Study shows acupuncture doesn't work

[Tricky]

From today's news
Study sticks a pin into the effectiveness of acupuncture therapy (http://www.chron.com/cs/CDA/ssistory.mpl/health/3253982)
Research finds the ancient remedy offers no greater pain relief than sham treatments

Acupuncture proved no more effective than sham treatments for pain from a common chronic condition, according to a new study.
...
The study concluded that adding acupuncture to other treatments the patients were already using provided no greater pain relief than sham acupuncture treatments, according to the Tuesday issue of Annals of Internal Medicine.
...
In the study, patients in all the groups improved, but very early, after only one or two treatments — far earlier than most acupuncturists would expect an improvement — and then remained at the same level for the rest of the study, Buchwald said.

This is very good news, because acupuncture is one quack treatment that seems to be accepted by a fairly large number of otherwise rational people. Of course, pin-heads will still continue to claim that it works for other things. Give it time. They'll all be debunked.

[Bronze Dog]

Originally posted by Tricky
Give it time. They'll all be debunked.
At which point, they'll probably invent some chi-related disease. Symptoms include tiredness at night, occasional forgetfulness, and spells of fatigue that set in after long days at work.

[Kiless]

Yes! Thank you. I'm taking this down to my Vet who has a set of cards on their front desk that I saw today, for cat acupuncture. :(

[Tricky]

Originally posted by Kiless
Yes! Thank you. I'm taking this down to my Vet who has a set of cards on their front desk that I saw today, for cat acupuncture. :(
LOL. Seriously? If so, why exactly do you use that vet office? Is it the only one nearby?

[Deetee]

Originally posted by Tricky
Of course, pin-heads will still continue to claim that it works for other things.

One thing that always amuses me/causes despair (depending on my state of mind at the time) is how when a study showing, say, acupuncture "helps relieve tension headache" (as an example), the Woos and Tabloids all scream "PROOF - Acupuncture works!" and then using a giant dollop of twisted logic then ascribe this miraculous curative ability to all medical modalities - they conclude acupuncture therefore works for absolutely everything.

This is a bit like someone saying "Paracetamol helps headaches", and having the entire medical profession then promote paracetamol as a cure-all for everything from in growing toe-nails to cancer.

KILESS - you have been warned - BRING BACK FAYE!

[Loon]

A single study does not invalidate a mode of treatment. Of course, I'm not aware of any really strong studies supporting accupuncture, and the general consensus is, I believe, that it is at more mildly effective in handling certain types of chroic pain.

[Mojo]

Originally posted by Loon
Of course, I'm not aware of any really strong studies supporting accupuncture, and the general consensus is, I believe, that it is at more mildly effective in handling certain types of chroic pain.In other words, a treatment for which it is notoriously difficult to devise a convincing double-blinded placebo has been observed to be possibly effective for conditions, such as pain, which have a subjective component...

[Kiless]

Originally posted by Tricky
LOL. Seriously? If so, why exactly do you use that vet office? Is it the only one nearby?

1) They're the place who gave us all our cats - they were all dumped there or sent there after being found dumped in the bushlands.
2) They have an attached cattery which looks after our cats on extended holidays.
3) It's the first time I've seen these cards appear on their front desk and I was there yesterday placing an order - so it's recent.
4) The cards themselves (I was tempted to quietly shift them behind some advertisments for microchipping so they were invisible...) appeared to have a person with veterinary qualifications or at least some official looking initials - I'll go back tomorrow and get one of the cards and show them your article :)

[Rolfe]

Originally posted by Loon
.... the general consensus is, I believe, that it is at more mildly effective in handling certain types of chroic pain. This, being translated, means that a mild beneficial effect on some types of chronic pain is the aspect that has been most successfully peddled by the usual "argument by blatant assertion" favoured by acupuncturists (along with all alt-meddlers). There is no convincing evidence to support this alleged "consensus" (which I certainly am not a part of), and every reason to suggest that the one or two studies which might possibly suggest this (and of course a single study does not validate a mode of treatment) are in fact simply poorly controlled placebo effect.

Rolfe.

[steenkh]

In the news report it is said:
For 12 weeks, researchers tested conventional acupuncture against treatments in which needles were improperly applied in 100 Seattle-area patients suffering from fibromyalgia, which is characterized by chronic pain in the head and torso.
So has it been tested against not inserting any needles at all, and if so, on how many patients?

