…just as well as not doing acupuncture! Now that’s what I call a medical procedure worth investing large sums of money in and foregoing other clinically proven treatments for. You don’t even need to actually do it for it to magically heal you! Hey, I wonder if we can make that work with chemotherapy.
This new study which has the skeptical (and not-so-skeptical) blogosphere abuzz randomly split 638 adults suffering from chronic back pain into four groups. All of these groups were given the usual care for back pain, but one of them also got a specific, personalised regimen of acupuncture, as prescribed by a practised acupuncturist; one group got a standard acupuncture treatment, in keeping with the traditions of Chinese medicine but not tailored to them individually; one group got prodded about with toothpicks as if there was some acupuncture going on, but nothing really happened; and the other avoided being jabbed by anything pointy at all.
The results showed that the first three groups – those who underwent either “real” or “simulated” acupuncture treatments – experienced significant and beneficial effects, compared with the fourth group. However, among those three groups, no one treatment regimen was shown to be any more effective than any other. They all seemed to work, but they all seemed to work equally well.
If you have at least a basic understanding of science, it should be clear that this is not a victory for the alternative medicine crowd. Actual science-based medicine has known for years that the placebo effect can be a powerful factor in treating symptoms, and in particular with pain relief. If someone takes a sugar pill which they think contains something that will make them feel better, then they will tend to feel better. It’s a bizarre aspect of human psychology and physiology, and not well understood, but there’s plenty of data suggesting that it does happen, in numerous unusual ways.
So modern medicine is left profoundly un-rocked by the idea that, if you bring someone to a shiny clinic and lie them down and have someone with a lab coat and a friendly professional demeanour explain how they’re going to unlock their flow of qi by poking them with some needles, something might actually happen to them. The thing is, modern medicine isn’t happy stopping there.
Fans of acupuncture might want to see results like this as proof that the ancient Chinese really knew their stuff when it came to mystical, invisible energy fields – because look, people are saying their backs hurt less after the treatment. But just because I’ve completely recovered from a bad cold that plagued me for most of last week, doesn’t mean I should start praising the curative effects of that bag of Gummi Bears I scoffed when I was at my worst. We have scientific tests so that we can find out whether our first guess about what’s going on is right, or whether it’s actually misleading. Maybe I really bought an undiscovered cure-all from the corner shop for 50p; or maybe something else (for example, my immune system + time) is actually what did the trick. And maybe we can find out which by doing some science.
Similarly, acupuncture purports to have an actual physiological effect on the human body by manipulating the flow of qi energy – and when patients were treated with it, their pain was indeed reduced. But as with my Gummi Bears, this isn’t enough to support an actual link. If it had turned out that you really do need to poke people in exactly the right way, as acupuncture experts suggest, for anything noticeable to happen, then their methods might start to seem useful and medically relevant. But if you can ignore all their principles of qi and whatnot, and just prod people with toothpicks a bit, and get virtually identical results, you really have to reconsider the unquestionable value of this Eastern wisdom. If I’d had Skittles instead of Gummi Bears, I’d probably have stopped dripping snot just as fast.
This trial demonstrates yet again that the only noticeable effect ever seen to result from any form of acupuncture is no greater than that of a placebo. It’s entirely consistent with the whole foundation of the practice being a myth.
Or, translated into mainstream media-speak: Acupuncture is the bestest thing ever!! Even if it’s fake!
…Dammit, you guys.
Though, interestingly, when I was trying to find the link to the Metro article my housemate first sent me about this story last week, the first result on Google for “metro news acupuncture” pointed to this brief story from January, which showed a much greater critical awareness, and explained the placebo effect very competently. Maybe there’s hope.
Big tip o’ the hat to Steve Novella over at Science-Based Medicine, and the other skeptical rogues who discussed this in depth on the Skeptics’ Guide to the Universe this week.
(This will do as a placeholder Skeptictionary entry on acupuncture for now, until I come up with something more general.)
Some scientist you are. Lumbago is one ailment of countless. Dismissing acupuncture as “just a placebo” ignores the force of self-healing that sometimes can’t be accessed otherwise. Getting “mind and body” to work in concert is no small thing. And acupuncture can direct a person’s awareness to the area of anatomy most in need – as opposed to assaulting the entire body with pharmaceutical chemicals. And Chinese herbal medicine is an adjunct to acupuncture that often surpasses Western medicine in curing chronic “degenerative” as well as acute respiratory and digestive complaints. I’ve been practicing Chinese herbology for 20 years, but sometimes it takes the time my patient is on a treatment table with needles in place for me to pinpoint the herbal formula that might best treat the specific individual. If that’s what it takes for a patient to avoid the side effects of gems like Vioxx, Rezulin, Prempro, Avandia, Redux, Baycol, Phen-phen…… Yes, maybe gummi bears are a better choice! But sugar depresses the immune system, while acupuncture honors the dictum, “Above all, do no harm.” Believe it or not, my needles often feel good! Science demands replication; given the population of China, there might be a billion people to confirm the observation that yes,”acupuncture works.”
First of all, thanks for the best opening line to a comment that this blog’s ever had.
When you talk about my dismissing it as “just a placebo”, do you mean that I shouldn’t say that the placebo effect is all there is to it? Or do you mean that I’m downplaying the importance of the placebo effect, as if I were calling da Vinci “just some painter guy”? If the latter, then you may have a point – the placebo effect is an effect, after all, and the possibility of using it as part of a treatment shouldn’t be ignored.
But if you’re insisting that there’s more to acupuncture than placebo, then I’m still waiting for the data. Random pith about “mind and body” working in concert doesn’t mean anything. If it’s useful to “direct a person’s awareness to the area of anatomy most in need”, where’s the evidence that this is actually happening and doing something good?
On what basis do you say that Western medicine is “surpassed” in treatment of these particular conditions? Your own personal experience? The history of every field of human study, not just medicine, is littered with examples of people’s personal experiences being unreliable guides and leading to incorrect conclusions, due to a whole slew of cognitive biases that it’s really hard to overcome. The scientific studies which have been done, where such biases are eliminated as much as we’re able, involve large numbers of people in controlled conditions, and examine under exactly what conditions people actually get better. These studies do not generally support any such claims about acupuncture. The concensus is with me on this one. I’m still waiting to see your evidence.
Also, if you think that “It’s really popular in China and there’s loads of people there” counts as reliable proof of anything, then you so don’t get to criticise my status as a “scientist” (which, by the way, I don’t recall ever claiming to be).
Thanks for a great article, I will pass this on to my patients…
Dr. Hardy