Thermal
August Member
According to arthwollipot. Not according to, you know... everybody else.
Split Thread Acupuncture
- Thread starter Chanakya
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arthwollipot
Observer of Phenomena, Pronouns: he/him
According to all the folks over at Science Based Medicine and Quackwatch.
What, you think I'm just pulling ◊◊◊◊ out of my arse?
Gulliver Foyle
Philosopher
Based on the information in the comments it was "single blinded" in that an effort was made to make it seem blinded without actually doing so. Look for comments talking about the descriptions of the actions taken with control and study groups prior to "treatment".
Thermal
August Member
Those websites are not authoritative. At all. From a definitional standpoint, they are meaningless.
You are very transparently attempting to Poison the Well, tainting the word "acupuncture" by relying on an outdated and irrelevant definition.
Actual licensed acupuncturists and their government regulatory boards say that yes, you are pulling ◊◊◊◊ out of your arse. World-respected Western research institutions say you are pulling ◊◊◊◊ out of your arse. What you are doing is the exact equivalent of claiming "you can't trust Western medicine. They used to leech".
Cosmic Yak
Philosopher
There is a difference between the practice of acupuncture, and the explanation of how it is supposed to work. Just because people in the past thought that it was the incantations chanted over the cauldron, rather than the effect of the herbs in the potion, that had the most effect, doesn't mean those medicinal herbs didn't work. They just didn't know enough to be able to provide a proper explanation of the effect. The same is true of acupuncture. If putting needles into certain spots has a beneficial effect, then that works, regardless of whether the explanation of chi meridians is accurate or not.
arthwollipot
Observer of Phenomena, Pronouns: he/him
Except that it can't be reliably demonstrated that it does. It certainly doesn't do what acupuncturists say it should do, when they can even agree.
Cosmic Yak
Philosopher
Well, thermal has posted evidence that it does, albeit in a more limited way than the claims for its efficacy would suggest.
Either way, I think my point still stands: even if the explanation is wrong, what is being tested and discussed here is still acupuncture.
I still think there's a Texas Sharpshooter Fallacy going on in calling acupressure and electroacupuncture "acupuncture" regardless of what proponents call it.
An acupuncture point is tiny, and it's the bullseye being drawn when the acupressure is done by a finger massaging it.
Same with electroacupuncture. A whole area is stimulated, not just a pinprick in exactly the magic point.
An acupuncture point is tiny, and it's the bullseye being drawn when the acupressure is done by a finger massaging it.
Same with electroacupuncture. A whole area is stimulated, not just a pinprick in exactly the magic point.
arthwollipot
Observer of Phenomena, Pronouns: he/him
Also, the meridian theory states that needles in different points will have different effects.
Thermal
August Member
Out of curiosity, where did you come up with the idea that an acupuncture point is tiny? Because they use thin needles? I kind of think that's because driving railroad spikes in might be problematic.
The points are located in a really +/- kind of way, not pinpoint precision. Just look at any chart. You don't draw graphs on the skin and break out micrometers to find them. The one I keep referring to on the hand is, IME, about 5mm around.
Acupressure works by keeping that tight area under pressure, not by massaging the wide area. And electro acupuncture generally works by feeding a mild current into one of the hair-thin needles. Some have success with large pads, like the ones some doctors put on you to loosen up the muscles. I'm not entirely sure that really qualifies as acupuncture, since they are not focusing on a point. It's more like Shiatsu, which works larger areas.
Eta: you mentioned the Texas Sharpshooter Fallacy. That's pretty much what I've been saying for some pages now. I think acupuncturists of old kind of stumbled onto this, then built an explanation around it, exactly like Cosmic Yak analogizes with the herbs and incantations. Western acupuncture research is looking at the herbs, not the chi incantations.
What I am expecting is that scientists will figure out how temporary neural pathways are being formed by stimulating these points that have shown promise, then figure out the underlying physiological mechanism, then extrapolate that to other areas of the body to create even a larger matrix of new and effective temporary pathways. And all without even considering chi or meridians.
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Well, given that shiatsu is also based on the idea of qi and meridians, which don't exist, and there is little evidence that it's effective as more than massage, I would agree that they are similar.
Thermal
August Member
Shiatsu is a twentieth century Japanese massage technique. Fair to say it's a few steps away from what we've been discussing.
Eta: BTW, there is significant evidence of shiatsu's beneficial effects for better sleep and overall well being. Nothing for curing cancer and other physiological maladies, though.
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Thermal
August Member
I wonder if we bring up Astronomy, if you guys will get all pissy about its geocentric origins and try to discredit the term?