I seem to recall that inserting needles at the "wrong" places has been tested before and with the same result: It has the same effect as inserting the needles at the "right" places. This does not really say that acupuncture is worthless as a pain killer, only that acupuncture theory is bollocks!

[Tricky]

Originally posted by steenkh
In the news report it is said:

So has it been tested against not inserting any needles at all, and if so, on how many patients?

I seem to recall that inserting needles at the "wrong" places has been tested before and with the same result: It has the same effect as inserting the needles at the "right" places. This does not really say that acupuncture is worthless as a pain killer, only that acupuncture theory is bollocks!
In the article it said:
The sham treatments — acupuncture for an unrelated condition, needle insertion at points that are not used in acupuncture, and simulated acupuncture that didn't actually pierce the skin — were intended to help pinpoint what elements of acupuncture might be beneficial.

I don't know how these sham treatments were compared to each other. I'd like to see the paper.

[Kiless]

Originally posted by steenkh
I seem to recall that inserting needles at the "wrong" places has been tested before and with the same result: It has the same effect as inserting the needles at the "right" places. This does not really say that acupuncture is worthless as a pain killer, only that acupuncture theory is bollocks!

*surpresses visions of daft acupuncturist practicing on cats and having cats claw and beat the living @&#^%@*&#^% out of them..... :D ...maybe I should just leave the cards there and let the simulus / response do the work for me.....*

[Ashles]

Originally posted by Kiless
Yes! Thank you. I'm taking this down to my Vet who has a set of cards on their front desk that I saw today, for cat acupuncture. :(
I think anyone who thinks cat acupuncture will have any healing effect on cats.... hmm, what would be a suitably painful punishment for them... ah yes - they should be allowed to go ahead and try it.

As long as I can watch. :)

[drkitten]

Originally posted by Loon
A single study does not invalidate a mode of treatment.



Of course not.

On the other hand, if there aren't any strong studies that support accupuncture, and there are strong studies refuting it, one kind of wonders what the standards for evidence are.

How many studies should it take?

How strong does the evidence against accupuncture need to be?

[Loon]

Originally posted by new drkitten
Of course not.

On the other hand, if there aren't any strong studies that support accupuncture, and there are strong studies refuting it, one kind of wonders what the standards for evidence are.

How many studies should it take?

How strong does the evidence against accupuncture need to be?

No idea how long it should take or how many studies. Nor do I claim to be an expert on accupuncture. I was just under the impression that the evidence before this study was stronger than everyone else here (all with more experience in the field than I have) seem so think it is.

[Kilik]

I think a major issue is the acupuncturist and the twisting of the needle.

This wasn't so clear in the article, as it was not an especially in-depth report. I know something is happening when the needle is turned. I wouldn't be quite so confident acupuncture is going to be debunked case after case, that's just a bit overconfident.

[Rolfe]

Originally posted by Loon
No idea how long it should take or how many studies. Nor do I claim to be an expert on accupuncture. I was just under the impression that the evidence before this study was stronger than everyone else here (all with more experience in the field than I have) seem so think it is. The evidence already in hand ranges from the pathetic to the non-existent. It's just that a lot of people have been asserting that there is evidence of efficacy for acupuncture, and if you peddle a lie long enough it tends to grow some roots.

I think some of it is a sort of politeness. Acupuncture isn't so obviously woo as, say, homoeopathy. Something is actually done to the patient. If indeed there were to be a demonstrable effect, we might reasonably expect to find a mechanism of action without having to rewrite all of basic physics and chemistry. So, when it seems just too impolite to go on rubbishing every woo-woo claim there is, some people seem to latch on to acupuncture as something they think might have a bit of semi-legitimacy to it, and say, well, that one might have some credibility. Thus you find quite a lot of medically-savvy people prepared to pay it some lip service, I suspcet just to make it sound as if they're not entirely "closed-minded", and so the impression of legitimacy grows.

There was also, in America, a committee of acupuncture proponents who once managed to get some officially-endorsed guidelines published saying that acupuncture should be integrated into conventional health-care, but really, it was just a group of acupuncturists promoting their own interests. But of course people have quoted this, because it sounds authoritative.

