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Jul 27 2013

An acupuncture poll

Every time I despair at the stupidity rampant in my own country, along comes the UK to reassure me that it is a worldwide phenomenon.

Does acupuncture work?

 51% Yes

 49% No

Jebus. Seriously?

42 comments

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  1. 1
    slatham

    I’d like to say, “Pfft, acupuncture,” but IMS (intramuscular stimulation) worked very well for me. It’s related to acupuncture.

  2. 2
    gbjames

    Define “work”.

  3. 3
    chigau (違う)

    After you define “work”, tell us what ailed you.

  4. 4
    Nemo

    The placebo effect works, doesn’t it?

  5. 5
    Nick Cazier

    There are people who claim that acupuncture works, too.

    At best it’s a placebo effect. It does not work as advertised.

  6. 6
    george gonzalez

    Hmmm, well I guess there’s a small chance that the pain is going to release endorphins or dolphins or something to counteract the act of having needles put into your body. But to actually PAY someone to stick needles of unknown provenance into your personal body parts, I don’t see how that could ever happen.

  7. 7
    Anthony K

    But to actually PAY someone to stick needles of unknown provenance into your personal body parts, I don’t see how that could ever happen.

    At least with acupuncture, unlike tattoos, I don’t have to see the aftermath.

  8. 8
    Al Dente

    Hmmm, well I guess there’s a small chance that the pain is going to release endorphins or dolphins

    Are you talking about porpoises or about fish?

  9. 9
    David Marjanović

    Sticking needles into you works: pain distracts from pain.

    Neither meridians nor acupuncture points exist; sticking needles anywhere has the same effect.

    Jebus. Seriously?

    I’m actually quite surprised “yes” wasn’t much higher.

    46% Yes
    54% No

    Numbers of votes not given.

  10. 10
    michaelbusch

    I’d like to say, “Pfft, acupuncture,” but IMS (intramuscular stimulation) worked very well for me. It’s related to acupuncture.

    Only in the sense that both involve being poked by needles. Acupuncture is exactly as effective as pricking the patient in randomly-selected positions (which is the relevant cross-comparison to do, since the magnitude of placebo effects depends on the type of intervention). Intramuscular stimulation actually has some evidence to support it.
    _
    Also note that even if the techniques of acupuncture were to be effective, which they aren’t, that wouldn’t justify the various supernatural claims associated with them (such as the supposed existence of qi).

  11. 11
    sharkspeare

    One needs only to read the comments on the Daily Mail Online to realize that the UK has their own fair share of total twits.

  12. 12
    anuran

    To be fair, the Chinese did find the same trigger points modern physicians use for pain management. It was unscientific by modern standards. The theory was wrong. But that particular bit of knowledge was discovered, preserved and passed on.

  13. 13
    Kevin Schelley

    It works well for lightening the wallet

  14. 14
    Gregory Greenwood

    Every time I despair at the stupidity rampant in my own country, along comes the UK to reassure me that it is a worldwide phenomenon.

    There is no need to worry at all PZ – teh stoopid is very, very strong with large sections of the populous over here. We may not quite reach the… dizzying heights that parts of the US get too, but we do a fine line in consistent credulousness in the face of countervailing evidence.

    As a humourous aside, when I clicked on the link to look at that painfully idiotic poll, there was an oddly appropriate advert right next to it for the new Wolverine movie. Logan’s mutant abilities are about on a par with many of the claims made about acupuncture when it comes to scientific evidence…

  15. 15
    slatham

    #2,3 — thanks for your interest. A couple of years ago, I was at physio complaining of lower back pain and numbing/tingling in my legs. She asked if she could try IMS. I was pretty desperate. I felt the needle enter my lower back above my hip, she pushed and re-positioned the needle inside, and then my muscles relaxed and the rigidity of my lower back ‘shattered’. She said, “Holy crap!” I left there able to walk with more fluidity (I could tilt my pelvis at will) than I had in the past couple of decades. Two weeks later I thought it was tightening again and asked for a repeat treatment. No such dramatic effect, but my hips are still much better than they were. No tingling/numbness down my legs.

    When ‘alternative’ medicine gets adopted by medicine, it loses its ‘alternative’ status. Right? Well, with IMS, medical practitioners are choosing to adopt it. I’m not saying that all acupuncture is good or useful. But those who are skeptical should look up IMS — it just might help you or someone close to you.

  16. 16
    johnm55

    The National Institute for Health and Care Excellence (Nice) which is the body that licences treatments in the National Health Service tend to do it on a cost/benefit basis. So an expensive treatment that doesn’t have a significant benefit over a cheaper treatment won’t be licensed. Acupuncture is cheap and if enough people think they are benefiting from the placebo effect it will appear to be a cost effective treatment even if it is in actual fact doing nothing.