We seem to be saying the same thing again.
Just that you seem to think the acupuncturists of old pinpointed the points exactly while I think the points are more random.
Thermal
August Member
I was asking where you got the idea that the points were tiny. I think it would help if I understood what your information was based on, since it will naturally effect your opinion.
I don't think they pinpointed anything exactly. I think they found them haphazardly. The hand point I keep talking about is a great example. If someone were to work that area, noticing that it was sensitive, and their headache quickly disappeared, surely they might take notes on where it was? Then play around the next time they had a headache, and get the same result? Like I said earlier, move a quarter inch away in any direction and it's not working anymore. That's what makes me feel pretty confident that they are not random. Or, more specifically, they are in definite locations, but not part of any mystical meridians attached to internal organs.
If I speculated a little, I might guess that the less effective points were found coincidentally, like they hit an area that felt sensitive and their congestion coincidentally cleared up, so they wrongly attributed the cause to the effect.
But the whole history doesn't interest me as much as those points that *do* seem to deliver results. Several of the studies that acupuncture performed only as well as placebo were using anterior/abdominal points, which notoriously don't give very good results. One of the most positive studies was using posterior/lower back points, which are generally the money shots.
Eta: I'm pretty sure we are saying virtually the same thing. I'm just very comfortable saying "acupuncture" without having associations of mystics and magical forces. To me, it's just a map of spots on the body that react in a super weird way, that I'd love to get a better understanding of, if it's reliable enough to treat people with. Especially in the area of opioid addiction: the endorphins attach to opioid receptors. If it could help a recovering addict to feel less desperate withdrawal symptoms and recover quicker, that would be amazing.
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arthwollipot
Observer of Phenomena, Pronouns: he/him
It's still based on the chi/meridian theory though.
About as much evidence as there is for other kinds of deep tissue massage that aren't based in magic.
Well, that's really the question, isn't it?
Thermal
August Member
*Was*. And astronomy *was* based on geocentricity.
More of a statement, but sure.
arthwollipot
Observer of Phenomena, Pronouns: he/him
In fact, it's because of astronomy that we realised that geocentricity was false.
That's the difference.
Thermal
August Member
And we don't have to even disprove meridians along that same line of thinking. We can already dismiss them.
But it doesn't change the point. You don't pooh-pooh astronomy because it has been improved since its origin. It's the same gig, farther along in its development. So is acupuncture.
arthwollipot
Observer of Phenomena, Pronouns: he/him
I have yet to see how acupuncture has developed since its origin.
Thermal
August Member
The same ways that we have been discussing. Doc Ma was not balancing chi. He was mapping neural pathways.
And yes he was so too doing acupuncture; as an acupuncturist himself, his claim is more valid than your lay obsevational inference.
arthwollipot
Observer of Phenomena, Pronouns: he/him
Well, I think it's obvious by now that you (and I guess he) have a much looser definition of what constitutes acupuncture than I (and the folks at Science Based Medicine and Quackwatch) have. I would say that he's not doing acupuncture, he's studying nerve pathways and endorphin release.
Thermal
August Member
You know something? For what may be the first time in this discussion, we are in complete agreement.
My side, including the NIH, National Library of Medicine, state and local acupuncture boards, and the entire Western research community, versus the unathoritative and low impact Quackwatch website. Yeah, I'm good with that.
arthwollipot
Observer of Phenomena, Pronouns: he/him
Quackwatch, FYI, is owned and maintained by the Center for Inquiry and contributed to by medical professionals from a wide variety of fields. It's a long-running, comprehensive, well-sourced and authoritative skeptical website.
And the "entire Western research community"? Come off it.
Thermal
August Member
Perhaps you could tick off some authoritative bodies that I have overlooked and have their crystals out to contradict my extremely authoritative surrogate sources?
arthwollipot
Observer of Phenomena, Pronouns: he/him
You think state and local acupuncture boards are authoritative? Don't they kind of have a bias?
Just from seeing various charts of acupuncture points. A lot have small points all over nearly the whole body, and only a couple of centimetres apart.
The first person to "find a point that works" might have just relaxed a bit when massaging the place and this eased the strain on the brain. He becomes conditioned to relaxing when that is done. Then he tells someone else it's a cure, and they have an expectation of a cure and gullibly have the same result. Placebo or it works? Tomato/tomarto.
*some spots* might be *the spot* for something (give or take a few centimetres), but it's almost shooting fish in a barrel to find an acupuncture spot somewhere, and yes, I think any positive results have been found haphazardly.
