The randomized trial by Cherkin et al1 comparing 2 forms of acupuncture, simulated acupuncture and usual care for low back pain, raises some questions we would like to address. The original Chinese term for acupuncture, Zhen Jiu, shows 2 ideograms: “needle” and “moxa.” It means that from the beginning the acupuncture stimulation of points could be performed in different ways, not only by needle insertion. Even the specific Western literature supports this notion.2 Nowadays, much effort has been applied on using the precepts of evidence-based medicine, adapting from drug trials, in the acupuncture clinical trials. Nevertheless, the so-called sham procedures are controversial,3 and we believe they cannot be accepted as placebos.4
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