How Placebo Needles Differ From Placebo Pills?

Author: Chae Y1, Lee YS1,2, Enck P3
1Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, South Korea.
2Department of Anatomy and Meridians, College of Korean Medicine, Gachon University, Seongnam, South Korea.
3Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany.
Conference/Journal: Front Psychiatry.
Date published: 2018 Jun 5
Other: Volume ID: 9 , Pages: 243 , Special Notes: doi: 10.3389/fpsyt.2018.00243. eCollection 2018. , Word Count: 175

Because acupuncture treatment is defined by the process of needles penetrating the body, placebo needles were originally developed with non-penetrating mechanisms. However, whether placebo needles are valid controls in acupuncture research is subject of an ongoing debate. The present review provides an overview of the characteristics of placebo needles and how they differ from placebo pills in two aspects: (1) physiological response and (2) blinding efficacy. We argue that placebo needles elicit physiological responses similar to real acupuncture and therefore provide similar clinical efficacy. We also demonstrate that this efficacy is further supported by ineffective blinding (even in acupuncture-naïve patients) which may lead to opposite guesses that will further enhances efficacy, as compared to no-treatment, e.g., with waiting list controls. Additionally, the manner in which placebo needles can exhibit therapeutic effects relative to placebo pills include enhanced touch sensations, direct stimulation of the somatosensory system and activation of multiple brain systems. We finally discuss alternative control strategies for the placebo effects in acupuncture therapy.

KEYWORDS: acupuncture; blinding; control; physiology; placebo

PMID: 29930521 PMCID: PMC6000751 DOI: 10.3389/fpsyt.2018.00243