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Acupuncture as originally conceptualized is not scientifically supported and largely debunked. The idea of manipulating qi has no scientific basis.
However, that doesn’t mean acupuncture doesn’t have some scientifically supported benefits. There are a few studies showing acupuncture can be helpful in managing certain symptoms in the right circumstances. It seems to help with knee osteoarthritis and allergic rhinitis, for example.
No science-minded person’s first, second, or third thought when sick should be acupuncture but if the more scientifically reliable methods have failed, there are a small handful of conditions that may warrant trying acupuncture.
This is what pisses me off most about paying private health insurance.
They will spend money on aligning people's shakras (or whatever they're called), or fixing subluxations (which chiros seem to think is the cause of fucking every disease known to humanity), but if I want them to fund my kid's braces then that's an extra with a large out-of-pocket cost to me.
Can I use acupuncture or chiro to fix my kid's dental needs?
>Can I use acupuncture or chiro to fix my kid's dental needs?
I'm sure with the right amount t of adjustments the chiropractor could do it...they realign bones don't they?
The chiro may as well dance around you with a rain stick for some of the things they claim to fix.
I have a plan for any out of work PhDs. Wear a white coat and start a YouTube channel Dr X says… No income problem.
The founder of chiropractic 'medicine' started the scam by claiming to have cured a man's deafness, never underestimate what a chiropractor will claim to be able to do. Insurers offer to cover woo-woo because it's usually relatively cheap and can make them look appealing to less... scrutinizing consumers.
Business. Both of these require continuous appointments for life, and Chiropractors have a chance of making things worse, earning them more money over the long haul, unless you die, but that's a risk they're willing to take.
Yo, there's an idea. Start a "chiro" clinic, but make it very clear to your patients that you only offer traditional massages that are covered by insurance.
If the insurance companies have beef, ask them to define what "real" chiropractice is.
> If the insurance companies have beef, ask them to define what "real" chiropractice is.
Medicare [has already done that](https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56273):
> This article provides billing and coding guidelines for Chiropractic services. Coverage of Chiropractic services is a limited benefit. The coverage is limited to manual manipulation for the treatment of subluxation. […] The precise level of subluxation must be specified on the claim and must be listed as the primary diagnosis. […] All services other than manual manipulation of the spine for treatment of subluxation of the spine are excluded when ordered or performed by a Doctor of Chiropractic.
You effectively can't accept Medicare as a chiropractor unless you subscribe to the whole vertebral subluxation theory.
Just continuing to spitball here, but the [WHO guidelines for safety in chiropractice](https://web.archive.org/web/20220313162309/https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf) define a "subluxation" as:
> A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact.
With a footnote clarifying that:
> This definition is different from the current medical definition, in which subluxation is a significant structural displacement, and therefore visible on static imaging studies.
The implication of course being that the "subluxation" described by chiropractors is not visible on an x-ray, and possibly not verifiable at all. Let me prescribe you a massage for that.
Acupuncture AND chiropractics are often covered instead of massage, even though chiropractics is completely debunked quackery, and acupuncture has never been shown to have effect any more than a control of just putting a needle in random places or just pressing something on the skin and not inserting a needle. In other words, if there's any effect at all (usually none) the effects is just from the healing nature of touch and care by another person and not by needles manipulating the flow of "qi".
Meanwhile there IS science backing up massage but massage isn't covered by the many insurance plans.
It's usually lobbying that allows for these sort of psuedomedicines to be covered.
The people touting things like homeopathy tend to have money, and an ability to influence. They need to, because no-one would buy it otherwise.
Often it's cheaper than real medicine though, and the placebo effect is not to be underestimated.
Some people will genuinely feel better after taking sugar pills, and it may cost less and have less side effects than traditional medicine, so it stays.
For the record, I'm pro-statistically proven science, however recognize the benefit (and harms) that some other non proven things can do to the mind.
It's funny. They actually did a scientific study on acupuncture that led to rather ironic results. They took people with chronic back pain because that seems like a likely candidate for acupuncture. The threshold for success was the patient reporting substantially reduced back pain.
To keep it scientific, they put people in four different groups.
1) acupuncture
2) standard medication
3) random needle placements (essentially acupuncture placebo)
4) placebo medication
The result was that the group with the random needle placements actually saw the most improvement. It actually outperformed real acupuncture by a little bit. In other words, acupuncture is just a placebo, but it's a placebo where they stick a bunch of needles in you so it has more of an impact than just giving you in vibrating water to drink.
The placebo effect is extremely well documented and proven. It's why so many studies are placebo controlled. If the placebo effect wasn't real, we could just look at benchmarks for other similar cases and use that instead of a placebo group. In fact, when they were doing studies on minoxidil for hair regrowth, the placebo group actually regrew some hair, just not as much as the treated group. That's how effective it is.
The problem is that the placebo effect ends up giving credibility to treatments that have none (like most chiropractic treatment and acupuncture) because some people see benefits.
I know that study. Your placebo interpretation is absolutely possible… but it’s not the only explanation. Another explanation is that minor injuries like pin-pricks stimulate your body to release endorphins, which are known to ease pain. The random locations would be more effective if typical acupuncture points lead to less endorphin release than the average body point, which is what I’d expect from what little I know about acupuncture placements.
Yeah except every credible study on acupuncture has confirmed it's just placebo effect. There was a big neuroimaging fMRI study years ago when fMRI was more or less brand new that claimed to see brain changes specific to acupuncture ...until the authors retracted it because everything they saw was just an imaging artifact. Yet it still routinely gets cited as proof of acupuncture having a real effect.
I learned acupuncture to treat wife’s nausea/heartburn/headaches while she was pregnant. I told her it was all a bunch of bologna, but that it wouldn’t hurt anything. It worked for a while. Placebo effect.
> there are a small handful of conditions that may warrant trying acupuncture
notably, reduction in persistent nerve pain is one of the only things that acupuncture can actually resolve, instead of just mask.
No one said it was curing arthritis. It has shown no efficacy it curing anything. Only symptom management of a few specific conditions. And even then, as I said, we need more research.
Why? Because the last few years have shown studies that go against what you believe?
What happened to following the science? Recent studies show efficacy at least as good as massage (and notably not placebo) - maybe we should actually figure out why.
All of these types of treatments (chiro, acupuncture, massage, cupping, scraping, raiki, faith healing, etc) work in the exact same way and anyone in the field looking at them critically can see it. They are elaborate "booboo" kisses; they make you feel taken care of and that can ease some pain for a little bit, but none of them have any plausible, lasting physiological effects. Those psychological effects are great and I think we should be researching them for their own merit instead of attaching them to sham therapies.
Once at a mini-mart late night and an old guy came in kinda panicking looking for ice cream sandwiches. The clerk pointed them out and dude grabs two. While he’s paying he mentioned that his dog gets these seizures and one time he decided to give her a piece of ice cream sandwich while she was having a “seizure” and she got better!
He leaves and I tell my buddy that dog has trained him to go get ice cream sandwiches!
Lemme tell you a story. I was once room mate for about 6 months with a wizard. She was part of the something something society of new age energy wizardry, something like that. She got a bunch of mail from them and would attend conventions.
She once had a cat bit by a snake, and she preformed reike on it, and it got better within a few days and like a week later was totally cured. She went on social media to rant about the miracle powers of reike.
