Wednesday, June 2, 2010

A biological basis for acupuncture?


Not Exactly Rocket Science (where I took the above graphic) has a great post about recent acupuncture research. According to Ed Yong, the researcher "claims to have found a biological explanation for the pain-relieving effects of acupuncture." But did she?

Taken on its own merits, this is a nice piece of biochemistry. But what does it really tell us about acupuncture? Does it actually validate this ancient method as a way of relieving pain? After reading the paper, you might walk away with that idea that we’re one step closer to understanding how a treatment with real medical benefits really works. ...

But these results have to be considered in the light of those that came before it. As mentioned above, new scientific discoveries stand on the shoulders of giants and in the case of acupuncture – one of the most well-researched of all “alternative therapies” – those shoulders are particularly large.

Many trials have demonstrated that acupuncture does have some pain-relieving effects – that is not in doubt. And as Steven Novella notes, unlike things like homeopathy or reiki, with acupuncture “something physical is actually happening… so it is therefore not impossible that a physiological response is happening”. But the big questions are whether this effect is genuine or nothing more than a placebo.

To answer that, clinical trials have used sophisticated methods, including “sham needles”, where the needle’s point retracts back into the shaft like the blade of a movie knife. It never breaks the skin, but patients can’t tell the difference from a real, penetrating needle. Last year, one such trial (which was widely misreported) found that acupuncture does help to relieve chronic back pain and outperformed “usual care”. However, it didn’t matter whether the needles actually pierce the skin, because sham needles were just as effective. Nor did it matter where the needles were placed, contrary to what acupuncturists would have us believe.

Unfortunately, this latest research did not use any sort of placebo control (maybe because it involved mice, not people?). It's an interesting study, but it really doesn't tell us very much. (And as Yong notes, one of the co-authors of the study is married to the director of the National Center for Complementary and Alternative Medicine, "an institute that has had its fair share of controversy in the past.")

As you might expect, though, the media haven't done a very good job of explaining all this. Reading newspaper articles about this research will likely give most people the wrong impression. Well, I thought that Yong did a very good job of showing why you really need to know the details about announcements like this. Don't believe everything you read.

And one scientific study, by itself, just doesn't mean very much. It needs to be duplicated by multiple, independent researchers, and previous research also needs to be considered. Let's face it, sensational headlines sell newspapers. So rational people might want to take such reports with a grain of salt.

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