Wednesday, July 1, 2009

Acupuncture: Evidence

So the other day I was at a friend’s house and the topic of acupuncture came up. Now, I’m one of those hard-line skeptics about “alternative” medicine, and I happened to have read several credible sources stating that acupuncture doesn’t work (is no better than a placebo treatment). But not everyone wanted to take me on my word, so I promised to produce the evidence. Here we go.

First, a caveat for those who want to do their own internet research: there are a large number of biased websites out there, on both sides. If you go to the websites of people who practice acupuncture, you’ll find links to many articles which indicate that acupuncture is beneficial. Don’t trust them! For example, on this website:

The Fertile Soul

You’ll find the oft-cited claim that acupuncture helps with in-vitro fertilization. Yet, the study linked is a poor one, and the most systematic review to date on the subject, here:

Cochrane Collective

Concludes: “Acupuncture performed on the day of ET [Embryo Transfer] shows a beneficial effect on the live birth rate; however, with the present evidence this could be attributed to placebo effect and the small number of women included in the trials. Acupuncture should not be offered during the luteal phase in routine clinical practice until further evidence is available from sufficiently powered RCTs [Randomized Clinical Trials].”

Translation: poorly conducted studies are inconclusive. Internet researchers should also be warned about overzealous skeptic sites, which will publicize the negative results that suit them, but not take the time to consider studies which seem at-odds with their views.

The best place to get your scientific evidence concerning medicine is, of course, from recent, systematic meta-analyses of randomized clinical trials published in leading medical journals. Here is one such meta-analysis, published in BMJ. The article is: “Acupuncture treatment for pain: systematic review of randomized clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups” by Matias Vested Madsen, Peter C Gøtzsche and Asbjørn Hróbjartsson and it is available for free here:

Meta Analysis

This article is recent, being published in 2009.

It is also systematic. A systematic meta-analysis looks at all the articles in a large database(s) that meet the inclusion criteria. According to the study’s authors: “We searched the Cochrane Library, Medline, Embase, Biological Abstracts, and PsycLIT. The last search included all trials published before 1 January 2008.”

Furthermore, it is published in a leading medical journal. According to wikipedia: “BMJ is considered to be one of the ‘core’ general medical journals; the others being the New England Journal of Medicine, (N Engl J Med), the JAMA, and The Lancet.”

The authors reached the following conclusions: “A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.”

To sum up: acupuncture treatments for pain are not clinically significant, and they may not even be statistically significant, once bias is accounted for. That seems pretty damning to me.

Still not convinced? I knew you wouldn’t be. So I direct you to one of my favorite science bloggers, Orac, over at Respectful Insolence.

Acupuncture 1

Acupuncture 2

Acupuncture 3

Acupuncture 4

Orac is a medical doctor, and much more knowledgeable than me. In the above blog posts, he dissects a number of studies and meta-analyses. He testifies:

“When I first became interested in ‘alternative medicine’--excuse me, I mean ‘complementary and alternative medicine’ (CAM)--I viewed acupuncture somewhat differently. No, I never bought the traditional explanation that sticking thin needles into the skin somehow alters the flow of qi in order to induce a therapeutic effect. That is no more plausible than reiki or therapeutic touch. However, there are needles breaking the skin in acupuncture. It was, at least to me, not entirely implausible that that might have some sort of physiologic effect. Then I had to go and ruin that lovely kumbaya feeling towards CAM by actually going and looking at the scientific literature on acupuncture… When I actually bothered to do that, I soon realized that the evidence that acupuncture is anything more than a highly elaborate placebo is shockingly thin. More like nonexistent, actually.”

You should read his posts, or the articles he links to, and see if you aren’t equally converted.

Finally, here’s a press article to stew on:

AP Report

It begins: “Ten years ago the [U.S.] government set out to test herbal and other alternative health remedies to find the ones that work. After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.”

Your tax dollars at work!


  1. Thanks for trying to put like 1 billion of my distant blood relatives out of business, Mike. Are you going to attack fried rice and massage handjobs next?

  2. I would like to thanκ you fοг the effortѕ you have put іn wгitіng thiѕ website.
    I am hορing to check out the ѕame high-grade blog
    posts bу you in the futuге
    аs wеll. In faсt, your creative ωritіng аbilities has enсоuraged
    me to get my veгу own blog now ;)

    Here iѕ my webpage :: isabel del los rios
    My site :: diet plans, diets that work, weight loss vibration machine, over weight, weight loss clinic vancouver, how many calories should i eat to lose weight

  3. Gгeеtingѕ! Very useful advice in thiѕ
    particulаr article! It's the little changes that produce the most significant changes. Many thanks for sharing!

    Here is my web blog; rectal Prolapse
    Also visit my website ; suffering from hemorrhoids

  4. Verу nіce post. I ϳust stumbled upοn your
    blog and ωantеd to ѕay that I've really enjoyed browsing your blog posts. After all I will be subscribing to your feed and I hope you write again soon!

    Feel free to surf to my blog post - chatroulette online advice
    My website: chat websites

  5. Hi thеre would уou minԁ stating which blog ρlatform you're using? I'm рlаnning to stаrt
    my оwn blοg in the near future but I'm having a tough time deciding between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your layout seems different then most blogs and I'm lоoking for something uniquе.
    P.S Ѕοгry for getting off-topic but I haԁ to aѕk!

    My webpаgе:
    Feel free to surf my web-site ; rectal cancer

  6. Wondегful blog! І found it while suгfing
    arοund on Yahoo News. Do yοu have any suggestіonѕ οn
    hoω to get listеd in Үаhoο Neωs?
    I've been trying for a while but I never seem to get there! Cheers

    Here is my site ... treat hemorrhoids prolapse
    Here is my blog post - hemorrhoidal bleeding

  7. I just сouldn't depart your site prior to suggesting that I really loved the standard information a person provide on your guests? Is gonna be again incessantly in order to inspect new posts

    Review my page present effect
    My homepage ... ever present

  8. Ηello to all, how is everything, І think every
    one іs getting more frοm thіs web sitе, and your views are fastidious designed for new vіsitors.

    Αlѕo visit my wеb-site ::
    Feel free to visit my page - internal hemorrhoids

  9. Ahaа, іts goоԁ dialogue regaгding thiѕ ρiеce of ωгiting at this place at this blοg, I have read all thаt, so now me also commentіng аt this place.

    Feel free to vіѕit my web site chat websites
    Here is my web-site chatroulette online advice

  10. We are а gaggle of volunteerѕ аnd starting a new scheme in
    our communitу. Үour site offered us with ѵаluable
    info to wοrk on. You have donе an impressive task and our whole communitу
    wіll likely be thankful tο you.

    Feel free to surf to my wеb page; how to i get rid of hemorrhoids
    Visit my homepage ; rectal bleeding

  11. However, these are the most functional for readers. *Viral Resistance:
    As a reader, my biggest concern when I download from the
    net, is the transference of viruses. Writers are aware of the growing popularity of e
    - Books and how it can help their work reach a global audience.

    Also visit my website - free pdf ebook download

  12. It is very informative post! Acupuncture originated in ancient China thousands of years ago and it is still used successfully today to treat medical conditions and to prevent sickness. Thanks.acupuncture in venice fl