Acupuncture can result in clinically significant improvements in pain for symptoms of basal thumb joint arthritis, but it does not outperform sham treatment, British clinicians report. Seventy patients with basal thumb joint arthritis were randomised to receive six sessions of true acupuncture or non-penetrating sham needling over a 3-week period. Four to six treatment points were selected from a predetermined list (Hegu L.I.-4, Yangxi L.I.-5, Pianli L.I.-6, Qichi L.I.-11, Yuji LU-10, direct ‘periosteal pecking’ near carpal-metacarpal joint, Taiyuan LU-9, Daling P-7 and Chize LU-5). Both groups showed statistically and clinically significant improvements in pain at week one post-treatment compared with baseline, but there was no difference between the treatment groups. The pain relief achieved was comparable with published data for standard treatments. In the setting of placebo-controlled trials of analgesics in chronic pain, previous investigators have concluded that a 50% reduction in subjective pain scores corresponded to being ‘very much improved’. In the new study, for pain with grip, this level of improvement was achieved in 58 per cent of patients following real acupuncture and in 48 per cent in the sham needling group, suggesting that in both groups the pain relief achieved was clinically significant. The real acupuncture group experienced minor bleeding from acupoints in 41 cases, however, there were also three cases of bleeding in the sham group, demonstrating that there were occasions where the sham apparatus penetrated skin and that the sham procedure was not entirely inert.

A randomized controlled trial of real versus sham acupuncture for basal thumb joint arthritis. J Hand Surg Eur Vol. 2020 Jun;45(5):488-494.