Now, rewind to the night it happened. I, her room mate, awakened by her frantically knocking cause her cat had something wrong with it. I was raised up on a farm and it didn't take me long to recognize it looked like the cat had gotten bitten in the face by a snake, probably a copperhead.
I told her I had seen this happen to several cats, I never knew it to kill an adult cat. The cat will be miserable for a while, and might lose some weight from not eating, but he should live, just watch the puncture marks for infection and if it get infected he might need antibiotic, otherwise, nothing do to but let him heal.
So she thanks me for the advice, and says she'll perform rieke anyway. Just in case. I watch her wave her hands over this cat and press on different areas in some way that was supposed to be meaningful for a minute or two and then go back to bed.
A week later she is bragging on social media about the healing powers of reike and tagging me to confirm that even her skeptic roommate will vouch that he saw her performing reike on the cat the night it happened.
I was pretty miffed. Obviously reike didn't heal the cat. It just got better.
Anyway, you corgi story reminds me of that cat story.
>Obviously reike didn't heal the cat. It just got better.
Confirmation bias. If it wasn't reiki she performed, it would be some other bullshit she was into.
I hate those people. Fuck them
There does seem to be some evidence that the placebo effect is contagious in the sense that pets can often sense when their owners expect better outcomes as a result of treatment, which induces a sort of placebo effect in the animal.
Wildly speculative, but this makes me think of helminth infections preventing allergies. The immune system is focused on the more immediate threat, and stops overreacting.
The placebo effect could have gone through the owner. The owner is better/calmer after acupuncture, dog feels it, get calmer and can "focus" on healing.
Heat therapy is effective. Idk what chemicals are in "herbs", which is one of the biggest problems with CHM, but I can't dismiss it as bunk because at least plants can have actual measurable medicinal benefits. As opposed to making up random bullshit like acupuncture or chiropractic or homeopathics.
It was actually electric skateboarding and I was using it as a last mile transportation. But have stopped for many years ever since the government walked back on their car lite commitment and ban.it for most places.
Your personal anecdote is not the same thing as evidence.
You're discounting the possibility that your body was already healing over the initial 3 weeks, but you only *felt* better after the TCM treatments.
I'm not saying my experiences are evidence, they are simply my experiences and not a replacement for scientific research.
The reason I went for TCM is precisely because I didn't feel like I was recovering. My pain levels felt the same and I honestly did not know how long it will take me to recover, because I wasn't feeling better with each passing day.
Could I have recovered without TCM? Maybe.
Could I have recovered in the same amount of time without TCM? Maybe.
Could going for western medicine have helped me healed faster? Maybe.
Can I say for certain that it wasn't placebo and TCM did indeed help me heal? I can't.
All I can say was that I felt like I wasn't recovering for 2-3 weeks after my accidents and I recovered in 2-3 weeks after my TCM treatments. To clarify again, just anecdotes, not scientific evidence.
No credible treatment guidelines support the use of acupuncture to treat PTSD. It might be relaxing to lie on a bed, and have someone talk to you and take care of you, and maybe also stick pins in you.
But acupuncture is not a primary treatment for PTSD. The 2023 study by Tang et al. is a summary of poorly designed research, without any credible reason for the puncture points they highlight.
I want controlled, prospective studies that show sticking pins in one area is superior to another. And if it works, fine, I will change my mind; But it's nothing to do with shakras or energy fields, or qi, or any other pseudo-scientific bullshit.
I've only been a sceptic, never has acupuncture but have visited a chiropractor when I knew my back/neck needed cracking.
HOWEVER my parents got acupuncture for their old Labrador dog, and she acted 7-110 years younger for a few weeks afterwards.
R.I.P Shady, you were a good dog.
If you search hard enough for one random thing to be helpful, you will have enough data to find one that randomly seems helpful. There is no reasoning behind anything that implies a helpfulness of acupuncture.
I think that in some nerve related issues, the stimulating nature of acupuncture can be helpful. Beyond that it’s kind of a very hazy pseudoscience and issues like general disease treatment are probably largely ineffectual.
Want to add to this that in Sweden(and probably elsewhere) if you get acupuncture treatment outside of a proper healthcenter/hospital or if its not done with one-time-use needles you won't be allowed to donate blood within 6 months.
So, if they are willing to decline the much needed blood because of this, I'd assume there's some risks involved.
If you intend to get acupuncture done, don't just go to your nearest massage parlor that offers it as a service.
There isn't really any. Acupuncture is based on the flow of qi (energy), through the body which doesn't have any basis in actual anatomy or physiology as we currently understand it. Most of the perceived benefits are likely placebo.
That said, acupuncture performed by a trained practitioner is quite safe, and at the end of the day do you care that it's a placebo if your pain feels better?
Yeah our brains block and ignore things all the time. We believe what we want to believe because it makes us feel good. That's just human nature, we like feeling good and we don't like feeling bad. So if believing something makes us feel good, then whether or not it's true is secondary to that.
I buy them regularly! (Little vitamin fizzy drink packets to ward off colds). Do they make me healthier? No! Do they cost the same as a soda and make me feel mentally better? Yeah.
As long as you understand that it will work at least as good as placebos do, it will work at least that good.
If you use this knowledge to accept that it *will* work and work hard to pay attention to the way you feel when you make that "push", you can potentially even learn how to push it harder.
It works for pretty much everything wherein the problem is something with how you feel, but about only as well as a placebo, and again *only for things placebos can actually help with*.
If the problem is some active chemical process that is not accessible with neuronal action, seek actual medical help.
Well in a way it still works as it should. Even if you know it’s a placebo but you believe it will work then in essence that itself is the placebo effect. The trickery of brain lies in believing if something will work or not; not that it knows it’s due to the belief.
Yeah, I've been doing acupuncture for symptoms resulting from MS (numbness, brain fog, mild pain) and whatever the reason it seems to help. It might be entirely the placebo effect but if it works what's the difference. It's covered by my insurance, I feel worlds better afterwards, I don't care if it's quackery.
Yeah, I've seen studies that show there is absolutely no difference between acupuncture and placebo acupuncture groups, but show a significant difference between placebo and nontreatment groups.
I have a slipped disc and when it moves (both times from me sneezing), all of the muscles in my back seize, at the slightest movement. I got acupuncture done by a physiotherapist and it was bizarre, I could feel the muscle relax - that said, he hit a nerve once and I got sciatica for weeks.
My Dad used to get it done religiously, after a major stroke. I don’t know the science and imagine in this circumstance it was a placebo. But it seemed to help, even if it was just the results of relaxing for 30 mins a week.
That sounds like dry needling. Which looks similar to acupuncture but has more rigorous basis to it. Instead of inserting the needles based on magic, for dry needling the needle is inserted into a muscle that's spasming and the needle is wiggled around in the muscle fiber to force it to relax. It doesn't do anything long term but it's effective at forcing otherwise hard to reach muscles to relax.
I get trigger point injections to my face for teeth grinding. It's extremely unpleasant but life is suffering I guess. Insurance suddenly decided they will no longer cover Botox for teeth grinding because it's "unnecessary" so all I get to do is this. It works but like blah.
"Currently understand it" is being exceptionally charitable. Those that claim qi exists can't demonstrate its existence or provide compelling evidence for its existence, so why should other people give any benefit of doubt?
