MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

An article in the ‘Huffpost Healthy Living’ recently discussed “the top three things that surprise people about acupuncture”. On closer inspection, they turn out to be the top three untruths about acupuncture. Here is (in italics and slightly abbreviated) what the article said.

Acupuncture is not just for pain

…It’s true that acupuncture can work wonders on pain conditions…However, acupuncture can alleviate a wide variety of ailments that have nothing to do with physical pain. Whether you have digestive issues, gynecological conditions, emotional concerns such as anxiety and depression, asthma, seasonal allergies, you name it, acupuncture can help address your symptoms.

Acupuncturists go to school for a long time

People tend to be unaware of the extent to which acupuncturists train to become licensed in their profession. Many assume becoming an acupuncturist is similar to becoming a massage therapist or Reiki practitioner or yoga instructor… At minimum, a licensed acupuncturist in the United States has been to three years of graduate school. Four years is more common. They hold master’s degrees. Some acupuncturists with doctorates have studied at the graduate level for five-plus years. Upon graduating from an accredited school, all acupuncturists must pass multiple board exams to become licensed in their state. In addition to the academic and state requirements for practicing acupuncture, many acupuncturists seek hands-on training and mentorship in the form of apprenticeships and continuing education seminars.

Acupuncture is relaxing

Acupuncture needles are surprisingly thin. They do not bear any resemblance to needles that are used for injections or to draw blood… In most cases, the insertion of acupuncture needles does not hurt…Once the needles are in, they start working their magic, which is where the relaxation part comes in. Acupuncture helps shift your body out of sympathetic mode (fight or flight) and into parasympathetic mode (rest and digest). It mellows out the nervous system, decreases muscular tension, and helps quiet internal chatter…

AND NOW THE FACTS:

1) There is not a single condition for which the evidence is truly compelling demonstrating that acupuncture is more than a placebo. Certainly there is no good evidence that acupuncture works for digestive issues, gynecological conditions, emotional concerns such as anxiety and depression, asthma or seasonal allergies.

2) In most countries, anyone can call themselves an acupuncturist, regardless of background or training.

3) The relaxing element of an acupuncture session is foremost the fact that patients lie down and have to keep still for 20 minutes or so. The insertion of needles does cause mild pain in many patients, and the claim about parasympathetic mode is mostly phantasy.

I despair about the nonsense that is published about alternative medicine on a daily basis – not because I have an axe to grind, but because it misleads patients into making wrong therapeutic decisions.

32 Responses to The top three untruths about acupuncture

  • “1) There is not a single condition for which the evidence is truly compelling demonstrating that acupuncture is more than a placebo. Certainly there is no good evidence that acupuncture works for digestive issues, gynecological conditions, emotional concerns such as anxiety and depression, asthma or seasonal allergies.”

    You seem to be countering a fluff piece by Huffington with fluff of your own. If you inserted “modern western evidence”, that statement might hold some weight. As it reads, it would seem that either a) China has been treating physical ailments for centuries with a placebo (that would be one helluva placebo)…or b) modern research methods haven’t figured out how to effectively study Chinese medicine.

    Which do you suppose is more likely?

    You seriously think that everything from diabetes to major war wounds have been treated for a few thousand years with a placebo?

    Really?
    Are you sure?

    Oh dear…

    • it’s a pity that the ‘argumentum ad traditionem’ is but a fallacy.

      • My point is hardly an appeal to tradition. I think you know that.

        • an appeal to irrationalism then?

          • Do you really think that China could not deal with disease before modern medicine? Paper, printing, gunpowder…I’m pulling this list from wikipedia, so you can read the rest here:

            http://en.wikipedia.org/wiki/List_of_Chinese_inventions

            But somehow, health and medicine was beyond them? Again – really? Are you sure? That would be a pretty strange one-off, don’t you think? Probably more likely that we don’t have a grasp on their process and how to accurately study it.

