Acupuncture Works, Say Scientists

May 30, 2010 at 7:02 pm (Acupuncture, Alternative Medicine, Media) (Acupuncture, Adenosine, Daily Mail, Guardian, Mice, Telegraph)

Another day, another story in the popular press suggesting that scientists have shown that a popular alternative treatment is effective.

The study (which basically involved sticking pins in mice) was immediately reported on by the Telegraph, Guardian, and Daily Mail. For further discussion of the study, click here and read Ed Yong’s thoughts.

The Telegraph win first prize for worst headline of the three English papers to report so far, with “Acupuncture does work as it stimulates a natural pain killer, scientists find“. This headline is already being tweeted by Alt Med Advocates (and lots of them). The headline makes the outright claim that acupuncture works and implies that this new study somehow proves it, by finding a possible mechanism.

The Daily Mail provide this gem in their second paragraph: “The finding will provide food for thought for detractors of the ancient Chinese art – including many scientists.” Some scientists think there might be a point to acupuncture. Take that skeptics!

The Guardian, I’m sad to say, disappoint. “Acupuncture ‘meridians’ match main nerve pathways, scientists believe” is bad enough. I think this, putting it in context, is worse:

One of the longstanding mysteries surrounding acupuncture is why the technique only seems to alleviate pain if needles are inserted at specific points. Nedergaard believes that most of these acupuncture points are along major nerve tracks, and as such are parts of the body that have plenty of adenosine receptors.

The major problem with this part of the article is that there is no long-standing mystery regarding the effectiveness of acupuncture relating to specific points.

Madsen et al [PDF] included trials with placebo interventions “such as insertion of needles into non-acupuncture points or use of non-penetrating needles” (seven trials used superficial needling at non-acupuncture points with fine needles).

The authors found that there was “no statistically significant relation between the type of placebo intervention and the effect of acupuncture“. Here is their conclusion in full:

We found a small analgesic effect of acupuncture that seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.

As I pointed out in my Beginners’ guide to acupuncture, this study – BMJ acupuncture [PDF] – had findings consistent with the above review. Acupuncture provided no additional improvement in pain scores compared with a course of six sessions of physiotherapy-led advice and exercise.

The authors concluded that true acupuncture did not show any greater therapeutic benefit than a credible control procedure (that is, “real” acupuncture performed no better than “sham” acupuncture). The authors also stated that the small additional benefits from acupuncture were unlikely to be clinically significant, were limited to pain intensity and unpleasantness, were mostly short lived, and could not be attributed to specific acupuncture needling effects.

As Ed Yong points out, the new study ignores previous trials on the efficacy of acupuncture. The mainstream media also ignore previous trials and so far have pretty much uncritically reported the views of the authors (although some have thrown in a sceptical quote at the end of the article to provide spurious ‘balance’).

More

If you want to read more on acupuncture, you could do a lot worse than Improbable Science. You could, for example, try reading more of the mainstream media’s take on this therapy. You should of course bear in mind that ‘journalists are shit’ – with the odd honourable exception, of course.

Update, 17:10 31st May

The Guardian have for some reason changed the url for their article. The original link is now broken and does not redirect to the new url. I have changed the link in my blogpost to match the new url. Changing url without redirecting or amending an article without providing the history of the article only encourages people like me to use freezepage or print to PDF rather than link to newspapers and I really cannot understand why they do these things.

The Nature Neuroscience paper: online, PDF, backup copy.

Update 19:00, 1st June

Lots more coverage of the study now: Google News.

Also, via @uponnothing, there’s this in the Daily Mail today: advertorial. This puff piece relates the information that acupuncture is used for:

a huge range of diseases and disorders, including arthritis, headache and migraine, sinusitis, neck and back pain, joint pain, hot flushes, allergies, hay fever, eczema, depression, anxiety, irritable bowel syndrome, infertility and insomnia.

Under the heading of “evidence”, the Mail write that “The jury is out. Research suggests the most promising area for acupuncture is conditions involving pain and inflammation.” This is a little misleading, though.

For example, the Mail include arthritis in the list of conditions that acupuncture is used for. This Cochrane review on acupuncture for rheumatoid arthritis found that “From the little evidence that there is, acupuncture does not appear to improve the symptoms of rheumatoid arthritis“. So we can probably strike that from the Mail’s list of conditions for a start…

The article also provides the contact details for the British Acupuncture Council and states that “members are bound by codes of ethics, practice and disciplinary procedures, and have extensive training“.

Forgive my cynicism, but the evidence I have seen regarding the effectiveness of other Alt Med regulators does not exactly fill me with confidence that the code of practice will be properly enforced. See for example the GCC: two bloggers made omnibus complaints about hundreds of chiropractors, because the code of practice was not being rigorously enforced. BANT and the Society of Homeopaths are other notable examples.