Acupuncture

Discussion in 'Health and Fitness' started by RickyC123, Jan 23, 2014.

  1. 47MartialMan

    47MartialMan Valued Member

    The relief of tension and message of tissue are the key. You can learn the same techniques (with practice*) to aid her and save her the trips.

    *There are a few places to study
     
  2. lieqi fan

    lieqi fan Valued Member

    Quite right too. Nobody needs to understand(or believe in) acupuncture (except the practitioner obvs). You just need to try it & see if it works for your condition (which is more about the skill level of the practitioner than the practice).
     
  3. lieqi fan

    lieqi fan Valued Member

    LOL
     
  4. philosoraptor

    philosoraptor carnivore in a top hat Supporter

    Actually there's a couple studies that dispute that. They compared groups who were stuck with needles by professional acupuncturists and folks who were just stabbed with needles randomly and the results were indistinguishable.
     
  5. The Iron Fist

    The Iron Fist Banned Banned

    But also philo those studies were themselves disputed by (peer reviewed controlled) studies that showed not only clear differences between real and 'sham' as they call it acupuncture, as well as noticeable effects beyond placebo. And to be perfectly clear the studies you reference didn't involve "random stabbings" per se. As I understand it they were attempting to be 'ballpark' with the applications of needles and so on. So we don't really know how close to real acupuncture any of them could have been, it's entirely possible to 'guesstimate' closely enough and absolute precision may not be required. However, the science on the matter seems to indicate (from what I can tell I am no scientist) that the closer to the 'canonical' points, the more noticeable the impact. Which leads some credence to the current theories on how acupuncture actually works (mechanically): it is a form of sensory/nervous system stimulation that promotes health and may work better given a number of external factors (experience of the practitioner, psychosomatic response of the patient and their general health etc). But most definitely certain spots on the body are more sensitive to 'probing' than others, there are nerve systems in the body that respond to stimulation in a wide variety of ways and some of those are certainly health-inducing (no one questions the effectiveness of massage, and it's hard to believe merely manipulating muscles can have great effects on the mind as well as body health, but it does!).

    What I do know for sure is that many times during discussions on acupuncture, older or poorly crafted studies are 'cherry picked' for supporting argument for either side (for or against). Especially for, and that's where we get to the hundreds of studies from China etc. But anybody firmly in the "against" camp needs to acknowledge there are (today in 2016) opposing studies they can't account for. I see the same 'sham' issue brought up many times, but that's been researched further and there were differences found. So in the case of those who believe sham acupuncture has been shown to be 'as effective'...that's not quite true any longer if you survey all of the studies to the present day and not just one or a few. There have been better studies (by respectable institutions) since then that do in fact show deviations between sham and true practice. Which makes sense if you think about it, if it's so common to find people helped by acupuncture, it may be because it's not that hard to do generally, and that practice makes one better than a 'random stabber'.

    But anyway if I have a point it's this: be careful when cherry picking certain studies because in the case of acupuncture there is almost always a conflicting study. In ages past, those studies came from Asia and were considered biased, but in 2016, they come from the major cancer centers in America as well, and they're using acupuncture effectively to treat a wide range of ailments (in an evidence-based methodology).

    Honestly the last time we chatted about this on M.A.P., I took the opportunity to look up the latest NIH and cancer center studies and they basically confirmed what many anecdotes already noted. There's a repeatable, testable effect to acupuncture that is not entirely "placebic" if that's even a word. There are always skeptics who discount new studies no matter what they find (and I generally recommend avoiding equating their skepticism with actual research and testing), but they seem to ignore the latest evidence and stick to studies performed 5, 10+ years ago when the studies were less rigid, more biased, and so forth. Or, they rely on speculation, such as assuming no matter what's found that it's 'noise', error, and so forth. There is a major disagreement now between the major health authorities in America and some of the leading skeptics, and I'm curious why the latter continue to be given so much undue weight, given the fact that many are not performing their own research on acupuncture, merely commenting on the research of others (which in peer review is expected, but not to an extreme conclusion). I agree acupuncture should be evidence based if it's to be used at all, but I also feel pretty confident in saying there is plenty of scientific evidence at this point that acupuncture helps/heals a hell of a lot of people. It can't be put in the same class as "humours" etc, for which there is just zero evidence, and zero supporting studies. They are OK for outright dismissal in my book :D