I don't think one pinprick is *the magic spot* for anything, but it can increase bloodflow to an area and might do the cytokine storm thingy to the area and relax the nerves. A lot of spots might all do the same thing, e.g ease pain, since all nerves pretty much affect the vagus nerve.
I must admit I can't locate exactly where this hand point is you keep mentioning. But I know myself that relaxing your arms helps with headaches, and it could be related
I asked one of the physiotherapists that did acupuncture on me how they decided where to put the needles and he said he put them around the area that was painful. I do know one who claims to put them on the meridians etc.
EHocking
Philosopher
That sounds like dry needling approach rather than acupuncture, e.g., myofascial trigger points rather than qi meridians being “targeted”.
Thermal
August Member
? In terms of defining what they regulate actually *is*? Yes, they have a very authoritative bias. You can't really jump up and declare yourself an acupuncturist without their formal nod.
But please: feel free to tick off sources of higher credibility than the National Library of Medicine and the rest regarding defining acupuncture. Whaddya got? Wikipedia or something? Yeah, I'm still feeling pretty good about that.
Chanakya
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Wait, let me get one thing clear: What is it that actually works? (For whatever definition of “works”?) …That is, let me break it down into two questions, so that I can clearly understand this:
1. How many “points” are there in acupuncture?
2. Of those, how many actually work? (For whatever definition of “work”?)
As far as I’ve followed this --- and I’ve been lazy, reading only people’s posts, and not any of the reports and abstracts linked --- there’s three such points discussed here, the Hoku thing, then the forehead thing (that's apparently got its own name and all), and finally one somewhere in the foot or leg was mentioned I think. ...So, where I’m coming from is: Say if there are like 10 points, and of those ten, 3 or 4 or 5 are found to work, then that’s pretty cool. Dump their meridian mumbo jumbo, sure, but acupuncture would then certainly have something going for it, no matter the mechanism. And likewise if there are ~100 points, and ~40 of them, or even ~30 or even ~20, actually work. …On the other hand, if there are like, I don’t know, 100 acupuncture points, and only a very few of them actually work, like 5 or 6 or less: well then, that’s just happenstance, particularly given that these positions aren’t even very precise at all.
So then, my question: How many acupuncture points are there? And how many of them, like this Hoku thing, are found to work (even if only anecdotally)?
1. How many “points” are there in acupuncture?
2. Of those, how many actually work? (For whatever definition of “work”?)
As far as I’ve followed this --- and I’ve been lazy, reading only people’s posts, and not any of the reports and abstracts linked --- there’s three such points discussed here, the Hoku thing, then the forehead thing (that's apparently got its own name and all), and finally one somewhere in the foot or leg was mentioned I think. ...So, where I’m coming from is: Say if there are like 10 points, and of those ten, 3 or 4 or 5 are found to work, then that’s pretty cool. Dump their meridian mumbo jumbo, sure, but acupuncture would then certainly have something going for it, no matter the mechanism. And likewise if there are ~100 points, and ~40 of them, or even ~30 or even ~20, actually work. …On the other hand, if there are like, I don’t know, 100 acupuncture points, and only a very few of them actually work, like 5 or 6 or less: well then, that’s just happenstance, particularly given that these positions aren’t even very precise at all.
So then, my question: How many acupuncture points are there? And how many of them, like this Hoku thing, are found to work (even if only anecdotally)?
The question also has to include "and which practitioners use the 'working' points?"
Thermal
August Member
Super short answer: there's about 350-360 which are broadly accepted as legit worldwide, and are the older, traditional ones {Eta: there are like a half dozen that remain disputed}. In the last few decades, other guys have identified up to like 2000 of them. These have met with minimal, if any, positive results. All have names, all have locations (like Hoku, alternatively spelled Hegu, is always on LI4, Large Intestine meridian point #4, and in the identical location).
Of the ones that "work", it kinda depends on if you pick the "right" ones, and who chooses them. I looked into one of the lower back pain studies where points were used that didn't seem to me to be the common ones, and acupuncture didn't perform well against sham poiints. The subjects in experimental and control groups were lying on their backs, and hitting abdominal points which pretty consistently "don't work".
Also eta: the ones that do "work" depends a lot on if you are diagnosing the "right" reason to choose them. With Hoku, you check both hands to see if one is more sensitive than the other. Work the sensitive one. But it kind of depends on what caused your headache in order to figure out if thats the one to hit. My headaches are almost always caused by the same things (loud noises and work conditions), so I get regular relief from Hoku. But if I like smash my head on something, Hoku wouldn't feel sensitive, because the cause is different. It would be a different point that needs to be hit.
