Article Text


Developing and validating a sham acupuncture needle
  1. Elizabeth A Tough1,
  2. Adrian R White2,
  3. Suzanne H Richards3,
  4. Brian Lord4,
  5. John L Campbell3
  1. 1
    Honorary Research Assistant Primary Care, Peninsula Medical School, Universities of Exeter and Plymouth, UK
  2. 2
    Clinical Research Fellow Primary Care, Peninsula Medical School, Universities of Exeter and Plymouth, UK
  3. 3
    Peninsula Medical School, Universities of Exeter and Plymouth, UK
  4. 4
    Faculty of Technology, University of Plymouth, UK
  1. Correspondence to Dr Elizabeth A Tough, Peninsula Medical School, Room N32; ITTC Building, Tamar Science Park, Plymouth PL6 8BX, UK; elizabeth.tough{at}


Objectives: To develop a sham needle device and test its credibility as a control for acupuncture when used in a randomised controlled trial of myofascial trigger point needling in patients with whiplash associated pain.

Methods: Sham needles were developed by blunting true acupuncture needles. Whiplash injured patients (<16 weeks duration) were randomly allocated to receive either true acupuncture or the “placebo” sham needle control. The true and sham needling interventions were delivered using the same standardised procedure. Patients were informed that they would receive either real or placebo needles, and asked (i) to state which treatment they believed they had received (treatment belief); (ii) to complete the four item Borkovec and Nau self-assessment credibility scale. Results were compared between groups and the analysis explored whether a patient’s previous experience of acupuncture was related to their treatment belief. Other outcomes of the study will be reported elsewhere.

Results: 20 patients received the true acupuncture and 21 received the sham. There was no significant difference between the treatment beliefs of the two groups (χ2 = 1.51; p>0.2) nor in the mean item scores on the Borkovec and Nau credibility scale (t test, p values ranged from 0.38 to 0.87). Of the patients in the sham acupuncture group who had previous experience of acupuncture, none recorded receiving the sham intervention.

Conclusion: Within the context of this pilot study, the sham acupuncture intervention was found to be a credible control for acupuncture. This supports its use in a planned, definitive, randomised controlled trial on a similar whiplash injured population.

Statistics from


  • Funding ET and AW are supported by the DH-National Co-ordinating Centre for Research Capacity Development (NCC RCD). Sources of support: ET and AW were supported by the National Institute for Health Research.

  • Competing interests AW is employed as editor of Acupuncture in Medicine.

  • Ethics approval The study was approved by the Cornwall and Plymouth Research Ethics Committee (REC reference: 07/Q2103/3) and Plymouth Hospitals NHS Trust Research and Development sub-committee.

  • Editorial handling Since the second author is editor of this journal, all editorial decisions on this submission were taken by David Grant on behalf of the Editorial Board.

  • Provenance and peer review not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.