Acupuncture, again.

[thaiboxerken]

Ok, there are several people on various forums that are trying to convince me that it is a "FACT" that acupuncture works more thand a placebo and that medical science has validated it. I highly doubt the claim, as I understand it works solely using placebo. What's the real medical science stance on this?

[geni]

Originally posted by thaiboxerken
Ok, there are several people on various forums that are trying to convince me that it is a "FACT" that acupuncture works more thand a placebo and that medical science has validated it. I highly doubt the claim, as I understand it works solely using placebo. What's the real medical science stance on this?

It may have some effect beyond the placebo at reliveing pain. However the evidence is iffy. A clasic case of insificient evidence to come to a valid judgement either way.

[Dr Adequate]

Originally posted by thaiboxerken
What's the real medical science stance on this?
The words: "Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence! Show me the evidence!"

And if they can, we've all learned something.

There was some discussion here lately about topical "electroacupunture"... jury's still out on that one, I think.

[thaiboxerken]

Yes, I do ask them for evidence and they usually fail to give it.

They did give some "Internal Archive" pubs, which are part of JAMA. However, when I look at the conclusions of those studies, they are inconclusive.

Why do believers think that "inconclusive" is evidence to support their claims?

[scotth]

It wouldn't surprise me that acupuncture has some minor benefit with pain management. Even rubbing a hurting area has some benefit for pain management, just by giving the nerves some other sensation to transmit.

However, the possibility of accupuncture having any real currative powers has effectively been ruled out, in my opinion.

Some things to note:

1) Accupuncture has changed little in many hundreds of years. And it advanced in a time that had a complete and total lack of anatomical knowledge. That is, they ancient founders of this tradition had no clue how the body worked! The qi and meridians, and the whole theory of disease under accupuncture is completely without the support of knowledge of anatomy and physiology learned in the last 100 years. There has not been once medical fact gleened from study REAL BODIES that support the existance of any of the constructs that accupuncture is based on.
2) If it works so damn well, why is western medicine being used at all in Asia?
3) Really now, does it take more than a couple of decades to get better than 'inconclusive' evidence if it is of much use at all?
4) (pure conjecture on my part) It will be spectacularly ironic if in a few decades, that you have to come to the U.S. to get treated by accupuncture. It could be that evidence based medicine will pretty much completely displace accupuncture in its traditional homeland, leaving only late adopters of the practice still hanging on.

[Pixel42]

If you're looking for actual study results, you may find this article useful:

http://www.guardian.co.uk/health/story/0,,1170061,00.html

[Ashles]

Well acupuncture points seem to coincide with nerve clusters. And 'confusing' pain signals will alleviate pain so I don't se why there might not be some truth to it.

But it's certainly not a 'Fact' yet.

Here is info from Skepdic (http://www.skepdic.com/acupunc.html)

[Xeriar]

See if, the next time you get a cold headache, biting your upper lip or pinching your philtrum works.

It seems to help for me... sometimes. I've also seen studies that it helped reduce arthritic pain and such.

I don't believe that it's any more useful than that, though.

[Sharon]

Hi all

I found this

http://www.csicop.org/si/2003-03/acupuncture.html

Sorry if it's been posted before.

Like Xeriar, I sometimes find it works. What I mean is if I'm going to sneeze and I rub my eye really hard It stops me sneezing. I know, it sounds silly but it seems to works for me?

Don't know how mind you

sharon

[thaiboxerken]

http://archives.cnn.com/2000/HEALTH/alternative/08/14/acupuncture.cocaine.ap/

Here is a link to some "evidence" that acupuncture works more than placebo. However, I think the protocols summarized are pretty weak. This does not look like a double-blind study.

[Jas]

I figure if you poke a needle in someone, you'll get a reaction. I think that overall acupuncture is just a scam. Unfortuanately, I can't find a single physio who doesn't practice acupuncture.

[Vim Razz]

There have been a few reasonably reliable studies that have shown acupucture-ing ( :p ) to stimulate an endorphin response, reducing pain perception.

That's it, and considering the extensive range of medical problems that acupuncturists claim to be able to fix -- but cannot provide any evidence for having such abilities -- it's really nothing to get exited about, imho.

There remains no evidence that "acupunture in general" actualy works. (i.e., to repair liver funcion, cure depression, fix arthritis, etc., etc., etc...)

[Rolfe]

Originally posted by Vim Razz
There have been a few reasonably reliable studies that have shown acupucture-ing ( :p ) to stimulate an endorphin response, reducing pain perception.Can you provide a reference for such a study? I've seen numerous claims that if acupuncture can produce any effects, this might explain how these occurred, and even claims that it was a known fact that this was how acupuincture "works". However, I've never seen anyone demonstrate that it actually happens.

And I've never seen a convincing piece of evidence that acupuncture does anything more than you'd expect from having a needle stuck in the body.

Rolfe.

[bjornart]

The thing is, the placebo effect varies with the remedy. One small white sugar pill is not as effective as two large red sugar pills. So when testing a pain killer that comes in the form of small white pills you give the placebo in the form of pills that are completely the same.

So what kind of placebo do you compare accupuncture with? And if it's sham accupuncture, how do you make the test double blind?

[Soapy Sam]

Like jas, I have been surprised to find that most physios are convinced there is something to it.
However, something to what, exactly?
One physio friend self-administers accupuncture to ease discomfort due to muscle spasm. She is convinced that it has a genuine effect in releasing tetanic areas of muscle and that the effect is mechanical in nature.

