Is acupuncture a sham?

One of my favorite blogs is the Science Based Medicine blog. They've written a crazy amount of material over the last few years and a lot of its has been in acupuncture. Suffice to say, they don't like it.

You can find their writings on that, along with other things, here:

http://www.sciencebasedmedicine.org/?cat=8

I don't think so since WHO has a fairly good document about it http://apps.who.int/medicinedocs/pdf/s4926e/s4926e.pdf

Felipe said:

I don't think so since WHO has a fairly good document about it http://apps.who.int/medicinedocs/pdf/s4926e/s4926e.pdf

Why do you think this document is fairly good? Looks pretty suspicious to me.

Accupunture is effective when used for appropriate reasons by a skilled practitioner.

"... Acupuncture gained attention in the United States when President Nixon visited China in 1972. Traveling with Nixon was New York Times reporter James Reston, who received acupuncture in China after undergoing an emergency appendectomy. Reston was so impressed with the post-operative pain relief he experienced from the procedure that he wrote about acupuncture upon returning to the United States ..."

(click here for reference article)

I also have an acquaintance who received immense relief from a debilitating wrist injury through a series of four acupunture treatments.

As with all other medical treatments however, it should be kept in mind that specific modalities of treatment work best on specific types of injuries/ailments. No single treatment modality is a panacea for all ills.

Yours in Fitness,

Coach Sommer

I know acupuncture worked on me.

I messed up my wrist at one point and the pain never went away. After one acupuncture treatment, the pain was gone and it stayed gone.

I've read studies that show that the placebo effect has a huge affect on acupuncture

The problem with acupuncture is that it survives on an emotional basis and wishful thinking. Of course it would be great if all you had to do to get better is stick (or even act like you stick) some needles into your body. If only it wasn't for those annoying laws of nature that prohibit the mysterious chi or other supposed energies that run through your body.

As far as I know until today there are no strict studies that concluded that what is said to be acupuncture (there is no clear definition) "works" better than placebo. That is to say it does not work.

From acupuncture advocates all you hear is anecdotal evidence or poor studies.

One of the main problems with acupuncture is that there is no clear definition of what it actually is.

Double blind studies ( neither the individuals nor the researchers know who belongs to the control group and the experimental group) have been performed to test whether it does matter if the person got acupuncture on random "trigger points", or acupuncture without the individual knowing that the needle penetrates the skin etc. . Such "treatments" perform no better than the control group (the individuals who got no treatment at all).

And that is what you would expect. The treatments don't outperform the Null Hypothesis suggests. It is classical wacky pseudosience.

There are many fallacies that will make people feel better after such a "treatment".

One has to consider all the cognitive biases that factor in when people resort to pseudosience in the first place. It is usually when their condition is at its worst, a point at which everything will make them feel better (usually the natural self healing process). Correlation does not equal causation.

With the data and studies available there is no reasonable conclusion but to dismiss acupuncture as a working treatment.

It is morally wrong to exploit desperate people who are looking for a cure to their illnesses.

If anybody is interested in more information, I recommend "Trick or Treatment, by Simon Singh" or read Neurologica Blog where the Steven Novella regulary takes apart and analyzes studies, or in general some critical thinking.

The placebo effect can be a powerful and useful tool. Personally, I'd like to see more research on exactly what it is and how it can be triggered deliberately and consistently without having to deceive people.

The confusion arises from people attempting to evaluate the efficacy of a particular protocol solely through isolated research and anecdotal references rather than their own practical experience. There is no substitute for your own personal involvement. If you are interested in acupuncture, find a local well-trained practioner and begin exploring its applications.

Often times the application of logic to this type of evaluation is pointless as all logic ever proves is that whatever has not been done in the past cannot be done in the future. Thus if something is outside of your personal or cultural frame of reference you will automatically discount it as rubbish.

For example, I had never seen ART used by a skilled therapist. Yet I personally observed a therapist greatly extend one of my athlete's shoulder ROM by 4-6' by simply pressing on his lat. I still remember the shock. If I had been foolish enough to try to attempt to gain the same ROM increase through conventional stretching the muscle would have assuredly torn.

Did it work? Absolutely. In addition the evidence of seeing it with my own eyes was irrefutable and worth more than any number of research studies. How did it work? I do not know. However I do not need to know how to build a computer in order to use one effectively. I simply need to be able to follow instructions in order to operate it correctly.

Yours in Fitness,

Coach Sommer

There is no substitute for your own personal involvement

I strongly disagree with that.

Personal involvement is anecdotal evidence. There needs to be repeatable, unbiased examination. Both of which cannot be achieved by personal involvement. I can go to the doctor and have my appendix removed without personal involvement in the treatment. I don't have to believe in it in order to work. This procedure stood up to the scientific method. Therefore we accept it.

Often times the application of logic to this type of evaluation is pointless as all logic ever proves is that whatever has not been done in the past cannot be done in the future. Thus if something is outside of your personal or cultural frame of reference you will automatically discount it as rubbish.

No, I don't discount something as rubbish by default. My default is: I don't believe in extraordinary claims, until I am provided with extraordinary evidence. Until acupuncturists fail to provide the scientific community with such it is simply not reasonable to take it serious.

