The paradox of acupuncture efficacy for chronic knee pain

In a recent clinical trial, Hinman and colleagues concluded that "neither laser nor needle acupuncture conferred benefit over sham for pain or function in patients older than 50 years with moderate or severe chronic knee pain", which contradicts with NIH's recognition and the positive clinical experience of most acupuncturists. This review article highlights - major shortfalls from Hinman et al's clinical trial as follows. Laser acupuncture, defined as «low intensity laser therapy to acupuncture points", should not be labeled as acupuncture. A sham acupuncture control was not -set by the trialdesign. As for the trial design, there was a greater degree of randomness in selecting acupoints and inconsistencies of needling parameters among multiple subjects, acupuncture providers and facilities. Furthermore, the acupuncture needles used in this study were also too short to achieve any targeted efficacy, and the total number of treatments was insufficient, which is less than that commonly applied by most acupuncturists. In addition, the trial lacked observations or comparisons of short-term acupuncture efficacy. By revealing these shortfalls of Hinman et al's clinical trial, one may understand more about the paradox of acupuncture efficacy for chronic knee pain.