Acupuncture

[foxholeatheist]

I blogged about this a few months ago after witnessing acupuncture being performed at an Aid Station in Baghdad.

One of my Soldiers has had chronic back pain for about a year now. Body armor, long patrols, and rucksacks can do that. He's been on various combinations of muscle relaxers and NSAIDs and nothing has worked long term for him.

A few weeks ago we stopped at a FOB which was equipped with a X-Ray machine and we both sacrificed a PX run to have some X-Rays done to see if we could find any problems. Sucks, the PX had Cookie Crisp cereal and I have really been craving some for a while.

Anyway, nada on the X-Rays. I brought them to a physical therapist and a pain management specialist (granted, outside his field but I wanted some input) and neither of them could see any abnormalities. I was told that back pain is an elusive creature and difficult to diagnose and more difficult to cure. Compounded by several patrols a week (US Troops out of Baghdad... HA! I'll post pictures when current operations cease) nothing seems to be getting better.

We are at a small FOB in Baghdad numbering about a company sized Armor unit, an infantry platoon, MiTT and STARK teams and a huge Iraqi Army contingent so resources here are very limited. Our Aid Station's OIC is an MD with a degree in...

Wait for it...

Reflexology. Yeah, I know. Anyway, he is also licensed to practice acupuncture and has offered to "treat" this Soldier's back pain with an acupuncture treatment.

Like I said, I blogged about this eariler and I have come to the conclusion that while I believe any perceived effect will be a placebo, I do worry that the Soldier, believing his back to be cured, will be again rucking out in full battle rattle with what may be a back condition.

All the while, I do not want to question the procedure to the Soldier directly because any skepticism might obscure the effect of the procedure.

So I have a problem. Should I recommend a different course of treatment? Should I brief the Soldier on the facts (and there are few) regarding acupuncture and in doing so risk voiding any pain relief he might experience? Should I play along and then see what's up?

Oh, and there will be pictures. The MD has offered to give me some acupuncture for stress.

[Garrette]

Where in Baghdad? I'm on VBC and occasionally travel to the NEC (sometimes via the Rhino; sometimes PSD). I can pick you up some goodies and try to get them to you.

Ref the acupuncture, it appears to be rife. The Corps Surgeon is a marvelous person (I'm saying that sincerely) who is among the most healthy and fit of people I have ever met. She also pushes acupuncture; I declined someone else's invitation to get treatment from her for neck pain.

That said, my recommendation is this:

Ask the OIC if acupuncture is recognized as acceptable/official treatment in the military system, i.e., is it officially prescribed or practiced at MTFs in the US?

If not, stay away from it.

If so, tell your colleague the facts and let him decide.

Regardless, ensure that the condition itself and whatever treatment is obtained are put soundly in the records and keep copies now. VA will need them, and if the question of disability comes up later, they will be vital.

[arthwollipot]

Study after study has determined that acupuncture works.

...exactly as well as a placebo.

[foxholeatheist]

VBC? Really? On occasion we find ourselves in that direction.

Anyway, I don't know if they bother with a DA600 when it comes to the acupuncture treatment or if any documentation is even made. A lot of treatments are "off the record" so to speak.

The question: "Ask the OIC if acupuncture is recognized as acceptable/official treatment in the military system, i.e., is it officially prescribed or practiced at MTFs in the US?" Has a little too much buckshot in it. Remember, I am a mere Specialist speaking to a LTC. I think I can figure out a more gentle way of asking.

And yes, I have been documenting the Soldier's condition for about a year and a half now. Every PA and MD in our unit is well aware of it.

@arthwollipot: Also no side effects! no effects either

[Garrette]

The question: "Ask the OIC if acupuncture is recognized as acceptable/official treatment in the military system, i.e., is it officially prescribed or practiced at MTFs in the US?" Has a little too much buckshot in it. Remember, I am a mere Specialist speaking to a LTC. I think I can figure out a more gentle way of asking.If I get the chance, I'll ask for you.

[Pure Argent]

It's strange how many people are willing to buy into acupuncture. Its operating principle is that sticking pins in yourself at certain points will adjust your chi flow, for Cthulhu's sake.