            Not so much an appeal to tradition, more an appeal to Occam’s razor. What you’re proposing (in the way you state ‘fact’ #1) seems more like an appeal to irrationalism.

            Huffpost’s article is fluff. But your counter makes a very broad, ridiculous claim – making it just as easy to dismiss your points as it is to dismiss HP’s.

          • where is the evidence that, in ancient China, acupuncture was effectively curing serious diseases?
            Huffpost is fluff and so are your arguments, I think.

          • Evidence wouldn’t help my argument at all. I’m not actually arguing for acupuncture (I know when to turn to Chinese med and when to turn to bio-med) – I’m saying the people you’re so concerned about making wrong therapeutic decisions aren’t going to take you seriously.

            Unfortunately what’s happening more and more (at least where I am) is that people are getting solid results from acupuncture/Chinese medicine and their doctor dismisses it as placebo (or, most commonly, gives a patronizing eye roll). The unfortunate part is that they no longer trust their doc’s advice.

            At least change the pathologies you’re using as examples. You use “…digestive issues, gynecological conditions, emotional concerns such as anxiety and depression, asthma or seasonal allergies…”. Those are situations where people are seeing pretty straightforward, cause/effect results – and those are the people that will assume that you have an axe to grind. At the very least, they won’t trust what you have to say – because they know better from personal experience.

            “Cancer, stroke, intestinal parasites, appendicitis…” would be better choices.

          • @JM
            You obviously did not read this and the book I referred to there or, what I imaginge is more likely, that you chose to ignore it because it hurt your cognitive dissonance.

          • @ Bjorn – you did read the preface to the book you link to, yes? It’s all of one paragraph, so it should be pretty quick. And, here’s one for you:

            Link

            Read pages 48 & 49 of the actual text. Then look at a map.

          • @jm

            Here is the foreword to Dugald Christie’s book that you allude to:

            This is not a History, still less is it an Autobiography. It does not attempt to give a complete account of Manchuria, nor even of Moukden, nor to depict minutely its people and their customs. There are important missionary developments which are not alluded to, or only lightly touched upon. Books on Manchuria, and on its wars, and on its Missions have already been written. This only attempts to deal with personal impressions, and to give a picture of life amid the Changeless East of the olden days, and amid the rapid march of events which have brought

            Are you proposing that these humble words reduce the credibility of the christian missionary and surgeon, Dugald Christie??? Maybe he is telling us that he made up the horrible stories of acupuncture and other medieval medical methods that he observed in Manchuria and his graphic accounts of the state of traditional healthcare in the region are wrong?
            You really are full of it 😀

            Regarding the book of antique oriental “medical” texts you refer to, the pages you mention are not to be found free on the internet as far as I can tell. From the free sample of pages all I can ascertain is that it contains nothing of value and is not worth the investment of fifteen pounds plus shipping, tax and customs. This book may be of use to historians but not those who deal with proper medicine. According to the TOC the contents of p.48-49 should be the beginning of chapter 12. “Methods of treatment”
            If there is an important message you want to relate from the named pages then feel free to tell us. We might even be bothered to lift an eyebrow.

            As an afterthought: It seems like this book about health and healing by(?) the jaundiced emperor, and for all I know adapted to the fantasies of modern meridian-prickers, contains the “science” that you base your practice on- right?
            Has it never occurred to your meridian-muddled mind that even if the chinamen were first with gunpowder and paper and whatnot, that they failed miserably in medicine until “western” science came to their aid? Try reading Dugald Christies book again and try finding out something credible about what really keeps all these millions over there alive and kicking today. Not acupuncture, moxa and cupping for sure.

          • That’s not what I’m suggesting. The link I sent you should have sent you to the book on google, where pages 48 & 49 are free. I was hoping you’d read it before spouting off about things you don’t know anything about…again.

            At least you’re consistant.

