Swell needles!

Southwind17 · 30th August 2010, 09:45 PM

I realize that acupuncture has been a well worn subject of debate on the Forum, but with reference to this article, in particular:

Quote:

Acupuncture works by reducing pain and swelling to increase the patient’s comfort level.

... surely the swelling claim could, and should (if it hasn't!), be easily tested scientifically. Can the placebo effect potentially account for reduced swelling?!

Uncayimmy · 30th August 2010, 10:49 PM

Originally Posted by Southwind17

I realize that acupuncture has been a well worn subject of debate on the Forum, but with reference to this article, in particular:

... surely the swelling claim could, and should (if it hasn't!), be easily tested scientifically. Can the placebo effect potentially account for reduced swelling?!

Personally, I think skeptics too quickly scoff at acupuncture because of its quaint beginnings in folklore. However, I've read a number studies (mostly abstracts - you know how it is) and publications by health organizations I respect (CDC, WHO). My conclusion is that there is something there, but we need to get away from calling it acupuncture and all the associated nonsense about chi and meridians. We should just look at it like we got lucky and noticed by accident that needle sticking might do some good while offering few negative results.

It's painfully obvious (pun intended) that needle sticking does something to the body. Studies have looked at and, of course, found chemical changes in response to the needles. Therefore, we can't just dismiss out of hand like we can with goofball stuff Reiki Touch where you can't even tell if anything is happening just by looking at the patient. Without a doubt you could blind a researcher, and she would be able to tell you which patients were getting stuck with needles and which weren't based on chemical analysis alone.

Studies like this one, which I think you will accept as being a couple of notches above a lot of the crap out there, have found that for certain conditions (in this case, pain relief), needle sticking is effective. They conclude, "Compared with physiotherapy and as-needed anti-inflammatory drugs, addition of either TCA [traditional Chinese acupuncture] or sham acupuncture led to greater improvement in WOMAC score at 26 weeks. No statistically significant difference was observed between TCA and sham acupuncture, suggesting that the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles."

It's going to be incredibly difficult to close or open the book on needle sticking. As you suggest, one line of research needs to look at the body's reactions to needle sticking to see if we can find any reason for there to be a positive effect. There seem to be a lot of small possibly crappy studies going down this route but we really need large, focused studies looking at a single condition like the study above.

At the same time we need to look to see if there are differences in the body's reactions based on the location of the needle sticking. Obviously some locations hurt more than others, so it would be reasonable to assume that different locations have different responses. We'd have to map out the body.

If there's an effect, these two lines of research should intersect somewhere. It's a waste of time to be looking at TCA because there's no such thing as chi. The traditional locations, if they are "right," are right by dumb luck. We should take a systematic approach.

We should also stop with all the silly studies trying to see if TCA works for this disease or that disease. That's not science - that's just wild ass guessing. Stick with the two areas that show promise: pain relief and nausea relief. Forget about Bell's palsy or insulin uptake for now. Of course, all the "researchers" who "believe" in TCA don't want to hear that.

Mojo · 30th August 2010, 11:22 PM

Originally Posted by UncaYimmy

Studies like this one, which I think you will accept as being a couple of notches above a lot of the crap out there...

Quote:

LIMITATIONS: There was no blinding between acupuncture and traditional therapy and no monitoring of acupuncture compliance with study protocol. In general, practitioner-patient contacts were less intense in the conservative therapy group than in the TCA and sham acupuncture groups.

The lack of blinding, along with the lack of a significant observed difference between actual and sham acupuncture, is something of a problem. The paper concludes, "the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles."

It concludes that the groups getting needling in addition to regular treatment did better than those who just had the regular treatment, but it doesn't eliminate factors other then the needling. A replication using non-penetrating sham needles as a control might be useful.

Uncayimmy · 30th August 2010, 11:34 PM

Originally Posted by Mojo

The lack of blinding, along with the lack of a significant observed difference between actual and sham acupuncture, is something of a problem. The paper concludes, "the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles."

