Surprising results and conclusions from the GERAC acupuncture trials for low back pain

Conflicting findings on the effectiveness of acupuncture are often attributed to flaws in study design and methods. The German Acupuncture Trials (GERAC) were intended to demonstrate that it’s possible to design acupuncture studies in accordance with the standards of good clinical practice.

Here’s what they report.

First, the details.

• 340 clinics in Germany studied 1162 patients aged 18 to 86 years.
• Patients had a history of chronic low back pain for an average of 8 years.
• Patients were randomly assigned to 10, 30-minute sessions (generally 2 sessions per week) of verum acupuncture according to principles of traditional Chinese medicine, or sham acupuncture (superficial needling at nonacupuncture points), or conventional therapy (drugs, physical therapy, and exercise).
• 5 more sessions were offered to patients who had a partial response to treatment.
• Patients and observers were not aware of the treatment given.

Verum acupuncture consisted of needling fixed points and additional points to a depth of 5 millimeters to 40 millimeters based on traditional Chinese medicine, while sham acupuncture consisted of inserting needles superficially (1 millimeter to 3 millimeters) into the lower back avoiding all known verum points or meridians.

And, the results.

• At 6 months, the response rate was 48% with verum acupuncture, 44% with sham acupuncture, and 27% with conventional therapy.
• There was no significant difference in the response to acupuncture vs sham acupuncture.
• Both acupuncture groups responded significantly better than conventional therapy.

The bottom line?
The authors concluded, “Low back pain improved after acupuncture treatment for at least 6 months. Effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy.”

But the best quote by these researchers comes from an article at the ScenceDaily website.

Are you ready? (emphasis added)

“The superiority of both forms of acupuncture suggests a common underlying mechanism that may act on pain generation, transmission of pain signals, or processing of pain signals by the central nervous system.”

Let’s be clear about what just happened. The researchers went out of their way to first publish an article touting the validity of their study design. And when the results reveal no difference between acupuncture and sham acupuncture, the authors conclude that sham acupuncture, like verum acupuncture, is a valid form of acupuncture!

Can you say “chutzpah?”

9/26/07 14:16 JR