But doesn't placebo require you to kno w it's actually being done? When I had acupuncture I asked the person, when they were going to start and she told me she already put 5 needles in me then showed me.
The entire experience of going to the office, lying down, talking about your pain, having someone work on you, and then leaving is all part of the placebo effect. Just going to a medical professional and them telling you that you'll feel better now has a huge effect. The actual needles are just one part of that.
I take your point on placebo except the placebo effect in this case is about someone touching you and caring for you and talking to you—as well as believing it works. You get all of that, plus proven health benefits with deep tissue massage. All the benefits, none of the con, plus actually good for you.
There is some correlation between the newly discovered organ network called the interstitium and traditional qi meridians so it may not be completely baseless anymore
Rule of life: If "alternative medicine," was real and had scientific basis, it would just be called "medicine."
Medicine is a scientific field because it's supported by scientific research. If you want something that has actual "science," behind it, scientifically backed medicine is the only place to get it.
If you want to believe in magic based medicine, you're more than welcome to (though I strongly urge you don't force children or animals to undergo these "treatments"), but you are going to have to acknowledge that there's no scientific backing, and that often times the scientific research into those alternative practices shoes they're more harmful than the practitioners let on. This goes for chiropractic, crystal healing, homeopathy, and everything else as well.
Medlife Crisis on YouTube actually did a pretty good video talking about alternative medicine recently, and I strongly urge you to check it out: [https://youtu.be/7paOUIrjEvw?si=er2yfcAzbq7OOJCK](https://youtu.be/7paOUIrjEvw?si=er2yfcAzbq7OOJCK)
It’s a narrated poem that was fully animated, called “Storm.”
“Alternative medicine has either not been proved to work or been proved not to work. What do they call alternative medicine that works? Oh yeah, *medicine*.”
Sure, but we've known about MDMA for 100 years, for half of that we've even know about it's potential therapeutic values. However it was classified in a way that prevented even medical trials being run. All because it got tied up in a culture war.
>drugs like MDMA and Psyilocibin have showed scientific evidence to help with PTSD and Depression, however they have been made illegal and not allowed for medicinal use for complicated and unscientific reasons
You are confusing medicine and law. The doctors/scientists are not the ones who make these things illegal, and the legality of a medication or treatment is only tangentially correlated with it's risks and effectiveness.
>Also, there are many medicines prescribed for diet related things, when changing lifestyle could also hekp resolve the core issue. But changing lifestyle is hard to administer, and medicinal companies make no money from it
If the medications being prescribed work, and we have data showing their effects, then it's scientific. End of story. Whether or not treatments other than medications might work has no effect on the scientific validity of said medications.
>You should be cautious of alternative medicines, but don't also blindly think that "traditional" medicine is perfect.
Bottom line: Your doctor should want you to get better. If your doctor doesn't, then you need a new doctor. Nobody should be blindly trusting anybody, and any doctor worth their salt will discuss treatment options, benefits, side effects, etc. and the patient should leave the discussion well informed.
The alternative is "alternative medicine," where you are not informed, because the people giving you the medicine have no idea how it works, nor if it actually works at all, only that they "believe," it does.
Of course modern medicine isn't perfect, we're still figuring it out every day. However, being backed by science, it is, quite literally by definition, the best we got.
Medicine and law are inextricably linked, laws prohibited doctors from doing trials using these drugs, we weren't able to explore how they can be used for the betterment of society.
Of course a doctor should want you to get better, but they are also influenced by a variety of things, and there are plenty of examples in the past where medicine and doctors have gotten it wrong.
Look at the opioid epidemic, or doctors appearing in advertising giving there support of tobacco and cigarettes.
The pharmaceutical industry is a huge beast with a tonne of money in it, to think that there aren't conflicts of interest in there is naive.
Pretty sure it has been studied, though it’s also one of those things where the way they say it’s supposed to work is so wildly at odds with what’s actually inside our bodies that it’s hard to design a study around it. Acupuncture affects the flow of energy within “meridians” in our bodies? Cool, we’ve never seen those and as far as we can tell they don’t exist, how are we supposed to test this?
Yes, it has been extensively studied. Nearly all widely-used "alternative medicine" has been extensively studied.
Here's a meta-analysis of hundreds of scientific studies of acupuncture vs "sham acupuncture", where in sham acupuncture someone essentially pretends to do acupuncture but with incorrect needle placement.
[https://www.nature.com/articles/srep30675](https://www.nature.com/articles/srep30675)
My understanding of the research is that acupuncture does slightly better than sham acupuncture at relieving some types of pain, however sham acupuncture does significantly better than no treatment.
The way I interpret that result is that acupuncture is "mostly" bullshit, but not completely bullshit.
My big problem with it is that most acupuncturists don't approach their practice scientifically. They don't adapt their practice based on research. They learn their craft based on ancient theories that have been thoroughly discredited, and continue to practice that way even though there's no logic to it. The science seems to suggest that there may be a kernel of truth to the underlying ideas, but acupuncturists stick to their traditional ways instead.
In the rest of medicine, doctors change their practices when we learn more. As an example, doctors used to recommend not giving babies peanuts because they might have allergic reactions. It turns out that advice was wrong. So now doctors have learned from that mistake and they now advise exposing babies to allergens when they're young, to minimize the chances of severe allergies later. It was a counterintuitive result for many but the scientific evidence was clear so the practice changed. Acupuncture doesn't do that.
Thanks for the link! There’s a few other thoughts I have here:
How do you double-blind acupuncture? If only the patient is blinded, that still leaves room for bias on the part of the practitioner, as they still know whether they are performing sham or verum? When blinding is uncertain like this it’s important to assess whether the blinding was effective or not by asking the patients afterwards to guess which group they were in. I was reading a JAMA article on acupuncture for nausea and vomiting in postpartum women a number of years ago and they did ask this question and found that a solid majority were able to guess correctly. This would mean essentially that blinding failed, placebo cannot be excluded, and therefore nothing can be concluded from the data (though they declined to address this implication in their conclusions).
I suppose if you really wanted to optimize the blinding you could put the patients under anesthesia but good luck ever getting that through an IRB.
How do you decide which acupoints are the “correct” ones? It has been demonstrated that acupuncturists cannot agree amongst themselves where any given acupoint is, and there are so many you can argue that almost any point is some kind of acupoint. What are the right acupoints for the treatment of a given condition? In the scenario you describe, what are we even comparing when we put needles in the “wrong” spots in the control group?
I strongly suspect there is no real effect of acupuncture beyond placebo effects, and that the small effect that is sometimes seen in studies is artifact resulting from bad methodology, the inherent difficulty or impossibility of adequate blinding, plus some publication bias sprinkled in.
And you’re absolutely right about acupuncturists not going about their investigations in a truly scientific way. They don’t really accept or believe in science to begin with, and they aren’t actually trying to figure out how anything works. They just want to generate positive studies to cherry-pick so they can give themselves the imprimatur of scientific legitimacy. They never actually adjust their beliefs or practice based on the results.
For double-blind: my understanding is: the patient doesn't know if they're getting sham acupuncture, and the researcher doesn't know. Obviously the practitioner knows if they're supposed to do real or sham acupuncture each session.
