Fake Acupuncture Better Than Medicine?

A study conducted in Germany found that "fake" acupuncture worked almost as well as "real" acupuncture, and that both performed better than conventional care (which included painkillers, massage, and heat therapy). Reportedly, 47 percent of patients receiving real acupuncture to treat lower back pain improved, as did 44 percent of the fake acupuncture group, but only 27 percent of the usual care group got relief. The study has been published in the Archives of Internal Medicine, which is a reputable journal.

According to the AP report, this is what is meant by fake acupuncture:
For the sham acupuncture, needles were inserted, but not as deeply as for the real thing. The sham acupuncture also did not insert needles in traditional acupuncture points on the body and the needles were not manually moved and rotated.
Personally, I've always been skeptical of acupuncture because I don't think that the theory of "qi energy" has any more validity than the ancient western notion of humoral theory. So it made sense to me that fake acupuncture would work about the same as real acupuncture. What surprised me was that both performed better than painkillers.

It's hard to explain why any form of acupuncture would work, unless it triggers a placebo effect, or if the pain of inserting needles is causing the body to produce its own painkillers. But I'm still going to be reaching for the advil when I have a muscle ache instead of poking needles in myself. (via Side Effects May Vary)


Posted on Tue Sep 25, 2007


Acupuncture would hardly be the first medical treatment whose originators were dead wrong on how it worked (look at hypnosis). The fact that veterinarians have successfully used acupuncture on animals suggests it's more than a placebo. But your theory that it might stimulate the body to produce natural painkillers could well be right.
Posted by Phred22  on  Tue Sep 25, 2007  at  12:28 PM
I would like to clear up one thing right off the top: acupuncture causes virtually no pain. The needles are filiform, so small that they can hardly be felt. As they mention, we don't fully understand why acupuncture is effective, but, in my experience, it works. I prefer a treatment of gentle needles to manufactured chemicals anyway.

Second, I would like to clarify the concept of Qi. The idea has been somewhat hijacked by Western new-age spiritualists and made into an esoteric force. In traditional Chinese medicine and ideology, Qi can be though of as the strength and energy one obtains from breathing. In modern, scientific, Western thought, Qi is more of a metaphor for the energy flow necessary to sustain homeostasis. To look at this concept in the frame of reference it usually falls in (the oriental one), we must remember that the idea of Qi wasn't developed in the Western way of thinking many of us are used to.
Posted by Draconegia  on  Tue Sep 25, 2007  at  08:49 PM
I'm not an expert, but I think a lot of back pain is caused by tense and strained muscles. Painkillers work by switching off the pain receptor in your brain. The muscle is still damaged, you just can't feel it. Acupuncture relaxes the muscle, easing the tension and the strain, and therefore getting rid of the back pain. Seems far better to me than painkillers.
Posted by Nona  on  Wed Sep 26, 2007  at  06:41 AM
An important thing to note:

The sample was specifically recruited from people who had been suffering chronic back pain for many years despite conventional treatment; one obvious inference of this is that the partiucipants were a specific population who had not responded well to such treatment. This selection means that a low response rate to conventional treatment was to be expected.

This in turn means that the finding does not show that (sham or real) acupuncture outperforms conventional treatments in the more general population of back-pain sufferers (though it does not exclude that possibility either).

And a corollary of that is that we should not be especially surprised if, in such a population, a highly ritualized new treatment routine outperforms conventional treatments solely on the basis of a strong placebo effect (or, as placebo expert Moerman call it, 'meaning response').

The question of whether this is merely a placebo response remains open, but it is certainly plausible: the high response rate relative to conventional treatments in this specific population should not mislead us into assuming that the impact is not placebo. Especially given that similar effectiveness of the real and sham acupuncture treatments!
Posted by outeast  on  Wed Sep 26, 2007  at  09:22 AM
Sometimes facts look different when we change our perspective on the subject matter at hand slightly.

According to some acupuncturist methods, one would be hard-pressed to find a point on the human body that does NOT relate to some corresponding lower-back pain relief.

