Chinese Medicine Demystified (Part V): A Closer Look At How Acupuncture Relieves Pain

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  1. Matto’s avatar

    If Acupuncture can treat or cure any given illness, then this is easily prove-able. At some point along the timeline, a given practitioner or group of practitioners will be able to isolate who has said condition and design a placebo controlled study. This has already been done. As placebo acupuncture is easy to do. There has never been a successful study like this that can be replicated. There have been many attempts, including the famous post partem depression studies and many many others. It has proven so completely impossible to demonstrate acupuncture’s effectiveness , that it is quite hard to get acupuncturists to participate these days. You can find many studies that seem to show the effectiveness of Acupuncture vs placebo Acupuncture, but if you look deeper, you will find many cases where the study was repeated by others and failed repeatedly. I did extensive research on the topic, originally hoping to find the opposite result. Don’t kill the messenger, I am truly just stating the facts of the matter, you can see for yourself.

  2. Jesse’s avatar

    I disagree, Matto: placebo acupuncture is not easy to do, at least not in a blinded manner. The person giving the treatment can easily tell whether the needles they are using are puncturing the skin or not, assuming they’re using the fake needles. Still, it seems like that should increase the apparent efficacy of the real acupuncture, if anything, so studies that show that it is no better than placebo might still be worth something… of course, it is claimed that even poking people with toothpicks is still real acupuncture.

  3. Chris Kresser’s avatar

    Matto,

    Thanks for your comment.

    Acupuncture has the potential to treat or cure any illness. But this is only true insofar as the human body has that potential, since acupuncture works by stimulating innate healing mechanisms. This means that acupuncture’s ability to treat or cure illness is dependent upon the status of the person being treated. If their self-repair mechanisms are significantly damaged in some way, acupuncture will not be able to address their condition.

    For this same reason (and several others), acupuncture research is difficult. Healing never takes place in a vacuum. If two study subjects receive the same acupuncture treatment, but one is eating well, exercising, and getting plenty of sleep, while the other is eating junk, not exercising at all, and sleeping 4-5 hours a night, who do you think will improve? RCTs have no way of controlling for these variables and they don’t even try to. This highlights the fundamental difference, once again, between holistic and allopathic medicine. In holistic medicine we consider not only the physiological functioning of the entire body, but also the effects environmental factors, nutrition, exercise, stress, emotional and psychological state, etc. In allopathy, the focus is usually on chemically altering the function of one part of the body without regard to the influence of the rest of the body or the other factors I just mentioned.

    What I’m suggesting is that together with an appropriate diet, stress management, exercise, and other aspects of a healthy lifestyle, acupuncture makes far more sense as a preventative care modality and a means to address mild to moderate imbalances than surgery and drugs.

  4. Chris Kresser’s avatar

    Matto,

    I forgot to mention, a new study was just published that addresses your question directly and reaches a different conclusion. From the abstract:

    We reviewed the available literature for different placebos (sham procedures) used to control the acupuncture effects, for moderators and potential biases in respective clinical trials, and for central and peripheral mechanisms involved that would allow differentiation of placebo effects from acupuncture and sham acupuncture effects. While the evidence is still limited, it seems that biological differences exist between a placebo response, e.g. in placebo analgesia, and analgesic response during acupunture that does not occur with sham acupuncture. It seems advisable that clinical trials should include potential biomarkers of acupuncture, e.g. measures of the autonomic nervous system function to verify that acupuncture and sham acupuncture are different despite similar clinical effects.

    After reviewing the available literature, these authors did find a biological difference between acupuncture and sham acupuncture. I think the jury is still out on this question.

  5. Jesse’s avatar

    “RCTs have no way of controlling for these variables and they don’t even try to.”

    What is the randomization for, then? If the sample size is large enough, it should work out that there are about the same number of people who eat well, exercise, and get sleep, so if the acupuncture works, those people should be affected by it enough to distinguish it from the controls. Right?