Why not go one step further and resort to bloodletting for example? Same rules apply. And I don't need personal involvement to dismiss it as quackery.

gymgreg said:

There is no substitute for your own personal involvement

I strongly disagree with that.

Personal involvement is anecdotal evidence. There needs to be repeatable, unbiased examination. Both of which cannot be achieved by personal involvement. I can go to the doctor and have my appendix removed without personal involvement in the treatment. I don't have to believe in it in order to work. This procedure stood up to the scientific method. Therefore we accept it.

I have more of middle ground on this. It's too strong to not believe anything unless multiple studies have confirmed it. Something can have a high prior probability before any studies have been done on it if it is based on a plausible mechanism, lots of people have a had success using he method, ect.

Coach's gymnastics methods are like that. No study has ever been done on them, but there are based on a plausible mechanism (progressive resistance using deceasing leverage, along with Coachs personal and coaching experience to guide him to know which variations are in fact higher or lesser in resistance, General adaptation syndrome) and many people have used them and gotten good results. So, given this, I will go ahead and try them because I see no a priori reason why they will not hurt me.

On the other hand, I reject Coach's assertion. "There is no substitute for personal experience" is something I am sure many schizophrenics have said. On a more serious note, there are a multitude of ways that we can can be fooled about the efficacy of a treatment. I'm sure a simple web search will turn up many results discussing these different ways.

When we look at acupuncture, we see a very implausible mechanism (chi) which has never been shown to exist. Furthermore, many people have claimed its benefit, but in this case this has actually works against it, not for it. Why? Because many people have claimed to be healed by a single mechanism for many different diseases with a diverse set of pathophysiology. This is highly suggestive that something else is going on (placebo? mass delusion? cognitive bias?). When the treatment has actually been studied, high quality studies have failed to show its beneficial. The weight of this evidence should clearly amend ones personal experience.

I have more of middle ground on this. It's too strong to not believe anything unless multiple studies have confirmed it. Something can have a high prior probability before any studies have been done on it if it is based on a plausible mechanism, lots of people have a had success using he method, ect.

The case with acupuncture is however that there have been lots of studies. It is not that researchers have been avoiding the issue. That is the main point. And what is the reasonable thing to do when strict double blind studies have shown that it is not working? To hope for the next poorly conducted,unblinded study ?

gymgreg said:

The case with acupuncture is however that there have been lots of studies.

Yeah I know, I said that.

gymgreg said:

Personal involvement is anecdotal evidence.

Anecdotal evidence is still worth something. If the researchers say that something shouldn't happen but your personal experience is that it did, are you going to believe the researchers or your own experience?

The Hansenator said:

gymgreg said:

Personal involvement is anecdotal evidence.

Anecdotal evidence is still worth something. If the researchers say that something shouldn't happen but your personal experience is that it did, are you going to believe the researchers or your own experience?

Depends. Don't you think? Can't you imagine any circumstance in which the conclusions you draw from your personal experience could be mistaken?

trianglechoke7 said:

Depends. Don't you think? Can't you imagine any circumstance in which the conclusions you draw from your personal experience could be mistaken?

Here's an example: Acupuncture made my pain go away. My wrist hurt and, after getting acupuncture, it didn't hurt. When someone says that acupuncture doesn't work, that doesn't change the fact that my wrist doesn't hurt anymore.

I'll give you another example: Eye exercises are generally laughed at by the medical community but, in my experience, there's something to it. I don't have any research to prove it but I can see things without my glasses that I couldn't before and no amount of medical evidence to the contrary will change the fact that my prescription is weaker than it used to be.

... I strongly disagree with that ...

Whether or not you agree, does not change the reality of the assertion.

Am I saying that acupunture is a panacea? Of course not. However to dismiss something out of hand because it is foreign to your world view is the first step toward being mired in mediocrity. Time after time, truths are uncovered in the trenches and then used to great effect within the elite community that are only later, often much later, explained in the lab.

Personally, my sole criteria for evaluating new information or techniques is quite simple; does it work? Not does this validate my current belief systems or did it come from a government approved source of information. You are of course free to dismiss this hard earned knowledge.

I find it interesting that some of you have such strong opinions on this subject and yet have never actually used acupuncture.

Yours in Fitness,

Coach Sommer

The Hansenator said:

trianglechoke7 said:

Depends. Don't you think? Can't you imagine any circumstance in which the conclusions you draw from your personal experience could be mistaken?

Here's an example: Acupuncture made my pain go away. My wrist hurt and, after getting acupuncture, it didn't hurt. When someone says that acupuncture doesn't work, that doesn't change the fact that my wrist doesn't hurt anymore.

I'll give you another example: Eye exercises are generally laughed at by the medical community but, in my experience, there's something to it. I don't have any research to prove it but I can see things without my glasses that I couldn't before and no amount of medical evidence to the contrary will change the fact that my prescription is weaker than it used to be.

You completely dodged my question.

Who cares if it is a placebo effect? If it works, and relieves your pain, then it worked right? Even if it was due to placebo...

