Puncturing the Acupuncture Myth

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bluegray (October 08, 2008, 11:54:03 AM):
A nice summary of the history of acupuncture.
eSkeptic: October 8th, 2008
To start with, this ancient Chinese treatment is not so ancient and may not even be Chinese! From studying the earliest documents, Chinese scholar Paul Unschuld suspects the idea may have originated with the Greek Hippocrates of Cos and later spread to China. It’s definitely not 3000 years old.
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Psychologists can list plenty of other things that could explain the apparent response to acupuncture. Diverting attention from original symptoms to the sensation of needling, expectation, suggestion, mutual consensus and compliance demand, causality error, classic conditioning, reciprocal conditioning, operant conditioning, operator conditioning, reinforcement, group consensus, economic and emotional investment, social and political disaffection, social rewards for believing, variable course of disease, regression to the mean — there are many ways human psychology can fool us into thinking ineffective treatments are effective. Then there’s the fact that all placebos are not equal — an elaborate system involving lying down, relaxing, and spending time with a caring authority can be expected to produce a much greater placebo effect than simply taking a sugar pill.
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Guess what? It doesn’t matter where you put the needle. It doesn’t matter whether you use a needle at all. In the best controlled studies, only one thing mattered: whether the patients believed they were getting acupuncture. If they believed they got the real thing, they got better pain relief — whether they actually got acupuncture or not! If they got acupuncture but believed they didn’t, it didn’t work. If they didn’t get it but believed they did, it did work.
benguela (October 08, 2008, 15:31:34 PM):
Nice article. The physio's I'm having a robust discussion with are saying they do "dry needling" not acupuncture. To me this like the religion in intelligent design clothing. The physios's are using the argument that "dry needling is based on modern scientific neurophysiology and anatomy" like it says in this article http://findarticles.com/p/articles/mi_qa3987/is_20080603/ai_n27512855.

I can't find any skeptical articles to expose what I suspect is a fraud although the article helps a little, "It doesn’t matter where you put the needle". What is incredible is that this appears to be accepted mainstream practise is physiotherapy. ???

maydont (October 31, 2008, 16:32:48 PM):
Acupuncture is a difficult one. Difficult to disprove simply because a double-blinded trial is really hard to construct. However we are left with a modality that if it does work, it's very difficult to determine how.

Firstly there seems to be two types: Traditional and Modern. Traditional is based on the 14 meridians and by doing so it claims to balance the QI/CHI (it's claim is that it is an imbalance in Qi that causes illness). Modern uses localised acupuncture (e.g. it will put pins in around an arthritic joint)...and they are really 2 different claims.

The meridian theory is the idea that 14 energy lines flow through the body. The idea is that the practitioner places pins on the meridian. However, if this be so and the practitioner can only be accurate to a degree (he/she doesn't use measurements or microscopes when placing the pins), then the lines must be big and therefore detectable. However the advent of microbiology still has never identified anything close to meridians nor evidence of energy flow. So if Qi exists it is as yet undetectable: basically magic.

With regard to the modern form. There are quite a few cases of people experiencing pain-relief. But of course pain is one of the symptoms most susceptible to the placebo effect. There is obviously a reaction (auto-immune or whatever) to the placing of the pins into the skin, however there is certainly no evidence of significant pain reduction here. It hasn't shown any significant effects in trials and of course is difficult to blind.

To accept the modern form is kind of like saying well I accepted that Santa Clause is fake, but I reckon his elves are real. Modern acupuncture is really just a different chapter of the same mythical story.
Wandapec (November 01, 2008, 21:46:52 PM):
When I was studying pharmacy during the early 90's, we did a couple of lectures in anatomy on the modern type of acupuncture i.e. connecting the needles with an electric charge etc. The whole idea was that it affected the levels of Prostaglandins and Cyclooxygenase to produce and anti-inflammatory or analgesic effect. The effect of the change in levels of Prostaglandins and Cyclooxygenase is well known and has led to the development of some of the worlds best and frequently used anti-inflammatories and analgesics. As I recall, probably because of the so-called mechanism of action, not one of people in our class questioned the validity of the claims. The pharmacy school had no time for homeopathy, so I find it strange that they would include the modern form of acupuncture is the claims were not valid.
I ended up in retail pharmacy for about 5 years and dispensed huge quantities of pain-killers and anti-inflammatories, but funnily enough never ended up sticking acupuncture needles into anyone!
Wandapec (November 15, 2008, 21:37:16 PM):
I had this blog flagged in my list of article to read without realising, just noticed it now. Steven Novella clears up what I mention as being transcutaneous electrical stimulation (TENS) and not acupuncture.
the effects on pain of electrical stimulation through acupuncture needles. This is not acupuncture - it is transcutaneous electrical stimulation (TENS), which is an accepted treatment for chronic pain, masquerading as acupuncture.

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