Totalwaste made a comment recently regarding acupuncture that prompted me to post a real response. For those who don’t know, acupuncture is claimed to be an ancient system of healing developed over thousands of years as part of chinese traditional medicine. The treatment supposedly restores the balance of chi – the universal energy that flows through you – by poking needles into special places on your body (no, not that special place). These are all mapped out according to ‘meridians’ that are about as real as the lines of latitude and longitude on the earth.
To give you some background, here is the official position of the National Council Against Health Fraud:
- Acupuncture is an unproven modality of treatment;
- Its theory and practice are based on primitive and fanciful concepts of health and disease that bear no relationship to present scientific knowledge;
- Research during the past 20 years has not demonstrated that acupuncture is effective against any disease;
- Perceived effects of acupuncture are probably due to a combination of expectation, suggestion, counter-irritation, conditioning, and other psychologic mechanisms;
- The use of acupuncture should be restricted to appropriate research settings;
- Insurance companies should not be required by law to cover acupuncture treatment;
- Licensure of lay acupuncturists should be phased out.
The question of whether acupuncture ‘works’ is actually twofold, because there are really two assumptions here – that sticking needles in your body is helpful, and that sticking needles in specific points in your body is helpful. The latter is the easiest to falsify, so I’ll start with that. Obviously the simplest way to control an acupuncture study that seeks to prove the theory of acupuncture points is to have half your group get acupuncture in the prescribed places, and have the other half get poked with needles in any old place. Not surprisingly, this has been done. Also not surprisingly, the studies have found that it doesn’t really matter where you get poked with a needle. As i’m sure you expected, the explanation of chi and meridians is a load of rubbish.
This leaves us with the idea that sticking needles into your body is helpful, regardless of where you put them. This poses a difficulty in controlled testing – how do you trick someone into thinking that you’re sticking a needle into them when you’re not? And what aspect is it that’s actually causing the effect – the pain of inserting the needle and the resulting endorphins, the whole drawn out ritual of the thing, or just the observed ebb and flow of chronic pain? There have been some efforts to create a sham acupuncture needle that is similar to a magician’s trick knife, and a significant number of patients reporting believing that they had in fact been pierced when they had not. However, there have been criticisms of the validity of this, so we are left with the problem that it is exceedingly difficult to reliably double blind an acupuncture test. This is exacerbated by the studies coming out of China, where doctors are actually not allowed to control studies for the placebo effect because giving a patient a placebo is considered medically unethical. On top of everything, most of the ailments that acupuncture claims to treat, such as pain, are highly subjective and difficult to quantify across subjects.
That said, what studies have been done have lead us to believe that the mechanism that produces an apparently successful acupuncture session is a combination of the following:
- Stimulating a release of endorphins
- Providing a diversion (similar to pinching yourself to hold off nausea)
- Psychological reasons – placebo effect, suggestion, confirmation bias etc
Either way the relief is temporary, which means that even if you feel better after a session, you’re never actually getting to the source of the problem, so you’ll keep experiencing the pain, and you’ll keep coming back and lining the acupuncturist’s pockets. Except in the case of ailments that are purely psychosomatic, you are far better off going to a real doctor and finding out what’s wrong with you, and how to fix it.