If someone starts talking to you about meridians, they're either brushing up on their geography or about to launch into a discussion about the medical efficacy of acupuncture. If it's the latter, and you're a traditional scientist, you might be in for a heated discussion.
Acupuncture 101
Most people know something about acupuncture; mainly, that very skinny needles are inserted into various areas of the body. In Traditional Chinese Medicine (TCM), treatment is applied to the meridian (channel) that governs the site of the pain, not necessarily the place where the pain is being experienced. Ch'i, the invisible nutritive energy that flows from the universe into the body at any one of 500 acupuncture points, is conducted through the 12 main meridians in (ideally) an unbroken circle. Meridians conduct either Yin energy (from the sun) or Yang energy (from the earth). All maladies are caused by disharmony or disturbances in the flow of energy. Acupuncture treatment is meant to realign or reharmonize these disturbances, and on a more elevated level, to enable the realigned cells to unite with the cosmic energy of the universe.
You don't have to have to have graduated medical school to see that this can be difficult to reconcile with modern science. And this is the heart of the problem. Acupuncture is a pre-scientific paradigm based on concepts with no counterpart in contemporary western medicine. Its treatments are founded on philosophical constructs, subjective impressions and responses to patterns of disharmony, whereas Western treatments are the result of controlled scientific research. Putting acupuncture under a microscope can be like trying to capture a spirit out of the clouds.
But before the commenters start typing wildly, let me say that there has been a fair amount of research that demonstrates acupuncture's efficacy. Nevertheless (a word you see a lot in acupuncture research summaries), the conclusion of most studies, or of organizations reviewing the results of clinical trials, is that there was insufficient evidence to recommend for or against acupuncture, or that the results were equivocal, or that further research would be required.
Testing the Tests
This is a result of the difficulty in creating an appropriate controlled, double-blind testing situation. Acupuncture is an invasive treatment, so it's hard to design an effective placebo control group for a study the way standard double blinding practices are used in trials for new drugs. Acupuncture is also a process, not a pill. A process has a lot of variables, including the influence of the acupuncturist, which is a major factor. Blinding both the acupuncturist and the patient as to the treatment being given is a challenge. To rectify this, the "sham" acupuncture placebo was developed, where needles are inserted, but not in the accepted acupuncture points, or not inserted at all (using retractable needles that just appear to be penetrating the skin).
Even with these efforts, as the Institute of Medicine has acknowledged, it's difficult to standardize a process and to separate the effectiveness of a treatment from that of the person providing it. True Traditional Chinese Medicine acupuncture is tailor-made for each patient based upon the condition and the examination, and there are multiple variables such as manual or electrical stimulation, number of acupuncture sites treated, frequency of the sessions, and length of treatment. Additionally, many of the trials suffered from low numbers of subjects and mixtures of conditions rather than examining a single homogenous condition. For example, headache trials often include patients with tension headaches, migraines, headaches due to cervical spine disease and other causes, each of which may have a different cause, and, thus, unlikely to respond to a "one size fits all" approach. On the upside, the quality of acupuncture research is improving. Still, the evidence for and against continues to grow, with many layers of nuance in-between.
Tests such as a positron emission tomography (PET) scan have shown that treatment with genuine needles, as opposed to the use of "sham" needles, does create objective changes in brain states. But, random placement of placebo needles also had that effect.
Where acupuncture seems to have gained the most clinical ground is in the area of pain reduction. Researchers in Germany conducting acupuncture trials for patients with chronic low back pain found that only 15 percent of subjects who received genuine acupuncture treatment needed extra pain medication, compared with 34 percent who were receiving "sham" treatments, and 59 percent receiving conventional therapy. Long-term pain reduction was also best for subjects who received either real or "sham" acupuncture versus those that received conventional therapy.
In another study, researchers used "sham" acupuncture controls entirely and compared it to the drug Effexor for relieving hot flashes in breast cancer patients. They found that acupuncture relieved hot flashes as effectively as the drug and with fewer side effects, namely the lack of energy and reduced sex drive.
So which is it? Does acupuncture work or not? Or does it work if you think it works? While some findings support acupuncture's efficacy, especially for post-operative or chemotherapy-induced nausea and vomiting and post-operative dental pain, others posit that its clinical effectiveness depends mainly on a placebo response.