If there is any truth in this view, it is a very diffferent effect from one involving endorphin release.

Like most people, I expect that sticking needles in people systematically should give some systematic response pattern. It might be beneficial, it might not. (I would expect not, on the general grounds that sticking needles in complex machinery is apt to do more harm than good.)

If accupuncture does have any beneficial effect or effects, it seems to me to be the responsibility of the practitioners to provide the necessary experimental data to prove their case, as drug tests are the responsibility of the manufacturers. In short, time for the claimants to pay for research and accept the results of it.

[Rolfe]

As Dr. Bandolier (Andrew Moore) said at that meeting in Oxford, if you want to go for acupuncture, carry on, just remember that it doesn't work and it can kill you (http://www.jr2.ox.ac.uk/bandolier/band68/b68-4.html). If they can't produce anything better than the vague, poorly blinded and clinically insignificant effects in the "best" of the proponents' papers, it's time to start remembering that it isn't safe.

Rolfe.

[thaiboxerken]

Originally posted by bjornart

So what kind of placebo do you compare accupuncture with? And if it's sham accupuncture, how do you make the test double blind?

Use needles for both the non-remedy and remedy. Have a "real" acupuncturist outline where the needles need to be placed for effect to "cure" the condition. Have another outline that has a "sham" of acupuncture points for a "cure". Have experimenters that are clueless apply, randomly, these needle points. Have observers that are clueless about who recieved what make their observations. A tester will be the only one who knows which people recieved "real" treatment and "fake" treatment.

[Rolfe]

Originally posted by thaiboxerken
Use needles for both the non-remedy and remedy. Have a "real" acupuncturist outline where the needles need to be placed for effect to "cure" the condition. Have another outline that has a "sham" of acupuncture points for a "cure". Have experimenters that are clueless apply, randomly, these needle points. Have observers that are clueless about who recieved what make their observations. A tester will be the only one who knows which people recieved "real" treatment and "fake" treatment. The problem with this is that when no difference is found the acupuncturists will assert that it's no good if it's done by a clueless amateur. Only the true master can achieve the effect. And if that's a stipulation you can never double-blind anything because the operator will always know which is which. See Are Toresen's article (http://www.vetlab.co.uk/voodoo/thoresen.html) for an example of the drivel they'll come up with to explain this theory.

Another problem is that if you combine all the acupuncture charts produced by all the acupuncture gurus throughout space and time, there isn't a spot on the human body that isn't an acupuncture point. So, find the same degree of Hawthorne Effect present in both the acupuncture group and the sham group, and they'll promptly start re-analysing the treatment given to the sham group to show that that was also valid acupuncture. For whatever condition was being treated. Even if they had agreed in advance that these points would do nothing. (OK, how this actually works is that the acupuncturists who agreed the sham points vanish into oblivion, and another group appear, who declare that the protocol was obviously rubbish and couldn't possibly be expected to show any effect.)

And if this hasn't happened already, it will, as soon as they take the homoeopaths' correspondence course.

Rolfe.

[thaiboxerken]

"The problem with this is that when no difference is found the acupuncturists will assert that it's no good if it's done by a clueless amateur."

I think this very fact shows that acupuncture is nonsense. If the needle points are placed in the exact spot that the acupuncturists say they need to be, then it should work regardless of how the point was poked. A robot should be able to do it.

Of course they'll come up with excuses, but that is all they are. They are definitely not reasons as to why it wouldn't work.

You are correct about Hawthorne Effect. The dishonesty of alt med people is steep.

[voidx]

If you read the article linked in Pixel42's post above you'll see this scenario has been tried. 3 groups, one without acupuncture, one with authentic and one with random acupuncture. What they found was that acupuncture period aided in recovery slightly. However there was no difference between authentic and random acupuncture. So it didn't matter where the needles went, but getting stuck with needles period seemed to help to some small degree. This to me would indicate its mostly a placebo effect. The trial size was quite large too, compared to the extremely small sizes usually used in most acupuncture studies.

[Rolfe]

Originally posted by thaiboxerken
"The problem with this is that when no difference is found the acupuncturists will assert that it's no good if it's done by a clueless amateur."

I think this very fact shows that acupuncture is nonsense.The problem is that these people talk a blue streak, and are apparently capable of convincing not only the new-age general public but people who should know better in positions of medical authority that the "skill" element is vital. People are used to understanding that they better not let a clueless amateur do surgery on them, and don't necessarily grasp how this is radically different.

Did you read the article I linked to by Are Thoresen? That's the sort of guff being put out that has to be countered. I mean, he's essentially admitting he's practising magic, but somehow the medical regulators think it's non-PC to accuse him of that.

Rolfe.

[bjornart]

Originally posted by voidx
If you read the article linked in Pixel42's post above you'll see this scenario has been tried. 3 groups, one without acupuncture, one with authentic and one with random acupuncture. What they found was that acupuncture period aided in recovery slightly. However there was no difference between authentic and random acupuncture. So it didn't matter where the needles went, but getting stuck with needles period seemed to help to some small degree. This to me would indicate its mostly a placebo effect. The trial size was quite large too, compared to the extremely small sizes usually used in most acupuncture studies.

The trials are not yet finished - they were due to end about now, but recruitment was slow and recently it was announced that the deadline has been extended until the end of this year. Preliminary results were leaked nevertheless. They are intriguing: adjunctive acupuncture turned out to be better than standard care but sham acupuncture yields the same benefit as "real" acupuncture.

This article is almost a year old. Anyone have access to the final results?