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Jul 05 2013

Not a pincushion

Athlete has bad headaches, goes to “therapist” who decides that sticking a needle in her chest will fix her headaches. Lung collapses, athlete’s life is trashed. This is called “traditional Chinese medicine.”

The therapist accidentally pierced Ms. Ribble-Orr’s left lung during acupuncture treatment that was later deemed unnecessary and ill-advised, causing the organ to collapse and leaving it permanently damaged. An Ontario court has just upheld the one-year disciplinary suspension imposed on therapist Scott Spurrell, rejecting his appeal in a case that highlights a rare but well-documented side effect of acupuncture.

Mr. Spurrell, who learned the ancient Chinese art on weekends at a local university, had no reason to stick the needle in his patient’s chest, and had wrongly advised Ms. Ribble-Orr that the chest pain and other symptoms she reported later were likely just from a muscle spasm, a discipline tribunal ruled.

It’s time for people to stop calling acupuncture things like “the ancient Chinese art” and other such honorifics. It’s just sticking needles in people for no medical reason. It’s bad and stupid and calling it an ancient art doesn’t make it any less so.

Acupuncture involves inserting solid needles into the body at specific points to encourage natural healing, improve mood and relieve pain, among other benefits, according to the Acupuncture Foundation of Canada Institute. Proponents tout it as a safe, drug-free alternative to traditional medicine, one that is used by close to one in 10 Canadians, a 2007 Alberta study suggested.

A Danish analysis of randomized clinical trials in 2009, however, concluded that acupuncture offered only a slight, clinically irrelevant benefit over placebo acupuncture for pain.

How “safe” can it really be when it involves sticking needles into people? “Safe” is things like murmuring incantations, it’s not sticking needles into people.

 

13 comments

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  1. 1
    evilDoug

    I’m really quite surprised that a puncture with something as small as an acupuncture needle can lead to a pneumothorax. I wonder if the business of twirling the needles is an aggravating factor.

    “She returned to the therapist later, wondering if she had suffered a pneumothorax.”
    I’m amazed that people believe that acupuncture has benefits. I am absolutely astounded by the incredibly gross idiocy conveyed by that statement. You have to be profoundly dim to go to a hack quack if you suspect pneumothorax. If you even know what a pneumothrorax is, you should know that it is life threatening and requires actual medical care. Stupid, stupid, stupid!

  2. 2
    Bernard Hurley

    Puncturing the lung is quite a well known acupuncture risk. Some of my Chinese relatives use acupuncture but would never allow a needle to be stuck into their chest. As you pointed out, there is a small amount of evidence that it can sometimes reduce pain[1], but pain reduction can be achieved in much cheaper, safer and more effective ways. Contrary to what acupuncturists often claim, there appears to be no evidence that it can do anything about obesity, baldness, irregular periods, impotence and a host of other problems .

    I believe athletes are often attracted to “drug-free” traditional remedies as they are afraid of being caught with forbidden substances in their blood. Actually many traditional herbal remedies do contain such things, without any of the controls to which bona fide drugs are subject.

    Footnotes:
    [1] Presumably by stimulating the body’s the production of endorphins.

  3. 3
    leftwingfox

    [1] Presumably by stimulating the body’s the production of endorphins.

    Certain placebos are more effective than others as well. An injected placebo is more effective than a pill, for instance. Part of the benefit of acupuncture may simply be because the treatment is more invasive, therefore more compelling psychologically.

    (reference)

  4. 4
    CaitieCat, in no way a robot nosireebot

    When doing rehab for a dislocated ring finger on my right hand (perils of goalkeeping, but I made the save! – cacked the rebound, though, because I was busy cradling my now-zed-shaped finger), among the pleasant and useful treatments suggested (stretching exercises, followed by a nice warm-wax bath) they also asked if I wanted to try acupuncture. I said sure, why not – it’s only on my hand that they wanted to poke, so I figured the odds of major damage were small, and why not indulge the experiment.

    I found no difference whatsoever between the days (I tried twice) they used the little needles and the days they didn’t. Well, except that I spent some time with needles sticking out of my hand. They wanted to do it on my chronically-awful back, but I declined.

    The wax bath, though, was really pleasant and definitely pain-reducing. Plus it was fun to take off a wax glove impression of my hand afterward.

    I don’t think, though, that I’d have let them anywhere near my torso with the pointy sticks. My military battlefield first-aid training spend a whole morning’s classes on pneumothorax (or, as they called it to me and the other grunts, “sucking chest wounds”), and in no way do I ever want to go near something reputed as horrifically painful and dangerous as collapsed/reinflating lungs. Yikes.

    And all they gave him was a suspended licence for a year? What the hell difference is that likely to make, do they really think people going to acupuncture are going to baulk at whether or not the licence is currently valid? If they had that much rationality, they wouldn’t be going in the first place.

  5. 5
    Marie-Thérèse O'Loughlin

    It’s very frightening reading what happened to “Ms. Ribble-Orr’s left lung during acupuncture treatment that was later deemed unnecessary and ill-advised, causing the organ to collapse and leaving it permanently damaged”.