Proponents of acupuncture say that it doesn't matter if a placebo effect is at work or not because the ultimate goal is to activate the body's power to heal itself. This, in fact, seems to be the point at which Western medicine and the relatively new approaches of Integrative Medicine (IM) or Complimentary Alternative Medicine (CAM) finally do converge. Over the past decade, integrative care has become an accepted element of treatment at many major medical institutions and part of traditional academic curriculums. It combines conventional Western medicine with holistic treatments like acupuncture, massage, biofeedback, yoga and stress reduction techniques to treat the whole person, not just a disease.
In this expanding holistic universe, acupuncture is a key player, even though scientists and scientific institutions continue to question the existing data and testing methodologies, which, of course, is the most scientific way to deal with the issue. The quintessential scientist, Einstein, noted that finding the right question is 95 percent of finding the solution. In the case of demonstrable clinical outcomes for acupuncture, perhaps the best question we have so far is, "Does it make you feel better?"
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And as for placebos, it's as possible to create a placebo for acupuncture as it is for surgery. How does one create a double blind study of having an appendix removed? Instead, why not use herbal medicine? It'd be easy enough to gather a group of people all diagnosed with Liver Qi Stagnation and see if the formula Xiao Yao San works compared to a placebo to treat Liver Qi Stagnation. Also, instead of testing effectiveness, why not test the concepts to see if they are valid? Is a harmonized state Yin and Yang a valid way describe a state of homeostasis?
I have chronic tension headaches, started with TMJ and have just gotten much worse. Of course I'd rather use acupunture than narcotics..not get my insurance company to cover it!
The description/explanation offered is more of the romantic/energetic view. I try not to use that with my patients...there are some physiologic effects that occur. Some times this works for people other times not, that is no different than any other therapy.
What is expanding and contracting energy?
Seriously? Wherever fundamental dualities are observed, and there are sort of a lot of them: hot-cold, light-dark, day-night, summer-winter, male-female (physical characteristics), inhale-exhale, nucleus-electron shells, Big Bang-black hole (or whatever the concentrated point of the universe is called before the big bang). If scientists actually have discovered right or lefthandedness in the universe or a DNA molecule, the ancients are nodding their heads (metaphorically) in agreement.
Doesn’t the body detect incursions, and respond with its own inbuilt defence mechanisms?
For example, deep wounds prompting the release of pain killing chemicals to permit escape from the danger zone. If insertion of a small needle were to trigger that “traumatic injury” response. Wouldn’t that suggest a way in which this treatment might function?
Compared to 40% relief from the actual drug. Most of prescription drugs effect is placebo.
I am a grad student working in the neural control of beta cell biology (pancreas). I have given the idea of accupuncture and the placebo effect a great deal of thought in relation to my studies. I believe it is real, a physiologically relevant and important phenomena and can probably be tested under controlled circumstances.
I read somewhere that NASA was doing work on voluntary neural control of metabolism for future Mars missions. Everyone has forced themselves to breathe deeply to control an extreme emotional state. If you can figure out the neural connection, you can control it.
Have a great day!
Mine was done by a Japanese doctor, who had studied in China and written up in newspapers and journals, said to be the best acupuncturist in the region, and credentialed in Japan and the US. Not knowing anything about the proper training and credentials for an acupuncturist, I went by the testimonies of several acquaintances who swore that he was the reason they were walking.
I had polio as a child and have serious lower body joint problems and significant pain. After spending hundreds of dollars in 6 sessions with the acupuncturist, who had guaranteed results, I felt no difference at all. It was never apparent to me that anything had happened except that I got stuck with a lot of pins. Most didn't hurt at all, and none hurt a lot. But neither did they accomplish anything.
When I complained to the acupuncturist that there was no difference in pain or my ability to walk normally, he told me that my attitude wasn't in the right place, but if he continued treatment long enough, eventually I would get better anyway. He wouldn't specify just how long or how expensive that was going to be.
Maybe acupuncture has real validity. I've heard of Chinese surgeons operating with it in lieu of anesthesia. But I wonder if some acupuncture "cures" or improvements are just another form of faith healing.
Every article I read ends the same, “more research is needed.” When do you think a definitive study will be conducted that can either give us acupuncture as a supportable medical tool or define it as just another placebo?
Acupuncture is not made-up as you suggest, and Western biomedicine is less scientific than you presume it to be. Both systems share more than you might imagine as the human physiology remains the same regardless of geography or medical protocol.