It concludes that the groups getting needling in addition to regular treatment did better than those who just had the regular treatment, but it doesn't eliminate factors other then the needling. A replication using non-penetrating sham needles as a control might be useful.

It's going to be really hard to come up with an adequate control for needle sticking. Some studies have used four groups:
TCA
Sham
Drug with a known effect
Placebo

I've seen some that reported benefits greater than placebo but less than the drug. Others had results where all three had similar effects. It's a mess.

That's why I argue that the best route to take is to study the chemical reactions in the body. If we can find one that explains an effect, then the control becomes far less important. We might even be able to find ways to stimulate the chemical responses without needles.

Southwind17 · 30th August 2010, 11:58 PM

Originally Posted by UncaYimmy

We might even be able to find ways to stimulate the chemical responses without needles.

Revert to snorting?!

bit_pattern · 31st August 2010, 12:06 AM

Originally Posted by Southwind17

Revert to snorting?!

Oh. Snap!

Southwind17 · 31st August 2010, 12:07 AM

Originally Posted by UncaYimmy

It's going to be really hard to come up with an adequate control for needle sticking. Some studies have used four groups:
TCA
Sham
Drug with a known effect
Placebo

I've seen some that reported benefits greater than placebo but less than the drug. Others had results where all three had similar effects. It's a mess.

That's why I argue that the best route to take is to study the chemical reactions in the body. If we can find one that explains an effect, then the control becomes far less important. We might even be able to find ways to stimulate the chemical responses without needles.

Have any studies involved anaesthetised or otherwise unconscious patients? Would this not overcome the placebo and sham questions? Obviously, this wouldn't be appropriate in respect of claimed pain and nausea relief!

Yuri Nalyssus · 31st August 2010, 08:43 AM

Originally Posted by UncaYimmy

It's going to be really hard to come up with an adequate control for needle sticking.

Fair comment, but researchers are getting better at it with self retracting needles and such like and by and large the better the blinding becomes the smaller the observed effect of acupuncture.

That, plus the sneakyness of pro-acupuncture dogmatists putting out press releases saying that acupuncture works for this that or the other condition while not mentioning that placebo needles did just as well, has got to make any right thinking person extremely sceptical of their claims - why would they feel the need to bend the truth otherwise?

There may be something in so-called 'non-specific needling', but it's not much and probably a lot less effective, less pleasant and more risky that a massage or a bit of meditation or even a jolly nice cup of tea - but then tea doesn't come with all the pseudoscientific technobabble that acupuncture does!

Yuri

Uncayimmy · 31st August 2010, 10:59 AM

Originally Posted by Southwind17

Have any studies involved anaesthetised or otherwise unconscious patients? Would this not overcome the placebo and sham questions? Obviously, this wouldn't be appropriate in respect of claimed pain and nausea relief!

I was thinking the same thing after I made my post. I have yet to see such a study. The problem, I think, is that you would need to knock people out completely so they wouldn't know if they got stuck with needles or not. That's too risky and expensive, I think.

Southwind17 · 31st August 2010, 05:57 PM

Originally Posted by Yuri Nalyssus

There may be something in so-called 'non-specific needling', but it's not much and probably a lot less effective, less pleasant and more risky that a massage or a bit of meditation or even a jolly nice cup of tea - but then tea doesn't come with all the pseudoscientific technobabble that acupuncture does!

Yuri

Oh, I'm not so sure about that!

Southwind17 · 31st August 2010, 05:58 PM

Originally Posted by UncaYimmy

I was thinking the same thing after I made my post. I have yet to see such a study. The problem, I think, is that you would need to knock people out completely so they wouldn't know if they got stuck with needles or not. That's too risky and expensive, I think.

What, to put the matter to rest once and for all?! Too risky and expensive for whom, I wonder!

ThunderChunky · 31st August 2010, 06:41 PM

Originally Posted by UncaYimmy

It's going to be really hard to come up with an adequate control for needle sticking.

Why not just stick the needles in different spots?