Coach said:

However to dismiss something out of hand because it is foreign to your world view is the first step toward being mired in mediocrity.

Again, I don't dismiss it because it is foreign to my world.

Coach said:

Personally, my sole criteria for evaluating new information or techniques is quite simple; does it work? Not does this validate my current belief systems or did it come from a government approved source of information.

And I don't need a treatment to validate my belief systems. That's the beauty of science. My beliefs and wishful thinking do not matter the least. If there is evidence then I have to change my beliefs. It is not like a dogmatic, religious world view.

Gymgreg honestly, you're wayyyyy to strict on this believing in science. What if the acupuncturists(spelling?) in the study were crappy? Just one example of how the study could be flawed. Since I haven't tried acupuncture, that's all I have to say in this matter.

Razz, I know my posts my seem harsh, but as long as you can't point out why rational thinking and believe in the scientific method is "wayyyy" to strict I choose to not fall for pseudoscience and superstitions.

Before I started to write my first post on that matter I was well aware that I won't make friends with Coach and acupuncture advocates on that matter. Which is fine. I think we are all grown ups and can disagree about things like that.

I know that people who believe in magic like chi and meridians probably won't change their opinion on matters like this. And that is not the point of public debates in the first place. It's to get the "on the fence sitters" to start thinking critically, which I hope I have done here.

No offence taken here at least, I was hoping to convince you that anecdotal evidence can be a powerful tool in winning the race to becoming the best athlete/coach/whatever. Many times anecdotal evidence is way ahead of science. Many times it's the opposite. Do you have any evidence that going in the sauna and hitting each others with sticks help recovery? Maybe not but certainly it has helped the russians many times. What do you think came first, science or anecdotal evidence on hot/cold showers? I know many cultures have been using this to their advantage way before science researched this stuff. Hope you get my point here

My personal experience is that can be useful. My brother in law is physiotherapist (from university, nothing about alternative medicine or chinese medicine or mystical medicine...). He uses and used with me to treat pain of may shoulder. You have to try to see how it can work. Is not just to put needle, is to put the needle in the right place where there is a motor neurone or something like that and you feel how it touch your nerves (in fact is quite disconfortable), in fact if the nerve (or whatever he is searching to arrive) is not touched you don't even feel the needle. After half an hour a pain like DOMS arrives all over and around the treated zone and doesn't goes away for a day (this is normal). When you feel that pain from just a few seconds of the needle you can be sure that this thing does something and it's not just mistical. And that pain i can asure it's not placebo one. Ah!! and the original pain goes. It worked for my shoulder. It's the panacea. No, as ibuprofen isnt't either but can be quit helpful.

I started to belive in physiotherapist when my brother in law just with pressure on my lower back, quit my pain of contractures due a herniated disc, that months of paracetamol could't do. Just with trigger points pressure. That opened my mind. Really.

This is such broad topic that it is more than i can handle to fully address. Indeed the fundamental questions that arise are so deep that the greatest minds in history have not been able to fully answer them, or agree on them.

Einstein, for example, spent the vast majority of his career trying to prove that 'God does not play dice' as he was unable to accept the probabilistic results that discoveries in quantum mechanics brought on. He failed, but kept working on the problem even on his deathbed.

He wanted things to be predictable in all circumstances, but couldn't prove they were!

There are things we can all agree that are difficult to measure, how do we measure creativity, or artistic talent? We can create a situation for someone to grow artistically, yet, they may never exhibit creative greatness.

So one question is where does creativity come from. Well we don't have an answer for that. Of course we can apply this more generally to thought and emotion.

We can say its just chemical reactions, well what causes the chemicals to react? Primarily Electrostatic force, ah now we are getting somewhere, but what causes electrostatic interaction? Photon exchange, and how does the photon know what to do? Well we are back to - we can't answer that.

On the fundamental level we always wind up with a question mark. Even in mathematics this is true as we find that any complete system will have a contradiction within it, in other words math isn't perfect and always breaks down when it tries to measure itself. There needs to be something outside for things to be perfect, or there must be something that is a contradiction if the system is self contained!

We are lead to one of the greatest questions in all existence, what is actually driving all this? And science is helpless for a simple reason, we can't measure something without being part of the measurement, we can't look at ourselves with out introducing a new observer.

One answer for this is to accept that there is something that we can't touch or observe directly that is driving the whole system. A good word for it is consciousness, another abstract unmeasurable. We know its there, we experience it everyday, yet when we look at it we find it slips out of our grasp.

Let consciousness represent the base driving force and for fun say Chi is that force in motion.

Again Chi is actually easy to feel, do the simplest of Chi Gong exercises and you can't help but feel something. Its there, it obvious to anyone, the thing that's not obvious is what to call it. Is it just a mind trick, who knows? Its nothing mystical though, its the same thing that lets you do a dip or pull up.

On the mind/body level there is so much going on we don't understand or accept. It isn't measurable, in the traditional sense. But neither is the position/velocity of an electron, we accept that now.

I personally think that we have gotten the placebo thing all wrong, if anything its a indication that the mind, consciousness is more powerful, more fundamental than we commonly understand.