White, Peter, Lewith, George and Prescott, Philip
Should we recruit patients or healthy volunteers for acupuncture studies of chronic pain?
Clinical Journal of Pain, 23, (8), . (doi:10.1097/AJP.0b013e31814da3d2).
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Objective: The aim of this study was to compare the results of
healthy volunteers with patients in chronic pain, in terms of
acupuncture needle sensation. The search for a credible
mechanism that underpins the effect of acupuncture in pain
has recently involved the use of brain imaging techniques in an
attempt to identify the neural correlates involved in pain
control. Such studies have usually enrolled healthy participants
rather than patients. This practice might be inappropriate as we
are unsure if we can generalize from healthy volunteers to
patients in chronic pain.
Method: This paper describes a comparison of data obtained
from 2 small randomized controlled studies, 1 involving patients
with chronic pain and the other which recruited healthy
volunteers. Both studies used real acupuncture and a nonpenetrating
‘‘placebo’’ needle in a crossover design. The outcome
studied in this paper was a comprehensive needling sensation
Results: There was a difference in the sensations experienced by
patients as compared with healthy volunteers. Patients tended to
feel much stronger sensation. Neither group differed in
distinguishing between real and placebo needling. However,
patients were more likely to state that both needles were real,
whereas healthy participants were more likely to suggest that
neither were real.
Discussion: It is concluded that if the nature of the sensation felt
is of importance, then it might be inappropriate to recruit
healthy volunteers in lieu of patients and a larger study is
required to clarify this.
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