Originally Posted by Yuri Nalyssus

There may be something in so-called 'non-specific needling', but it's not much and probably a lot less effective, less pleasant and more risky that a massage or a bit of meditation or even a jolly nice cup of tea - but then tea doesn't come with all the pseudoscientific technobabble that acupuncture does!

True, but I wouldn't rule out the bodies response to getting pricked as having some positive effect for certain pains.

ectoplasm · 31st August 2010, 07:12 PM

Originally Posted by ThunderChunky

Why not just stick the needles in different spots?

True, but I wouldn't rule out the bodies response to getting pricked as having some positive effect for certain pains.

On another forum there was a discussion of so-called "dry needling" or acupuncture without meridians, qui and all that nonsense. It was claimed that sticking needles into trigger points would alleviate pain and relax tight or cramped muscles.

It seems plausible to me as it doesn't invoke any unmeasurable supernatural qualities, but there doesn't appear to be a medical consensus on whether trigger points actually exist and studies that show efficacy of needling are weak.

Mojo · 31st August 2010, 07:12 PM

Originally Posted by ThunderChunky

Why not just stick the needles in different spots?

That's what the study linked above did.

Yuri Nalyssus · 31st August 2010, 11:09 PM

Originally Posted by Southwind17

Oh, I'm not so sure about that!

"learn about the healing properties of different types of tea, and to read inspiring ways in which tea imitates life"

... sigh, I should have known

Yuri

Yuri Nalyssus · 31st August 2010, 11:12 PM

Originally Posted by ThunderChunky

True, but I wouldn't rule out the bodies response to getting pricked as having some positive effect for certain pains.

I wasn't. Infact that's exactly what I was saying - getting pricked may have an effect on certain pains but it's not as fun or safe as other complementary treatments such as massage...

Yuri

30th August 2010, 09:45 PM	#1
Southwind17 Illuminator Join Date: Sep 2007 Location: Location: Location Posts: 4,465	Swell needles! I realize that acupuncture has been a well worn subject of debate on the Forum, but with reference to this article, in particular: Quote: Acupuncture works by reducing pain and swelling to increase the patient’s comfort level. ... surely the swelling claim could, and should (if it hasn't!), be easily tested scientifically. Can the placebo effect potentially account for reduced swelling?!
	__________________ The views expressed here do not necessarily represent the unanimous view of all parts of my mind "Always" and "never" are two words that you should always remember never to use. Facts do not cease to exist because they are ignored. Why is it that when I ask for a pair of hands a brain comes attached?

30th August 2010, 10:49 PM	#2
Uncayimmy Banned Join Date: Oct 2008 Posts: 7,485	Originally Posted by Southwind17 I realize that acupuncture has been a well worn subject of debate on the Forum, but with reference to this article, in particular: ... surely the swelling claim could, and should (if it hasn't!), be easily tested scientifically. Can the placebo effect potentially account for reduced swelling?! Personally, I think skeptics too quickly scoff at acupuncture because of its quaint beginnings in folklore. However, I've read a number studies (mostly abstracts - you know how it is) and publications by health organizations I respect (CDC, WHO). My conclusion is that there is something there, but we need to get away from calling it acupuncture and all the associated nonsense about chi and meridians. We should just look at it like we got lucky and noticed by accident that needle sticking might do some good while offering few negative results. It's painfully obvious (pun intended) that needle sticking does something to the body. Studies have looked at and, of course, found chemical changes in response to the needles. Therefore, we can't just dismiss out of hand like we can with goofball stuff Reiki Touch where you can't even tell if anything is happening just by looking at the patient. Without a doubt you could blind a researcher, and she would be able to tell you which patients were getting stuck with needles and which weren't based on chemical analysis alone. Studies like this one, which I think you will accept as being a couple of notches above a lot of the crap out there, have found that for certain conditions (in this case, pain relief), needle sticking is effective. They conclude, "Compared with physiotherapy and as-needed anti-inflammatory drugs, addition of either TCA [traditional Chinese acupuncture] or sham acupuncture led to greater improvement in WOMAC score at 26 weeks. No statistically significant difference was observed between TCA and sham acupuncture, suggesting that the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles." It's going to be incredibly difficult to close or open the book on needle sticking. As you suggest, one line of research needs to look at the body's reactions to needle sticking to see if we can find any reason for there to be a positive effect. There seem to be a lot of small possibly crappy studies going down this route but we really need large, focused studies looking at a single condition like the study above. At the same time we need to look to see if there are differences in the body's reactions based on the location of the needle sticking. Obviously some locations hurt more than others, so it would be reasonable to assume that different locations have different responses. We'd have to map out the body. If there's an effect, these two lines of research should intersect somewhere. It's a waste of time to be looking at TCA because there's no such thing as chi. The traditional locations, if they are "right," are right by dumb luck. We should take a systematic approach. We should also stop with all the silly studies trying to see if TCA works for this disease or that disease. That's not science - that's just wild ass guessing. Stick with the two areas that show promise: pain relief and nausea relief. Forget about Bell's palsy or insulin uptake for now. Of course, all the "researchers" who "believe" in TCA don't want to hear that.
Uncayimmy Banned Join Date: Oct 2008 Posts: 7,485