Take a look at Nonsense with Needles (http://www.vet-task-force.com/Acuref1.htm).

Rolfe.

PS. There are only two "c"s in acupuncture, and they don't come together.

[drkitten]

Originally posted by Kilik
I know something is happening when the needle is turned.


How do you "know" this?

I wouldn't be quite so confident acupuncture is going to be debunked case after case, that's just a bit overconfident.

"I wouldn't be quite so confident the sun is going to continue to rise day after day, that's just a bit overconfident."

I have the same question for you as for Loon, then. If you're suggesting that we take a cautious wait-and-see approach to acupuncture --- at what point is it reasonable to stop waiting? At what point would it no longer be overconfidence to expect the rest of the experiments to show the same things as the ones we have already done?

How much evidence would need be amassed before acupuncture is no longer considered a viable medical hypothesis?

[drkitten]

Originally posted by Rolfe

PS. There are only two "c"s in acupuncture, and they don't come together.

Only unimaginative people can only think of a single way to spell a word.

[Kilik]

I have had acupuncture a few years ago which when the needle was twisted it was a very real sensation and effect, like almost a mild tightening and shooting, with electric type sensations too, but not just like a reflex, it stays and effects deep in the body. So that is at least real. I felt effects afterward in my body and health but that's not really provable

I also can feel qi without acupuncture. It starts out very similar to a TENS type machine or electrical current machine, but becomes alot more, a thicker more flowing energy.

I also know there are less effective acupuncturists too.

SO that's my experience anyways

It is also the single most important and effective factor for vitalization of the body. What is called the "runner's high" is a part of this.

[Rolfe]

The body does tend to notice when you stick needles into it, nobody disputes that. And some effects will vary depending on where the needles are stuck, usually according to whether the needle literally "hit a nerve".

However, this goes absolutely nowhere towards proving the therapeutic effects claimed for it.

Anyone who can prove the existence of "qi" or the vital force or energy is elegible for the Challenge. Physics can measure the angular momentum of a single electron. Biochemistry can accurately demonstrate exactly how many joules are consumed or liberated by any metabolic reaction. Physology can demonstrate the nerve potential and muscle contractions and so on.

Nobody has ever measured anything describable as "qi".

"Vitalisation of the body"? What on earth do you mean by this? The mechanisms involved in the "runner's high" and similar euphoric states are very well understood, and they have nothing at all to do with this unmeasurable and undemonstrable (and frankly non-existent) "qi".

Rolfe.

[Kilik]

Well, I still say 5 minutes of qigong is going to effectively vitalise the body and induce a long "runner's high" , much more than 30 minutes running.

It's the activation and awareness of the sensation of qi which is the major difference IME.

[Rolfe]

And you can prove that this isn't just your active imagination, exactly how? Come on, a million bucks awaits you.

Rolfe.

[Kilik]

Well, I don't know.

But I bet it is connected to, the "runner's high" idea, but greater. Electrical sensations similar to some machines is also produced.

[Jas]

Originally posted by Kiless
Yes! Thank you. I'm taking this down to my Vet who has a set of cards on their front desk that I saw today, for cat acupuncture. :(

That's upsetting. When I see something like that in a veterinary office (or homeopathic drops, or whatnot), it always makes me wonder where else their knowledge is deficient. While my vet is wonderful, the emergency vet is into all of that crap (so I try to keep my pets from getting sick outside office hours-:p ).

[Rolfe]

Originally posted by Kilik
Well, I don't know.

But I bet it is connected to, the "runner's high" idea, but greater. Electrical sensations similar to some machines is also produced. True, you don't know.

Did you not understand what I was saying earlier? The angular momentum on a single electron, can be measured and shown to exist. The energy that fuels our bodies can be measured and tracked and shown to exist. The electrical potentials that fire nerves and contract muscles can be measured and shown to exist. The chemicals that produce euphoric feelings in the brain can be measured and shown to exist.

"Qi" cannot be measured, absolutely nothing at all is going on in the body that corresponds with what you say you're feeling. It's purely a feeling in your brain. It's psychological. Brought on by belief.

Electricity and electrical sensations in the body are extremely well understood, and measured and charted and can be induced. If there was any possible truth at all in what you "bet", it would be possible to measure it. It isn't.

Rolfe.