    Anyways sorry for the long rant brother but here's one source for my comment:

    http://well.blogs.nytimes.com/2012/09/11/acupuncture-provides-true-pain-relief-in-study/?_r=0

    http://archinte.jamanetwork.com/article.aspx?articleid=1357513
     
    Last edited: Jan 5, 2016
  6. David Harrison

    David Harrison MAPper without portfolio

    "The acupuncture literature does include the occasional well-designed study that follows this trend. The Archives of Internal Medicine acupuncture study in back pain published in 2009 was one such study – excellent control groups isolating specific variables. But then the authors blew it by completely misinterpreting their own data, confusing sham and placebo acupuncture for acupuncture."
    - https://www.sciencebasedmedicine.org/an-industry-of-worthless-acupuncture-studies/

    https://www.sciencebasedmedicine.org/acupuncture-doesnt-work/
     
  7. philosoraptor

    philosoraptor carnivore in a top hat Supporter

    Yeah I'm yet unconvinced - we've discussed several meta studies conducted by western institutions, which studies are you referring to?

    Edit: Damn phone, sorry for slow response, didn't catch your edit.
     
    Last edited: Jan 5, 2016
  8. The Iron Fist

    The Iron Fist Banned Banned

    "Acupuncture Doesn’t Work", "the authors blew it", "completely misinterpreted their own data??" Talk about laying your bias on the table stud poker style! :D Isn't he just speaking to his 'base' on the internet? This is not a peer reviewed source and I don't think anyone in the medical community takes this kind of opinionated commentary seriously, but it gets parroted by folks online anyway when they try to poke holes or be skeptical. But why would you compare "sciencebasedmedicine.org" to actual industry research, no matter the credentials of the author? That's like comparing the letters to the editor section with the classifieds. One contains opinions, the other is relatively factual and open to evaluation. SO unless there is a consensus somewhere that this editorial is, in fact, defensible, which doesn't appear to be the case...why would you think it bears any weight? It shouldn't because none of that commentary is peer reviewed itself. It's not in a respected journal, and even if the author is respected, he's posing nothing but speculations about the findings, not directly assailing them in any way. So if anything it only bears the weight of the author's opinion with nothing more to back it up. He's not providing any data or clinical research of his own merely suggesting possibilities that, on their face, appear strongly biased.

    Wow man I just also noted "an-industry-of-worthless-acupuncture-studies" is the title of that misleading and quite non-objective blog entry. That is not research though it's a single educated opinion. I know plenty of people confuse the two but make no mistake that is like comparing apples and oranges or in this case, peer reviewed research involving over 18,000 cases, and one no-name doctor's online opinion on the results. Has anyone from "sciencebasedmedicine.org" actually done any recent hands-on clinical research. From my point of view unless they have that site is merely commentary or editorial, it has zero scientific weight (other than the opinion coming from an MD).
     
    Last edited: Jan 5, 2016
  9. The Iron Fist

    The Iron Fist Banned Banned

    That's cool and I'm not going to try to convince anybody but I've noticed a trend that people when skeptical about acupuncture include one or another doctor's opinions like Dr. Ernst's. BUT BUT does the fact that he remains skeptical (he seems to stick to the 'skeptic' role no matter what) really invalidate the research results supported by the entire National Institutes of Health? Skepticism I can buy that, but does he really think that he speaks for the whole medical community? Because it really does appear he's just one of a few vocal minority, whereas the vast majority of MDs have no problem today calling acupuncture both "science based" as well as "evidence based". Once upon a time quite recently I will wholeheartedly agree there was were much better studies required to truly stand behind that...but they appear to be in place now. So I guess if I had to choose between who I trusted more, NIH or Dr. Ernst...why would I not choose NIH's findings as both trustyworthy and evidence-based, science-based medicine?? (For those British folk who don't know NIH is the main government health body for the US, so their stance on acupuncture is considered by many people in the US to be authoritative). I guess I am trying to see your point but also not understanding why a single doctor's blog is equivalent to NIH-supported clinical findings. If the answer is being skeptical for skepticism's' sake, I can dig it but let's be fair, Dr. Ernst's positions amount to speculative skepticism vs evidence based clinical research of Dr. Vickers, et al.
     
  10. philosoraptor

    philosoraptor carnivore in a top hat Supporter

    I found the Vickers paper unconvincing due to its methodology. You can keep talking about how we should trust the NIH, but that's not how science works. I'm curious what you actually mean when you say 'supported' by the NIH. You refer to Vickers conducting clinical research, he did not, at least not in the paper you've linked.

    For reference, the official position of the NIH on acupuncture is: "Although millions of Americans use acupuncture each year, often for chronic pain, there has been considerable controversy surrounding its value as a therapy and whether it is anything more than placebo. Research exploring a number of possible mechanisms for acupuncture’s pain-relieving effects is ongoing."

    further:

    "What the Science Says About the Effectiveness of Acupuncture
    Results from a number of studies suggest that acupuncture may help ease types of pain that are often chronic such as low-back pain, neck pain, and osteoarthritis/knee pain. It also may help reduce the frequency of tension headaches and prevent migraine headaches. Therefore, acupuncture appears to be a reasonable option for people with chronic pain to consider. However, clinical practice guidelines are inconsistent in recommendations about acupuncture.

