Design of dry-needling and acupuncture sham devices: an illustrative review.

Dry needling and acupuncture are non-pharmacological therapies for managing musculoskeletal pain. Although they noticeably differ in their application and proposed rationale, the common ground between the two therapies is the invasive soft-tissue needling. Over the past 30 years, researchers have developed and used various forms of sham/placebo needling devices in randomized controlled clinical trials for assessing a causation-based relationship between needling into myofascial trigger points (dry needling) or acupoints (acupuncture) and purported therapeutic outcomes. However, no clear guidelines exist for choosing a sham needling device for research purposes. Based on the English literature search on PubMed, EMBASE, J-STAGE, and Taiwan Electronic Periodicals, the present illustrative review identified five forms of sham dry-needling/acupuncture needle devices that had been validated and/or used in clinical trials. As of today, however, there is a lack of standardization in sham needling devices, making it difficult to compare results across different studies.