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I’ve done a lot of research looking up acupuncture studies. If you want to do the same, I suggest taking a memory stick to a teaching hospital and visiting their library. You’ll be able to get articles galore. Also Google Scholar is awesome but incomplete unless used in the library. Usually you can get abstracts and complete articles for about 30% of all articles. (Go ahead and check it out. Scholar at the library is unbelievable.)
Anyway, there are always some studies that show acupuncture doesn’t work. Or show that it works only a few percentage points better than placebo - but not enough to be statistically significant.
These studies all have one thing in common. I wanted to share this with you, because if you didn’t already know this, you should. We need answers for the skeptics.
What “acupuncture doesn’t work” studies almost all have in common is they use a pre-determined point selection, The same points are used no matter what. Essentially it’s like “medical acupuncture” - acupuncture without a proper TCM or OM diagnosis. The only thing they use is a Western medicine based diagnosis - a diagnosis usually based on symptoms and not a root cause.
For example, Fibromyalgia has at least four different TCM diagnoses. Choosing points for just one of these diagnoses, or choosing points between four different diagnoses is just plain negligent, and proves nothing.
To me, this is like prescribing aspirin for headaches by default. Suppose migraine, cluster, tension, premenstrual causes, spinal headaches were all treated the same as brain tumors, sinus infections and aneurysms? Aspirin might work for some things, but not others.
Another common claim is that acupuncture results aren’t lasting. These studies usually have six to 10 treatments, then stop. When the researchers check back 6 months later, the results often didn’t persist.
Of course not - there was no check if the underlying imbalance was ever resolved. This is like a patient taking an antibiotic just until they feel better. The underlying infection is still there and will come back.
Hope this helps you deal with skeptics. What do you tell people when they say acupuncture doesn’t work?
8 responses so far ↓
1 Michael // Jun 11, 2008 at 12:46 am
Really good points. So often people use research to either justify their point of view or disparage someone else’s. One of the problems with research on Chinese medicine is that the worldview of Chinese science is wildly different than that of Western science. In Western science we think one size should fit all. One drug should have the same effect on everyone. One point prescription for headaches should work for all headaches.
It has been a wonder to me for many years now, how the Western world with its focus on the *individual* has created a medicine that considers the group. While the Chinese world with its focus on *group* has created this intensely personal medicine.
In the West we are looking for that “one size that fits all”, and our research often is skewed toward that perspective. While in the East the focus is on “which principle is at work?”
Personally, I very much enjoy skeptical patients, as the experience of Chinese medicine is often completely wondrous for them. Either that, or they get better, but have no explanation. For me, as a practitioner, it does not matter if they get it or not. That alone proves the value of what we have to offer.
2 Therese // Jun 11, 2008 at 3:36 am
I don’t even feel comfortable citing studies with the “one size fits all” point selection even if they have been found to SUPPORT the use of acupuncture.
It’s really too bad that western science dismisses anecdotal evidence, requiring instead this group-oriented medicine (good point, Michael!) It levels out the individual.
I like to give 2 reasons, when I can, to explain Chinese medicine - one, the more western-medical explanation and the other a more Chinese-oriented, energetics description. It can bridge that gap in people’s minds, and links the mental and the mystic.
3 Andy // Jun 11, 2008 at 10:14 am
Great point about the use of protocols and number or treatments…each patient is diffrent and some need more treatment than others.
Another BIG factor in studies like this is the needling skill of the practitioner.
4 Joseph Alban // Jun 11, 2008 at 12:14 pm
There are a number of great studies out there, and a lot of crap. In terms of defending acupuncture, it is good to know what is out there, so you can make your case. And if you can make the case well, people know you mean, even docs.
Usually I say that acupuncture is a physical therapy, so it has limitations for the Random Control Trial, which is the current gold standard. You wouldn’t ask a surgeon to do an RCT. Also, this can resonate with PT’s and OT’s who also do a physical medicine.
I personally don’t talk so much about qi anymore, or an energy medicine, until I know they are sold. I took Burton’s advice on that one.
5 Dennis Kinnane // Jun 11, 2008 at 9:04 pm
“Protocols” are effective seating arrangements for diplomatic parties or weddings but completely useless in medicine unless “hit and miss” is the order of the day. Every patient is different and requires tailoring treatment to the underlying condition. Thus a “heart condition” in Chinese medicine can actually be due to a problem with the kidneys, lungs, spleen or liver or combination of these organs with an actual heart component thrown in. Using “heart channel points” for every “heart condition” walking thru the door would be like injecting everyone who walks thru the door with penicillin no matter what their ailment. Some would get better, most would not. But, now that I mention it, isn’t that just exactly what the “cure rate” of Western medicine reflects …… some get better from serious illness but most do not…..
No wonder our system is going bankrupt …… few patients with serious illness ever do get better! But then again….that’s why we’re here!
6 Allan Fradsham // Jun 12, 2008 at 12:46 pm
Good Point! I had a patient two days ago that had read a study that said acupuncture didn’t work long term, and had to work to convince her. I told her that if it didn’t really work then all of China would have been sick for the last 3500 years….seems to have helped since she has re-booked.
The funny thing is she is someone that I have seen for a year or so. We will fix something and then if something else comes up she is back in the office, so she knows that it works it has worked for her. It just goes to show you that what we read or hear can change what we have found for ourselves. Scary but true.
Allan
7 Michael Max // Jun 12, 2008 at 12:55 pm
Allan, good point.
It is a fascination to me that one dose of “research shows”, can negate years of “in my experience.”
Goes to show the power of the prevailing myth of the times.
8 Marie // Jun 24, 2008 at 11:34 am
So true. It’s always funny that the big studies which appear in the news are rarely the best designed studies – they’re just the most advertised.
1) Why not have a committee of acupuncturists that sets the standards for our research. It’s not impossible to do a study that sub-classifies cases according to a Chinese rather than Western, using tongue appearance etc. There are many such studies done in China, but the US tends not to trust them. One one hand we need to have many controls: placebos, manipulation techniques, retention time, office settings, practitioner attitude - yet at the same time, does this completely controlled treatment situation look at all like reality? If not, how can we generalize the results?
2) Why not have a nationwide acupuncture ad campaign to inform people about who an acupuncturist is? The main obstacle I have found in practice stems simply from the fact that people have no idea how much training we go through. We spend considerable time and effort to become licensed, probably as much or more than a chiropractor, yet many think we could easily be slightly weirdo high school dropouts who went to a massage-type school, because for most of us there’s no “D”attached to our “L.Ac.”. But they’ll respect an MD who’s had a 4 week-end training in acupuncture. I don’t want to tell every single patient what we go through…. everybody should know this before coming in! If all acupuncturists come together we can all benefit.
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