New acupuncture evidence

[MRT]

What's the feeling on here about acupuncture? There does seem to be some evidence that it works (see http://news.bbc.co.uk/1/hi/health/7011738.stm for instance).

[Admin]

The trouble is that before long there'll be another study showing that acupuncture is not any good for treating back pain.

Acupuncture can't be done double-blind so there's always the chance, or rather likelihood, that experimenter effects will affect the outcome of any trial.

There's no real strong evidence to back up that acupuncture works for anything and, personally, I view any form of 'therapy' where the results are 'suggestive' rather than definite as being a one that doesn't really work. If acupuncture really did anything, we'd know about it by now.

Or, alternatively, if it does do something then it isn't much! So, is there any point in pursuing a therapy if its effect size is so small that it's practically indiscernible?

There was a trial done a few years ago which showed that acupuncture was efficacious in treating knee osteoarthritis and this example is often used by proponents as 'proof'.

A recent study has shown just the opposite however: http://dcscience.net/?p=45

So what are we seeing? Is it that some trials are accurately picking up the small but real effects of acupuncture or are these positive findings just spikes in the noise?

Either way, I really don't think there's much to shout about. Even if it does work, e.g. for pain relief, it's effect is only about as much as taking a couple of aspirin.

[Araneus]

I think one of the problems with acupuncture is that there are actually two different treatments referred to as "acupuncture": there is the traditional Chinese stuff based on Chi and energy lines, which is nonsense, but there also the physiotherapists' version based on stimulating soft tissue with needles to alleviate muscle pain, which as far as I am aware is an effective medical technique unrelated to oriental woo.

I have not had either form of acupuncture, but I have had "acupressure" from a physiotherapist to combat muscle pain, which is based on the same idea (restricting the blood flow causes the tight muscles to relax, IIRC).

[Cuddles]

This really doesn't seem to be anything new. It's fairly well established that sticking needles in people has a physiological effect, the trouble is that there seems to be no difference between sticking them in randomly and doing what is refered to as acupuncture. There is also the problem that it is virtually impossible to use a placebo. I've looked into this before and although there have been several attempts to develop a convincing placebo needle they all seem to have two problems - they are not convincing enough to the patients, even those who have never had acupuncture before, and they seem to cause some response from the body, meaning they are not a true placebo.

This study just shows once again that although there may be a response to having needles stuck in you, not really all that surprising, there is no real difference between "real" acupuncture and fake acupuncture. Like many types of woo that later became science, acupuncture may have been doing something right, but in the wrong way and for the wrong reasons.

[Matt]

Yes, I read this story in the Mtro this mornng and was amazaed how they got from

The Archives of Internal Medicine study also suggests fake acupuncture works nearly as well as the real thing.
The researchers, from the Ruhr University Bochum, say their findings suggest that the body may react positively to any thin needle prick - or that acupuncture may simply trigger a placebo effect.

a resounding vote of confidence for accupuncture....?

I mean it did no better than the placebo. The headline fact here is not the sucess of acupunture but the failure of "conventional" treatment to beat sham acupuncture. Just what was the "conventional" treatment anyway?

Conventional therapies tested in the study included painkillers, injections, heat therapy and massage.

So sticking needles randomly into people's backs has a 44% sucessrate but if those needles are replaced with a painkilling injections the success rate drops to 27%

erm....

I wonder what would happen if you told people they were getting acupunture but used the process to inject them with painkilling drugs.

[Admin]

I think one of the problems with acupuncture is that there are actually two different treatments referred to as "acupuncture": there is the traditional Chinese stuff based on Chi and energy lines, which is nonsense, but there also the physiotherapists' version based on stimulating soft tissue with needles to alleviate muscle pain, which as far as I am aware is an effective medical technique unrelated to oriental woo.

Is what physiotherapists do actually acupuncture though? ???

If they're doing needling and massage then it would be interesting to see what the results of needling without massage and massage without needling are to see how they all compare.

My guess is that massage would be the efficacious treatment.

However, it actually does makes sense that needling into affected tissue like muscle could possibly have an effect. As you say though, this is quite different to what 'traditional' acupuncture is all about.

[Admin]

I mean it did no better than the placebo. The headline fact here is not the sucess of acupunture but the failure of "conventional" treatment to beat sham acupuncture. Just what was the "conventional" treatment anyway?

I don't know about this case but when these trials are done comparing alt. meds. to conventional treatment, they often use a conventional treatment that is known to be ineffective itself.

So when the results come back they can claim to be 'as good as' or 'better than' conventional treatment.

[Matt]

I don't know about this case but when these trials are done comparing alt. meds. to conventional treatment, they often use a conventional treatment that is known to be ineffective itself.

So when the results come back they can claim to be 'as good as' or 'better than' conventional treatment.

Strikes me that convential treatment for back pain is known to be ineffective not just by the researchers but by the test subjects - after all they're reporting chronic back pain - surely most of them will have experienced conventional treatments and already found them ineffective. Those for whom the conventional treatment works will have been excluded from the study by dint of not having chronic back pain any more. Perhaps then a treatment perceived to be "more of the same" suffers from the so called nocebo effect.

[brettdbass]

I take it everyone else is a miffed as I am over the media's trumpetting over this non-story?

And entire 30 mins dedicated to it on the midday show on Radio 2 today, the biggest radio station in the Uk no less. And how much airing did the results of the sham acupuncture get? About 2 minutes, wherein they got a chiropuncturist to "explain" why it still "works" even when it's just sham needles in any old places, and then they just left it there unchallenged.

Hang on, this is the most important part of the story - look everyone, acupuncture is as effective as placebo! Wow, that makes this story - - - no story at all.

What you should do is get sugar pills and place them on your body in random places in the belief that it'll heal your migraines, back pains and diabetes simultaneously. It's bound to work! I call it Homeopunctufakeathy. Now give me money.