So the distinction between so-called "sham" and "actual" acupuncture may seem somewhat arbitrary to a practitioner aware of the myriad points that effect back pain on the body.

As noted by another comment, it does seem that acupuncture causes the release of endorphins. These endorphins may be described as the body's ability to provide its own pain relief.

A good science follow-up experiement would be to use 1 recognized meridian point with one anticipated effect that can measure that against a control group. This way the specific effect of that point could be evaluated physiologically, without complications from all the other stimulated points.

Recent approaches to medicine in the United States continue to emphasize the need to validate so-called alternative medicine with science and to understand the need to investigate all potential therapies. This does not mean accepting something blindly but observing effects and understanding results through vigorous testing and science.

Serious acupuncturists want this just as much as we in the general public do. Calling it "sham or true," in my opinion, mis-states the nature of the issue. There's no need to believe it outright nor is there a need to dismiss an approach that seems to be helping a lot of people, especially with pain relief. Unlike some pharmaceuticals that impact a population (sometimes in dire ways) without sufficient long-term studies, the minor potential side effects of acupuncture make it a logical "why not?" therapy for people who seek relief from the cost and systemic hit of drug-based pain relief.
Posted by wendao  on  Wed Sep 26, 2007  at  02:27 PM
I was a patient of a Doctor who performed acupuncture on my neck (15 sessions) the procedure worked too well, it removed the pain but the problem increased. So much so that I required emergency surgery to remove two disks from my neck.
The pain was an indicator of a serious condition,
Cervical radiculopathy, which left untreated, would result in the loss of the use of my hands.
The acupuncture did work but it almost caused me a more serious problem.
Posted by John Healy  on  Wed Sep 26, 2007  at  03:38 PM
This isn't between real and false acupuncture.

It's about acupuncture and just sticking needles into people.

Both have much the same effect.
Posted by zoo  on  Wed Sep 26, 2007  at  03:49 PM
I had acupuncture a few years ago...it was a gift from a friend, as I was experiencing terrible lower back pain. The needles were put in, and after a few minutes I felt a lovely gentle warming sensation. 'Wow!' I thought. 'Maybe there's something in this after all!' I lay quietly for half an hour...then the acupuncturist returned, removed the needles...and turned off the heat lamp over my back I hadn't realized was there.

Did I feel better? A little. But I suspect no better than I would have felt if I had skipped the needles, and just lain perfectly still for a bit under a heat lamp.
Posted by Edward Wilford  on  Thu Sep 27, 2007  at  01:18 AM
The thing is, chronic back pain is one area where evidence-based medicine is largely not effective. Another study, less widely reported, showed that back surgery and doing nothing at all had the same outcome.
Posted by Carl Fink  on  Thu Sep 27, 2007  at  10:45 PM

As I (sort of) pointed out in my comment, this is rather circular: back pain which is readily alleviated by CM stops and thus does not become chronic. It doesn't follow that alt med treatments stand more chance of doing anything real to help the pain ('real' here meaning medically active ie 'non-placebo' - the placebo effect itself is real and can bring real relief).

The most probable hypothsis is that most chronic back pain is lifestyle-related, an effect possibly compounded by long-term damage that is slow to mend(and that may not get given the chance to mend). I suffer from (bearable) chronic back pain myself: I'm sure that if I had a less sedentary job I'd do better, but the reality is that I just have to put up with it (and pop painkillers when it gets roughest). I doubt that my circumstances are unusual.
Posted by outeast  on  Mon Oct 01, 2007  at  02:18 AM
Of course, no sooner do I comment than I find that Ben Goldacre over at Bad Science has got very good commentary on the whole deal (as usual). I really recommend anyone following this story to read his column: http://www.badscience.net/?p=542#more-542
Posted by outeast  on  Mon Oct 01, 2007  at  02:36 AM
i had an acupuncture 2 years ago and it was terrible for me. i had never try again :(
Posted by abdok  on  Sat Dec 27, 2008  at  01:45 AM
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