Methodological problems on acupunture research in pain therapy

Western Medicine (WM) and Traditional Chinese Medicine (TCM) look like two deeply different worlds with different languages and pradygms, making TCM neither understandable nor plausible at a glance by western physicians. On the other hand, acupuncture has been used for thousands years and nowadays it is an essential part of the Chinese Health System, while neurophysiological and neurochemical effects of acupuncture proved in the past 20 years provide the evidence that it is not a placebo. This is of paramount importance, when we simply consider how helpful would be an effective, non pharmacologic treatment with low costs and negligeable side effects on socioeconomic point of view. The data available in the literature suggest that acupuncture is effective in several painful syndromes, but the evidence is still wake. However, the systematic reviews published so far clearly show a great variability of study design, methods of stimulation and acupoint selection, which behave like a strong bias and may lead to underscore acupuncture effects. In this regard, it is worth emphasizing that in many studies the acupoint selection is inappropriate according to both TCM and reflexological point of view; therefore, it resembles an arbitrary choice, rather than a potentially effective treatment. Further studies with more rigorous methods, accurate diagnosis (according to both WM and TCM) and proper acupoint selection are required to check the its real effectiveness.