    The effects of acupuncture on the brain and body and how best to measure them are only beginning to be understood. Current evidence suggests that many factors—like expectation and belief—that are unrelated to acupuncture needling may play important roles in the beneficial effects of acupuncture on pain."

    Hardly a ringing endorsement or clear position.
     
    Last edited: Jan 5, 2016
  11. The Iron Fist

    The Iron Fist Banned Banned

    Ok here goes nothing I'll try to sum up my point here. First I think maybe it would be useful to read more about Dr. Vickers who does indeed perform quite a bit of original research in addition to various meta-studies. I don't know why anyone including Dr. Ernst would assume his methodology was flawed without providing a more detailed analysis. I don't see that from Dr. Ernst, just some questions posed is all on a 'daily blog' bit which is his wont, but it doesn't take a Dr. to pose those kinds of questions such as it's noise or error. He might as well just keep it simple and make his point based on the title of his other articles: 'it's all fake'. Dr. Vickers is in fact considered a leader in this field and Dr. Ernst is not at the end of the day, so I don't get why their work is compared one is a leading researcher working in the field today, the other writes on a blog about other people's research and seems to practically be a 'troll' of sorts, especially given his tone.

    https://www.mskcc.org/profile/andrew-vickers

    Second I don't think I can agree with 'that's not how science works'...we're not talking about how science works but how people learn to accept and trust science (through authorities). Most people don't understand basic science, so we rely on many government and educational bodies for the advancement of science as well as education in it, not the least of which in the US are places like NIH or for that matter, NASA, NOAA and so forth. NIH has in fact funded and heralded quite a lot of medical research and is trusted for doing so not just in the US but globally. You can be ask skeptical as you want about the science but again we're just bystanders (like Dr. Ernst from what I can tell). So as far as trusting national authorities on medicine, NIH is a golden source in the US, so I admit I do trust it. I don't think anyone's online opinion of science is going to change my mind on that bit :D

    Third to address the subject of what the NIH's actual position on it, that is listed here and it includes a wide variety of good references, studies. Again this is the scientific underpinning of a field that is often mislabeled as not being science or evidence based, so the fact the the NIH even has a scientific statement to make on acupuncture would at least seem to me to invalidate those accusations. Basically even the Unites States government is saying it appears to work somehow, but is still relying on active leaders in research methodology (e.g. Vickers) to lead the way, and they've already had some promising results. I totally get brother why there needs to be the skeptic or two out there to challenge things...but the challenges such as those at "Science-Based Medicine" are kind of superficial. To truly be useful Dr. Ernst would need to provide some solid evidence that the latest research is flawed somehow. Instead he's telling a huge wing of American medical research they've got it all wrong, they're clueless, they don't know what they're doing et cetera...in as many words.

    In a nutshell, here's what the NIH says Science says about acupuncture, and the results part of which Vickers et al utilized confirms that while some studies don't show differences between sham and real, some indicate it does depending on the condition, which to me makes sense. We're talking about a holistic (whole body) treatment method. The response of the body to acupuncture should then vary based on the underlying condition treated. I particularly noted that some things like smoking cessation and depression have been literally "ruled out" due to practically no evidence. BUT most important is that so many other conditions haven't been ruled out, in fact the more studies produced, the more evidence there is!!! :D

    https://nccih.nih.gov/health/acupuncture/introduction

     
    Last edited: Jan 6, 2016
  12. philosoraptor

    philosoraptor carnivore in a top hat Supporter

    Yes, I've introduced my objections previously in this thread.

    This is just a naked appeal to authority.

    Do you want to discuss science or public opinion?

    Healthcare is literally riddled with bad science, after a recent experience with a relative, trust me when I say you are your own best advocate.

    No, these are the scientific investigations of the field, they've also done research into homeopathy, that doesn't endorse the practice.

    No one's arguing that it works, we're arguing why it works. If belief and expectation are the key components then it's likely that going into a soothing room with some incense and a dude who promises to make you feel better are the important bits and the needles are secondary.
     
  13. David Harrison

    David Harrison MAPper without portfolio

    Um, all I see is a lot of studies showing that acupuncture is not significantly more effective than sham treatments.

    My position is that we should be researching how to make placebo treatments more effective, rather than pouring all this money into trying to prove acupuncture is not a placebo treatment.

    I also don't particularly trust the NIH when it comes to alternative medicine, as it's spin on chiropractic treatment and risk of stroke leads me to believe it is not above bowing to economic interests.
     