            Let’s depart from the grade school “chinamen”, “full of it”, “meridian-muddled mind” blah blah blah that seems to be your default position. Re-read the post and the comments, and let’s get back on track, eh?

          • @jm

            I was rather looking forward to hear what you were suggesting. You’re implying, suggesting and insinuating. Not discussing. Why don’t you just tell us what you’re thinking?

            If the proof of acupuncture magic lies in the jaundiced emperors works, hidden but to those who cough up fifteen pounds plus expenses, then please convince us why we should read it.

            And by the way, what’s with looking at the map? Last time I checked, Manchuria was part of the mysterious “east” where all the wonderful magic originated and developed – right? Or is there a secret that you want us to find out by ourselves?

            As far as my choice of words…
            When trying fruitlessly to have an enlightening dialog with a nameless promoter of medieval magic better suited for a story by J.K. Rowling, who answers in riddles and insinuations, it is rather difficult to refrain from revealing one’s irritation and resentment. Convince us that you deserve respect and we will duly show it.

          • Bjorn – were you trying to make a point relevant to Edzard’s 3 “facts”? I think all 3 need some help, but #1 would be the most soundly dismissed by people receiving acupuncture (or people who have talked to acupuncture patients). Like I said, the conditions Edzard uses as examples are among the most common treated in the west. Modern research doesn’t match up with actual patient experience.

            That’s either a bizarre worldwide fluke, or a flaw in the research methodology.

            Of course, this is assuming that you would want acupunture patients to read what you have to say. The more I read on the blog, the less I’m convinced that’s the case.

            If you respond – leaving out the magic, racial slurs, and grade school mud slinging would be appreciated. Sorting through all of that to figure out if you have an actual point is pretty tedious.

    • jm writes: “it would seem that either a) China has been treating physical ailments for centuries with a placebo (that would be one helluva placebo)…or b) modern research methods haven’t figured out how to effectively study Chinese medicine.

      Which do you suppose is more likely?”

      I think the first option is more likely and for every country, not just China. People used whatever they had or whatever they could dream up to treat ailments. It wasn’t necessarily “one helluva placebo”. No doubt, just like today, there was some placebo effect in some cases, where the mere fact of being treated led to a perception of improvement in the patient. And in other cases patients recovered as well as they would have without any treatment and they wrongly attributed their recovery to the treatment they were given.

      But a hell of a lot of people more died from conditions that are treatable today.

      As for your suggested alternative – if modern research methods, which are designed to as far as possible eliminate bias, fail to provide “really compelling evidence that acupuncture is more than a placebo,” what more do we need to know?

      • “…what more do we need to know?”

        Over here we use the phrase “good enough for government standards”. But I like your phrasing better.

    • Quote – – You seriously think that everything from diabetes to major war wounds have been treated for a few thousand years with a placebo?

      Dead dog meat, fig leaves, marijuana or sea salt would have been just as effective. So what war wounds were treated by the ancient Chinese? And are these accepted methods of treatment at Harvard, Oxford, Princeton? Those poor Chinese were not treated at all, but rather received “last rites” in the form of acupuncture from a non scientific, practical philosopher not a doctor. War wounds contaminated with clostridium welchii KILL KILL KILL . Ask anybody who has survived necrotizing [NF] fasciitis AKA flesh eating disease, the National Enquirer version. No alternative medicine in any shape or form will save your ass if you have NF

