Perspective proposes random-point acupuncture as improved sham control

A Perspective article argues that commonly used sham acupuncture controls, such as superficial needling or non-penetrating devices, may not be physiologically inert, as neuroimaging and clinical studies suggest they can activate pain-modulation pathways and thus function as low-intensity interventions rather than true placebos. The authors propose random-point acupuncture, in which real needling is applied at acupoints unrelated to the treatment protocol, as a control strategy that preserves blinding while allowing direct evaluation of acupoint specificity. They state this approach could improve methodological rigor and clarify mechanisms underlying acupuncture analgesia in trials for conditions such as chronic low back pain.

Most relevant for: Researchers designing or interpreting randomized controlled trials of acupuncture for chronic pain conditions, including low back pain.

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