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

I found this acupuncture study from the Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy. As this seems to be a respectable institution, I had a look. What I found was remarkable! Let me show you the abstract in its full beauty:

Background: Pain related to Temporomandibular Disorders (TMD) is severe, negatively affecting patients’ quality of life, and often resistant to conventional treatments. Abdominal Acupuncture (AA) is known to be particularly effective for pain, especially chronic and musculoskeletal pain, but it is still poorly studied and never investigated in TMD patients. Objectives: To analyze the efficacy of AA for the treatment of patients with subacute and chronic pain related to TMD and non-responding to previous conventional therapies (occlusal splint, medications, physical therapy).

Methods: Twenty-eight patients, 24 F and four M (mean age 49.36 years), were recruited from January 2019-February 2021. All patients underwent AA treatment: two sessions per week for four weeks, for a total of eight sessions. At the beginning of therapy (T0) and at the end of the cycle (T1) the following data were evaluated: maximum mouth opening (MMO); cranio-facial pain related to TMD (verbal numeric scale, VNS); pain interference with normal activities and quality of life of patients (Brief Pain Inventory, BPI); oral functioning (Oral Behavior Checklist, OBC); impression of treatment effectiveness (Patients’ Global Impression of Improvement, PGI-I Scale). Statistical comparison of data before and after the AA treatment was performed by Wilcoxon’s signed-rank test (significance level p < 0.05).

Results: The MMO values were significantly improved after one cycle of AA (p = 0.0002). In addition, TMD-related pain had a statistically significant decline following AA treatment (all p < 0.001). Patients’ general activity and quality of life (BPI) were described as improved following a course of AA, with statistically significant values for all aspects considered (all p < 0.05).

Conclusion: Abdominal acupuncture resulted in effective treatment of subacute/chronic resistant pain related to TMD, capable of improving mandibular function and facial pain, and reduced the interference of pain affecting patients’ quality of life.

_____________________

Shocked?

Me too!

This study did not include a control group. Such uncontrolled studies are not necessarily useless. In areas where there is no prior evidence, they can be a reasonable starting point for further research. In the case of TMD/acupuncture, however, this does not imply. Here we already have about a dozen controlled trials. This means an uncontrolled study cannot possibly contribute to our knowledge. This means that the present study is useless. And that, in turn, means it is unethical.

But even if we ignore all this, the study is very misleading. It concludes that acupuncture improved TMD. This, however, can be doubted!

  • What about placebo?
  • What about regression toward the mean?
  • What about the natural history of the condition?

Bad science is regrettable and dangerous, as it

  • wastes resources,
  • misleads vulnerable patients,
  • violates ethics,
  • and undermines trust in science.

I fear that the Italian group has just provided us with a prime example of these points.

3 Responses to Possibly the worst acupuncture study of the year so far

  • This paper provides important proof that there is a chakra and/or meridian connecting the TMJ to the ‘abdomen’.
    Who’d have guessed?
    (Unless I am mistaken and the paper’s authors are deluded.)

  • It occurs to me that one or two readers of this blog might be ignorant of the remarkable benefits of ‘Abdominal Acupuncture’. Here I provide a synopsis from the web:

    “Abdominal Acupuncture, created by Dr. Zhiyun Bo, is an easy modality to learn and apply. It is not only gentle and relaxing, it is also very effective because it works with the qi in the core of the body. In addition, it directly affects the digestive system.
    The following overview to Abdominal Acupuncture is compiled from the online courses by Dave Shipsey (in English), and online resources by Dr. Zhiyun Bo (in Chinese).

    Abdominal Acupuncture utilizes a hologram of the abdomen of a tortoise on its back. Abdominal points prescriptions follow the same concept of herbal prescriptions in which there are Jun, Chen, Zuo, Shi (Chief, Deputy, Assistant, Envoy) points, with each playing an important and essential function.
    • Chief points treat the patient’s chief complaints, and regulate and harmonize the organs. Usually 1-2 points are selected.
    • Deputy points enhance the organ regulating effects of the Chief points.
    • Assistant points enhance Chief and Deputy functions, as well as regulate affected channels.
    • Envoy points provide symptomatic relief. They often image the corresponding pain areas, and can also be guiding points.

    There is no set number of points to use for each category above, however, there are usually more Envoy points than Chief points. Depending on the condition, some point prescriptions may only contain points from one or two of the categories.

    In addition, different combinations of the same points can yield different effects. Take Guanyuan (CV 4), Xiawan (CV 10), and Zhongwan (CV 12) for example. Guanyuan (CV 4) and Zhongwan (CV 12) combined tonify the Spleen and the Kidney; whereas, Guanyuan (CV 4) and Xiawan (CV 10) combined harmonize the Stomach and strengthen the Spleen; and Xiawan (CV 10) and Zhongwan (CV 12) combined treat a broader range of gastrointestinal disorders, as opposed to using only one of the points.

    Point locations and needling depths are the keys to successful treatment outcomes.”

    This paper provides important proof of the benefits of AA, but, of course, the aurthors of the paper cited might be at the forefront of knowledge, deluded, or charlatans. How are we to know?

  • Good grief. This is the sort of junk I’d expect out of China. But Italy? Just awful.

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