[Kilik]

The electrical aspects are part of what is understood as effects in the body, but not fully understood.

[Rolfe]

Originally posted by Kilik
The electrical aspects are part of what is understood as effects in the body, but not fully understood. "God of the Gaps" now, is it?

Explain what is not fully understood. (Bet you can't.) Explain how come an entire "energy" system in the body can not only have gone unnoticed by all of physiology, but failed to show up even when actively looked for, by a science that can measure the angular momentum on a single electron.

Just imagining you feel something, and then declaring that this is some unknown and unmeasurable energy, and then declaring that this proves that acupuncture is valid medicine, is one of the silliest trains of argument I have come across outside of Kumar's posts.

Rolfe.

[tkingdoll]

My sister went to her doctor last year with recurring back pain. After several visits and ineffective prescriptions, her doctor personally administered acupuncture and her symptoms disappeared. Obviously, this alarmed me, I had no idea that ordinary GPs ever used acupuncture. I wasn't surprised it had worked, her back pain was one of a list of 'mysterious' ailments that she has suffered from over the years during particulary stressful periods of her life. An imaginary cure for imaginary symptoms, indeed.

Anyway, my point is, does anyone else think that the doctor administered the acupuncture as a placebo?

Or is it likely that a medical GP would actually genuinely believe and utilise such quackery?

I'd like to think it's the former, but as this same doctor failed to diagnose a slipped disc this year, I'm not so sure.

[Loon]

Originally posted by Rolfe
PS. There are only two "c"s in acupuncture, and they don't come together.

Ah, ha! The evidence for acupuncture is from non-existent to pathetic, but the evidence for accupuncture is much closer to tenuous.

:P

[Physiotherapist]

Anyway, my point is, does anyone else think that the doctor administered the acupuncture as a placebo? Or is it likely that a medical GP would actually genuinely believe and utilise such quackery?


To answer your question, there are a lot of GP's that do utilize acupuncture. However, they normally train in medical acupuncture, which is called trigger point acupuncture. They are then normally registered with BMAS, which is the British Medical Acupuncture Society.

Basically, they are using the acupuncture points as a form of pain relief and cutting the TCM aspect out of it.

It can be quite effective for low back pain and other kinds of musculoskeletal complaints and there is some research around to demonstrate this.

[steenkh]

My wife was given "pain relief" by one of such doctor. Without asking, the doctor suddenly started jabbing my wife with needles, and and she got such pain that she nearly fainted (but I bet she forgot her original pain for a moment). It took close to a month before the pain from the needles was gone.

My wife believes that one of the needles hit a nerve, and next time someone brandishes a needle in front of her, she is going to react violently!

[tkingdoll]

Originally posted by Physiotherapist
To answer your question, there are a lot of GP's that do utilize acupuncture. However, they normally train in medical acupuncture, which is called trigger point acupuncture. They are then normally registered with BMAS, which is the British Medical Acupuncture Society.

Basically, they are using the acupuncture points as a form of pain relief and cutting the TCM aspect out of it.

It can be quite effective for low back pain and other kinds of musculoskeletal complaints and there is some research around to demonstrate this.

Now I'm really confused! So are you saying there's good acupuncture, and bad acupuncture?

I thought it was the whole 'trigger point' thing that was the issue of debate, i.e. that in reality there are no trigger points and you could stick the needles any old where.

So where is the line between the BMAS-approved acupuncture and the woo acupuncture?:confused:

[supercorgi]

Originally posted by Kiless
*surpresses visions of daft acupuncturist practicing on cats and having cats claw and beat the living @&#^%@*&#^% out of them..... :D ...maybe I should just leave the cards there and let the simulus / response do the work for me.....*
And I hope the poor cats bite the damn quack too! Having recently been bitten by my cat, and having to go through two intravenous antibiotic treatments for it, I can tell you that is a great incentive not to stick sharp, pointy objects into cats. I never had any idea how bad cat bites were!

[Rolfe]

Originally posted by Physiotherapist
To answer your question, there are a lot of GP's that do utilize acupuncture. However, they normally train in medical acupuncture, which is called trigger point acupuncture. They are then normally registered with BMAS, which is the British Medical Acupuncture Society.

Basically, they are using the acupuncture points as a form of pain relief and cutting the TCM aspect out of it.

