Acupuncture appears to show results.

The Atheist

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The Atheist
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There's no suggestion that "qi" is resposible for benefits from acupuncture, but a study by an Italian specialist seems to have produced some interesting results:

Details here.

The doctor involved seems to be a recognised specialist in pain therapy, so it looks like it will be a well-controlled and performed test.
 
While I personally have no problem with CAM leading to promising scientific discoveries, I do have an issue with people associating such finds as this with CAM.

Acupuncture is a little like chiropracty in this way. Chiropractors can make your back better by manipulating it. This, however, does not support chiropracty as a practice - the principles behind the system are no more 'cracking your back to make it feel better' than conventional medicine is 'take a pill to make you feel better'. Acupuncture is not simply sticking needles in somebody to alleviate pain. It is the philosophy that the correct placement of needles will correct imbalances in the body and heal it of most problems. Pain relief is an incredibly small part of it.

By no means am I criticising the study or the outcome. If this leads to another tool for the physician's box of tricks, I'm all for it. Yet I'll be damned if this is touted as a win for acupuncture, any more than alleviation of back pain supports the practice of chiropracty or rehydration through homeopathy supports ol' man Hahnemann's philosophies.

Athon
 
It's not clear what the results actually were. At any rate this study would be countered by the number of negative studies done already. If they had discovered something it should be repeatable.
 
Dogdoctor said:
It's not clear what the results actually were. At any rate this study would be countered by the number of negative studies done already. If they had discovered something it should be repeatable.
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No doubt someone will try to!

athon said:
Acupuncture is not simply sticking needles in somebody to alleviate pain. It is the philosophy that the correct placement of needles will correct imbalances in the body and heal it of most problems. Pain relief is an incredibly small part of it.
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Yep, fair comments, it looks as though it may be a lucky
accidental side-effect of the needles and their placement.

As you say, it'd be interesting if a positive treatment came out of it.
 
"They randomly assigned 160 migraine sufferers to one of four groups: In one, patients received twice-weekly sessions of acupuncture using traditional acupuncture points; a second group received sham acupuncture as it is usually performed in studies; a third group also underwent sham acupuncture but with the blunted needles touching traditional acupuncture points; the fourth served as a control group, in which patients received no acupuncture or preventive medication."

Anyone spot the glaring omission?

Where is the group that received skin penetrating acupuncture at random locations? Change conclusion from "Traditional acupuncture may relieve migraines" to "Pokey needles anywhere on body may relieve migrines."
 
We need a link and access to the actual paper to determine if there were any methodological flaws.

However, off the top of my head, one of the reasons that patients who received true acupuncture treatment feel better than those who receive sham acupuncture is that it is impossible to have a sham acupuncture procedure with double blinding. The best that can be achieved for the sham acupuncture procedure is to have practitioners trained in true acupuncture treat patients in exactly the same way as for true acupuncture except that they use acupuncture points indicated for a condition other than those used for migraine.

At best, therefore, there is only single blinding because the acupuncturist knows when he is using true acupuncture and when he is using sham acupuncture, and this information can leak to the patient, even if only at a subconscious level, thereby producing a greater placebo response for true acupuncture.

A small improvement with true acupuncture above sham acupuncture could therefore all be due to placebo.

BillyJoe
 
Timothy said:
Where is the group that received skin penetrating acupuncture at random locations?
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Group two. ;)


(a second group received sham acupuncture as it is usually performed in studies)
 
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athon said:
Acupuncture is a little like chiropracty in this way. Chiropractors can make your back better by manipulating it. This, however, does not support chiropracty as a practice - the principles behind the system are no more 'cracking your back to make it feel better' than conventional medicine is 'take a pill to make you feel better'.
Click to expand...

Some chiropractors do acknowledge this, and shun the woo side.
 
Conclusions.—TA was the only treatment able to provide a steady outcome improvement in comparison to the use of only Rizatriptan, while RMA showed a transient placebo effect at T1.
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Why was the placebo effect of the sham acupuncture transient?
Did it start to become obvious to the patient that the acupuncturist was starting to go through the motions?

Why could the effect of the true acupuncture not also be due to placebo?
Couldn't the lack of double blinding have leaked through to producing a somewhat better placebo effect for true acupuncture than for sham acupuncture?

How much more effective was the true acupuncture placebo ;) anyway?
 
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Prof. Enrico Sacco teaches Pharmacology and Anestesiology at Padua Medical School (Northern Italy) one of the 5 best Italian medical schools. His specialties are Anestesiology and Neurology and he completed all his studies with top marks.
 
The Atheist said:
There's no suggestion that "qi" is resposible for benefits from acupuncture, but a study by an Italian specialist seems to have produced some interesting results:

Details here.

The doctor involved seems to be a recognised specialist in pain therapy, so it looks like it will be a well-controlled and performed test.
Click to expand...