30th August 2010, 11:22 PM	#3
Mojo Mostly harmless Join Date: Jul 2004 Location: Nor Flanden Posts: 22,097	Originally Posted by UncaYimmy Studies like this one, which I think you will accept as being a couple of notches above a lot of the crap out there... Quote: LIMITATIONS: There was no blinding between acupuncture and traditional therapy and no monitoring of acupuncture compliance with study protocol. In general, practitioner-patient contacts were less intense in the conservative therapy group than in the TCA and sham acupuncture groups. The lack of blinding, along with the lack of a significant observed difference between actual and sham acupuncture, is something of a problem. The paper concludes, "the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles." It concludes that the groups getting needling in addition to regular treatment did better than those who just had the regular treatment, but it doesn't eliminate factors other then the needling. A replication using non-penetrating sham needles as a control might be useful.
	__________________ "You got to use your brain." - McKinley Morganfield "The poor mystic homeopaths feel like petted house-cats thrown at high flood on the breaking ice." - Leon Trotsky

30th August 2010, 11:34 PM	#4
Uncayimmy Banned Join Date: Oct 2008 Posts: 7,485	Originally Posted by Mojo The lack of blinding, along with the lack of a significant observed difference between actual and sham acupuncture, is something of a problem. The paper concludes, "the observed differences could be due to placebo effects, differences in intensity of provider contact, or a physiologic effect of needling regardless of whether it is done according to TCA principles." It concludes that the groups getting needling in addition to regular treatment did better than those who just had the regular treatment, but it doesn't eliminate factors other then the needling. A replication using non-penetrating sham needles as a control might be useful. It's going to be really hard to come up with an adequate control for needle sticking. Some studies have used four groups: TCA Sham Drug with a known effect Placebo I've seen some that reported benefits greater than placebo but less than the drug. Others had results where all three had similar effects. It's a mess. That's why I argue that the best route to take is to study the chemical reactions in the body. If we can find one that explains an effect, then the control becomes far less important. We might even be able to find ways to stimulate the chemical responses without needles.
Uncayimmy Banned Join Date: Oct 2008 Posts: 7,485

30th August 2010, 11:58 PM	#5
Southwind17 Illuminator Join Date: Sep 2007 Location: Location: Location Posts: 4,465	Originally Posted by UncaYimmy We might even be able to find ways to stimulate the chemical responses without needles. Revert to snorting?!
	__________________ The views expressed here do not necessarily represent the unanimous view of all parts of my mind "Always" and "never" are two words that you should always remember never to use. Facts do not cease to exist because they are ignored. Why is it that when I ask for a pair of hands a brain comes attached?