So the theory goes, anyway
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Thermal
August Member
Similar to going to a regular doc: go to three, and get three different diagnoses and treatment protocols.
Chanakya
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Oh, so many? Heh, I threw out the 100 number as a random high outlier (or so I thought).
So okay, there's around 350 mainstream points, and another 1650 or so more fringe points (fringe in terms of how well accepted they are). And you're saying these latter don't much work. So cool, let's focus on the 350.
Of those 350, how many actually do work? I get you, it'll only work for some kinds of pain, not for every kind. Even accounting for that, how many would you say do work?
(Like I said, where I was coming from is, of those 350: if say 200, or 100, or maybe even 75, turned out to work: then clearly there's something there, even if not meridians per se. On the other hand, if only some 25 or less of those 350 points were found to work, then I'd put that down to happenstance, given that those points are not even precisely defined, and given that the human body isn't really this huge thing, so that 350 points would cover a significant proportion of the whole human body, right?)
Thermal
August Member
I've got like no authority at all to say how many "work", and IIUC, several are usually stimulated at the same time, not just one. Hoku and that handful of outliers are the exceptions, not the rule.
{Eta: and keep.in mind, many are not for pain relief. The pain and nausea relief points show the most promise, more than "opening your third eye", so the "working" basket of point choices would be a hell of a lot lower than 350}
But 25 or so? I'd spitball guess that's about right, although what I'd rather see is if a particularly talented practitioner has a better batting average than another, much like there are good docs and bad.
The thing is, there is no known mechanism that would make even one point "do" anything at all. There's nothing going on at hoku to relieve headaches, no special nerve intersection or anything. it's just kind of a boring patch of bone and I guess tendons.
It seemed to.me that piercing your skin with a bunch of needles should set off a kind of endorphin response, like your body thinking it was being stung by bees or whatever. But it doesn't seem to be the case (doesn't happen more with sham). Or maybe T-cells go ape ◊◊◊◊ around the needle insertion, which triggers a temporary neural pathway in a way we hadn't considered before, chemically short circuiting at those specific places? I dunno.
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Chanakya
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So then, with just around 25 out of around 350, that probably rules out acupuncture as a thing. Not just the meridian and chi-qi explanation, but the whole acupuncture schema itself. Because a 7% strike rate is probably simply happenstance.
I do take your point, though, that, as you say, there's no known mechanism that would make even one point do anything. That is, I don't know if that is the case; but should that actually be the case, then I agree, you do have a point. ...That is, squeezing on your head in order to relax a pain in the head itself, that's probably simply a form of massage. Ditto squeezing and poking your leg to get rid of a cramp, or a persistent pain there. Probably not a big deal. ...But your hoku, it does seem to be different. I mean, how the heck does one go from pressing on the thumb, or wherever on the hand it is, to consistently relieving a pain in the head?
While I'd agree with the others that that's probably not acupuncture at all: but equally, I'd agree with you that that nevertheless sounds very interesting, and useful as well, and potentially something that might yield more interesting and more detailed answers in future.
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Also: any idea how many such counter-intuitive points there are that work? Where you manipulate one portion of your anatomy, and relief is experienced, consistently, at a very different and apparently unrelated part of the body? (Heh, don't mean to be interrogating you, perfectly cool if you don't know that!)
Thermal
August Member
There's definitely a bunch that are said to work on remote areas of the body. Like, kind of most of them? Unfortunately I don't know much about them, as I've never gotten acupuncture. Acupressure was more my interest, after seeing results with the hand one. I tried the points associated with tinnitus relief, (i have it bad), but got no results.
My daughter, that would do 1 treatment per month for migraines in her late teens, had about 4-6 needles put in fairly random places (on arms and shoulders) to my eye, none on the head. Same points every time for some, but the others moved around. She got relief, and fast.
Chanakya
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Ok, so you're saying, of ~350 points, there's ~25 that actually work. And most all of those ~25 are "counter-intuitive", in the sense that you poke the heel of the left foot, and that brings relief to the elbow of your right hand, or something apparently unconnected like that.
Cool. ...That's doesn't quite take us to acupuncture, but it does take us to somewhere that's interesting, certainly, in general terms. ...It'll be interesting to see if maybe there's actually some actual physiological explanation for this (beyond just the placebo thing, the feeling good because someone's attending to you thing, the expect it will work so it works thing).
(By the way, acupressure, is that Chinese as well? And does it also follow meridian and chi-qi woo?)