It can be quite effective for low back pain and other kinds of musculoskeletal complaints and there is some research around to demonstrate this. Not really. Acupuncture has managed to get a fair measure of (undeserved) legitimacy within the real medical establishment. Like I said, I think a lot of it is people not wanting to seem closed-minded, and being relieved to agree that at least one SCAM modality might have some validity. But the actual evidence is that it's just placebo effect, and it doesn't matter where the needles are placed.

Doing something almost always seems to be better than doing nothing. And the more "something" you do, or the more invasive the "something" is, the more marked the effect often is. So, when you actually stick needles in the patient, and maybe even hurt them, hey, heap powerful medicine that!

No doubt the doctors who are using this method don't think it's placebo, they're just believing what they've been told. But there's no evidence of any specific effect from acupuncture needling of particular places (apart form the obviousl consequence of hitting a particular anatomical structure).

Anyway, this whole pain relief part is pretty much a modern invention. Acupuncture as she was originally marketed was a cure-all medical system, needle in the ear would cure your sick liver, needle in the big toe would be the answer to your kidney failure (not real examples) and so on. This is such blatant nonsense, but somehow the (apparently intuitive) idea that it might provide pain relief sort of caught on.

Rolfe.

[patnray]

Originally posted by supercorgi
Having recently been bitten by my cat, and having to go through two intravenous antibiotic treatments for it, I can tell you that is a great incentive not to stick sharp, pointy objects into cats. I never had any idea how bad cat bites were!
Happened to me, too, a few years back. Nasty. Thank science for the antibiotics.

[Bronze Dog]

Scratches are pretty bad, too. Brother has a black cat named Kafka. He's got extra sharp claws (spends half of his waking time sharpening them), and lots of muscle. (Advantage when he's in a good mood: You can treat him like a dog. He loves hard, vigorous tummy rubs.)

Oh, and since acupuncture's the same regardless of where you stick the needles, does that mean I can have a nail gun war?

[Physiotherapist]

Now I'm really confused! So are you saying there's good acupuncture, and bad acupuncture?


No need to be confused.

There are two different types of acupuncture that are practiced. One is by practitioners who are registered with the British Acupuncture Council and who mostly train for 3 years and use Traditional Chinese Medicine as their diagnostic tool.

The other type of medical acupuncture can be practiced by doctors, physiotherapists and other registered health care practitioners. This training is limited to a few weekends though and as I said, the doctors are then registered with BMAS and the others are registered with a healthcare acupuncture society of some kind.

That is the distinction and is not intrinsictly good or bad. Some of my physio colleagues have undertaken acupuncture courses.

[neutrino_cannon]

Buchwald said acupuncturists generally tailor treatment for each patient and often combine it with other forms of therapy, which cannot be done in a clinical trial.


Wouldn't that make this study unrepresentative of acupuncture as a whole then?

And I didn't see it stated whether or not the study was performed double blind.

[Rolfe]

Originally posted by neutrino_cannon
And I didn't see it stated whether or not the study was performed double blind. We went into this on another thread. Although it might be possible to blind the patient, with enough care, it is impossible in practical terms to blind an acupuncturist as to whether he is performing real acupuncture or sham acupuncture.

Rolfe.

[bignickel]

If I may, I suspect that Neutrino is positing that we don't know whether the judges were blinded to which subjects had acupuncture done on them, when deciding on who 'improved'.

Thus, their bias pro or con can easily leak in.

[drkitten]

Originally posted by bignickel
If I may, I suspect that Neutrino is positing that we don't know whether the judges were blinded to which subjects had acupuncture done on them, when deciding on who 'improved'.


Judges? In a study of pain relief?

I'd be very surprised if the study used anything other than medication requests or self-reportage by the patients as the dependent variable. In which case the notion of "judges" is somewhat questionable.

[bigred]

Originally posted by Tricky
From today's news


This is very good news, because acupuncture is one quack treatment that seems to be accepted by a fairly large number of otherwise rational people. Of course, pin-heads will still continue to claim that it works for other things. Give it time. They'll all be debunked. I'm no "pro-acupuncturist" whatsoever, but that is some seriously weak proof/testing. How about just doing a study where it's used and it doesn't show results vs adding it to other remedies already being used, it didn't work quick enough, etc etc.