31st August 2010, 12:06 AM	#6
bit_pattern Illuminator Join Date: Apr 2010 Posts: 4,349	Originally Posted by Southwind17 Revert to snorting?! Oh. Snap!
bit_pattern Illuminator Join Date: Apr 2010 Posts: 4,349	__________________ "You are the epitome of the 'pigeon playing chess'. No matter how good I am at chess, you are just going to knock the pieces over, **** on the board and strut around like you've won something" "In this political climate, all of science is vulnerable to ideological attack when reality disagrees with political beliefs."

31st August 2010, 12:07 AM	#7
Southwind17 Illuminator Join Date: Sep 2007 Location: Location: Location Posts: 4,465	Originally Posted by UncaYimmy It's going to be really hard to come up with an adequate control for needle sticking. Some studies have used four groups: TCA Sham Drug with a known effect Placebo I've seen some that reported benefits greater than placebo but less than the drug. Others had results where all three had similar effects. It's a mess. That's why I argue that the best route to take is to study the chemical reactions in the body. If we can find one that explains an effect, then the control becomes far less important. We might even be able to find ways to stimulate the chemical responses without needles. Have any studies involved anaesthetised or otherwise unconscious patients? Would this not overcome the placebo and sham questions? Obviously, this wouldn't be appropriate in respect of claimed pain and nausea relief!
	__________________ The views expressed here do not necessarily represent the unanimous view of all parts of my mind "Always" and "never" are two words that you should always remember never to use. Facts do not cease to exist because they are ignored. Why is it that when I ask for a pair of hands a brain comes attached?

31st August 2010, 08:43 AM	#8
Yuri Nalyssus Graduate Poster Join Date: Jun 2004 Location: The Ancient Isle of Avignuon Posts: 1,074	Originally Posted by UncaYimmy It's going to be really hard to come up with an adequate control for needle sticking. Fair comment, but researchers are getting better at it with self retracting needles and such like and by and large the better the blinding becomes the smaller the observed effect of acupuncture. That, plus the sneakyness of pro-acupuncture dogmatists putting out press releases saying that acupuncture works for this that or the other condition while not mentioning that placebo needles did just as well, has got to make any right thinking person extremely sceptical of their claims - why would they feel the need to bend the truth otherwise? There may be something in so-called 'non-specific needling', but it's not much and probably a lot less effective, less pleasant and more risky that a massage or a bit of meditation or even a jolly nice cup of tea - but then tea doesn't come with all the pseudoscientific technobabble that acupuncture does! Yuri
	__________________ "The test of democracy is freedom of criticism." -David Ben-Gurion Peasant: Now we see the violence inherent in the system. King: Shut up! Peasant: Come and see the violence inherent in the system, help, help! I’m being repressed! King: Bloody peasant! Peasant: Ooh, what a giveaway, did you hear that... that’s what I’m on about, d’you see him repressing me? You saw it didn’t you... - Monty Python and The Holy Grail

31st August 2010, 10:59 AM	#9
Uncayimmy Banned Join Date: Oct 2008 Posts: 7,485	Originally Posted by Southwind17 Have any studies involved anaesthetised or otherwise unconscious patients? Would this not overcome the placebo and sham questions? Obviously, this wouldn't be appropriate in respect of claimed pain and nausea relief! I was thinking the same thing after I made my post. I have yet to see such a study. The problem, I think, is that you would need to knock people out completely so they wouldn't know if they got stuck with needles or not. That's too risky and expensive, I think.
Uncayimmy Banned Join Date: Oct 2008 Posts: 7,485

31st August 2010, 05:57 PM	#10
Southwind17 Illuminator Join Date: Sep 2007 Location: Location: Location Posts: 4,465	Originally Posted by Yuri Nalyssus There may be something in so-called 'non-specific needling', but it's not much and probably a lot less effective, less pleasant and more risky that a massage or a bit of meditation or even a jolly nice cup of tea - but then tea doesn't come with all the pseudoscientific technobabble that acupuncture does! Yuri Oh, I'm not so sure about that!
	__________________ The views expressed here do not necessarily represent the unanimous view of all parts of my mind "Always" and "never" are two words that you should always remember never to use. Facts do not cease to exist because they are ignored. Why is it that when I ask for a pair of hands a brain comes attached?

