Sham Acupuncture

The small sham group of 11 participants makes EA-versus-sham comparisons exploratory rather than definitive. Sham acupuncture may not be physiologically inert because superficial needling can activate sensory pathways and placebo-related neuromodulatory responses, potentially reducing observed differences between groups. The sham procedure uses superficial needling of 0.2 to 0.3 cm at Baxie points and one non-meridian, non-acupoint on the affected hand, with the EA device connected but delivering no electrical current. Sham participants are told they will receive EA and are not informed that the electrical stimulation is inactive, to maintain participant blinding.