Hey! I Feel … a Little Bit Better!

I’ve said in the past that while acupuncture has no proven track record of relieving the symptoms (or root causes) of major illnesses like cancer, heart disease, viral infections or the like, it did have some potential application in the area of pain relief.  One look at Wikipedia and you’ll see a list of citations showing the studies that have suggested there was a statistically significant difference between normal and “sham” (fake) acupuncture, while both were significantly higher than no treatment at all.  Even the American Medical Association and the National Institute of Health have suggested it for pain management and other possible maladies, but their endorsements are far from enthusiastic.

So there might be something to it?  Maybe?  Sort of?

I found this recent meta-analysis published in the June issue of Anesthesia and Analgesia, concluding that after pouring through thousands of studies and their methodologies, there is still not enough data to conclude that there’s any benefit at all to the procedure.  Most points of contention revolved around the control of the studies, saying that even though there may have been some statistical significance to the findings by researchers like Vickers and Cronin, it wasn’t enough to be of any clinical significance.

The best controlled studies show a clear pattern, with acupuncture the outcome does not depend on needle location or even needle insertion. Since these variables are those that define acupuncture, the only sensible conclusion is that acupuncture does not work. Everything else is the expected noise of clinical trials, and this noise seems particularly high with acupuncture research. The most parsimonious conclusion is that with acupuncture there is no signal, only noise.

The PDF of the journal article is here.  It’s in the June issue of Anesthesia and Analgesia, Vol. 16 No. 6, pp 1360-3.

As with Reiki and other alternative forms of “medicine”, there’s such an incredible amount of noise in the form of placebo effect and confirmation bias that it becomes far more difficult to measure its efficacy versus something with more definitive benchmarks like a cancer drug or cholesterol medication.  Keep in mind that if the standard for acupuncture were similar, it’s clear that on the quality of the research alone it wouldn’t have ever been approved by the FDA.  I personally think it’s been given a pass because even if it does little good, it supposedly does little harm either … provided it’s done with sterile needles.

So what do you do?  If you’re the kind of person who believes in meridians and qi, then you’re likely going to think this stuff works regardless of any scientific study.  In reality, there’s no reason to believe in a mystical flow of energy going through your body in lines that have something to do with your internal organs but aren’t located anywhere near the ones they reference.  That said, I think it’s possible that the use of needles and the small endorphin / cortisol boost they supposedly provide could give some benefit, but for the reasons given above it’s damn near impossible to tell by way of a clinical study.  It didn’t help me for my back pain, I know that much.

In conclusion, my suggestion is if you’re interested in pain relief and relaxation, take some aspirin and schedule a massage with a cute therapist.  At the very least know you’re getting something tangible for your money.

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5 Responses to Hey! I Feel … a Little Bit Better!

  1. …What was your field of study? Just wondering.

    I know people at the gym who swear by acupuncture, but I’m not so sure I’d try it. One woman I know said she used it to help her with migraines, and one day, she showed up for class with bruising all over her face. She said it was from the acupuncture….hmmm….I’d think that massage is more effective, too. Oh, and take Motrin rather than aspirin, right? The former is an anti-inflammatory.

    • Whatever NSAID works for you :). Aspirin and Ibuprofen are both anti-inflammatories, but their mechanisms of action are different.

      I’ve also heard personal testimony from people who have not only received acupuncture, but Reiki and other forms of alternative treatments as well. I keep hearing, “well, a friend of mine says it works, and I felt a difference, so I’m sticking with it.” Hardly scientific, but difficult to argue against. Plus, I’ll freely admit that there’s something inherently comforting about lying down in a softly lit room and having someone giving you their undivided attention for the better part of an hour. They could do nothing more than lay a handful of crayons on different parts of your body, and I’m sure that a good percentage of us would come out of there feeling more relaxed and energized. It’s all in the presentation.

      Incidentally, I also get the same story from folks who try homeopathy … and not the stuff that actually has measurable ingredients in it (some of it actually does … who knew?), but the stuff that’s been diluted so much that it would be statistically impossible to find a single molecule of the “effective” ingredient in a sample the size of one of our oceans. Yet I’m the closed-minded buzzkill for telling them they’ve wasted their money on sugar water.

      I’m in the wrong line of work (I’m a mechanical engineer by trade). I should sell homeopathic ingredients instead. In fact, I’ll dilute mine even more to make them extra intense … because apparently that’s how they’re supposed to work.

  2. Interesting. Do you subscribe to Medscape? I get a lot of their studies and updates and it’s really good info. You might like it. I think I had read some where that you were in ME. My ex has a PhD in solid state physics, and I edited his papers, then his thesis and dissertation, so I picked up a little here and there about EE. I’m also interested in energy and the environment. So much interesting sh*t. So little time.

    • No, I don’t have subscriptions to any journal archives, though I should probably get a few now that I think about it. All of the research that I end up doing for this blog is just a result of my nightly Google-fu.

      A PhD in solid state physics is pretty damned impressive … and it’s amazing the stuff you’ll pick up through constant exposure. I had a physics professor who told me once that “understanding is nothing more than being exposed to an idea often enough that it doesn’t bother you anymore”. I actually have a degree in physics, so I remain fascinated with Big Bang cosmology, astrophysics, and the like. My only problem is that I can’t understand it as much as I would have if I remained in the field. In general I find myself faced with so many things I want to learn that I end up doing *none of them* out of a concern that I’ll choose the wrong one.

      Because that makes sense.

      • That’s interesting what your professor said: ” I had a physics professor who told me once that “understanding is nothing more than being exposed to an idea often enough that it doesn’t bother you anymore”.

        I had a professor that said we learn through analogies, connecting what we already know to what we don’t,

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