head, for pain in the associated area. What needs to be understood here is the fact that inserting an acupuncture needle into a painful location on the body, will stimulate the body to heal itself. The mechanisms are well documented, they range from increased blood circulation, enkephalin release, to the shear fact that inserting a needle into a muscle will cause the muscle fibers to relax. There are many scientifically proven reasons for the patient to feel relief with both needle treatment protocols, feel free to insert your own.

Yet, in the studies the “True Acupuncture” protocols are superficial as well. The patients in the “True” group seem to get a general point prescription very similar to the “Sham” group. There is virtually no difference between the groups. The vast majority of patients improve in these studies. Amaro states, “True blind or double-blind studies may essentially be impossible within acupuncture research due to the fact as long as a patient is able to feel a sensation at the point of needle contact (whether actual or simulated), it cannot be considered a valid blind study. The methods utilized in most acupuncture research are without question, a ‘sham.’”

Therefore, the attempt to create a placebo group is the real “sham.”

Amaro continues, “It is very apparent that those who are conducting what would otherwise be considered valid and scientific research at extremely impressive and recognized institutes are in fact guilty of the highest malfeasance with the models they have chosen to use regarding the effectiveness of acupuncture. Unfortunately, the general public and the scientific community regard research from these sources as gospel and would never question the validity of these studies.”

The Point of This Article

Both “Sham” and “True” acupuncture treatment protocols are superficial and imprecise. Yet, they provide relief to the majority of patients.

The most important of the earliest books about acupuncture, Nei Jing: Ling Shu, chapter four expresses the importance of proper diagnostic techniques and treatment. “故善调尺者，不待于寸，善调脉者，不待于色。能参合而行之者，可以为上工，上工十全九；行二者，为中工，中工十全七；行一者，为下工，下工十全六。” “Therefore, the doctor that is good at interpreting the condition of the forearm, does not need to refer to the Cun Kou pulse, the doctor that is good at regulating the pulse, does not need to wait to check the complexion. The physicians that are capable of diagnosing using all three of these aspects are called superior doctors, they can cure nine of ten patients; the physicians that are capable to use two of the three diagnostic methods are called the middle level doctors, they can cure seven of ten patients; physicians that use only one method of diagnosis are considered low level doctors, they can cure six of ten patients.”

The generalized treatments in the studies would probably be categorized as the treatment of lower level doctors according to the Nei Jing.

The real lesson to be learned is that acupuncture works. The message to the patient is to imagine the benefit when a qualified acupuncturist is allowed to use more precise diagnostic protocols and treatments. The results are greater.