31st August 2010, 05:58 PM	#11
Southwind17 Illuminator Join Date: Sep 2007 Location: Location: Location Posts: 4,465	Originally Posted by UncaYimmy I was thinking the same thing after I made my post. I have yet to see such a study. The problem, I think, is that you would need to knock people out completely so they wouldn't know if they got stuck with needles or not. That's too risky and expensive, I think. What, to put the matter to rest once and for all?! Too risky and expensive for whom, I wonder!
	__________________ The views expressed here do not necessarily represent the unanimous view of all parts of my mind "Always" and "never" are two words that you should always remember never to use. Facts do not cease to exist because they are ignored. Why is it that when I ask for a pair of hands a brain comes attached?

31st August 2010, 06:41 PM	#12
ThunderChunky Muse Join Date: Jul 2007 Posts: 982	Originally Posted by UncaYimmy It's going to be really hard to come up with an adequate control for needle sticking. Why not just stick the needles in different spots? Originally Posted by Yuri Nalyssus There may be something in so-called 'non-specific needling', but it's not much and probably a lot less effective, less pleasant and more risky that a massage or a bit of meditation or even a jolly nice cup of tea - but then tea doesn't come with all the pseudoscientific technobabble that acupuncture does! True, but I wouldn't rule out the bodies response to getting pricked as having some positive effect for certain pains.
ThunderChunky Muse Join Date: Jul 2007 Posts: 982	Last edited by ThunderChunky; 31st August 2010 at 06:45 PM.

31st August 2010, 07:12 PM	#13
ectoplasm Thinker Join Date: Mar 2008 Posts: 213	Originally Posted by ThunderChunky Why not just stick the needles in different spots? True, but I wouldn't rule out the bodies response to getting pricked as having some positive effect for certain pains. On another forum there was a discussion of so-called "dry needling" or acupuncture without meridians, qui and all that nonsense. It was claimed that sticking needles into trigger points would alleviate pain and relax tight or cramped muscles. It seems plausible to me as it doesn't invoke any unmeasurable supernatural qualities, but there doesn't appear to be a medical consensus on whether trigger points actually exist and studies that show efficacy of needling are weak.
ectoplasm Thinker Join Date: Mar 2008 Posts: 213

31st August 2010, 11:09 PM	#15
Yuri Nalyssus Graduate Poster Join Date: Jun 2004 Location: The Ancient Isle of Avignuon Posts: 1,074	Originally Posted by Southwind17 Oh, I'm not so sure about that! "learn about the healing properties of different types of tea, and to read inspiring ways in which tea imitates life" ... sigh, I should have known Yuri
	__________________ "The test of democracy is freedom of criticism." -David Ben-Gurion Peasant: Now we see the violence inherent in the system. King: Shut up! Peasant: Come and see the violence inherent in the system, help, help! I’m being repressed! King: Bloody peasant! Peasant: Ooh, what a giveaway, did you hear that... that’s what I’m on about, d’you see him repressing me? You saw it didn’t you... - Monty Python and The Holy Grail

31st August 2010, 11:12 PM	#16
Yuri Nalyssus Graduate Poster Join Date: Jun 2004 Location: The Ancient Isle of Avignuon Posts: 1,074	Originally Posted by ThunderChunky True, but I wouldn't rule out the bodies response to getting pricked as having some positive effect for certain pains. I wasn't. Infact that's exactly what I was saying - getting pricked may have an effect on certain pains but it's not as fun or safe as other complementary treatments such as massage... Yuri
	__________________ "The test of democracy is freedom of criticism." -David Ben-Gurion Peasant: Now we see the violence inherent in the system. King: Shut up! Peasant: Come and see the violence inherent in the system, help, help! I’m being repressed! King: Bloody peasant! Peasant: Ooh, what a giveaway, did you hear that... that’s what I’m on about, d’you see him repressing me? You saw it didn’t you... - Monty Python and The Holy Grail