      These illnesses/injuries were not and still are not being treated at all. The therapist was/remains delusional in thinking what they did and are still doing worked or is working. All Chinese medicine is pre scientific era medicine and is “cock and bull’ as the Brits would say. Only those people who have taken the time to study biochemistry, cellular biology and genetics have an idea what they are doing. The remaining CAM crowd are devoid of science, they base their treatments on philosophies as do witch doctors, medicine men, Chinese herbalists and acupuncturists. There is only one kind of medicine – scientific medicine. The rest is a sham based on myths, misinterpretation and in some case pure unadulterated fraud. What the Chinese studied for centuries is cock and bull. It was not based on the Krebs Cycle, Monophosphate shunts or oxidative phosphorylation. Pre microscope, pre virus and bacterial, yeast and parasite. It was simply a belief system – just like religion. Belief is not science – proof is science. And by proof is meant properly conducted prospective double blinded, case controlled, washout, non biased trials. The rest is crap. If you stick a acupuncture needle into a person and they feel better it is meaningless. Without a decent sample size e.g. 2000 cases split 50:50 sham versus real, the results are purely junk. Of course MD’s don’t see any better results even when doing nothing for backache. Nothing works. The back heals itself. Some tylenol or brufen does not heal aching sprained backs, it merely gives some pain relief. So a big recent trial that showed acupuncture is no better than placebo is hardly surprising. Nineteen Cochrane reviews of acupuncture conducted over the past 10 years show no benefit whatsoever from acupuncture and never will. Acupuncture is a philosophy, devoid of science or better yet, scientific proof. No science, no proof, no benefit, to man or beast. To even compare BELIEFS surrounding acupuncture with biochemical cell structure and function, which is proven, is utterly insane. For example would you think that astrology should be viewed in the same light as astrophysics and astronomy? One former is delusional philosophy and the latter is science and the two shall never ever meet.

  • 1) Are you using the large number of studies on acupuncture based on ‘placebo’ needling for this assertion? If so, that’s highly questionable.
    2) You are correct, but the people most likely to be doing this are doctors. Acupuncture bodies have been trying to stop this.
    3) They can’t say this. Do you have anything to back up your assertion beyond common sense, as you see it?

  • I dont think edzard Ernst is for REAL !! Hes only PLACEBO …..

  • “Once the needles are in, they start working their magic” – – presumably this is the science behind acupuncture?
    When did “magic” get a promotion?

  • Björn Geir – I tend to lurk in the shadows these days rather than get involved in the ‘debates’ here, as there is generally very little real debate to be had. But I am moved to comment on your outrageously arrogant comments regarding the Neijing above. I am currently a few weeks into a one year introduction course studying this extraordinary text, and I am completely blow away by the level of detail it contains, much of which is very much in line with modern anatomical knowledge. I would go as far as to say it is a humbling experience. I know that upon completion of the course, I will only be scratching the surface of the knowledge and wisdom it contains. The teacher has been studying it intensively for 15 years, and he and his team are achieving some amazing things. Research is in its infancy, but it is underway: http://www.xinglininstitute.org/current-research.html

    Please try to have a little respect for things you obviously have absolutely no knowledge of.

    • Tom – thanks for reposting that link. I couldn’t remember where you originally posted it, and my bookmark was a casualty of an operating system upgrade :).

      • jm – no problem. I’m not sure whether you’re an acupuncturist, but if you are I’d highly recommend looking into Dr. Neal’s courses. Although I think modern styles of acupuncture (TCM/5 Element/Japanese etc.) have a lot to offer – and certainly more than scientific fundamentalists would suggest – it is becoming clear to me how much has been forgotten or misunderstood over the centuries. I think there is a general misguided impression that any text this old must be full of mumbo jumbpo written by superstitious beard-strokers, but nothing could be further from the truth – the level of anatomical knowledge is staggering, and clearly informed by extensive use of autopsy.

        In the coming years I think people on all sides of the debate will start to see tangible evidence of this, and that many people will benefit. Dr. Neal and his team are modern-day pioneers in this respect, and if they’d have looked at the evidence base in the way certain people do – ‘there’s no great evidence that acupuncture is much beyond placebo so let’s forget about it all and mock those who think it has any value’ – they never would have made the extraordinary discoveries they are making. I know which approach I admire more, but each to their own I guess.