  17. 17
    marko

    The question is vague, “Do you believe the treatment has a beneficial effect?” Beneficial in what way? They don’t actually ask if you think it works in the intended fashion.

  18. 18
    slatham

    Perhaps it will help if I mention that I’ve got had tight neck/scapular muscles for a few months that I can’t seem to relax. I wanted to find the same relief that the IMS on my lower back provided. I went in search of the ‘magic’ needle again. But I tried and found no real relief. I was predisposed to believe it would work; I would have been happy for a placebo effect. But the effect was no longer-lasting than a massage. So … it didn’t work, but that doesn’t negate the effect of the treatment on my lower back years before.

  19. 19
    Azkyroth Drinked the Grammar Too :)

    But it DOES work. The ability of a pin to penetrate human skin is extensively documented.

    Oh, is that not what they meant?

    Fuck.

  20. 20
    lorn

    It depends on what they mean by “work”.

    Is it a biologically effective therapy? No.

    Is it a sometimes effective method of applying the placebo effect to illness, real or imagined? Sometimes.

    Is it an effective, cost effective, way for a person of little but theatrical and presentational skills to make a living while accepting the mantle of “healer” through the use of inscrutable methods? Absolutely.

  21. 21
    abbeycadabra

    I have invariably been unsatisfied with this question, because I haven’t heard of any actual clinical tests for acupuncture – not even an informal double-blind. Are the points truly random? I’m perfectly willing to believe they are (and obviously the ‘chi’ explanation is pure hooey), but I’ve never actually encountered any kind of evidence putting this one to bed.

    Perhaps the rest of you can enlighten me?

  22. 22
    Nerd of Redhead, Dances OM Trolls

    because I haven’t heard of any actual clinical tests for acupuncture – not even an informal double-blind.

    Actually, NCAM did a study with sham needles, which felt like they penetrated the skin, but didn’t. Just as effective, if not a smidgen better, than the needles (references in the OP). Placebo is big factor in pain relief.

  23. 23
    chakolate

    Acupuncture *does* work – it’s called the Placebo Effect.

  24. 24
    Inaji

    A needle jammed into a certain spot in my spine can temporarily help with my pain issues, but that’s because it’s a hypo full of helpful corticosteroids.

  25. 25
    slatham

    #22. In contrast, this study found deeper needling yielded better long-term results: http://www.ncbi.nlm.nih.gov/pubmed/12048416

  26. 26
    tororosoba

    21, 22: The German Acupuntcture Trials (http://en.wikipedia.org/wiki/German_Acupuncture_Trials) revealed that sham and real acupuncture are about equal. Interestingly, both are more effective than conventional treatments.

    The study is not double-blinded, since the sham acupuncturists must know what they are doing.

  27. 27
    chemicalscum

    http://www.ncbi.nlm.nih.gov/pubmed/15135942
    Neurosci Lett. 2004 May 6;361(1-3):258-61.
    Acupuncture and endorphins.
    Han JS.

    Abstract:
    “Acupuncture and electroacupuncture (EA) as complementary and alternative medicine have been accepted worldwide mainly for the treatment of acute and chronic pain. Studies on the mechanisms of action have revealed that endogenous opioid peptides in the central nervous system play an essential role in mediating the analgesic effect of EA. Further studies have shown that different kinds of neuropeptides are released by EA with different frequencies. For example, EA of 2 Hz accelerates the release of enkephalin, beta-endorphin and endomorphin, while that of 100 Hz selectively increases the release of dynorphin. A combination of the two frequencies produces a simultaneous release of all four opioid peptides, resulting in a maximal therapeutic effect. This finding has been verified in clinical studies in patients with various kinds of chronic pain including low back pain and diabetic neuropathic pain”

    So yes acupuncture does work for analgesia. There is no such thing as Qi but there is a sound scientific basis for acupuncture analgesia it is more than just a placebo effect. Guys consult the scientific literature before you launch a quack hunt. By the way the original Chinese scientific work on acupuncture analgesia, in the first issue of Academica Sinica published just after the end of the Cultural Revolution in 1974 there was a paper on an an experimental animal model that used acupressure, which explains why the “sham needles” work in the control study. This experimental research demonstrated the production of an unknown circulating endogenous material with an opioid activity. This was a year or so before the discovery of the endorphins. Good science, good prediction eh!

  28. 28
    A Hermit

    Then there’s this to consider…

    Canadian Olympian’s ‘nightmare’ after acupuncture needle collapses her lung

    It’s a rare event with acupuncture, but not unheard of and has even caused deaths…http://www.guardian.co.uk/science/2010/oct/18/dozens-killed-acupuncture-needles

  29. 29
    imthegenieicandoanything

    I’m no fan of this treatment and much, much less of its long and deep popularity where I live, but at least there is some question about its degree of quackery (unlike, say, the proven 100% dangerous and dishonest bullshit of homeopathy).

