A Beginner’s Guide To Acupuncture

May 5, 2009 at 4:50 pm (Acupuncture, Alternative Medicine, Beginner's Guides) (, )

[BPSDB]

Part Two in an occasional series (I’ve already done a guide to chiropractic) focuses on acupuncture.

The origin of acupuncture is difficult to ascertain. It is alleged that acupuncture needles dating back to 3000 B.C. have been found by archeologists in Inner Mongolia. According to Wikipedia:

The earliest Chinese medical text that first describes acupuncture is the Yellow Emperor’s Classic of Internal Medicine (History of Acupuncture) Huangdi Neijing, which was compiled around 305–204 B.C. However, the Chinese medical texts (Ma-wang-tui graves, 68 BC) do not mention acupuncture.

This is rather confusing, but it does suggest that acupuncuture perhaps has not been practised consistently in China for as long as one might be led to believe. Rather, it seems to have been revived as a medical treatment.

Acupuncture involves sticking needles in a patient. It is claimed by advocates of acupuncture that it works by regulating the flow of Qi and Blood. Qi (as described by advocates of Traditional Chinese Medicine) is comparable to the vital force. Vitalism consists of untested and untestable hypotheses and is therefore unscientific. It is claimed that acupuncture works by way of points found on “meridians”, which are described as pathways through which Qi and Blood flow. These meridians are claimed to correspond to different parts of the body (heart, spleen, liver etc). Studies comparing acupuncture with sham acupuncture have found little or no difference between the two – suggesting that these supposed meridians are irrelevant to any effect of the treatment.

Does acupuncture work? Well, there have been several Cochrane reviews of this TCM. Using acupuncture to help quit smoking may be a waste of time. The authors of a Cochrane review concluded that There is no consistent evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation, but methodological problems mean that no firm conclusions can be drawn. It might be expected that acupuncture would be effective in terms of reducing pain, given that pain reduction is frequently claimed to be something that acupuncture is useful for. Nevertheless, when a review was undertaken only A small analgesic effect of acupuncture was found, which 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. What about pain due to osteoarthritis of the knee? Well, according to the conclusions of this study (PDF), acupuncture provided no additional improvement in pain scores compared with a course of six sessions of physiotherapy-led advice and exercise. The authors also 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.

In short: acupuncture has little or no benefit; meridians and Qi are meaningless in the context of acupuncture.

9 Comments

  1. Nigel said,

    Ötzi had approximately 57 carbon tattoos consisting of simple dots and lines on his lower spine, behind his left knee, and on his right ankle. Using X-rays, it was determined that the Iceman may have had arthritis in these joints. It has been speculated that they may be related to acupuncture. Ötzi was found to be about 5,000 years old when his body was discovered near the northern Italian border

  2. Sceric said,

    @Nigel: yeah sure, it must have been accupuncture and not any other superstition, like the pattern draw out the evil spirits that are causing the pain?? and wasn’t he tattooed on other places as well?? and a bit too many “may” for a conclusive argument.

  3. Nigel said,

    I am not one of the doctors who claimed the tattoos were acupuncture points. However, as they have scientific qualifications and experience, I suspect that their supposition will be on target. The “iceman’s” remains have been studied by allegedly knowledgeable people for years and I expect they would not have mentioned acupuncture unless there was good evidence for stating this. It has been shown in a number of trials that acupuncture works for many. Whether it really does the job or is just a placebo will not matter to the people it helps. I do believe that it has actually helped those who claim it has. Especially for pain relief or those who have been operated on using acupuncture as an “anesthetic.” (English spelling)

  4. jdc325 said,

    “It has been shown in a number of trials that acupuncture works for many.”
    Would you like to provide references to these trials, Nigel? Are they systematic reviews, like those from the Cochrane Library?

  5. delighted said,

    Hi JDC,

    I came across your blog following the comments on one of the so-called health experts. First of all I have to declar that I am training to be an acupuncturist. However, I won’t say that acupuncture absolutely works -yet- as I want to discover its advantages / limitations through practice.
    I broadly agree with your sentiment that there are a lot of unfound claims out there and well come a good dose of healthy cynicism. But (I know you were waiting for this b word) I just want to update you on a paper in Brain Research called “Acupuncture mobilizes the brain’s default mode and its anti-correlated network in healthy subjects” which took fMRI and found different activations between acupuncture needling & sham needling and also differences between acupuncture points. So it is not just about sticking needling in anywhere and anyhow. Whether the existing meridian theory is effective is another topic – it’s a very old theory and there have been many changes through the past few millenia- beliefs, society, politics, economy, enviroment, biological changes, etc. and so it is not a surprise that at least some adjustment would be needed to make it work for today.

    Anyhow, part of me welcome new technology & scientific advances but the other part of me ask whether all practice have to be legitimize by western science? WS is the dominant way of thinking but it is not the only way. Are your familiar with Jean-François Lyotard’s A Report on Knowledge? What do you think of his view on the way WS legitimizes itself? I think it is important to keep our minds critical but also open.

    Finally, I think it would add more weight to your argument if you have at least try some of the therapies you discuss. Would you discuss cars that you have never driven in this way?

  6. jdc325 said,

    a paper in Brain Research called “Acupuncture mobilizes the brain’s default mode and its anti-correlated network in healthy subjects” which took fMRI and found different activations between acupuncture needling & sham needling and also differences between acupuncture points

    Looks interesting – do you have a copy of the paper in question that you could email me?

    I think it would add more weight to your argument if you have at least try some of the therapies you discuss. Would you discuss cars that you have never driven in this way?

    I’m not sure that it would help to try the remedies I discuss, actually – if I felt better after treatment, I wouldn’t know whether my improvement was due to the treatment. This is why randomised, controlled trials are conducted – if the group receiving the active treatment improve to a greater degree than those receiving the placebo treatment then it is a good indication that the treatment works. If I try a treatment as an individual and either improve or deteriorate, I don’t know whether the treatment has effected the change or whether I am experiencing natural fluctuation in symptoms.

    As for discussing cars one has never driven – I am sure it would be possible to write an article about the relative merits of different cars based on the available information about them. In fact, much of the content in car reviews is based on data. As well as giving their personal, subjective opinions about a car the likes of Jeremy Clarkson also provide various facts and figures – for example on brake horsepower or how quickly a car can go from 0-60mph. I also think that whether a person enjoys driving a particular car or not is a subjective matter, while whether or not a treatment works is really an objective question.

  7. BANT: A Profile « Stuff And Nonsense said,

    […] Barber, meanwhile, works alongside acupuncturists and chiropractors at a health clinic. Jill believes that BANT impose a strict Code of Ethics and […]

  8. Acupuncture Works, Say Scientists « Stuff And Nonsense said,

    […] I pointed out in my Beginners’ guide to acupuncture, this study – BMJ acupuncture [PDF] – had findings consistent with the above review. […]

  9. Health Select Committee – Dorries And Tredinnick « Stuff And Nonsense said,

    […] no more effective than sham acupuncture might also have something to do with skepticism toward acupuncture. In this paper, the authors found that the analgesic effect of acupuncture was small, could not be […]

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