We read with great interest the German Acupuncture Trials (GERAC) for chronic low back pain by Haake et al.1 Such a randomized and multicenter trial is always welcomed. The trials compared 3 different treatments and showed that almost half of the patients in the verum and sham acupuncture groups responded to treatment. This result was nearly twice the responders to multimodal conventional therapy. The sham acupuncture was described as “a form of acupuncture developed especially for this study,”1(p1894) and it was used to differentiate the physiologic (specific) from the psychologic (nonspecific) effects of acupuncture. But the trials proved that sham acupuncture has not only psychologic or nonspecific effects because it works better than multimodal conventional therapy used in routine care. In addition, almost half of the enrolled subjects responded by showing some improvement on the pain scale or functional ability, although the trial did not demonstrate the range of improvement. So, once more, we believe that sham acupuncture should not be considered as a placebo because it is neither an inert nor innocuous procedure that could be used in controlled experiments.2 Finally, for the patients with chronic low back pain, if the multimodal conventional therapy is accepted, then the acupuncture treatment should be recommended and should be included as an insured benefit, as in Brazil.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 6
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.