To the Editor.—
In his comment about acupuncture treatment for pain relief, George A. Ulett, MD (1981; 245:768), fails to mention controlled studies of acupuncture that have shown that acupuncture is no more effective than placebo in the relief of chronic pain (1975;232:1133).1,2
Although scientific explanations of the mechanism of acupuncture analgesia in the experimental setting have indeed been put forward, and— contrary to Dr Ulett's statement— there is now direct evidence that in man electroacupuncture increases the level of endorphins in CSF,4 this experimental evidence cannot be directly extrapolated to the clinical situation.
The evidence of controlled trials, when compared with results reported for series of patients treated without any placebo control, show that, whereas the latter claim a 70% success rate, there is no advantage shown for acupuncture over placebo in controlled studies.5 This suggests that clinically, pain relief attributed to acupuncture is more likely
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