    I went to a Chinese acupuncturist, and had needles stuck into me everywhere. The first time around there was such a fuss made of me by a recognised doctor of acupuncture that I felt very confident in pursuing ongoing treatment to the tune of E1,000.

    Alas, second time around it was a different kettle of fish. I was left lying on my own in a very cold room with a tiny infrared lamp for over half an hour (first session = 1 hour). The needles were then yanked out of me by a brusque assistant whilst she was intermittently chatting away to another worker, and treating me as though I didn’t exist at all. I was left bleeding in parts of the skin in the aftermath. I found the assistant to be extremely uncaring and cold in manner when I pointed it out to her. The penny dropped. I then realised what I had let myself in for. I went to the person in charge and told him that I was not happy with the second treatment, and would therefore like to cancel my whole treatment. He tried to persuade me to think about it, and that I could go to the clinic where the professional doctor was for the remainder of the treatment. I was not persuaded at all. I was lucky to get out of the treatment that I’d signed up to. The placebo effect was indeed short-lived.

    The athlete’s life is now very damaged because of inaccurate acupuncture treatment. Reading this post is a real eye-opener. Combined with the lack of care I received, and reading this post, I shan’t ever be tempted into going to an acupuncturist again.

  6. 6
    Eneraldo Carneiro

    I’ve used acupunture myself sometimes, essencially to please my wife who really belive such stuff. She’s the boss you know. Generally it was very relaxing, I fall asleep many times. No harm done. However, the needles were stick very superficially n the skin. And I mean very superficially, almost falling. This story is very strange.
    I’m not saying this to deffend the practice or something, but I’ve never heard of this. To puncture the lung the needle would have to go through skin and flesh. It would need not a regular acupunture neede but sometihng like those icepicks or a atylet.
    Very strange.

  7. 7
    latsot

    My sister used to work as a physiotherapist in the UK and I’m ashamed to say that she used acupuncture. Of course, she used it alongside regular treatments so people generally got better. She claimed, without tests of any kind that “yeah, but they got better *faster* with acupuncture.”

    It’s OK though, she was fully trained. She went on a two day course. To learn this supposedly ancient and mysterious product of mystical Chinese wisdom. Two days training was all that was required to practice acupuncture on the NHS.

    A lot of that nonsense is being gradually kicked out of the NHS now, but there are still plenty of horror stories.

    Can you kick something gradually?

  8. 8
    Nick Gotts

    latsot@7,

    I recently suffered from tennis elbow, and both a private and an NHS physiotherapist suggested acupuncture – although the NHS guy said it “wasn’t really acupuncture” but did involve sticking a needle deep in my elbow. So there seems to be something of a cult belief in it among UK physiotherapists. Certainly, there’s no evidence I could find that it helps with tennis elbow, which is generally self-limiting but tends to recur. I declined the needles, stuck to exercises, massage and a bit of ultrasound (though in fact I don’t think there’s much evidence for any of these either), and it’s now more-or-less resolved.

  9. 9
    Claire Ramsey

    Once an MD stuck a needle deep into my injured foot and delivered a dose of a steroid to zap the horrid inflammation and resulting pain. That is what needles are for at the clinic.

    I had acupuncture a few times too, for a skeletal problem. But I didn’t even get a placebo effect, I am so hard headed and resistant to believing.

  10. 10
    Jafafa Hots

    “inaccurate acupuncture treatment”

    There’s another kind?

  11. 11
    rorschach

    To be fair, that person got pretty unlucky by the sounds of it. The penumothoraces that result from acupuncture (or more common, intercostal nerve block for rib fracture) are not normally very significant, most of them you can just watch with followup xrays, and they don’t need anything done at all to re-expand over time.

  12. 12
    A

    Unfortunately, paired down “home-training” courses allowed in some countries, such as Canada, opens the doors for inexperienced individuals, like Ribble-Orr’s therapist, to use tools of the trade without proper qualifications. In areas in which practice of Chinese medical techniques is well-established, such as the US and China, licencing is established after a minimum of four academic years of focused training and the completion of national board exams. Ribble-Orr’s experience is a visceral reminder of why Chinese Medicine needs to be strongly regulated by specialized academic boards and informed licensing groups.

    One of the many benefits of well-regulated practices is the opportunity for good research on implementation and efficacy. In the US, the increase of regulation has seen the expected corresponding rise in research. The National Institute for Health, the Department of Defense, and private organizations like Sloan-Kettering and Columbia University have all funded and supported acupuncture research and are reaping the benefits.

    It is a shame that poor regulation and a lack of understanding have lead to dangerous situations such as the story of Ribble-Orr. Equally disappointing is the lack of responsible research done by many of those reporting on this story. Quick to make “news,” they’ve failed to look deep enough into the issue to offer much meaningful insight. Rather than blaming ignorant poking toted as “acupuncture” for horrendous outcomes, reports should use this story as a caution to messing around with medicine.

  13. 13
    CaitieCat, in no way a robot nosireebot

    So…basically, “No True Acupuncturist”, then.

    Okay.

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