      • Tom – I’m not an acupuncturist, but I work pretty closely with 2 in our clinic. One practices very classical, one is a few years out of school. I’m a massage therapist, focusing on Thai massage/medicine and cupping. I’m pretty “non-denominational” as far as cupping goes – I use pieces from Greek, Chinese, Russian, Thai, Cambodian…but apply them using Thai medical science theory & practice.

        Over the years I’ve had to dig into Chinese medical theory for qigong/taijiquan studies (all pre-TCM), and some injury medicine training – and of course to speak the same language as the acupuncturists I work with (I’d say I’m slightly more than ‘conversationally literate’…but only slightly). The Neijing is a fantastic resource, and it’s very exciting that folks are working on new translations.

        I’ve only looked at a couple studies done on acupuncture – one in particular (I don’t have a link – I only saw a print-out) for low back pain that had a bunch of acupuncturist up in arms, as acupunture only performed slightly better than ‘sham’ acupuncture. From what I could tell…that would be far from the big take-away from that study.

        In this particular study, acupuncture & sham acupuncture outperformed “standard treatment”. Which is hardly surprising. What I thought was weird was the way the study was set up. It seems that one person prescribed treatments for the subjects, and a handful of other acupunturists executed the treatment plan. That seems utterly bizarre to me, as no acupuncturist I know would treat that way. Students in clinic wouldn’t be able to get away with that. At best, it’s more akin to a point location test early on in training.

        What’s really amazing (to me anyway) is that a basic point location test outperformed current standard treatment for low back pain. And that few seem to be curious what an actual treatment would do. So the work the Xinlin Institute (and some others) are doing is quite exciting – folks who actually understand the medical system they’re studying. Woohoo! And godspeed.

  • @jm

    Modern research doesn’t match up with actual patient experience

    You really are disengaged from reality. By your logic, if findings from carefully conducted research do not agree with your perception of the (misinformed) “patient’s” experience induced by theatrical placebo, then you make the assumption that it is the research/science that is wrong. There is no “alternative truth.

    “Either it is true that a medicine works or it isn’t.
    It cannot be false in the ordinary sense but true in some ‘alternative’ sense.”
    Prof. Richard Dawkins, Oxford, April 2001

    @Tom
    Kudos for not hiding your identity.

    Had another look at your site. Have used it before as an example of how pseudoscience works in practice.
    Is this You? :
    http://youtu.be/bvlxggeIG4E
    Missed it before.
    Hilarious! An almost a montypython-esque script! One couldn’t have made this all up or what? 😀

    One starts laughing but then one starts thinking what the poor subject paid for this. Hopefully he got the performance for free for agreeing to keep a straight face.
    The poor gentleman does seem somewhat puzzled by your antics. Pulse-diagnostics! I thought you couldn’t sell that kind of ancient foolery to anyone graduated from primary school?

    Incidentally Edzard just this afternoon entered a piece on the matter of the evaluating the absurd.
    Looking at the mumbo-jumbo under the Xingling-something link I think it perfectly fits the term: “Evaluating the absurd”. Junk-science at its best.

    I am sorry if I hurt your religious devotion to Neijing but I am simply fed-up with the false healthcare people are fooled into these days.

    You may freely call me arrogant or whatever you like. I am not offended by serious symptoms of delusional fervor.
    You have a right to believe the earth is flat and water has memory or whatever. But you have no right to fool people who mistakenly rely upon you.
    I do respect you as a fellow human being, I do respect your right to believe religiously in whatever you choose but I certainly do not respect your peddling of untrue and often injurious antics under the pretext of health therapy.

    I may not be able to open your (or jm’s for that matter) eyes to reality but I can hopefully influence those readers seeking information and education by expressing in no uncertain terms my opinion of the absurdity of such services and the fraudulent act of selling untrue pseudotherapy.

    • @Bjorn – somebody once said (I forget who) of ad hominem attacks: ‘It is nothing else than an open admission by “the other side” that they have no more reasonable arguments, that they are resorting to unreasonable notions, and that they have lost not just the plot but also the debate. In other words, being personally attacked in this way is a compliment and an unfailing sign of victory’.