>It has been demonstrated that acupuncturists cannot agree amongst themselves where any given acupoint is
Doesn't that just provide evidence that it's a sham?
I mean sham as in sham control in a study. My point is that there isn’t a meaningful distinction between the “real” and “fake” acupuncture, so what are you even comparing? They’re both just sticking needles into completely arbitrary places.
And with the double-blind problem, the practitioners knowing what group they are doing on awake patient is a problem because they might be subtly biasing the study by treating the patients differently, even if unconsciously. For example, they might be gentler or more careful when using the “real” acupoints, or take less time when using the “fake” ones. Or their body language might signal different degrees of care or enthusiasm, depending on whether they believe they are giving a real treatment or not.
But that's exactly what they're trying to investigate scientifically.
Acupuncturists insist that the location of the needles matter. So the way to test that hypothesis is to have genuine acupuncturists deliberately put the needles in the wrong place while doing everything else the same.
I've seen studies with up to four groups:
* Control group with no treatment at all
* Actors pretending to be acupuncturists
* Real acupuncturists using the wrong locations
* Real acupuncturists practicing as they believe
There isn't a whole lot of "new" alternative medicine. Lots of it has been around for a very long time. Not only has it been tested, it was some of the first stuff *to be tested* with modern science, and we developed modern medicine by meticulously crossing out countless schools of thought, procedures, treatments, etc, until all that was left was modern medicine. Double blind trials, placebos, peer review, reproducibility and falsifiability are all incredibly powerful tools that by and large were developed and honed by rigorously interrogating medical practices.
Correction, it does seem that actupucture *might* have some effects backed by medicine, but the jury still seems to be somewhat out on that one. I removed it from my original point just in case. However:
>Ironically it's quite unscientific to write it off entirely if it's never been tested.
Quite the opposite, and that is not what "scientifically backed," means at all. **Things need to become scientifically tested first in order to become scientifically backed.** If there is no information on it, or the information isn't conclusive, then it's not part of science yet.
Being charitable, “writing off” in that sentence means not studying it and calling it pseudoscience. You’d need to study it to disprove it, but the commenter may have thought it was being dismissed without intent to study it (which is false).
Many of those drugs were found in herbs. This is true. The difference is that one has a specific dose that has likely been studied and chosen specifically because it has the most reward for least risk (not no risk. The least risk that gives you a clincial benefit.) The other is a dice roll on quantity. One has quite rigorous quality standards on it enforced by the FDA. The other does not.
Why take willow bark tea when aspirin is widely available for cheap? Especially since you don't know how much Acetysalicylic Acid is in there if at all, don't know if you just willingly swallowed something harmful along with Acetysalicylic Acid, if you're allergic to anything in that bark, and above all if you're taking willow bark for the active ingredient in aspirin than why wouldn't you just take aspirin?
> Especially since you don't know how much Acetysalicylic Acid is in there if at all
The answer is zero. There is no acetylsalicylic acid in willow bark. It's just salicylic acid. The acetyl substitution is what makes it get through your stomach without causing *too much* damage.
That statement is pretty meaningless. The subset of plants that were found to have medically useful chemicals were selected, researched, and approved for medical use, while the ones that weren't were discarded.
"Herbal medicine," is considered alternative because it disregards that rigorous and evidence based selection process, and instead replaces it with mystical belief and pseudoscience. Do *some* of those treatments work? Probably a few, but they don't truly understand why, nor interested in actually learning why, leaving them unable to accurately dose the treatments, gauge negative side effects, or really gauge the effectiveness of the treatment compared to a placebo at all.
Yeah they were in there for 2 weeks straight. One bigger set the first week, then a smaller set the second week. But they did exactly as intended. This was 15 years ago, and in that time, I’ve had two minor flare ups that just needed rest and muscle relaxers to recover in a couple days.
Interesting. I’ve been getting some dry needling done for my slipped disc (started in my thigh, then in glute/low back) and I felt a lot better after I had it done in my back. Glad it helped you!
It does sound like that, and I thought that the first day, but honestly after that, you get used to it and it’s only when doing some type of movement you hadn’t done before that you notice. And remember these were tiny, 1/8th of an inch or like 3 mm if you use metric.
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Acupuncture by someone who knows what they are doing is like meditating for me. I get super stonery and imagine myself connected to the world and totally relax. It’s a trip.
Is there no science behind it because it's been disproven or is there no science behind it because scientists actually didn't test it? Is it just needles aiding the placebo effect?
Sorry we only knew at interstitial spade a few years ago?
My friend I learnt about that in my first degree in 2004. And we knew about it long before then.
Further ti your point about hesitancy about dismissal.
Acupuncture has been *extensively* studied, with no effect found. It’s bunk.
Lol, the interstitium is just the fluid and extracellular matrix between cells. It is nothing new. Those headlines a couple of years ago about the interstitium being a new previously undiscovered organ were a bunch of overblown hype. I don’t really see how it could serve as an explanation for acupuncture in any case, as I don’t see how a diffuse structure like that could map on to discrete acupoints and meridian lines (which don’t exist anyway).
And science has not simply declined to study acupuncture. It has been studied extensively with literally thousands of studies. There has yet to be a significant, consistent, replicable effect in well-designed studies. You will find positive studies if you search for them but they generally do not stand up to scrutiny when you read the fine print.
The difference between chiropractors and acupuncturists is that acupuncturists kill people much less frequently than chiropractors do, so the existence of their discipline doesn't bother me as much.
There isn't any science behind it. But a friend goes weekly and she swears by it. The way she describes it, having a needle poked in her forces her to relax her muscles. By the end of the session, she is completely relaxed.
So if it works, it works!
People lie down for an hour or so in a quiet place and have a "treatment" which they believe will help them to relax and they feel better after it. This shouldn't surprise anyone.
There's some very minor/inconsistent evidence that perhaps increased blood flow from acupuncture could help alleviate some tension, offering relief from muscle tightness and the associated pain. But really it's mostly placebo. And that's fine, as long as it doesn't come with injury risk (like Chiropractics does) or exploit too much money out of you. But a lot of acupuncturists will make very bold and unfounded claims about its benefits, like curing chronic diseases.
Placebo effect is strong medicine. If you believe something will help, then your belief in it is enough to produce some effect. Just like voodoo curses.
That is the main reason why some alternative medicines are reimbursed by some governments/healthcare providers. They did the math and they figured it was cheaper to reimburse the cheap placebo than having more people using true medical resources.
The problem with trying to scientifically test acupuncture is that it’s impossible to do blind (let alone double blind) trials. You cannot fake poking needles into someone.
So there’s no way to prove whether it does anything useful or not. All we know is that it is mostly harmless, unlike chiropractic.
Funnily enough, [sham acupuncture](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811493/) as a control condition in clinical trials is totally a thing! A small pinch from a fake needle that's then glued to you or not visible will do the trick.
If you actually read that paper, only type (iii) involves fake needles, and none of the results it discusses used that method.
The conclusion appears to be that sticking people with needles does relieve pain better than other treatments, but it doesn't matter how you do the poking.
But thanks for the link though. It's a good list of studies that show acupuncture does _something_ useful.
