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Acupuncture

September 21, 2010

For the general entry on Alternative Medicine, click here

The Claims

Acupuncture practitioners believe that inserting needles into the skin can have biological effects in relieving a variety of symptoms when these needles are placed in precise locations. The location of these needles is determined using the concept of chi that is part of Traditional Chinese Medicine. This theoretical framework consists of the belief that there is a life force in living things that flow through areas known as meridians, and that illness can result when these meridians are blocked. In order for acupunture to work, needles must be placed in specific places according to the position of these meridians.

The Evidence

Experimental Evidence
A recent study found that pain could be alleviated in mice who receive electrical stimulation through the insertion of needles (using a technique called transcutaneous electrical stimulation, or TENS). This study has been widely touted as proof of acupuncture’s efficacy and mechanism. While this study provides interesting data about the ability of injury to relieve pain from a nearby source, it does not provide convincing evidence for the merits of acupuncture. This study was not truly an acupuncture study since it used electrical stimulation, and there is no way to discern if the measured effects were due to the needle itself or to the electrical stimulation. Further, the site of needle insertion in this study was not determined using chi or meridians, but rather due to its proximity to the site of pain. This is not consistent with how acupuncture is actually practiced, and does not prove that needle placements along meridians have any effect.

There have been a large number of clinical trials undertaken to study the effects of Acupuncture. Controlled clinical trials, which include groups that receive “mock” acupunture have not found any significant effect. These trials often include a group that does not receive acupunture at all, and this group tends to do worse than the true acupuncture and the “mock” acupuncture group. This finding is easily explained by the fact that all medical interventions result in some degree of placebo effect. Therefore the act of placing acupuncture needles in specific locations and in a specific manner has not been shown to be effective.

Theoretical Plausibility
The theoretical underpinning of Acupuncture does not sit on a firm footing. There is no evidence for a life force in living things, nor is there any evidence of the presence of meridians, or of a link between blocked meridians and illness. These ideas run counter to our current understanding of biology and medicine, which is based on centuries of data. There is speculation that the insertion of needles may have various physiological effects independent of chi, which could influence certain symptoms or conditions. However, in light of the studies that have been undertaken this hypothesis is unlikely.

Conclusions

Acupuncture involves needles inserted into the skin at points which are determined using knowledge of a mystical life force which flows through all living beings. The theory underlying this method does not make biological sense, and the clinical trial data that has been gathered has failed to find any evidence of an effect. There is no evidence that Acupunture works to alleviate symptoms of any kind.

Links

http://www.sciencebasedmedicine.org/reference/?p=34

http://nccam.nih.gov/health/acupuncture/introduction.htm

http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm

Madsen MV, Gotzsche PC, Hrobjartsson A. Acupuncture treatment for pain:systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ 2009; 338:a3115

Goldman N, Chen M, Fujita T, Xu Q, Peng W, Liu W, Jensen TK, Pei Y, Wang F, Han X, Chen JF, Schnermann J, Takano T, Bekar L, Tieu K, Nedergaard M. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci. 2010 Jul;13(7):883-8. Epub 2010 May 30

Critique of Goldman et al: http://www.sciencebasedmedicine.org/?p=5437

13 Comments leave one →
  1. June 15, 2012 7:22 PM

    Jeez you’re worse than the liberal media with biases. I’ve never tried acupuncture, but even wikipedia does a better job of presenting the facts and studies from both sides of the argument. You must only read the papers that agree with yiou. At least include some of the scientific research that has had positive results, and then tell us why you don’t accept them.

  2. Tony O Connor permalink
    June 2, 2011 2:02 PM

    Aside from the myriad problems associated with ‘sham’ or ‘placebo’ acupuncture trials and those inherent with the practice (e.g. that it is impossible to conduct a double-blind study on acupuncture effectiveness) there is plenty of well-documented scientific evidence for the practice. The World Health Organisation (‘Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials’) lists twenty-eight ‘disease, symptoms or conditions for which acupuncture has been proved-through controlled trials- to be an effective treatment and many more, ‘for which the therapeutic effect of acupuncture has been shown but for which further proof is needed’.

    Also linked below is a study showing acupuncture’s effectiveness in treating Crohn’s disease in rats, which shows it’s far more than just a placebo effect.

    http://www.healthcmi.com/index.php/acupuncturist-news-online/362-acupuncturecrohnsdiseasenew

  3. Mike permalink
    June 2, 2011 1:58 PM

    The World Health Organization disagrees with your findings. See link for their review of acupuncture.

    http://apps.who.int/medicinedocs/en/d/Js4926e/5.html

  4. Danielle Robare permalink
    May 26, 2011 11:13 PM

    Why don’t these skeptic’s websites ever publish anything about the problems with Western Medicine? The ineffectiveness and side effects of antidepressants for example?

