MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Auricular acupuncture (AA), according to the ‘COLLEGE OF AURICULAR ACUPUNCTURE’, has its origins in Modern Europe. In 1957 Dr. Paul Nogier, a neurologist from Lyons in France, observed a locum doctor treating sciatica by cauterizing an area of the ear. This prompted extensive research culminating in the development of the somatopic correspondence of specific parts of the body to the ear based upon the concept of an inverted foetus. Dr. Nogier believed that pain and other symptoms in the body could be alleviated by needling, massaging or electronically stimulating the corresponding region of the ear. Auricular Acupuncture is a specialized complementary therapy where acupuncture points on the outer ear are treated, using either needles or acupunctoscopes (electrical location and stimulation machines) to help relieve many chronic complaints. There are over 200 acupuncture points on the ear, each point named after an area of our anatomy. The outer ear acts like a switchboard to the brain. Each acupuncture point being treated, triggers electrical impulses from the ear via the brain, to the specific part of the body being treated.

Sounds odd? Well, that’s because it is odd!

But just because something is odd does not mean it is ineffective – so, what does the reliable evidence tell us? Here are some conclusions from systematic reviews:

The evidence that auricular acupuncture reduces postoperative pain is promising but not compelling.

The evidence for the effectiveness of AA for the symptomatic treatment of insomnia is limited.

The benefit of ear-acupressure for symptomatic relief of allergic rhinitis is unknown…

All of these analyses point out that the quality of the studies is usually very poor, and stress that more and better research is required. It is therefore interesting to note that a new study has just been published. Perhaps it could settle the question about the effectiveness of AA?

The aim of this study was 1) to evaluate whether auricular acupuncture effective for reducing health care provider stress and anxiety and 2) to determine, if auricular acupuncture impacts provider capacity for developing caring relationships with patients. Pre-intervention and post-intervention surveys were evaluated to see, if auricular acupuncture was associated with changes in State-Trait Anxiety Inventory (STAI), Professional Quality of Life, and Caring Ability Inventory scores. The results indicate that, compared with baseline, participants had a significant reduction in state anxiety (STAI), trait anxiety (STAI), burnout, and secondary traumatic stress scores (Professional Quality of Life). Significant increases were noted in courage and patience, two dimensions of the Caring Ability Inventory.

From these findings, the authors conclude that auricular acupuncture is an effective intervention for the relief of stress/anxiety in providers and supports heightened capacity for caring.

Sounds odd again? Yes, because it is odd!

I would argue that a study of any controversial therapy that has already been tested repeatedly in poor quality trials must have sufficient scientific rigor to advance the field of inquiry. If it does not fulfil this criterion, it is quite simply not ethical. The new study does not even have a control group; we can therefore not begin to tell whether the observed outcomes were due to non-specific effects, the natural history of the condition or regression towards the mean (to mention but a few of the possible sources of bias). To conclude that AA is ‘an effective intervention’ is therefore utterly barmy.

All of this could be entirely trivial and inconsequential. I am afraid, however, that it is not. Alternative medicine is littered with such unethically flawed research conducted by naïve and clueless pseudo-scientists who arrive at outrageous conclusions. This relentless flow of false-positive findings misleads consumers, health care professionals, decision makers and everyone else to draw the wrong conclusions about bogus therapies. And, in the end, this sort of thing even does a grave disfavour to any branch of alternative medicine that might have some degree of respectability.

IT IS HIGH TIME THAT THIS NONSENSE STOPS! IT BORDERS ON SCIENTIFIC MISCONDUCT.

2 Responses to Auricular acupuncture: more dismal research that is a disfavour to everyone and borders on scientific misconduct

  • 6 years, and zero comments?

    Reflexive modalities like ‘auriculotherapy’ are used in many places around the world, and studied in many academic centers. Are we to assume that all these people are misguided, blinded by their ambitions or simple-mindedness?

    More likely: effects occur, but not predictably. The complexity of the phenomena defies reducing interventions into categories that fit nicely into a matrix for analysis. How complex are these interventions?

    Start with the vast complexity of the physiological functions of the body, then add another layer in the form of patient/therapist interaction. Another layer is the skill of the therapist, and yet another is the idiosycratic response of the patient. And these are just the obvious layers.

    Are there any “scientific” supports for mechanisms that might allow “reflexive therapy” such as auriculotherapy? Two strong ones come to mind: first are the observations of Head Zones and the findings included in Sir Head’s published work starting in 1893. I think these observations establish that some characteristic of human function results in cause/effect relationships that have been only partially “explained”. So far, the most accepted pathways would be the nervous and circulatory systems. The second is the work of Bjorn Nordenstrom, whose theory and demonstration of complex physiological electrical circuits points to an even larger number of pathways by which these “reflexive” relationships can exist.

    It seems likely that until researchers become well-versed in these basics, and others which possibly have effects on these, that solid studies will remain elusive. That fact does not undermine the reflexive modality, it merely shows how much remains to be learned.

    However, as long as ‘authorities’ continue to throw out the conceptual babies with the bathwater, the necessary study and research is unlikely.

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