  14. The Iron Fist

    The Iron Fist Banned Banned

    If I may add one side topic, I find the whole idea of "simulated acupuncture" as stated above fascinating. So sometimes it's not even acupuncture but something designed to look like it, and the body responds. Placebo effect sure, but the thing about placebo effect is that it can be quite random and not consistently a triggerable thing. With acupuncture, it appears to be the case. If an effect real or simulated should not matter, has an actual healing effect, what does that say about the difference between real or simulated actions? Maybe we should really be focusing on the mechanics of what the body is doing to itself, as opposed to what's being done by the body.

    Something is getting 'triggered'. Who cares what its called, shouldn't we learn to use it? Even if all the naysayers are right after all when the science is 'settled' as they say, we've still figured out a consistent way to provoke a placebo effect. What else is out there that is as consistent as even 'sham' acupuncture at inducing healing effects? I guess this sums up where I am on acupuncture, the government and science authorities have convinced me it's real, but also that they're way behind on the science of it and the answer is more science, not as Dr. Ernst seems to proscribe that the entire effort is pointless. That's clearly his stated position, it's all a waste of money. I'm not convinced :D
     
  15. David Harrison

    David Harrison MAPper without portfolio

    I honestly think that is a good idea.

    We've lost the sense of theatre in medicine.

    "The doctor will see you now..."
     

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  16. philosoraptor

    philosoraptor carnivore in a top hat Supporter

    So we get into brass tacks here:

    "A 2012 analysis of data on participants in acupuncture studies looked at back and neck pain together and found that actual acupuncture was more helpful than either no acupuncture or simulated acupuncture."

    What method of simulation did they use?

    "acupuncture relieved low-back pain immediately after treatment but not over longer periods of time."

    This pattern is associated with the placebo effect - you feel better momentarily, but not long term.

    "strong evidence that combining acupuncture with usual care helps more than usual care alone."

    You have people entering a study who know that they are either getting acupuncture or not, then someone asks "Hey, we haven't done anything… Do you feel better?" Do you see the methodological problem here?
     
  17. The Iron Fist

    The Iron Fist Banned Banned

    Well that's the thing it's already been proven acupuncture is not just placebo. That's been the case for several years now unless the current leading research is wrong and nobody's shown that is the case.

    To make the differences a bit clearer I bold faced a bunch of the studies above that did show significant differences between real and sham practices and again I think that makes sense because it should vary. Some things should be relatively treatable using acupuncture, some marginally, and some not at all. Smoking and depression can't be helped with acupuncture, but other conditions show clear benefits, and some studies show that real vs. sham actually matters.
     
  18. philosoraptor

    philosoraptor carnivore in a top hat Supporter

    No, the placebo effect honestly is a pretty predictable thing. You tell people that they will feel better after you perform a treatment and generally they do.

    Sugar pills.
     
  19. The Iron Fist

    The Iron Fist Banned Banned

    Ok like I said I get your position but I think claiming it's all just placebo is no longer plausible. To be clear I think belief and expectation affect any sort of healing and I think that's reasonable like I said the term 'psychosomatic' exists for that reason. Stress has a clear negative impact on the human body, and how intangible is stress. What I don't agree with is that acupuncture requires belief or expectation any more than say chemotherapy, and in the case of the more modern applications such as lasers vs. needles, it's even less important to consider environmental factors like lighting, incense et cetera :D If anything I think taking acupuncture out of the traditional setting and into the LABS is what's been required all along, but not really given the full attention of the medical establishment.
     
  20. The Iron Fist

    The Iron Fist Banned Banned

    Can I challenge you on this? What's "generally"? Can you actually prove any case where placebo effect is actually consistent if we agree on a baseline? Including sugar pills, where has the placebo effect been clearly noted at least, say, 80% of the time. If the placebo effect were truly that consistent brother, we could heal people with sugar pills, but we can't because it's not consistent. The placebo effect is not that repeatable, it is a 'sometimes' effect. Sometimes you give the guy no medicine but sugar, he gets better, usually he doesn't get better. That's how they figure out which medicine actually works 'better', and that's my supporting argument in a nutshell, they can't prove acupuncture is actually any worse than other forms of medicine for certain things especially pain management, especially for people who don't find relief in other options. If acupuncture is the 'magic sugar pill' that works 8/10 times consistently (and sometimes better when done for certain things or in certain ways), shouldn't we use it and most importantly continue to fund exploring it? That's where the good Dr. Ernst lost me, in the very titles of his blog. Where are the more objective skeptics I guess... I would prefer to read their blogs :D
     
    Last edited: Jan 6, 2016

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