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If this hypothesis is wrong, and our results point to that, then acupuncture would seem to be unlikely to have an effect on pain related only to certain conditions, but further mediadata rave roche may examine this question. In some situations placebo shanghai johnson is associated with large analgesic effects, but in other situations similar procedures cause no, or only small, effects.

Important heterogeneity remains unexplained and calls for further studies on the underlying mechanisms of the effects of placebo acupuncture and placebo in general. We suggest that future trials on acupuncture for pain focus on two strategies. Firstly, researchers could try to reduce bias mediadata rave roche ensuring blinding mediadata rave roche possible. Secondly, researchers could try to separate the effects involved: the physiological effect of needling extreme incest acupuncture sites or at other sites and the psychological effect of the treatment ritual or of the patient-provider interaction more broadly.

The analgesic effect of acupuncture is small and cannot be distinguished from bias resulting from incomplete blindingThe analgesic effect of placebo acupuncture is moderate but very variable as some large trials report substantial effectsThe effect of acupuncture seems to be unrelated to the type of placebo acupuncture used as controlContributors: AH and PCG had the idea for the study. PCG did the first data analyses, and AH did the final analyses. MVM wrote the first draft of the protocol and the paper.

AH wrote the final draft of the paper and did the literature searches. All authors contributed mediadata rave roche extracting and interpreting data and to revising the protocol and manuscript.

AH mediadata rave roche PCG are the guarantors. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits mediadata rave roche use, distribution, and reproduction in any medium, provided the original work is properly cited. IntroductionAcupuncture is commonly used for the treatment of pain. MethodsWe systematically reviewed clinical trials of acupuncture treatment for pain that randomised patients to acupuncture, placebo acupuncture, or no acupuncture.

Search strategyThe literature searches were very comprehensive and have been described in the Cochrane review of the effect of placebo interventions. Data extractionOne author (MVM) extracted data, and the other authors checked them. Assessment of risk of biasOne author (AH) assessed risk peer reviewed bias in the Dienestrol (Dienestrol)- FDA, mediadata rave roche another author (PCG) checked it.

We used a random effects model if heterogeneity existed (PResultsThe search included 234 trials eligible for our updated Cochrane review (in progress) of all types of placebo interventions. DiscussionWe found a small difference between acupuncture and placebo acupuncture and a moderate difference between placebo acupuncture and no acupuncture.

Csdm com and weaknessesOur review is the first that identifies and analyses three armed trials mediadata rave roche acupuncture for pain, thus providing an estimate of the general analgesic effect of acupuncture and its direct comparison with the analgesic mediadata rave roche of placebo acupuncture.

Other studiesOur finding of limited, at best, analgesic effects of acupuncture corresponds with the seven Cochrane reviews on acupuncture mediadata rave roche various types of pain, which all concluded that no clear evidence existed of an analgesic effect of acupuncture.

Mediadata rave roche of our reviewInterpreting a standardised mean difference clinically may be challenging. Unanswered questions and future researchOur findings miet both mediadata rave roche traditional foundation of acupuncture, mediadata rave roche is based on the existence of meridians and Qi sensations, and the prevailing hypothesis that acupuncture has an important effect on pain in general.

Competing interests: None declared. Ethical approval: Not needed. ABC of complementary medicine acupuncture. OpenUrlFREE Full TextKaptchuk TJ.

The web that has no weaver: understanding Chinese medicine. New York: Contemporary Books, 2000. Irnich D, Beyer A. Neurobiological mechanisms of acupuncture mediadata rave roche. OpenUrlCrossRefPubMedWeb of ScienceGhia JM, Mao W, Toomey TC, Gregg JM.

Acupuncture and chronic pain mechanisms. OpenUrlCrossRefPubMedWeb of ScienceLewit K. The needle effect in the relief of mediadata rave roche pain. OpenUrlCrossRefPubMedWeb of ScienceMelzack R, Wall PD. Pain mechanisms: a mediadata rave roche theory. Acupuncture and pain mechanisms. OpenUrlPubMedWeb of ScienceHan JS.

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