[neutrino_cannon]

Originally posted by bignickel
If I may, I suspect that Neutrino is positing that we don't know whether the judges were blinded to which subjects had acupuncture done on them, when deciding on who 'improved'.

Thus, their bias pro or con can easily leak in.

Indeed, but if they judgement was done by the patients, who were effectively blind, then it probably doesn't matter.

[Rolfe]

Originally posted by neutrino_cannon
Indeed, but if they judgement was done by the patients, who were effectively blind, then it probably doesn't matter. But that's the point. The inability to blind the operatives is a problem here, because the patients have close contact with the operatives, and it's quite likely that some information about whether someone is getting the real deal or not might leak through.

Rolfe.

[neutrino_cannon]

Originally posted by Rolfe
But that's the point. The inability to blind the operatives is a problem here, because the patients have close contact with the operatives, and it's quite likely that some information about whether someone is getting the real deal or not might leak through.

Rolfe.

I hadn't thought of that.

This leaves two alternatives:


Train some folks to think they're doing real acupuncture, when in fact they're just randomly sticking in needles.

or

Break out hose robots!

[EdipisReks]

you could always give the patients a frontal leucotomy. properly done, it would probably prevent them from picking up cues from the acupuncturists, but they [the patients] would probably still be able to report on their perceived pain. a release form signed by the patients would probably be a good idea.

[neutrino_cannon]

Originally posted by EdipisReks
you could always give the patients a frontal leucotomy. properly done, it would probably prevent them from picking up cues from the acupuncturists, but they [the patients] would probably still be able to report on their perceived pain. a release form signed by the patients would probably be a good idea.

Umm... ethics board on line 1 for you. ;)

[EdipisReks]

Originally posted by neutrino_cannon
Umm... ethics board on line 1 for you. ;)
tell them i'm out of the office!

[neutrino_cannon]

Originally posted by EdipisReks
tell them i'm out of the office!

Too late, I told them that it was merely summer vacation, thus explaining your lack of class or principles.


[/bad pun]

That's not to say anything about the potential health effects of major brain surgery clouding the effects of the study.

[/mild derail]

So, any brilliant ideas on how an acupuncture study should be conducted?

[Jyera]

Originally posted by Tricky
From today's news
quote:
--------------------------------------------------------------------------------
Study sticks a pin into the effectiveness of acupuncture therapy
Research finds the ancient remedy offers no greater pain relief than sham treatments

Acupuncture proved no more effective than sham treatments for pain from a common chronic condition, according to a new study.
...
The study concluded that adding acupuncture to other treatments the patients were already using provided no greater pain relief than sham acupuncture treatments, according to the Tuesday issue of Annals of Internal Medicine.
...
In the study, patients in all the groups improved, but very early, after only one or two treatments — far earlier than most acupuncturists would expect an improvement — and then remained at the same level for the rest of the study, Buchwald said.
--------------------------------------------------------------------------------
...snipe ...
On second look , I thought there are something doubious.

If the "treatment the patient were already using" were already effective, then there would little additional benefit regardless of whether sham acupunture or acupuncture was used.

If someone has a fever, and was given paracetamol which is effective in lowering the body temperature.
Then adding additional alternative treatment might be insignificant (sham or not-sham).

Especially when "all groups improved very early". "far earlier than most acupuncturists would expect an improvement".
Doesn't that indicate that the "other treatment" has already made this comparison between sham-Acu and Acu invalid?

[drkitten]

Originally posted by Jyera

If the "treatment the patient were already using" were already effective, then there would little additional benefit regardless of whether sham acupunture or acupuncture was used.


That depends on the exact claim being tested.

Some acupuncturists claim that acupuncture alone is an effective treatment for everything up to and including Overheavy Wallet Syndrome.

Other acupuncturists claim that acupuncture is a useful treatment adjunct. From the original story:


Buchwald said acupuncturists [...] often combine it with other forms of therapy.


At the least, this suggests that the "other forms of therapy" with which acupuncture is often combined may be responsible for all or most of the apparent effectiveness.


If someone has a fever, and was given paracetamol which is effective in lowering the body temperature. Then adding additional alternative treatment might be insignificant (sham or not-sham).


Look at it the other way. If someone has a fever, and is given acupuncture to treat it, and then "often" given paracetamol as well, why give the acupuncture in the first place?