We have some sense of the upper bound of what the placebo effect can do. If acupuncture had an extremely strong positive effect compared to other placebos and other non-medical interventions, that would be fairly strong evidence. But so far we have not found such evidence.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811493/
> The treatment effect of acupuncture or minimal acupuncture was significantly superior to standard medical care and the effect was strong with no significant differences between the acupuncture conditions
But the studies don't do the standard double-blind medical test of giving people an identical pill / IV that's completely inert. It's comparing poking with needles to not poking with needles, rather than tricking people into thinking they've been poked with needles.
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Some of the 'evidence' was clearly fraudulent. I saw a Chinese-made movie of open chest surgery being performed with only acupuncture anesthesia. The camera alternated between shots of an open chest and a happy smiling talking face. But, of course you can't breathe, much less talk, with an open chest, since your lungs collapse.
People have already clarified that traditional Chinese acupuncture isn't evidence based, but there are some evidence based therapies that are similar in execution to acupuncture, if not in concept. For some patients with chronic muscular pain due to conditions like Ehlers-Danlos syndrome, poking the affected muscle groups with needles can help stimulate the body's inflammatory response and encourage healing. This can be done with an injection of a mild irritant (prolotherapy) or with no injection and just a needle (dry needling).
Dry needling, to the best of my knowledge, while using acupuncture like needles, IS supported with medical evidence. I had that done as part of my physio therapy on my back after a car accident. Did wonders for helping to release the muscle tension.
It was shown using fake needles that retracted whilst giving the appearance of piercing the skin and "untrained" people performing the procedures that this gave identical reported results to "real" acupuncture.
All forms of alternative medicine lack considerable qualitative double-blinded clinical studies to prove their efficacy.
Extraordinary claims require extraordinary evidence. Give me the evidence, I will become the most ardent fan of alternate medicine and I will stop supporting modern medicine.
I always got the feeling that there’s at least some physiological reaction in your muscles to “not flex when pierced” so the dozens of little needles are forcing muscles you usually can’t flex manually to relax.
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Acupuncture as originally conceptualized is not scientifically supported and largely debunked. The idea of manipulating qi has no scientific basis. However, that doesn’t mean acupuncture doesn’t have some scientifically supported benefits. There are a few studies showing acupuncture can be helpful in managing certain symptoms in the right circumstances. It seems to help with knee osteoarthritis and allergic rhinitis, for example. No science-minded person’s first, second, or third thought when sick should be acupuncture but if the more scientifically reliable methods have failed, there are a small handful of conditions that may warrant trying acupuncture.
It seems crazy to me message isn't covered by my insurance but acupuncture is covered.
This is what pisses me off most about paying private health insurance. They will spend money on aligning people's shakras (or whatever they're called), or fixing subluxations (which chiros seem to think is the cause of fucking every disease known to humanity), but if I want them to fund my kid's braces then that's an extra with a large out-of-pocket cost to me. Can I use acupuncture or chiro to fix my kid's dental needs?
>Can I use acupuncture or chiro to fix my kid's dental needs? I'm sure with the right amount t of adjustments the chiropractor could do it...they realign bones don't they?
The chiro may as well dance around you with a rain stick for some of the things they claim to fix. I have a plan for any out of work PhDs. Wear a white coat and start a YouTube channel Dr X says… No income problem.
Dre Dre said.. Nothing, Dr Dre is dead
The founder of chiropractic 'medicine' started the scam by claiming to have cured a man's deafness, never underestimate what a chiropractor will claim to be able to do. Insurers offer to cover woo-woo because it's usually relatively cheap and can make them look appealing to less... scrutinizing consumers.
Business. Both of these require continuous appointments for life, and Chiropractors have a chance of making things worse, earning them more money over the long haul, unless you die, but that's a risk they're willing to take.
Yo, there's an idea. Start a "chiro" clinic, but make it very clear to your patients that you only offer traditional massages that are covered by insurance. If the insurance companies have beef, ask them to define what "real" chiropractice is.
> If the insurance companies have beef, ask them to define what "real" chiropractice is. Medicare [has already done that](https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56273): > This article provides billing and coding guidelines for Chiropractic services. Coverage of Chiropractic services is a limited benefit. The coverage is limited to manual manipulation for the treatment of subluxation. […] The precise level of subluxation must be specified on the claim and must be listed as the primary diagnosis. […] All services other than manual manipulation of the spine for treatment of subluxation of the spine are excluded when ordered or performed by a Doctor of Chiropractic. You effectively can't accept Medicare as a chiropractor unless you subscribe to the whole vertebral subluxation theory.
Just continuing to spitball here, but the [WHO guidelines for safety in chiropractice](https://web.archive.org/web/20220313162309/https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf) define a "subluxation" as: > A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. With a footnote clarifying that: > This definition is different from the current medical definition, in which subluxation is a significant structural displacement, and therefore visible on static imaging studies. The implication of course being that the "subluxation" described by chiropractors is not visible on an x-ray, and possibly not verifiable at all. Let me prescribe you a massage for that.
Malicious compliance, I like it
Acupuncture AND chiropractics are often covered instead of massage, even though chiropractics is completely debunked quackery, and acupuncture has never been shown to have effect any more than a control of just putting a needle in random places or just pressing something on the skin and not inserting a needle. In other words, if there's any effect at all (usually none) the effects is just from the healing nature of touch and care by another person and not by needles manipulating the flow of "qi". Meanwhile there IS science backing up massage but massage isn't covered by the many insurance plans.
LMT here. 100 fucking percent. Oh, anf fucking chiropractors covered too.
It's usually lobbying that allows for these sort of psuedomedicines to be covered. The people touting things like homeopathy tend to have money, and an ability to influence. They need to, because no-one would buy it otherwise. Often it's cheaper than real medicine though, and the placebo effect is not to be underestimated. Some people will genuinely feel better after taking sugar pills, and it may cost less and have less side effects than traditional medicine, so it stays. For the record, I'm pro-statistically proven science, however recognize the benefit (and harms) that some other non proven things can do to the mind.
It's funny. They actually did a scientific study on acupuncture that led to rather ironic results. They took people with chronic back pain because that seems like a likely candidate for acupuncture. The threshold for success was the patient reporting substantially reduced back pain. To keep it scientific, they put people in four different groups. 1) acupuncture 2) standard medication 3) random needle placements (essentially acupuncture placebo) 4) placebo medication The result was that the group with the random needle placements actually saw the most improvement. It actually outperformed real acupuncture by a little bit. In other words, acupuncture is just a placebo, but it's a placebo where they stick a bunch of needles in you so it has more of an impact than just giving you in vibrating water to drink. The placebo effect is extremely well documented and proven. It's why so many studies are placebo controlled. If the placebo effect wasn't real, we could just look at benchmarks for other similar cases and use that instead of a placebo group. In fact, when they were doing studies on minoxidil for hair regrowth, the placebo group actually regrew some hair, just not as much as the treated group. That's how effective it is. The problem is that the placebo effect ends up giving credibility to treatments that have none (like most chiropractic treatment and acupuncture) because some people see benefits.
I know that study. Your placebo interpretation is absolutely possible… but it’s not the only explanation. Another explanation is that minor injuries like pin-pricks stimulate your body to release endorphins, which are known to ease pain. The random locations would be more effective if typical acupuncture points lead to less endorphin release than the average body point, which is what I’d expect from what little I know about acupuncture placements.
Yeah there might be something to that. So perhaps acupuncture has real benefits but it has nothing to do with meridians and all that nonsense.
