From John Schreiber:

Re: Acupuncture found to beat “usual” care for back pain (May 11): The headline “Acupuncture found to beat “usual” care for back pain” does not appear to be supported by the research as you describe it. More accurate would be; “Any attention found to beat ‘usual’ care for back pain”.

The description did not say that “real” acupuncture performed better than “sham” acupuncture. And, I would be willing to bet that it did not really compare “usual” care with acupuncture, it compared “usual” care with acupuncture or acupuncture like extra attention and “usual” care. It would have been unethical and impractical for the researchers to prohibit the test groups from also receiving “usual” care, so we can assume that they did not. Therefore, the three test groups received “usual” and acupuncture, the other received only “usual” care.

Because there is no testable theoretical basis for one part of the test treatment - acupuncture, but there is an established and tested theoretical basis the other - placebo effects, especially on subjective measures like lower back pain, I feel that saying that acupuncture has been show to “beat” another is mistaken.