Just like to add that an increasing number of Vets are self funding training in accupuncture (legally they are the only people allowed to stick needles into animals as it is an invasive procedure).

This growth is because they are impressed by the results achieved esp. in chronic cases. There are also no drug induced side effects to be accounted for, nor the huge costs of drugs for the owner.

And there is no placebo effect..... Think carefully about the implications of all this - it's time for western science to be more open to complementary approaches.

LizM, Horsham, Sussex

Acupuncture is a firm favorite in the eyes of health insurer in Holland becauce it is effective and much cheaper than regular medicine.

george, alkmaar,

My sister had acupuncture on her dog, because the dog could not move its hind legs. I thought it was crazy at the time, but after the acupuncture it was up walking around. Unless this dog is smarter than I thought, this would argue against a placebo affect.

Kevin Koboldt, St. Louis, MO/USA

I read this article with interest on the benefits of acupuncture for back pain. I am a physiotherapist assessing and treating spinal patients on a daily basis. Many of these patients have chronic and recurring back pain. I use a number of treatment approaches based on both previous experience and current evidence. I use a combination of exercise based rehabilitation, manual therapy, ergonomics and back care advice and acupuncture. No one has mentioned in these articles the recent guidelines produced (by the CSP)on the management of chronic low back pain. The exercise section is based on over 100 studies (rather than than the single study in germany on acupuncture) that have been reviewed by a panel of experts on this area. The conclusion was that exercise (Which can take various formats) is a crucial part of spinal rehabilitation.

claire farmer, london, uk

Nigel Hawkes has done a good job in his article. The point is that it is pricking that "works" (whether or not as as an elaborate placebo one can't say). Acupuncture is revealed as a sham. The "ancient Chinese wisdom" is seen not to be wisdom at all, but just empty words.

The proper, response, I think, is to seek more honest ways to help people for whom nothing can be done and to relegate acupuncture (and all the other myths of alternative medicine) to history.

David Colquhoun, London, UK

Traditional Chinese Medicine is the extract of our great ancestor' thoughts. It is a complete system of phylosophy, some of the theories are really hard to be understood, especially, to a person who has little knowledge of Chinese culture. Even some people conclude :it is j ust superstition. What here I would like to say is that there is a long way to go in understanding and learning Chinese medicine. We need patience and objective attitude in the issue how to treat WESTERN medicine or CHINESE medicine.Thanks.

aaaa04275903, Pan jin,Liaoning, China

Something really bothers me about this trial. I have had a lot of acupuncture treatments, and also assisted an acupuncturist many years ago. From my own experience and observations, if the acupuncture point is missed, then needling really hurts. If an acupuncture point is needled then any discomfort felt is very different. And, I have noticed that inserting needles to points that are painful to finger pressure, actually relieves that pain. So, I don't see how random pricking, unless to genuine points would be bearable.

Further, the suggestion that lengthy training is unnecessary, seems ludicrous. Again, from my own experience and that of others I know, the better trained the practitioner the better the outcome.

A Anderton, Paignton, UK

Don't forget - the trial was done in Germany. Knowing the german medical system - it is completly different from what we are practising here. Physio here and there is different, so is the traditional treatment for lower back pain. I do however agree that "sham" acupuncture is successful and I think the publishers mean "western dry needling".

Dr Stefan Scheuner, Stroud, Gloucestershire, UK

I am not agree with the artical. Acupunctur works so well when apply to body shaping and body weight control. There could not be a misstake when so many years approval on the table. This is simply unbelievable!

Chen Hung An, Guangzhou, China

Perhaps I've missed the point!

A number of acupuncture points on the back are closely distributed. The randomly placed needles in the placebo acupuncture test may well have hit other classical points/meridians, helping blood flow and lymph etc?

Unless the fake acupuncture trial used areas never associated with any traditional acupuncture point or other meridian, the results of this "random" test are worthless.

Can someone direct me to the information that categorically shows that in the "random/placebo" acupuncture test, no other meridian lines could have possibly been involved.

This would require that the researchers had professional acupuncturists placing needles in the wrong areas.

Would any real therapist agree to this?

Andre Gadomsky, Rye Harbour, United Kingdom

To be described as an acupuncturist requires far more than being able to stick needles into someone. This article doesn't state whether the person needling was an acupuncturist or a western doctor. The approach of the two would be hugely different and in the case of an acupuncturist includes study of Chinese Medicine Theory (not just acupuncture points) as well as Western Medical Science.
Additionally in NHS trusts there have been success rates for such treatments of over 70%, well above the placebo rating and giving real and continued benefits and results for both patients and the Department of Health. Treatment of this type doesn't occur in the NHS unless it has proven results and is financially shrewd (eg. saves the Department of Health money).

A W, London,

I find the definitions here quite concerning. It seems to me that 'physiotherapy' is used to describe a set fast treatment regardless of the findings on examination. In fact a physiotherapist is an autonomous clinician whose treatment is very much decided upon the initial assessment. Physios use exercise, mobilisation, manipulation, postural advice, electro-therapy, massage and acupuncture amongst other modalities to treat the patient as an individual. In my experience; when a doctor, physio, psychologist and other members of the multi-disciplinary work closely together to combat lower back pain the best outcome is commonly achieved.

N Southorn, Lancashire, UK

Just maybe, the nerves in the skin, even when needle not placed deeply or in the 'right place', still react to the stimulation providing a pain relieving effect.

YVETTE SEDLEWICZ, boise, usa/id

Acupuncture is my source of medical help..It has helped my husband with aphasia after a stroke, it has cured my tmj and it keeps us well and h ealthy so that we dont need to rely on prescriptions..which are deadly.......
However,,,a very qualified acupuncturist is the answer...not one who has had 6 months of training..look for a Chinese dr with medical qualifications...you will never be sick again!!!!!

psyverson, eden praire, mn