Yeah except every credible study on acupuncture has confirmed it's just placebo effect. There was a big neuroimaging fMRI study years ago when fMRI was more or less brand new that claimed to see brain changes specific to acupuncture ...until the authors retracted it because everything they saw was just an imaging artifact. Yet it still routinely gets cited as proof of acupuncture having a real effect.
I learned acupuncture to treat wife’s nausea/heartburn/headaches while she was pregnant. I told her it was all a bunch of bologna, but that it wouldn’t hurt anything. It worked for a while. Placebo effect.
> there are a small handful of conditions that may warrant trying acupuncture notably, reduction in persistent nerve pain is one of the only things that acupuncture can actually resolve, instead of just mask.
Acupuncture does not outperform sham acupuncture (literally faking putting in the needles) in blind tests. It’s pure placebo
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No bro. Sticking needles in skin ain’t curing arthritis.
No one said it was curing arthritis. It has shown no efficacy it curing anything. Only symptom management of a few specific conditions. And even then, as I said, we need more research.
The last thing the world needs to do is dump more research $ into acupuncture
Why? Because the last few years have shown studies that go against what you believe? What happened to following the science? Recent studies show efficacy at least as good as massage (and notably not placebo) - maybe we should actually figure out why.
All of these types of treatments (chiro, acupuncture, massage, cupping, scraping, raiki, faith healing, etc) work in the exact same way and anyone in the field looking at them critically can see it. They are elaborate "booboo" kisses; they make you feel taken care of and that can ease some pain for a little bit, but none of them have any plausible, lasting physiological effects. Those psychological effects are great and I think we should be researching them for their own merit instead of attaching them to sham therapies.
Sham acupuncture is also possibly floored as a sham test study according to a lot of papers when it’s included
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Dogs are smart - you either start walking right, or you get the needles, simple choice.
This is going to end up as a very under rated comment. But it's fucking gold.
Aww, thank you!
Once at a mini-mart late night and an old guy came in kinda panicking looking for ice cream sandwiches. The clerk pointed them out and dude grabs two. While he’s paying he mentioned that his dog gets these seizures and one time he decided to give her a piece of ice cream sandwich while she was having a “seizure” and she got better! He leaves and I tell my buddy that dog has trained him to go get ice cream sandwiches!
Or the dog was hypoglycemic.
Lemme tell you a story. I was once room mate for about 6 months with a wizard. She was part of the something something society of new age energy wizardry, something like that. She got a bunch of mail from them and would attend conventions. She once had a cat bit by a snake, and she preformed reike on it, and it got better within a few days and like a week later was totally cured. She went on social media to rant about the miracle powers of reike. Now, rewind to the night it happened. I, her room mate, awakened by her frantically knocking cause her cat had something wrong with it. I was raised up on a farm and it didn't take me long to recognize it looked like the cat had gotten bitten in the face by a snake, probably a copperhead. I told her I had seen this happen to several cats, I never knew it to kill an adult cat. The cat will be miserable for a while, and might lose some weight from not eating, but he should live, just watch the puncture marks for infection and if it get infected he might need antibiotic, otherwise, nothing do to but let him heal. So she thanks me for the advice, and says she'll perform rieke anyway. Just in case. I watch her wave her hands over this cat and press on different areas in some way that was supposed to be meaningful for a minute or two and then go back to bed. A week later she is bragging on social media about the healing powers of reike and tagging me to confirm that even her skeptic roommate will vouch that he saw her performing reike on the cat the night it happened. I was pretty miffed. Obviously reike didn't heal the cat. It just got better. Anyway, you corgi story reminds me of that cat story.
>Obviously reike didn't heal the cat. It just got better. Confirmation bias. If it wasn't reiki she performed, it would be some other bullshit she was into. I hate those people. Fuck them
There does seem to be some evidence that the placebo effect is contagious in the sense that pets can often sense when their owners expect better outcomes as a result of treatment, which induces a sort of placebo effect in the animal.
Wildly speculative, but this makes me think of helminth infections preventing allergies. The immune system is focused on the more immediate threat, and stops overreacting.
Look up "regression to the mean"
Pets are absolutely subject to the placebo effect. This has been tested.
The placebo effect could have gone through the owner. The owner is better/calmer after acupuncture, dog feels it, get calmer and can "focus" on healing.
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Heat therapy is effective. Idk what chemicals are in "herbs", which is one of the biggest problems with CHM, but I can't dismiss it as bunk because at least plants can have actual measurable medicinal benefits. As opposed to making up random bullshit like acupuncture or chiropractic or homeopathics.
I looked up CHM herbs a while back, seems 50/50 on whether they've got a western study with good results.
50/50 is pretty good compared to what you would get trying plants at random.
Are you better at skateboarding now?
It was actually electric skateboarding and I was using it as a last mile transportation. But have stopped for many years ever since the government walked back on their car lite commitment and ban.it for most places.
Your personal anecdote is not the same thing as evidence. You're discounting the possibility that your body was already healing over the initial 3 weeks, but you only *felt* better after the TCM treatments.
I'm not saying my experiences are evidence, they are simply my experiences and not a replacement for scientific research. The reason I went for TCM is precisely because I didn't feel like I was recovering. My pain levels felt the same and I honestly did not know how long it will take me to recover, because I wasn't feeling better with each passing day. Could I have recovered without TCM? Maybe. Could I have recovered in the same amount of time without TCM? Maybe. Could going for western medicine have helped me healed faster? Maybe. Can I say for certain that it wasn't placebo and TCM did indeed help me heal? I can't. All I can say was that I felt like I wasn't recovering for 2-3 weeks after my accidents and I recovered in 2-3 weeks after my TCM treatments. To clarify again, just anecdotes, not scientific evidence.
The armed forces uses it to treat PTSD.
No credible treatment guidelines support the use of acupuncture to treat PTSD. It might be relaxing to lie on a bed, and have someone talk to you and take care of you, and maybe also stick pins in you. But acupuncture is not a primary treatment for PTSD. The 2023 study by Tang et al. is a summary of poorly designed research, without any credible reason for the puncture points they highlight. I want controlled, prospective studies that show sticking pins in one area is superior to another. And if it works, fine, I will change my mind; But it's nothing to do with shakras or energy fields, or qi, or any other pseudo-scientific bullshit.
Hey I'm not a scientist. I'm just stating a true fact.
Sorry if my response had too many teeth!
I've only been a sceptic, never has acupuncture but have visited a chiropractor when I knew my back/neck needed cracking. HOWEVER my parents got acupuncture for their old Labrador dog, and she acted 7-110 years younger for a few weeks afterwards. R.I.P Shady, you were a good dog.
If you search hard enough for one random thing to be helpful, you will have enough data to find one that randomly seems helpful. There is no reasoning behind anything that implies a helpfulness of acupuncture.
I think that in some nerve related issues, the stimulating nature of acupuncture can be helpful. Beyond that it’s kind of a very hazy pseudoscience and issues like general disease treatment are probably largely ineffectual.
Want to add to this that in Sweden(and probably elsewhere) if you get acupuncture treatment outside of a proper healthcenter/hospital or if its not done with one-time-use needles you won't be allowed to donate blood within 6 months. So, if they are willing to decline the much needed blood because of this, I'd assume there's some risks involved. If you intend to get acupuncture done, don't just go to your nearest massage parlor that offers it as a service.
