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)
Comments
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.
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!
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.
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.
It's about acupuncture and just sticking needles into people.
Both have much the same effect.
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.
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.