After the nationwide huha created by the BBC’s promotion of auriculotherapy and AcuSeeds, it comes as a surprise to learn that, in Kent (UK), the NHS seems to advocate and provide this form of quackery. Here is the text of the patient leaflet:
Kent Community Health, NHS Foundation Trust
Auriculotherapy
This section provides information to patients who might benefit from auriculotherapy, to complement their acupuncture treatment, as part of their chronic pain management plan.
What is auriculotherapy?
In traditional Chinese medicine, the ear is seen as a microsystem representing the entire body. Auricular acupuncture focuses on ear points that may help a wide variety of conditions including pain. Acupuncture points on the ear are stimulated with fine needles or with earseeds and massage (acupressure).
How does it work?
Recent research has shown that auriculotherapy stimulates the release of natural endorphins, the body’s own feel good chemicals, which may help some patients as part of their chronic pain management plan.
What are earseeds?
Earseeds are traditionally small seeds from the Vaccaria plant, but they can also be made from different types of metal or ceramic. Vaccaria earseeds are held in place over auricular points by a small piece of adhesive tape, or plaster. Applying these small and barely noticeable earseeds between acupuncture treatments allows for patient massage of the auricular points. Earseeds may be left in place for up to a week.
Who can use earseeds?
Earseeds are sometimes used by our Chronic Pain Service to prolong the effects of standard acupuncture treatments and may help some patients to self manage their chronic pain.
How can I get the most out my treatment with earseeds?
It is recommended that the earseeds are massaged two to three times a day or when symptoms occur by applying gentle pressure to the earseeds and massaging in small circles.
Will using earseeds cure my chronic pain?
As with any treatment, earseeds are not a cure but they can reduce pain levels for some patients as part of their chronic pain management programme.
________________________
What the authors of the leaflet forgot to tell the reader is this:
- Auriculotherapy is based on ideas that fly in the face of science.
- The evidence that auriculotherapy works is flimsy, to say the least.
- The evidence earseeds work is even worse.
- To arrive at a positive recommendation, the NHS had to heavily indulge in the pseudo-scientific art of cherry-picking.
- The positive experience that some patients report is due to a placebo response.
- For whichever condition auriculotherapy is used, there are treatments that are much more adequate.
- Advocating auriculotherapy is therefore not in the best interest of the patient.
- Arguably, it is unethical.
- Definitely, it is not what the NHS should be doing.
14 Responses to HARD TO BELIEVE: In Kent (UK), the NHS advocates and pays for pure quackery
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DAMNED DISGRACE. The NHS in Kent should be ashamed.
Edzard, you said this: ” …The positive experience that some patients report is due to a placebo response”.
But wait – did you know that NHS doctors prescribe placebo pills and other fake ‘treatments’, here is a report for your perusal:
QUOTE: ‘The study shows that placebo use is widespread in the UK, and doctors clearly believe that placebos can help patients.’
This widespread use and acceptance of placebos is consistent with similar studies worldwide.
https://www.ox.ac.uk/news/2013-03-21-97-uk-doctors-have-given-placebos-patients-least-once
1) so what?
2) your study is 11 years old
3) medical ethics evolve
I’d not come across the terms “pure” and “impure” placebos before, but the headline of that piece – “97% of UK doctors have given placebos to patients at least once” – I think is misleading.
It seems that the 97% figure refers to “impure” placebos, and an example given of such is “more commonly non-essential physical examinations and blood tests performed to reassure patients”. To even call such a thing a “placebo” compared with giving an inert sugar pill seems like a real semantic stretch. Is is possible that this term was invented by researchers to make it look like giving placebos was more common that it actually is?
Apologies Edzard for quoting such an ancient study – I will try to do better in future. As you imply, 11 years is a long time in the history of medicine.
After reading that I would suggest that much, if not all, of the “impure placebo” will be the anti-biotics for likely viral infections. This one can skirt around informed consent with a suggestion of such treatment dealing with any secondary bacterial infections. Essentially we are looking at the GP prescribing to getr someone out of the room syndrome, rather than any more widespread use of placebo.
I used to (around 2010) while away time (appointment no shows – the bane of community services) talking to our then senior registrar about the ethics of placebo use and we always got stuck on informed consent, even before we got into other aspects of medical and nursing ethics.
The NHS is in such a state trying to provide even basic healthcare. Under these circumstances if the public want CAM treatments then they should pay for it.
It’s not clear from the above that the NHS is actually providing this stuff, but merely giving information to patients that it might be helpful. If that’s so then that is bad enough but at least NHS money isn’t being wasted. Though misinformation like this may encourage there to lobby for NHS funding.
the leaflet says the following:
The Community Chronic Pain team are able to provide a single, short
course of acupuncture up to a maximum of 12 sessions. Repeat
acupuncture courses are not available. Acupuncture is not provided
as a stand-alone therapy, but is utilised to support your care pathway.
All patients are encouraged to use long-term self-management
strategies, which will make the most of any benefits of acupuncture.
TO ME, THIS IMPLIES THEY PAY FOR IT
How much autonomy do these NHS trusts have ? I thought that they were bound by NICE. Ridiculous that NHS should offer such rubbish when it cannot even get basic pain care consistent
The Christie NHS Foundation Trust also offers ear seeds for sleep disturbance:
https://www.christie.nhs.uk/media/usybshpk/1456-sleeping-with-ease-comp-may-2021.pdf
Some NHS Trusts are offering sterile water injections for women in labour and wooden combs to grip in the hands during contractions.
Here is a recent article on placebo – the question being, is this practice unethical even if the patient is aware the medicine contains non-active ingredients? There are studies that reported the colour of the pill or capsule can have a psychological effect on how the patient responds – even improvements in blood pressure have been reported.
https://le.ac.uk/news/2023/october/placebo
https://pubmed.ncbi.nlm.nih.gov/19963285/
https://pubmed.ncbi.nlm.nih.gov/10025049/
https://pubmed.ncbi.nlm.nih.gov/1514301/
If aculotherapy is real why do not people with ear piercings especially those with multiple such report side effects elsewhere in the body?