Search Results for "acupuncture"

May 06 2016

Acupuncture for Tension-Type Headache

acupuncture2A newly updated Cochrane systematic review of 12 studies looking at acupuncture for the treatment of tension-type headaches (TTH) concluded:

The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with frequent tension-type headache.

This has led to another round of headlines that, “Acupuncture works but no one knows how.”

A closer look at the data, however, does not back up that conclusion, in my opinion. Cochrane is generally considered to be the gold standard for evidence-based systematic reviews, but their history is dodgy when it comes to unconventional treatments. For example, they famously had to withdraw their review of homeopathic occillococcinum for the flu because they concluded, although the evidence was insufficient to recommend, it was “promising” and deserved further research.

Their updated review is not much better, however:

There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling.

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26 responses so far

Jul 24 2015

Another Study that Doesn’t Show How Acupuncture Works

Published by under Skepticism

The pattern is now quite familiar – a study looking at some physiological outcome while rats or mice are being jabbed with needles is breathlessly presented as, “finally we know how acupuncture works.” As is always the case, a closer look reveals that the study shows nothing of the sort.

The current study making the rounds is, “Effects of Acupuncture, RU-486 on the Hypothalamic-Pituitary-Adrenal Axis in Chronically Stressed Adult Male Rats.” We are told that acupuncture has the same effect as pain medication, but honestly I don’t see that anywhere in the study.

The study presents two experiments with rats in which there is a control group, a stress group, stress plus acupuncture, and stress plus sham acupuncture. The first thing to notice is that the rats were not actually getting acupuncture. They were getting the fiction known as “electroacupuncture.” Electroacupuncture is not a real thing – it’s just electrical stimulation through a needle which is called an acupuncture needle.

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28 responses so far

Feb 19 2015

Phantom Acupuncture

There are two basic schools of thought when it comes to acupuncture, which is the practice of placing thin needles into alleged acupuncture points in order to have a therapeutic or symptomatic effect. The “traditional” interpretation is that the needles are stimulating a physiological response of some kind at the acupuncture points. Within this school there is a range of opinions as to whether this response is due to a biochemical, neurological, or another known biological response or whether it is due to the still more traditional (but actually less than a century old) belief that the needles are manipulating the life force or Qi.

The other school holds that acupuncture is essentially an elaborate placebo. (Note – this article contains all the references necessary to support my statements below, so I will not repeat them.) Any apparent response is a non-specific response to the attention of the practitioner, expectation, distraction from pain, simple regression to the mean, and other illusory effects.

Each school makes different predictions about the various lines of evidence that can be brought to bear to resolve this question. There have been in total several thousand clinical studies looking at the apparent effects of acupuncture. These have failed to convincingly reject the null hypothesis, meaning that they have not demonstrated a clear biological response to acupuncture for any indication. The better controlled studies consistently show that needle location does not matter (sham acupuncture), and that needle insertion does not matter (placebo acupuncture). You can literally have a non-acupuncturist randomly poke someone with toothpicks and get the same response as the full acupuncture treatment.

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194 responses so far

Jul 15 2014

BBC Fail on Acupuncture Documentary

Alternative Medicine’s best friend, and in my opinion largely responsible for what popularity it has, is a gullible media. I had thought we were turning a corner, and the press were over the gushing maximally clueless approach to CAM, and were starting to at least ask some probing questions (like, you know, does it actually work), but a 2006 BBC documentary inspires a more pessimistic view.

The documentary is part of a BBC series hosted by Kathy Sykes: Alternative Medicine, The Evidence. This episode is on acupuncture. The episode is from 2006, but was just posted on YouTube as a “2014 documentary.” Unfortunately, old news frequently has a second life on social media.

First, let me point out that Sykes is a scientist (a fact she quickly points out). She is a physicist, which means that she has the credibility of being able to say she is a scientist but has absolutely no medical training. It’s the worst case scenario – she brings the credibility of being a scientist, and probably thinks that her background prepares her to make her own judgments about the evidence, and yet clearly should have relied more on real experts.

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24 responses so far

Mar 31 2014

Acupuncture – Science as Promotion

Almost weekly I see a new press release about an acupuncture study claiming benefits. While I have written extensively about acupuncture previously, and will continue to cover the topic, I can’t cover every little study that comes out. Most of the studies are utterly useless – they contain no control group, they are effectively pilot studies, they are of “electroacupuncture” (which is really just transdermal electrical nerve stimulation pretending to be acupuncture), or they are looking at some dubious biomarker rather than objective clinical outcomes.

Occasionally, however, an acupuncture study deserves a mention, in this case because it is particularly abusive.

Rachael Dunlop, my skeptical colleague from down under, sent me a report of an acupuncture study performed in Melbourne. News outlets are reporting the study at face value, in typical gushing terms, stating that “acupuncture is just as effective as drugs in treating back pain and migraine.”

It seems to me that this is the actual purpose of such studies – to produce positive news coverage. They are not designed to actually answer the question of efficacy.