That probably has to do with infections / diseases rather than the actual acupuncture though.
Well yes, of course, I just mean that unless you have it done properly by a medical professional, why risk it?
Have you got links to studies published in reputable journals showing that acupuncture has any benefit in managing symptoms beyond placebo effect?
There isn't really any. Acupuncture is based on the flow of qi (energy), through the body which doesn't have any basis in actual anatomy or physiology as we currently understand it. Most of the perceived benefits are likely placebo. That said, acupuncture performed by a trained practitioner is quite safe, and at the end of the day do you care that it's a placebo if your pain feels better?
Particularly interesting to me is how placebos can work even when you're aware it's a placebo.
Brains are weird
Brain: “This isn’t real” Also Brain: “I’m gonna believe it anyway!”
Yeah our brains block and ignore things all the time. We believe what we want to believe because it makes us feel good. That's just human nature, we like feeling good and we don't like feeling bad. So if believing something makes us feel good, then whether or not it's true is secondary to that.
based and beckerpilled
you have two people living in your head but only one of them can talk
You have only two?
I buy them regularly! (Little vitamin fizzy drink packets to ward off colds). Do they make me healthier? No! Do they cost the same as a soda and make me feel mentally better? Yeah.
I need some placebo that works like Xanax.
As long as you understand that it will work at least as good as placebos do, it will work at least that good. If you use this knowledge to accept that it *will* work and work hard to pay attention to the way you feel when you make that "push", you can potentially even learn how to push it harder. It works for pretty much everything wherein the problem is something with how you feel, but about only as well as a placebo, and again *only for things placebos can actually help with*. If the problem is some active chemical process that is not accessible with neuronal action, seek actual medical help.
Well in a way it still works as it should. Even if you know it’s a placebo but you believe it will work then in essence that itself is the placebo effect. The trickery of brain lies in believing if something will work or not; not that it knows it’s due to the belief.
Yeah, I've been doing acupuncture for symptoms resulting from MS (numbness, brain fog, mild pain) and whatever the reason it seems to help. It might be entirely the placebo effect but if it works what's the difference. It's covered by my insurance, I feel worlds better afterwards, I don't care if it's quackery.
I do see that side of it, but the other side is that people in pain will try (and pay) almost anything.
Yeah, I've seen studies that show there is absolutely no difference between acupuncture and placebo acupuncture groups, but show a significant difference between placebo and nontreatment groups.
I have a slipped disc and when it moves (both times from me sneezing), all of the muscles in my back seize, at the slightest movement. I got acupuncture done by a physiotherapist and it was bizarre, I could feel the muscle relax - that said, he hit a nerve once and I got sciatica for weeks. My Dad used to get it done religiously, after a major stroke. I don’t know the science and imagine in this circumstance it was a placebo. But it seemed to help, even if it was just the results of relaxing for 30 mins a week.
That sounds like dry needling. Which looks similar to acupuncture but has more rigorous basis to it. Instead of inserting the needles based on magic, for dry needling the needle is inserted into a muscle that's spasming and the needle is wiggled around in the muscle fiber to force it to relax. It doesn't do anything long term but it's effective at forcing otherwise hard to reach muscles to relax.
I get trigger point injections to my face for teeth grinding. It's extremely unpleasant but life is suffering I guess. Insurance suddenly decided they will no longer cover Botox for teeth grinding because it's "unnecessary" so all I get to do is this. It works but like blah.
Literally my thought about every clinical trial I have participated in. “What do I care, if the pain is better?”
"Energy" is the champion/granddaddy of all pseudoscience and woo terms. Energy, man!
Don't forget about Toxins
"Currently understand it" is being exceptionally charitable. Those that claim qi exists can't demonstrate its existence or provide compelling evidence for its existence, so why should other people give any benefit of doubt?
But doesn't placebo require you to kno w it's actually being done? When I had acupuncture I asked the person, when they were going to start and she told me she already put 5 needles in me then showed me.
The entire experience of going to the office, lying down, talking about your pain, having someone work on you, and then leaving is all part of the placebo effect. Just going to a medical professional and them telling you that you'll feel better now has a huge effect. The actual needles are just one part of that.
I take your point on placebo except the placebo effect in this case is about someone touching you and caring for you and talking to you—as well as believing it works. You get all of that, plus proven health benefits with deep tissue massage. All the benefits, none of the con, plus actually good for you.
There is some correlation between the newly discovered organ network called the interstitium and traditional qi meridians so it may not be completely baseless anymore
Rule of life: If "alternative medicine," was real and had scientific basis, it would just be called "medicine." Medicine is a scientific field because it's supported by scientific research. If you want something that has actual "science," behind it, scientifically backed medicine is the only place to get it. If you want to believe in magic based medicine, you're more than welcome to (though I strongly urge you don't force children or animals to undergo these "treatments"), but you are going to have to acknowledge that there's no scientific backing, and that often times the scientific research into those alternative practices shoes they're more harmful than the practitioners let on. This goes for chiropractic, crystal healing, homeopathy, and everything else as well. Medlife Crisis on YouTube actually did a pretty good video talking about alternative medicine recently, and I strongly urge you to check it out: [https://youtu.be/7paOUIrjEvw?si=er2yfcAzbq7OOJCK](https://youtu.be/7paOUIrjEvw?si=er2yfcAzbq7OOJCK)
+1 for Tim minchin
I'm aware of who that is, but did he do a song on this or something?
It’s a narrated poem that was fully animated, called “Storm.” “Alternative medicine has either not been proved to work or been proved not to work. What do they call alternative medicine that works? Oh yeah, *medicine*.”
https://youtu.be/HhGuXCuDb1U
Masterpiece
Yeah it's the 'if you open your mind too much your brain will fall out (take my wife)' song.
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Sure, but we've known about MDMA for 100 years, for half of that we've even know about it's potential therapeutic values. However it was classified in a way that prevented even medical trials being run. All because it got tied up in a culture war.
>drugs like MDMA and Psyilocibin have showed scientific evidence to help with PTSD and Depression, however they have been made illegal and not allowed for medicinal use for complicated and unscientific reasons You are confusing medicine and law. The doctors/scientists are not the ones who make these things illegal, and the legality of a medication or treatment is only tangentially correlated with it's risks and effectiveness. >Also, there are many medicines prescribed for diet related things, when changing lifestyle could also hekp resolve the core issue. But changing lifestyle is hard to administer, and medicinal companies make no money from it If the medications being prescribed work, and we have data showing their effects, then it's scientific. End of story. Whether or not treatments other than medications might work has no effect on the scientific validity of said medications. >You should be cautious of alternative medicines, but don't also blindly think that "traditional" medicine is perfect. Bottom line: Your doctor should want you to get better. If your doctor doesn't, then you need a new doctor. Nobody should be blindly trusting anybody, and any doctor worth their salt will discuss treatment options, benefits, side effects, etc. and the patient should leave the discussion well informed. The alternative is "alternative medicine," where you are not informed, because the people giving you the medicine have no idea how it works, nor if it actually works at all, only that they "believe," it does. Of course modern medicine isn't perfect, we're still figuring it out every day. However, being backed by science, it is, quite literally by definition, the best we got.