  6. Philip Tan-Gatue’s avatar

    Why it is difficult to design studies for acupuncture.  Tooting my own horn here but I’ve blogged on these topics:
    http://qi-spot.com/2010/03/30/how-to-research-acupuncture/ and
    http://qi-spot.com/2010/04/04/from-the-mouth-of-a-legendary-acupuncturist-shi-xue-min-on-acupuncture-technique/

  7. Mark Mandel’s avatar

    Slow down a bit there,  Skeptic, your typing fingers are running on ahead of your brain, or else you edited too fast. I’d bet dollars to donuts that you’re confusing nerves with nerve signals, in your text if not in your mind. Quoting you:

    There are two different types of sensory nerves involved in the acupuncture response. There are A-Delta fibers, which transmit sharp, burning pain messages. And there are C-fibers, which transmit dull, throbbing pain messages. A-Delta fibers are responsible for acute pain, and are short-lived. They fire for a while and then die off. C-fibers are responsible for chronic pain, and fire over an extended period of time.

    Do you really mean that an A-Delta fiber is short-lived and dies soon after it transmits a pain signal? It seems much more likely that the signal carried by an A-Delta fiber is short-lived and dies off quickly.
    Similarly, immediately after that:

    A-Delta fibers are surrounded by a fatty, myelin sheath and travel at 60 ft/second (that’s fast!). C-fibers are unmyelinated and travel at 20 ft/second.

    Damn, how do either of them stay in our bodies? Again, it’s the signals that travel at these rates, not the nerves that carry them. The nerves are the tracks, the signal is the train.
    I’ve been reading this article with interest, but now your carelessness is making me cautious.
     

  8. Chris Kresser’s avatar

    Mark,

    I meant to describe the signals sent by those fibers, not the fibers themselves. Thanks for catching the mistake.

  9. Mark Mandel’s avatar

    BTW,

    why does this comment form have icons for lists if they don’t make lists?
    And let’s test the

    bold,
    italic,
    underline, and
    strikeout icons as well.

  10. Mark Mandel’s avatar

    Well, two out of six ain’t too good.

  11. Chris Kresser’s avatar

    The list works fine for me:

    1. This
    2. is
    3. a
    4. test.
    As does the underline and strikeout.
    What platform are you using?

  12. Mark Mandel’s avatar

    I’m using Firefox 3.6.3 in WinXP + SP3.
    BTW, your comment, sent to me in gmail, had all the HTML code exposed, not rendered. Like so (I’ve changed the angles to square brackets):
    Author: Chris Kresser
    Comment:
    [p]The list works fine for me:[/p]
    [p][ol]
    [li]This[/li]
    [li]is[/li]
    [li]a [/li]
    [li]test.[/li]
    [/ol]
    [div]As does the [span style="text-decoration: underline;"]underline[/spanand [span style="text-decoration: line-through;"]strikeout[/span].[/div]
    [div][/div]
    [div]What platform are you using?[/div]
    [/p]
    Oh, I hate this sort of thing, and it happens all the time. Not just to me, I mean.

  13. Mark Mandel’s avatar

    (slight fix in the quoted HTML)
    I’m using Firefox 3.6.3 in WinXP + SP3.
    BTW, your comment, sent to me in gmail, had all the HTML code exposed, not rendered. Like so (I’ve changed the angles to square brackets):
    Author: Chris Kresser
    Comment:
    [p]The list works fine for me:[/p]
    [p][ol]
    [li]This[/li]
    [li]is[/li]
    [li]a [/li]
    [li]test.[/li]
    [/ol]
    [div]As does the [span style="text-decoration: underline;"]underline[/span] and [span style="text-decoration: line-through;"]strikeout[/span].[/div]
    [div][/div]
    [div]What platform are you using?[/div]
    [/p]
    Oh, I hate this sort of thing, and it happens all the time. Not just to me, I mean.

  14. Chris Kresser’s avatar

    I’ll have to look into a new comments plugin for WordPress that does a better job.

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