Source: Long-Term Effect of Acupuncture for Treatment of Tinnitus” A Randomized , Patient and Assessor Blind, Sham-Acupuncture-Controlled, Pilot Trial. The Journal of Alternative and Complementary Medicine , Vol 18, No 7, 2012 pp.693-699
Tinnitus is a perception of noise within the person’s ears. Some patients describe it as “beeping” or “hissing” noises, others a buzzing sound ‘like swarm of bees”. The severity and type of noise varies amongst sufferers. With this constant internal noise a suffers hearing can be impaired. We are yet to understand the patho-physiology of this condition and this lack of understanding is demonstrated in the fact that there is currently no drug on the market that provide a long-term relief for Tinnitus.
The subjective outcome was the score of Tinnitus Handicap Inventory (THI) and Visual
Analogue Scale (VAS) from baseline to 3 months after.
Pure Tone Average (PTA) and Speech Discrimination
(SD) from baseline to 3 months after were assessed as objective outcomes.
Results: A significant interaction between time and group in VAS ( p = 0.017) was evident, but not in THI, PTA, and SD scores. THI showed significant improvement at the end of treatment and 3 months after, compared to baseline, in real acupuncture ( p = 0.004). In SD, a significant long-term effect of real acupuncture was observed until 3 months after ( p = 0.011). However, the effect of real acupuncture in PTA was not maintained until 3 months after the end of treatment. No significant difference in the sham-acupuncture treatment group was evident. No statistical difference in any outcome was observed between real and sham acupuncture. Only in the mean percent change of VAS, real acupuncture showed statistical significance, compared with sham-acupuncture
from baseline to 3 months after ( p = 0.019).
Conclusions: Through evaluation of subjective (THI and VAS) and objective outcomes (PTA and SD), this study demonstrates the long-term effect of real acupuncture.
More information about treatment
All Real-acupuncture points were inserted to depth of 2mm, stimulated and retained for ten minutes. Points used in real acupuncture group were:
In prone position
GV-14, 15 ,20
Then in supine position
Extra Point HN3
The Sham-Acupuncture group used points not at specific documented meridian points. This included inserting points around the ear but not at any meridian point. Inserting points a few CMs from ST36, SJ-5. No specific stimulation technique was used . needles inserted to depth of 3mm and retained for ten minutes.
Other treatments applied for both groups were infrared light projected to area around ear to promote blood circulation during acupuncture.
Comments on study
Comparing Sham-acupuncture to real-acupuncture challenges a lot of acupuncturists because it can often the results have no-significant statistical difference. This study is a good example of this contradiction to real-acupuncture. However when you look at each measurement it gets more complicated. In the case of this study the Tinnitus Health Inventory (THI) scores are reported, a subjective self-reporting questionnaire of patients health, to have significantly improved for real-acupuncture at end of the treatment and this was maintained 3 month follow-up. But the sham group did not replicate these positive results. THI looks at patients emotional, psychological and physiological responses to their condition. All other measurements are more specific and there was no significant statistical difference between these. You can read more about measurements in the paper itself.
Regarding acupuncture in general it seems that for some conditions acupuncture works very well and is completely safe. However there are still fundamental unanswered questions about this medicine.
We really don’t know how acupuncture works and why.
Why is it that sometimes real acupuncture is superior to sham-acupuncture and sometimes it is not?
There is no high quality studies that have tested whether treatment variables such as: needling technique, needle retention time, needle type, needle depth, needles quantity, and needling style] provides any significant difference in patient outcomes.
How do we account for the placebo effect in clinical trials as a factor in sham and real acupuncture?
We may never be able to answer these questions, but does this matter if we have evidence based acupuncture that proves it works or doesn’t?