Psychosocial factors as mediators of acupuncture therapy

This study investigated a number of psychosocial variables that have been suggested as possible mediating factors in acupuncture therapy. Forty-two volunteers with bursitis and/or tendonitis of the shoulder served as subjects. All were randomly assigned to one of four treatment groups: acupuncture-positive milieu, acupuncture-negative milieu, placebo acupuncture-positive milieu, and placebo acupuncture-negative milieu. Pretreatment and posttreatment subjective pain reports and shoulder motion studies, as well as pretreatment assessments of hypnotic susceptibility and suggestibility, were determined for each subject. Results indicated that acupuncture and placebo acupuncture were equally effective in producing highly significant reductions in subjective pain reports; neither treatment effectively improved objective shoulder motion; subjects treated in the positive milieu reported more improvement than those in the negative milieu; and hypnotic susceptibility, suggestibility, belief in the treatment, and the satisfaction of expectations showed no relationship to treatment outcome. It is concluded that acupuncture therapy provides a powerful placebo. Treatment milieu variables warrant future study in the attempt to understand the acupuncture phenomena.