      So thank you! And thanks also for the comparison to Monty Python, I’m a fan of their work. And finally, thanks for posting a link to my video – hopefully that will bring a few more unsuspecting members of the gullible public who obviously can’t think for themselves to my door, so I can peddle my ‘often injurious antics’ to them.

      As an aside, the director of the xinglin institute is a western medical doctor as well as a scholar of the Neijing – if you are also both of these things I will take your comments a little more seriously.

      • Your responses are quite demonstrative. One is constantly surprised at the proportions of human fallibility.

        Just one comment. I feel no contempt for the person. As I said I have loving respect for my fellow humans. My deliberatly harsh comments (for didactic purposes) is not ad hominem it is ad fatuitas.

        • It seems to me you are simply here to mock and deride, rather than debate, which is why I find it hard to summon the energy to respond seriously. You attack me, the Neijing, and the Xinglin Institute without any attempt to engage or understand as far as I can tell. It’s your prerogative not to be interested, but to pass judgement in the way you have without the knowledge to back it up is rather childish in my opinion. You accuse me of religious fervor, but in fact I am very much open to the benefits of the scientific approach and Western medicine. It is you who is taking a fundamentalist approach, excluding the possibility of merit in that which you don’t understand.

          I have loving respect for you too, and I don’t expect to change your views either – casual visitors to this thread will have to make their own minds up, just as the public do when they visit me for a treatment.

          • I think Bjorn’s racial slurs will point out to the casual visitor the depth and quality of his character.

          • Racial? Is that the best you could find for a counter-attack 😀 Actually, I did not realize that the term “chinaman” might be considered derisive. “Englishman”, “Frenchman” and “Irishman” are alright and widely used as far as I know. If that is a fact, I stand corrected. Or does your indignation stem from your religious admiration of anything oriental?
            I am still learning.

            We are also waiting to hear what we should learn from reading pages 48 and 49 of the named textbook of ancient oriental medicine that we do not know why we need to buy.
            Why are you not answering these questions?
            And also, what will looking at the map tell us as far as understanding or rejecting the horrifying accounts of chinese traditional torture that Dugald Christie called acu-puncture in his book published in 1914 and seems to have been reinvented by the Mao regime as a less injurious substitute for real medical services?

            Please enlighten us so we can understand your alternative world.

    • @ Edzard – this is why I was recommending a rewording of #1. Bjorn’s comment:

      “By your logic, if findings from carefully conducted research do not agree with your perception of the (misinformed) “patient’s” experience induced by theatrical placebo, then you make the assumption that it is the research/science that is wrong. There is no “alternative truth.”

      Patients realize they are considered misinformed by the western med profession, and their treatment (I’m talking about acupuncturre specifically here) dismissed as plecebo. They also know it works. They also know when things aren’t working and the treatment needs adjusted. And, they don’t think that science is wrong. Most don’t think that docs are too stupid to figure this out (or at least they aren’t expressing it as such) – most think the docs just don’t care. Many mention the need for better research. All are aware that there is no alternative truth – and for those getting treated for the conditions you listed, the truth is reseach doesn’t match reality.

      Patients aren’t as dumb as Bjorn thinks.

    • @ Bjorn – this:

      https://en.wikipedia.org/wiki/Huangdi_Neijing

      …is the link you were looking for. Nèijìng (內勁) which is what you linked to, means something like “internal strength” (as I’m sure you now know, thanks to Wikipedia). The book in question is the Huángdì Nèijīng (黄帝内经). Usually it’s just referred to as the Nèijīng. And usually without the tone marks. Most people figure out which you mean, based on context.

      Maybe you should stick with a less confusing western book, like Grey’s Anatomy.

  • When you reflect on it, the use of terms like ‘chinaman’ tells us everything we might need to know about a person.

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