Acupuncture - woo or not

Soapy Sam said:
He meant " more accurate ressults."
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Actually, I'm fairly certain he was being silly, since "accupuncture" was wrong, so he spelled "acurate" wrong also.

That was an appreciative sigh, much like a good pun would warrant one.
 
Soapy Sam said:
I know several physiotherapists who are convinced it works.
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It does work. It just works by placebo. :)

Here's an article that was written about a study on acupuncture that clearly shows that when people received it (or thought they received it), they had better results than the usual care given for back pain. Of course the acupuncture enthusiasts were quick to spin the results of the study to their benefit.
 
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mazyloron said:
Actually, I'm fairly certain he was being silly, since "accupuncture" was wrong, so he spelled "acurate" wrong also.

That was an appreciative sigh, much like a good pun would warrant one.
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Er, as we seem to be torturing fragile jokes to death here, take note of how Soapy Sam spelled "ressults" before assuming he didn't get it.... :wink:

Rolfe.
 
MikeSun5 said:
It does work. It just works by placebo. :)

Here's an article that was written about a study on acupuncture that clearly shows that when people received it (or thought they received it), they had better results than the usual care given for back pain. Of course the acupuncture enthusiasts were quick to spin the results of the study to their benefit.
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No argument there's a placebo effect.
My argument is that physios are possibly achieving an actual, real effect- relaxation of spasmed muscle fibres- by using needles. This is either real or not and I'm not qualified to judge.
Assume for the moment it IS real.

Is it ac(c)upuncture? If muscle trigger points exist and can be affected in this way, it would seem the only connection to the traditional concept is the use of needles. The whole qi / meridian business is removed.
But the people using the needles refer to it as accupuncture. (Dammit, I prefer that spelling and I'm staying with it).

I understand in the USA the technique is also referred to as "dry needling".

If "Trigger Points" don't exist, then this technique is also woo and any result is also a placebo effect, but I don't know whether they do or not.
 
mazyloron said:
Actually, I'm fairly certain he was being silly, since "accupuncture" was wrong, so he spelled "acurate" wrong also.

That was an appreciative sigh, much like a good pun would warrant one.
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Yep. Hence the "SS" for "Soapy Sam" in "ressults".
 
Soapy Sam said:
I understand in the USA the technique is also referred to as "dry needling".

If "Trigger Points" don't exist, then this technique is also woo and any result is also a placebo effect, but I don't know whether they do or not.
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I would have to say that from the point of view of my own practice, Trigger Points (TrP's) do exist.

Travell and Simons have written their Trigger Point manual in two volumes and others have written on Trigger Points as well.

The technique is referred to as dry needling in the UK too and yes, lots of physios use this. Personally, I don't.
 
Is it really only placebo?
If I remember correctly, one hypothesis is that the needle in the skin triggers endorphine release, which could help to reduce pain.
This has nothing to do with the chinese woo, but could be an explanation for the effect, and an explanation why it doesn´t matter where on the body you put the needles in.
Does anybody know anything about that?
 
I don't think anyone has actually demonstrated anything like that is happening. It's a bit like the "it's quantum, man!" explanations for homoeoapthy, only less implausible. A suggested explanation for something that hasn't really been demonstrated to happen.

Rolfe.
 
Back to the subject at hand...

Yes, acupuncture does have an effect. But, it's generally the same as placebo. It's more dramatic in acupuncture than, say, the placebo effect in a study involving taking pills, but the human body/brain tends to match the effect with the stimulus, as Rolfe said here.

This is something that acupuncture (and many other forms of woo) supporters forget, however: if it's not more effective than placebo, then it's not effective. Plain and simple.

Now, the trigger point thing seems to be easily testable, as it's not "the latest in ancient Chinese medicine" or any of that mumbo-jumbo. I'm also not qualified to judge, but at the same time, this seems like a simple concept: if someone inserts a needle into Point A, then Muscle B will relax/contract. Simple, repeatable, testable. If it stands up to testing, then it's a valid technique, and could certainly have plenty of useful applications. It does not, however, validate acupuncture.
 
A few more things I found while checking up on that WHO link I posted earlier, if anyone is interested, or looking for a little more ammo for convincing friends/family who might be a little too credulous:

http://www.bmj.com/cgi/content/full/338/jan27_2/a3115
Conclusions: A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.
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Also, the Mayo Clinic did a test of acupuncture as a treatment for hot flashes in menopausal women, and found no difference between it and the placebo effect:
http://www.washingtonpost.com/wp-dyn/content/article/2006/06/19/AR2006061900833_pf.html

AMA's official statement on "alternative therapies" (which include acupuncture, homeopathy, naturopathy, ayurveda, energy healing, chiropractic, etc.):
http://www.ama-assn.org/ama/no-index/about-ama/13638.shtml
There is little evidence to confirm the safety or efficacy of most alternative therapies. Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies.
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arthwollipot said:
Oh no - there's a consensus. Acupuncture is just as effective as a placebo.
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I thought there was some suggestion that poking needles into people had some more effect than not poking needles into people. It is that it doesn't matter that much where you put the needle.
 
FWIW, The Cochrane Collaboration have some interesting reviews regarding acupuncture. Here are two links with rather positive outcomes.

Acupuncture for migraine prophylaxis

From the abstract, authors' conclusions:

In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care. There is no evidence for an effect of 'true' acupuncture over sham interventions, though this is difficult to interpret, as exact point location could be of limited importance. Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.
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Also this.

Acupuncture for tension-type headache

From the abstract, authors' conclusions:

In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches.
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Now, I'm not a doctor, so I'm not sure if I read these right, but they state that, at least for these ailments, acupuncture (be it 'real' or sham) is far from useless, right? And Cochrane's fairly highly regarded for it's reviews, right?
 
ponderingturtle said:
I thought there was some suggestion that poking needles into people had some more effect than not poking needles into people. It is that it doesn't matter that much where you put the needle.
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I think that's where a little communication disconnect happens...some people are considering "placebo" to mean "sugar pill" where others are taking it to mean "sham acupuncture" (sheathed toothpicks tapped on the skin, so the patient doesn't know it didn't pierce the skin), and still others think it means "puncturing the skin with needles in random places, not trying to follow 'Qi meridians'".

When I say it, I mean mostly the latter, or the second one. The effect on people who think their skin has been pierced is similar enough to those who actually were punctured to cast doubt on there being anything more than a placebo effect. Likewise, the effect on people who've had needles stuck in them is relatively similar, regardless of where the needles are stuck, indicating that, again, it's likely a psychological response to the stimulus, and not a direct result of the needle piercing a meridian.

Tapio said:
FWIW, The Cochrane Collaboration have some interesting reviews regarding acupuncture. Here are two links with rather positive outcomes.

Also this.

Now, I'm not a doctor, so I'm not sure if I read these right, but they state that, at least for these ailments, acupuncture (be it 'real' or sham) is far from useless, right? And Cochrane's fairly highly regarded for it's reviews, right?
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What I think is the telling statement there is this:
There is no evidence for an effect of 'true' acupuncture over sham interventions, though this is difficult to interpret, as exact point location could be of limited importance.
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Essentially, the act of poking the patient with a needle is what prompts the response, presumably also because you've told them that they're being poked in order to make them feel better...so, not surprisingly, they do. Which means that it's a placebo effect, just a strong one. It may have a practical application, but saying that acupuncture works just because of this, is misleading.

Alternately, this could be a form of the trigger point theory, which would also have a practical application, yet still in no way prove the Ancient Chinese Medicine theory of Qi and meridians and such.
 
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