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164 responses so far

Sep 03 2013

The 1996 WHO Acupuncture Report

One interesting effects of social media is that news items can have a second life – someone posts an item from years ago on their Facebook page, for example, and it makes the rounds as if it’s something new. Those of us who spend time analyzing science news reports and correcting misreporting or misleading information often refers to such items as zombies. They keep rising from the dead and have to be staked all over again.

The World Health Organization (WHO) 1996 report on acupuncture has recently risen from the grave and is haunting online acupuncture discussions. The fact that the data on which this report is based is over 17 years out of date does not seem to be a problem for those referencing it. The allure seems to be the apparent authority of the WHO.

The WHO report is generally positive toward acupuncture, reviewing clinical evidence and listing many conditions for which acupuncture is apparently effective. The report, however, is also deeply flawed.

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6 responses so far

Mar 12 2013

Another Acupuncture Meta-Analysis – Low Back Pain

As Carl Sagan observed, “randomness is clumpy,” which means that sometimes, for no specific reason, I write two or more blog posts in a row about the same topic. Perhaps it’s not entirely random, meaning that when a topic is being discussed related news items are more likely to come to my attention.

In any case, there was recently published yet another meta-analysis of acupuncture, this time specifically for low back pain. The findings and interpretation add to the pile of evidence for two important conclusions:

1 – Acupuncture does not work.

2- Acupuncturists refuse to admit that acupuncture does not work.

I would further infer from these two unavoidable conclusions the dire need for a greater understanding of the core principles of science-based medicine.

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60 responses so far

Aug 26 2011

Acupuncture and Acoustic Waves

Here is yet another study claiming to show “how acupuncture works” when in fact it does nothing of the kind. The bias of the researchers is so obvious in this study it’s astounding that it was published in a peer-reviewed journal. Of course, the mainstream media is dutifully reporting the biased claims of the researchers without any independent verification or analysis.

There are numerous fatal problems with this study. The first, like in many physiological studies that purport to be about acupuncture, is that the connection to acupuncture is tenuous. The researchers claim that they are testing the effects of an acupuncture needle – but what makes a needle an acupuncture needle? Other such studies were ultimately just seeing the effects of local tissue trauma. The fact that this trauma was induced by an “acupuncture needle” is not necessarily relevant.

This study is far worse, because it is simply using the acupuncture needle as a mechanism for inducing an unrelated physiological stimulus. This is similar to “electroacupuncture” where electrical current is applied through an acupuncture needle – what you are actually studying is the effects of electricity, not “acupuncture.”

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12 responses so far

Mar 25 2011

Another Acupuncture Fail

Here we go again. What if I said to you that drug X and a placebo of drug X (i.e. a placebo) worked better for the relief of a subjective symptom than no treatment, but no different from each other? I conclude from this that the “drug cohort” (whether the real drug or the placebo of the drug) did better than the no-treatment control group.  This may mean that the drug works through a general care effect and patient expectancy.

Let’s say, rather, that a pharmaceutical rep were saying this about their latest drug. It would be obvious that the drug company decided to use some Orwellian new speak in order to contrive a sentence in which they get to say that their drug works (by a general care effect). And in order to obscure the fact that their drug worked no better than placebo, they refer to both the drug and the placebo as the “drug cohort” and compare them both to a no-treatment group. The “drug cohort” had an effect.

In the real world of scientific medicine (not the bizarro world of CAM), when a treatment works no better than the placebo control we conclude that – the treatment does not work. Looking past all the obvious spin above, a more honest conclusion would simply be – drug X does not work for the tested symptom. Period. There is no “drug cohort”, and you don’t have to confuse the reader by calling placebo effects a “general care effect” or “expectation.” These are placebo effects.

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47 responses so far

Aug 20 2010

More Evidence that Acupuncture is a Placebo

I have written numerous blogs both here and on SBM about the acupuncture literature, which clearly shows that acupuncture, for any indication, is nothing but an elaborate placebo. Rigorous studies of acupuncture that actually try to isolate variables have shown that it does not matter where you stick the needles or even if you stick the needles – those variable do not have any specific effect. Acupuncture points and meridians are an illusion – nothing but superstition.

But there does appear to be a significant placebo effect, in addition to non-specific effects from relaxation and therapeutic attention, to the ritual of acupuncture. Does this mean “fake acupuncture works?” No – it means acupuncture does not work, but there are known placebo effects from the process of getting treated.

Now we have yet another study that supports the conclusion that acupuncture is just a placebo – but with an added element that is very interesting. Researchers compared traditional Chinese acupuncture (TCA) with sham acupuncture (non acupuncture points, shallow needle insertion) and another control group with no treatment for knee osteoarthritis. The researchers also did one very interesting thing, and one very sloppy and annoying thing (in my opinion). The sloppy thing was to use “electroacupunture” – which isn’t pure acupuncture. It’s acupuncture plus transcutaneous electrical nerve stimulation, which is an already proven modality for pain. In the TCA group they gave full “electroacupuncture” and in the sham group they gave less stimulation – enough to serve as an active placebo but not enough to have any effect.

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41 responses so far

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