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Saturday, February 21, 2015

Some Doubt About Acupuncture

Phantom Acupuncture

There are two basic schools of thought when it comes to acupuncture, which is the practice of placing thin needles into alleged acupuncture points in order to have a therapeutic or symptomatic effect. The “traditional” interpretation is that the needles are stimulating a physiological response of some kind at the acupuncture points. Within this school there is a range of opinions as to whether this response is due to a biochemical, neurological, or another known biological response or whether it is due to the still more traditional (but actually less than a century old) belief that the needles are manipulating the life force or Qi.
The other school holds that acupuncture is essentially an elaborate placebo. (Note – this article contains all the references necessary to support my statements below, so I will not repeat them.) Any apparent response is a non-specific response to the attention of the practitioner, expectation, distraction from pain, simple regression to the mean, and other illusory effects.
Each school makes different predictions about the various lines of evidence that can be brought to bear to resolve this question. There have been in total several thousand clinical studies looking at the apparent effects of acupuncture. These have failed to convincingly reject the null hypothesis, meaning that they have not demonstrated a clear biological response to acupuncture for any indication. The better controlled studies consistently show that needle location does not matter (sham acupuncture), and that needle insertion does not matter (placebo acupuncture). You can literally have a non-acupuncturist randomly poke someone with toothpicks and get the same response as the full acupuncture treatment.
The other line of evidence regarding acupuncture are studies that look at physiological responses to having needles poked through the skin. These studies, completely unsurprisingly, show that “stuff happens” when you stick a needle through the skin. There is a local reaction to the trauma, and the brain reacts in a predictable way. I do not think these studies in any way distinguish between the two interpretations of acupuncture. Even if acupuncture is nothing but a placebo, we would still expect these types of responses to sticking needles into tissue......
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