  5. Johnson D permalink
    April 24, 2011 1:53 AM

    Acupuncture evokes the placebo effect and does have scientific data proving its effectiveness as a placebo.

  6. Andrew permalink
    April 8, 2011 10:32 AM

    From the acupuncturist that i have seen, they do in fact use electricity to ease the pain as well. I am pretty sure based on speaking with him that they just use the same practices that the Chinese once did, but without all the magical sounding stuff. It did not end up helping me, but the acupuncturist did refer me to someone who actually did something besides prescribe me pills. Allopathic medicine needs to get off its high horse.

  7. Kathleen permalink
    April 6, 2011 6:11 PM

    My mom is a nurse, an got extreme carpal tunnel in both wrists from preparing needles, which require a twisting motion. She saw a ton of specialists and had treatments of every sort, but still she had to wear a splint and get relocated to a desk job because of the pain and mobility issues. One of the specialists referred her to an acupuncturist. My mom was very skeptical and nervous about being stuck with needles, but it couldn’t really get any worse, so she tried it. After the treatments, she could rotate her wrists near painlessly and do wrist excercises more comfortably. Sometimes she would just get needles, sometime electric shocks. It worked for her somehow, despite her complete misbelief at first :)

  8. plassebo permalink
    March 10, 2011 10:06 AM

    I too have been helped by acupunture … or placebo. It’s kind of hard to tell, and I wish that the so-called scientists would show atleast some of that humility when debunking the whole field of acupuncture by merely looking at PAIN RELIEF! (it really is just about that, I’ve read the metas) How lame is that?

    Secondly, why are stupid man-made fairy tales such as chi, meridians etc. crucial for showing that acupuncture doesn’t work? Who cares about the wrappings? I’ve seen this arguments from sceptics so many times and frankly it gives us a bad reputation. It might very well be that AP doesn’t work and that it’s all placebo, but please go for substance. F.i. the geocentric model created by Ptolemy was very useful indeed for predictions despite its inherent misconception.

  9. Charles Mitchard permalink
    December 11, 2010 5:24 AM

    I fractured L4 L5 in my back in the 70′s.
    I was in amazing amounts of pain from the damaged disks that was only lessened with very powerful painkillers.
    The pain was not permanent but usually the result of me moving awkwardly for some reason whereupon I would be disabled for anything from 6 weeks to 6 months depending upon what I had done to bring it on.
    I found one practitioner who could put me straight after one 45 min session.
    Needles from head to toe and wired up for electro stimulation.
    I would be carried in but could walk out pain free.
    She always warned me that it was not a cure just the removal of pain.
    I moved out the area and have visited 6 different practitioners all to no avail.
    She was the only one who added the electro stimulation and the only one who removed the pain.
    I have tried a tenze machine since then but again on its own (under medical supervision) it was a waste of time.

  10. RandomCapitalizations permalink
    December 10, 2010 7:09 PM

    There was a review done of 229 trials where researchers compared acupuncture to so-called sham acupuncture, where needles are inserted at points where they are not supposed to be according to acupuncture rules
    (Moffet HH. J Altern Complement Med. 2009 Mar;15(3):213-6.
    Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials.)

    Result? No difference. Makes you wonder why anyone studies acupuncture methods if sham is as good as the ‘real thing.’

  11. December 7, 2010 1:38 PM

    @Larry – hopping on one foot (probably not the injured one, to be sure) also improves blood flow. It requires zero needles, and isn’t based on faulty science. Besides, the theory underlying acupuncture is not based on blood flow or localized endorphin release or prostaglandins or any of the other post-hoc “explanations” of how acupuncture “works”.

    I, too, have seen acupuncture “work” with my own eyes – this is why we have science.

  12. Larry permalink
    December 5, 2010 3:50 PM

    I’ve experience with an Acupuncturist whose treatment has been effective with a particular type of injury, namely strained or sprained tendons or connective tissue. A sprained ankle that wasn’t healing was
    finally better after a few treatments. A much younger person with a recent sprained ankle was able to recover and compete after a single treatment.

    I attribute this to him being able to increase blood circulation to these tissues. Increased blood supply is a major factor healing and for example, why muscles heal faster than tendons. When he was treating an troublesome foot problem I thought it seemed that the foot being treated was warming up.

    I could not reach and touch that foot until he had disconnected me from the setup and needles. Then I reached over and touched that foot and it was very warm, almost as if I’d laid a hot water bottle on it.

    There is nothing mysterious about increased blood circulation improving healing.

    If there is a problem he doesn’t think he can treat he says so. He does not recommend extra treatments unless he really thinks it is necessary. I’ve only seen him a few times over the years. His reputation among athletes is very good.

    He specialized in sports medicine acupuncture after graduation. He is the third Acupuncturist I’ve seen and the only one to who I could credit with a discernible positive outcome.

    When I told a Prof. of Medicine, who I know personally, about my experience she replied. We know that the treatment assists healing but we don’t understand the why it works.

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