    The tone of superior, mocking meanness in the post (and most comments) here is pretty unpleasant, like Republicans mocking people standing in line at a soup kitchen. And unnecessary. Just present the evidence against it, strongly. Protest its being covered by insurance. The self-convinced are just that, and will not be reached by mocking of this brutal and self-satisfied sort if reason doesn’t.

    I’d ask us to keep our noses a little lower in the air, but likely enough all that will happen is that extra-venomous comments will come my way. (What passion some people here have when nothing is at stake!)

    We’re human beings as well, and pretty much as foolish, about one thing or another. If we’re “better” at all, it’s because of our actions, not our beliefs.

  30. 30
    chigau (違う)

    … but likely enough all that will happen is that extra-venomous comments will come my way…

    or most people will just ignore you

  31. 31
    Nerd of Redhead, Dances OM Trolls

    Chemicalscum, the abstract only demonstrates what would be expected from Placebo Effect. If acupuncture was really efficacious, it would work on double the amount of testees, similar to NSIADs, vicodin, etc.

  32. 32
    dannysichel

    First, in response to tororosoba@26 – if you wanted to do a proper double-blind experiment, I’m sure someone could engineer a device that would conceal the target area of the patient’s flesh, and then either mechanically insert the needle, or produce the sound of a needle being inserted.

    Second – I’m thinking about cutters. People who cut their arms, etc, in order to… ease some sort of pent-up stress? As I understand it — and this is based solely on anecdotal evidence — they experience some sort of short-term effect. Assuming that jabbing-with-needles does in fact have some sort of effect, could cutting be related?

  33. 33
    slatham

    The URL I posted in #25 links to a double blind study. For pain, there are many short-term methods to find some relief. And people with pain often experience high variability in the pain they experience (there is a lot of statistical noise), probably related to the effects of so many factors (less agitation, more warmth, different sleep position, etc). The key is to find treatment that allows a person to live a normal life — long term response, probably not endorphins. The double blind study I cited found a difference experienced 3 months after treatment. Sample size < 50, statistically significant difference in a noisy system.

  34. 34
    slatham

    Alternative medical treatment that works will become medicine. Right? What would that transition be like? The alternative treatment would usually be all wrapped up in myth related to the crap in the rest of the alternative field. If a science-based medicine were to adopt efficacious treatments from some traditions, it would have to separate the potentially therapeutic aspects from the mystical aspects. That is a difficult task when your main goal may be to stop your society from wasting resources on promoting an entire alternative field. Support for any particular practice within that field might legitimize it. But science is good at breaking things down and isolating component parts to test hypotheses and generate improved understanding. Scientific observers should appreciate that nature is nuanced and that over-generalization rarely leads to new insight.
    I think that’s a tension here in this discussion of acupuncture. Most of acupuncture might be crap. I received little benefit (if any) from it twice, but before that had an amazingly positive experience. I would hope that someone is studying how those results can differ so much. I didn’t vote in the online poll regarding acupuncture — my answer from experience is “both”. I suspect that a more educated vocabulary, such that specific acupuncture procedures could be interrogated for various health issues, would find that the demonstrably right answer is “Yes, it works,” for some subset of problems/treatments, and “No” for the rest. A blanket “Qi doesn’t exist so the whole thing is a waste of time” sort of attitude will inhibit the ability of science-based medicine to detect and incorporate useful treatments from alternative medicine (if there are any).

  35. 35
    larrylyons

    Have to disagree with you about this one. There is a fair degree of properly controlled double blind studies that used sham acupuncture or placebo controls that still found an effect in the reduction of perceived pain over and above what was found in the placebo or sham conditions. Some examples

    http://www.painjournalonline.com/article/S0304-3959(02)00062-3/abstract
    http://www.sciencedirect.com/science/article/pii/S0965229902000821
    http://www.sciencedirect.com/science/article/pii/S0304395904004154
    http://www.sciencedirect.com/science/article/pii/S0304395901004444

    So there may be something there that cannot be explained by placebo or expectancy effects. Whether its endorphin release or other mechanism I do not know. But to some extent pain control via acupuncture is a real phenomenon that is not necessarily explained by placebo.

  36. 36
    David Marjanović

    To be fair, the Chinese did find the same trigger points modern physicians use for pain management.

    What trigger points? Do you mean the acupuncture points? Those, as I mentioned, don’t exist – sticking the needles in random points has the same effect.