In any case, if your friend does end up getting the treatment and thinking that he's been cured, you should probably keep a close eye on him. Like you said, the condition could return at a very bad time if he thinks it's fixed and keeps putting his back under strain. Even if the treatment is officially off the record, you should probably make a note of when and where it was applied and by whom, just in case.

[rjh01]

Acupuncture does have side effects. Your ability to donate blood is reduced in Australia.

Ref http://www.donateblood.com.au/page.aspx?IDDataTreeMenu=88#answer61

ACUPUNCTURE - I HAVE JUST HAD ACUPUNCTURE. CAN I DONATE?
Yes, as long as only sterile single-use (disposable) equipment was used, but only the plasma portion from your donation can be used for 4 months following the last procedure. After this time you can donate blood for full use.
If sterile single-use (disposable) equipment was not used, or you are unsure if it was used, you will not be able to donate for 12 months after the last acupuncture procedure.

[Andrew Wiggin]

Study after study has determined that acupuncture works.

...exactly as well as a placebo.

I'm actually thinking about doing some training in the various woo woo healing techniques, for just this reason. I've had patients who could get high from snorting pixie-stix dust if someone they trusted had sold it to them as 'colored coke'. (real story, by the way) Very vunerable to placebo effects. Given that, I'd actually be doing the treatment with the expectation that it would have an effect, even if the effect was mental in nature. Not sure how I feel about that yet.
A

[dlorde]

Pain does seem to be very tractable to placebos - so I guess if there's no available medical method for controlling the pain, acupuncture could be considered as a placebo candidate. I have also heard of good results in the field for controlling acute pain with dummy morphine injections (e.g. when morphine isn't available). Whether administering dummy treatments for their placebo effect in non-emergency situations is ethical, I couldn't say. Pure_Argent's advice seems very sensible.

[blutoski]

(Apropos)

[Skeptic North (http://www.skepticnorth.com)]: [Pseudo-quackery in Pain Management: a field with a large gray zone between overt quackery and evidence-based care (http://www.skepticnorth.com/2009/11/pseudo-quackery-in-pain-management.html)]

[foxholeatheist]

Here they are, as promised!!

http://forums.randi.org/imagehosting/thum_320584afc39ca139b8.jpg (http://forums.randi.org/vbimghost.php?do=displayimg&imgid=18169)

http://forums.randi.org/imagehosting/thum_320584afc39f5e475a.jpg (http://forums.randi.org/vbimghost.php?do=displayimg&imgid=18170)

http://forums.randi.org/imagehosting/thum_320584afc3a739a4b7.jpg (http://forums.randi.org/vbimghost.php?do=displayimg&imgid=18171)

Check out all the details here: Loser blog (http://foxholeatheist.wordpress.com/).

[Blackwell]

Since resources are limited, is it possible that the doc opted for acupuncture as a "cure" simply because it's cheap and easy? (Although, reading that the doc has a "degree" in reflexology, he's probably convinced that it's more than just placebo.)
You might want to offer to shave your buddy's back. That should reduce his load by a few pounds...

[phoenixphire24]

If what I'm seeing is right from the pictures you posted, then it looks like the needles are being hooked up to some sort of electricity source. Is this correct? If so than this is not traditional acupuncture, but rather a treatment called TENS (http://en.wikipedia.org/wiki/TENS), which has been shown to help back pain. They're pulling what Dr. Novella calls the bait and switch- referring to is as acupuncture, when really it's not. You can read about it here on his blog.

http://www.theness.com/neurologicablog/?p=362

http://www.theness.com/neurologicablog/?p=103

Of course, if the person doing the procedure is not a doctor then I still would be worried about the treatment because there's no way to tell if it's being done correctly.

[cgordon]

Not a doctor, and don't play one on TV ... but I've read that acupuncture CAN be effective in pain relief in some cases, but almost all other claims about it are bogus.

Something about histamine reactions, IIRC ...

Additionally, the electrical component does mimic the TENS effects and TENS is well-documented in pain relief.