Category: Acupuncture

  • Research: Acupuncture vs Conventional Medicine for Lower Back Pain

    This study appeared in the Archives of Internal Medicine, Vol. 169 No. 9, May 11, 2009

    The study followed 638 adults with chronic mechanical low back pain who were given one of the following treatments:

    1. individualized acupuncture (acupuncture treatment formula tailored to the patient)
    2. standardized acupuncture (typical acupuncture points for lower back pain)
    3. simulated acupuncture (sham acupuncture using toothpicks on acupuncture points)
    4. conventional medical treatments of medicine and physiotherapy

    Ten treatments were provided over 7 weeks by experienced acupuncturists.  The results were as follows:

    • By the 8 week mark, all of the acupuncture groups showed an improvement of 4.4 or 4.5 while the conventional medicine group showed an improvement of only 2.1 points.
    • By the 8 week mark, the acupuncture groups reported improved symptoms of 1.6 to 1.9 while the conventional medicine group improved symptoms by only 0.7 points.
    • By the 1 year mark, the acupuncture groups showed clinically meaningful improvements in dysfunction of 59% to 65% vs the conventional medicine group which showed an improvement of 50%
    • In summary, the acupuncture groups showed a larger improvement, greater reduced symptoms and longer lasting improvements than conventional medicine.
    • It should also be noted that while the results of sham acupuncture were the same as real acupuncture, sham acupuncture also proved to yield much better results than conventional medicine.
  • Research: Acupuncture Better than Corticosteroids for Carpal Tunnel Syndrome

    The May 2009 issue of The Clinical Journal of Pain included the results of a randomized controlled trial comparing the use of acupuncture vs corticosteroids for the treatment of carpal tunnel syndrome. The study showed positive results favouring acupuncture.

    The study followed 77 subjects that were either given acupuncture (8 treatments over 4 weeks) or the corticosteroid prednisone, taken orally, daily for 4 weeks.  Acupuncture proved to have better results for controlling pain, numbness, tingling, and weakness.  Acupuncture had better results for night time awakening and motor function.

    Acupuncture also has less side effects and is safer than corticosteroids.  The side effects of a typical medical acupuncture treatment for carpal tunnel syndrome are:

    • minor bruising at the needle site that lasts 1 day after treatment
    • the sensation of a slight “prick” with the insertion of the needle, but not during the treatment

    Here is a list of the side effects of the corticosteroid prednisone:

    • increased appetite
    • indigestion
    • nervousness or restlessness
    • darkening or lightening of skin color
    • dizziness or lightheadedness
    • flushing of face or cheeks
    • hiccups
    • increased sweating
    • sensation of spinning
    • Decreased or blurred vision
    • frequent urination
    • increased thirst
    • confusion
    • excitement
    • false sense of well-being
    • hallucinations (seeing, hearing, or feeling things that are not there)
    • mental depression
    • mistaken feelings of self-importance or being mistreated
    • mood swings (sudden and wide)
    • restlessness
    • skin rash or hives
    • abdominal or stomach pain or burning (continuing)
    • acne
    • bloody or black, tarry stools
    • changes in vision
    • eye pain
    • filling or rounding out of the face
    • headache
    • irregular heartbeat
    • menstrual problems
    • muscle cramps or pain
    • muscle weakness
    • nausea
    • pain in arms, back, hips, legs, ribs, or shoulders
    • reddish purple lines on arms, face, groin, legs, or trunk
    • redness of eyes
    • sensitivity of eyes to light
    • stunting of growth (in children)
    • swelling of feet or lower legs
    • tearing of eyes
    • thin, shiny skin
    • trouble in sleeping
    • unusual bruising
    • unusual increase in hair growth
    • unusual tiredness or weakness
    • vomiting
    • weight gain (rapid)
    • wounds that will not heal
  • "Sham Wow!!!" or The Problem with Acupuncture Research

    You have probably heard from all the acupuncture skeptics that research proves that acupuncture doesn’t work because many studies have shown that acupuncture is no more effective than a placebo.