    The study is not double-blinded, since the sham acupuncturists must know what they are doing.

    Double-blind needles were developed years ago! They work much like theater daggers, AFAIK.

    Google moar.

    By the way the original Chinese scientific work on acupuncture analgesia, in the first issue of Academica Sinica published just after the end of the Cultural Revolution in 1974 there was a paper on an an experimental animal model that used acupressure, which explains why the “sham needles” work in the control study. This experimental research demonstrated the production of an unknown circulating endogenous material with an opioid activity. This was a year or so before the discovery of the endorphins. Good science, good prediction eh!

    …When exactly was the period when Máo pushed acupuncture based on outright fake evidence?

    Assuming that jabbing-with-needles does in fact have some sort of effect, could cutting be related?

    Wouldn’t surprise me at all. I’m told (n = 1) that the pain brings relief.

  37. 37
    chemicalscum

    @Nerd of Redhead, Dances OM Trolls

    The abstract reports a correlation of acupuncture to the circulating release of endorphins. It is indeed possible that there could be a possible placebo effect that results in the production of endogenous endorphins. However the electroacupuncture results are not consistent with it being a placebo effect as different frequencies produce different patterns of endorphin release and a combination of frequencies produces a composite mix of endorphins.

    The original animal model work using rabbits in 1974 was an animal experiment and thus excludes the placebo effect. Furthermore they transfused cerebrospinal fluid from a treated rabbit showing an analagesic response to a second untreated rabbit and find an analgesic response in that animal. This resulted in the prediction of unknown endogenous opiate like species being present in CSF. This was subsequently explained by the discovery of the endorphins.

    It is effectively impossible to do double blind studies of acupuncture treatment. Therefore the best evidence for excluding the placebo effect are results using animal models. There is an extensive literature on this over the last few decades including primate models. A simple Pub Med search provides 610 results.

  38. 38
    Nerd of Redhead, Dances OM Trolls

    The abstract reports a correlation of acupuncture to the circulating release of endorphins. It is indeed possible that there could be a possible placebo effect that results in the production of endogenous endorphins.

    When the Placebo Effect works, endorphins are increased. That was and is my point. Your citation showed nothing outside of Placebo Effect.

  39. 39
    chemicalscum

    @David Marjanović

    The “double blind” needles are the sham needles discussed earlier and as I have pointed out that animal studies have shown than acupressure is as effective as acupuncture with needles. Treatment with the sham needles would be equivalent to acupressure. A real double blind experiment is not therefore possible, consequently animal models are needed.

    The results in I mentioned that were released following the end of the Cultural Revolution occurred when Chinese scientists were trying to re-establish themselves and do good science. During the Cultural Revolution so called “Acupuncture Anaesthesia” was trumpeted as a wonderful triumph. This was obviously grossly overblown. Any sensible person would want real anaesthesia. However it was possible that their was some real analgesic effect. The work I mentioned was a solid scientific effort to determine this. They chose a careful animal model to eliminate the placebo effect. Yes a placebo effect is possible in badly designed animal studies. Here they placed a metal tube over the nose of the rabbits. The tube was heated at a constant rate and the time for the rabbit to withdraw its nose from the tube recorded, this was repeated at a series of intervals after treatment, The same experiment was performed on untreated control animals to obtain a control acclimatization curve that could be used as a baseline. Animals were treated morphine injections and the curves obtained were the same as for the acupressure treated animals. Animals were given injections of catecholamines and the results were the same as for the controls. Perfusion experiments where CSF from acupressure treated animals was transferred to untreated animals showed the response was carried over. This work resulted in the testable prediction that there existed an endogenous circulating opiate like material in the CSF that could be released by CNS stimulation.

    This prediction was confirmed by the discovery of the endorphins not long after these experiments. Making testable predictions is good science. Getting them confirmed is even better science.

  40. 40
    Thumper: Who Presents Boxes Which Are Not Opened

    I am so ashamed of my country right now…

    *He mumbles, his voice muffled by the desk he’s just smashed his face into*

  41. 41
    OldEd

    Of Course acupuncture works!!!!! It performs its designed function perfectly!!!!

    Of course, the function it is designed to perform is not to heal the patient, but rather to transfer the patient’s assets to the Heel performing the acupuncture…

    That is why acupuncture is “performed” on the patient: it is all an act…

  42. 42
    blf

    The poll is now closed. Final results (for what it is worth, which is basically nothing) is 38% No, 62% Yes.

    I am so ashamed of my country right now…

    Quite right. Yer letting the Ozlanders loose cricket matches through ineptitude. That’s so completely backwards extra reversing gears are needed. (Sighs wishfully for the days when Ingerland played entertaining cricket: “How will they manage to loose this time?”).

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