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.