    This is a valid point because a control group is needed in any study to compare participants that received no treatment at all, a fake treatment, or other types of treament.  A placebo is usually a fake version of the treatment, but as you can imagine, it is very difficult to give somebody a fake version of acupncture.  In studying a new drug medication it’s easy to give a sugar pill placebo and trick the participant into believing that they are taking real medication. The people giving or taking the pills have no real way of knowing which side of the study they are on, thus producing a double blinded randomized controlled trial or “the gold standard” of research. Also, it is easy to produce a pill that will have absolutely no effect on the patient. With acupuncture it is a bit trickier to produce placebos which can trick both the participant and the clinician.  Even more difficult is to produce a placebo version of acupuncture that has no effect on the patient.  Here are some of the placebos that scientists have come up with:

    Fake Acupuncture Points

    The first studies typically used standard acupuncture needles but inserted them into points that were not “real” acupuncture points. The problem is that it is hard to find a point on the body that is not somehow an acupuncture point.  There are about 400 classical acupuncture points. In addition, there are also ah-shi points which are acupuncture points that are not standard. Then there are the extra points which have officially been added. Acupuncture is over 3000 years old, but new points are still being discovered and new approaches or techniques are still being developed today. Also, consider that even though acupuncture is most effective if a prescribed acupuncture point is used, being “a bit off” of the exact point location is still effective and yields positive results. The drawback with using real acupuncture needles on “non-acupuncture” points is that the points could possibly be real acupuncture points after all.  Another drawback to using fake points is that it still involves inserting acupuncture needles into the body. This simple act still sets off a chain of hormonal and chemical reactions which could have a profound effect on the body.

    The Fake Acupuncture Needle

    There is a contraption sometimes used as a sham acupuncture that looks like a tube holding an acupuncture needle that is designed to mimic the look and feel of an acupuncture needle, but which doesn’t actually puncture the skin. The problem here is that the disguise isn’t perfect and the patient and clinician can at times tell the difference. Also, even though the needle is not puncturing the skin, there is still a sensation and a contact that could have an effect. Remember that Traditional Chinese Medicine also has a component called Tui Na Massage which involved massaging the same points and energy meridians as real acupuncture. In other words, Chinese medicine even works without the needles.

    Fake Laser Acupuncture

    Laser acupuncture can sometimes be used as the sham. This involves using a laser acupuncture light at an ineffective low intensity. This is a very good sham as it still tricks the patient into believing that they are being treated, thus isolating that component from the results. Most importantly it is able to appear as a real treatment without inadvertently treating.

    The problem with acupuncture research is not in proving that acupuncture works.  Most studies show that acupuncture in real or sham form produces better results than no acupuncture.  The problem with acupuncture research is actually proving that acupuncture DOESN’T work. Inserting acupuncture needles into non-acupuncture points or stimulating energy meridians with fake needles often yields positive results as they are still a form of acupuncture.

    The next time you read an article of how acupuncture is no better than the placebo, try to find out what type of placebo was used.  The placebo might have been acupuncture too.

  • Research: Acupuncture & Headaches

    Here is a selection of research on the effectiveness of acupuncture in treating headaches.

    In a 2005 randomized trial, Linde et al studied the effects of acupuncture, sham acupuncture and a control on 302 patients with migraine headaches. The study found the acupuncture and sham acupuncture produced a greater reduction in moderate to severe headaches.

    A study by Hansen & Hansen in 1985 showed that classical Chinese acupuncture was more effective than the sham acupuncture placebo in relieving headaches.

    A study by Vincent in 1989 found that acupuncture was more effective than the sham acupuncture placebo in treating chronic migraine headaches.

    A systematic review by Melchart et al in 2001 included, among others, 16 trials comparing acupuncture to sham acupuncture. The review found that true acupuncture was reported to be significantly superior to sham acupuncture.

  • Research: Acupuncture & Tennis Elbow

    A 2004 systematic review conducted by Dr. Trinh of McMaster University showed strong evidence to support the treatment of lateral epicondyle pain with acupuncture.  The systematic review included 6 high quality studies.  All studies showed that acupuncture provided relief for lateral epicondyle pain.  Five of the six studies showed that acupuncture was more effective than the control.

  • Research: Acupuncture & Diabetes

    A 1997 study conducted by the University of Manchester appeared in Diabetes Research and Clinical Practice Volume 39, Issue 2, February 1998, Pages 115-121.

    The study followed 46 diabetic patients with chronic painful peripheral neuropathy and studied the long term effects of acupuncture.  63% of the patients were already following the standard medical treatment for painful neuropathy.  Patients received 6 treatments of acupuncture over 10 weeks.  By the end of the study, 77% showed significant improvement in their symptoms.  After the study, the patients were followed for another year, during which 67% were able to stop or reduce their medications significantly.  21% noted that their symptoms had cleared completely.