When it comes to the placebo effect, our perception of relief is strongly related to our expectation. And there's no getting around the fact that acupuncture is very good at setting up expectations. It's dramatic, mysterious and ritualized. And as soon as you give some clues that expectations should be reduced (such as clues as to whether you are getting sham acupuncture), you see a corresponding reduction in the perception of relief. The fewer clues you give that you may be receiving a sham treatment, the closer the results between the sham and the true acupuncture. When you get to the point where you give no discernible clues (needles pierce the skin at non-acupoint places, the provider is blinded), the results are indistinguishable.

The description of this study allows for discernible clues. So in the end, we can't tell whether the results reflect expectation or whether there is some effect specific to the sticking of needles in our body. As others have pointed out, we are long past the point where the results, even if specific to the sticking of needles in our body, reflect any evidence for TCM. It shouldn't even be called acupuncture, since the 'where' has nothing to do with qi. I don't think it's unreasonable to experiment with physical modalities for pain relief (we already use other techniques), but we may as well divorce the use of needles from something called acupuncture, since the ideas behind TCM add nothing to our understanding, at this point.

I don't have access to the full text, right now. I suspect (because they didn't report on this in the abstract) that the pain relief from true acupuncture was not significantly different from the sham acupuncture groups. The other problem with this study is the low numbers (less than 50 per group) and the high drop-out rate (21 percent). And what I found weird was that not only did they have the wrong comparison group in order to answer their question, they didn't even report on the differences between the comparison group that they did use and the treatment group (in the abstract). Which is why I suspect that there was no difference and that their conclusion is unsupported by the results.

Basically, this study tells us nothing we don't already know.

Linda
 
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Timothy said:
"They randomly assigned 160 migraine sufferers to one of four groups: In one, patients received twice-weekly sessions of acupuncture using traditional acupuncture points; a second group received sham acupuncture as it is usually performed in studies; a third group also underwent sham acupuncture but with the blunted needles touching traditional acupuncture points; the fourth served as a control group, in which patients received no acupuncture or preventive medication."

Anyone spot the glaring omission?

Where is the group that received skin penetrating acupuncture at random locations? Change conclusion from "Traditional acupuncture may relieve migraines" to "Pokey needles anywhere on body may relieve migrines."
Click to expand...
Right. Both group 2 and 3 received sham (blunted needles) treatment, but group 2 was "ritualized sham" which involved shamming the imaginary qi points.
Also, if anyone pays for the article, I would like to know the details on the "blunted needle". A placebo is not a placebo if the patient can tell the difference. Also, there appears to be no double blinding to control for experimenter bias. That essential control should have been mentioned in the abstract.
 
Fortunately I can get it for free.

Jeff Corey said:
Also, if anyone pays for the article, I would like to know the details on the "blunted needle".
Click to expand...

Facco et al. said:
In patients belonging to group RMA,the acupuncture was apparently the same as in group TA, but the needles were not inserted. A small cylinder of foam (height and Ø = 1 cm) was applied to the skin by means of a double-adhesive plaster on each acupoint; then, needles with blunted tips were inserted into the cylinder, touching but not penetrating the skin. This allowed the patient to feel a superficial, light pricking-like sensation, thus simulating the needle insertion. A slight pressure was applied on the needle handle 3 times at 3 seconds intervals, in order to simulate the “arrival of Qi.”The reducing or reinforcing methods were also simulated by rotating the needles within the foam cylinder. The protocol for diagnosis as well as acupoint selection according to TCM syndromes was the same as group TA, in order to check possible placebo effects related to the use of the TCM approach.
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Jeff Corey said:
Also, there appears to be no double blinding to control for experimenter bias. That essential control should have been mentioned in the abstract.
Click to expand...

I skimmed the rest of it (and did a word search), and didn't see blinding mentioned at all.
 
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I thought group two had needles inserted but at the wrong points.
It seems from the above that is not the case.

It seems that they used three control groups and that none of them was optimal. Why have three control groups? Why not use one control and make it optimal? They could then have treated half of the subjects by inserting needles at the acupuncture points recommneded for migraine (True Acupuncture) and the other half by inserting needles at false acupuncture points (Sham Acupuncture).

Do they do this deliberately so as to get a positive result?
 
If I may add a comment here from a layman's perspective. What always greatly bothers me with positive news about woo-related medical studies is that they always seem to indicate a slight tendency towards success of the remedy/method/procedure/whatever.

Given that acupuncture is allegedly practiced for thousands of years, I as a layman would certainly expect much, much more dramatic outcomes of such studies. To me, it seems that too many times they are looking through a magnifying glass in the hope of finding some meaningful results in their study, something that would explain why this or that treatment has been around for centuries.

And even a medical dork like me notices that the ailments treated in those studies always are of the rather fuzzy kind, like headache, migraine, the not-feeling-good stuff and everyday come and go ailments like "argh, my back hurts".

And then I mentally compare this to well-known science based treatments, for example classics like Aspirin or penicillin. Even a badly conducted study of penicillin would show dramatic effects, and it did not take centuries to figure that out. Apparently, these things simply work. So why bother with questionable remedies and treatments where centuries passed and nothing could be proved? I just don't get it.
 
I accept these results because I've carefully checked the qualifications of all the people involved in this research and they are certainly more qualified than any member of this Forum. Moreover, there are no economic interests behind this research.
 
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