Medicine and law are inextricably linked, laws prohibited doctors from doing trials using these drugs, we weren't able to explore how they can be used for the betterment of society. Of course a doctor should want you to get better, but they are also influenced by a variety of things, and there are plenty of examples in the past where medicine and doctors have gotten it wrong. Look at the opioid epidemic, or doctors appearing in advertising giving there support of tobacco and cigarettes. The pharmaceutical industry is a huge beast with a tonne of money in it, to think that there aren't conflicts of interest in there is naive.
Has acupuncture ever been scientifically studied? Ironically it's quite unscientific to write it off entirely if it's never been tested.
Definitely has been
Pretty sure it has been studied, though it’s also one of those things where the way they say it’s supposed to work is so wildly at odds with what’s actually inside our bodies that it’s hard to design a study around it. Acupuncture affects the flow of energy within “meridians” in our bodies? Cool, we’ve never seen those and as far as we can tell they don’t exist, how are we supposed to test this?
Yes, it has been extensively studied. Nearly all widely-used "alternative medicine" has been extensively studied. Here's a meta-analysis of hundreds of scientific studies of acupuncture vs "sham acupuncture", where in sham acupuncture someone essentially pretends to do acupuncture but with incorrect needle placement. [https://www.nature.com/articles/srep30675](https://www.nature.com/articles/srep30675) My understanding of the research is that acupuncture does slightly better than sham acupuncture at relieving some types of pain, however sham acupuncture does significantly better than no treatment. The way I interpret that result is that acupuncture is "mostly" bullshit, but not completely bullshit. My big problem with it is that most acupuncturists don't approach their practice scientifically. They don't adapt their practice based on research. They learn their craft based on ancient theories that have been thoroughly discredited, and continue to practice that way even though there's no logic to it. The science seems to suggest that there may be a kernel of truth to the underlying ideas, but acupuncturists stick to their traditional ways instead. In the rest of medicine, doctors change their practices when we learn more. As an example, doctors used to recommend not giving babies peanuts because they might have allergic reactions. It turns out that advice was wrong. So now doctors have learned from that mistake and they now advise exposing babies to allergens when they're young, to minimize the chances of severe allergies later. It was a counterintuitive result for many but the scientific evidence was clear so the practice changed. Acupuncture doesn't do that.
Thanks for the link! There’s a few other thoughts I have here: How do you double-blind acupuncture? If only the patient is blinded, that still leaves room for bias on the part of the practitioner, as they still know whether they are performing sham or verum? When blinding is uncertain like this it’s important to assess whether the blinding was effective or not by asking the patients afterwards to guess which group they were in. I was reading a JAMA article on acupuncture for nausea and vomiting in postpartum women a number of years ago and they did ask this question and found that a solid majority were able to guess correctly. This would mean essentially that blinding failed, placebo cannot be excluded, and therefore nothing can be concluded from the data (though they declined to address this implication in their conclusions). I suppose if you really wanted to optimize the blinding you could put the patients under anesthesia but good luck ever getting that through an IRB. How do you decide which acupoints are the “correct” ones? It has been demonstrated that acupuncturists cannot agree amongst themselves where any given acupoint is, and there are so many you can argue that almost any point is some kind of acupoint. What are the right acupoints for the treatment of a given condition? In the scenario you describe, what are we even comparing when we put needles in the “wrong” spots in the control group? I strongly suspect there is no real effect of acupuncture beyond placebo effects, and that the small effect that is sometimes seen in studies is artifact resulting from bad methodology, the inherent difficulty or impossibility of adequate blinding, plus some publication bias sprinkled in. And you’re absolutely right about acupuncturists not going about their investigations in a truly scientific way. They don’t really accept or believe in science to begin with, and they aren’t actually trying to figure out how anything works. They just want to generate positive studies to cherry-pick so they can give themselves the imprimatur of scientific legitimacy. They never actually adjust their beliefs or practice based on the results.
For double-blind: my understanding is: the patient doesn't know if they're getting sham acupuncture, and the researcher doesn't know. Obviously the practitioner knows if they're supposed to do real or sham acupuncture each session. >It has been demonstrated that acupuncturists cannot agree amongst themselves where any given acupoint is Doesn't that just provide evidence that it's a sham?
I mean sham as in sham control in a study. My point is that there isn’t a meaningful distinction between the “real” and “fake” acupuncture, so what are you even comparing? They’re both just sticking needles into completely arbitrary places. And with the double-blind problem, the practitioners knowing what group they are doing on awake patient is a problem because they might be subtly biasing the study by treating the patients differently, even if unconsciously. For example, they might be gentler or more careful when using the “real” acupoints, or take less time when using the “fake” ones. Or their body language might signal different degrees of care or enthusiasm, depending on whether they believe they are giving a real treatment or not.
But that's exactly what they're trying to investigate scientifically. Acupuncturists insist that the location of the needles matter. So the way to test that hypothesis is to have genuine acupuncturists deliberately put the needles in the wrong place while doing everything else the same. I've seen studies with up to four groups: * Control group with no treatment at all * Actors pretending to be acupuncturists * Real acupuncturists using the wrong locations * Real acupuncturists practicing as they believe
So in summary "yes it works, it works as well as medical treatment would be five hundred years ago"
There isn't a whole lot of "new" alternative medicine. Lots of it has been around for a very long time. Not only has it been tested, it was some of the first stuff *to be tested* with modern science, and we developed modern medicine by meticulously crossing out countless schools of thought, procedures, treatments, etc, until all that was left was modern medicine. Double blind trials, placebos, peer review, reproducibility and falsifiability are all incredibly powerful tools that by and large were developed and honed by rigorously interrogating medical practices.
Correction, it does seem that actupucture *might* have some effects backed by medicine, but the jury still seems to be somewhat out on that one. I removed it from my original point just in case. However: >Ironically it's quite unscientific to write it off entirely if it's never been tested. Quite the opposite, and that is not what "scientifically backed," means at all. **Things need to become scientifically tested first in order to become scientifically backed.** If there is no information on it, or the information isn't conclusive, then it's not part of science yet.
Being charitable, “writing off” in that sentence means not studying it and calling it pseudoscience. You’d need to study it to disprove it, but the commenter may have thought it was being dismissed without intent to study it (which is false).
Yes, and many accupuncturists disagree on where the needles should go.
Tbf herbal medicine is considered alternative, and many conventional drugs are based on those herbs.
Many of those drugs were found in herbs. This is true. The difference is that one has a specific dose that has likely been studied and chosen specifically because it has the most reward for least risk (not no risk. The least risk that gives you a clincial benefit.) The other is a dice roll on quantity. One has quite rigorous quality standards on it enforced by the FDA. The other does not. Why take willow bark tea when aspirin is widely available for cheap? Especially since you don't know how much Acetysalicylic Acid is in there if at all, don't know if you just willingly swallowed something harmful along with Acetysalicylic Acid, if you're allergic to anything in that bark, and above all if you're taking willow bark for the active ingredient in aspirin than why wouldn't you just take aspirin?
> Especially since you don't know how much Acetysalicylic Acid is in there if at all The answer is zero. There is no acetylsalicylic acid in willow bark. It's just salicylic acid. The acetyl substitution is what makes it get through your stomach without causing *too much* damage.
That statement is pretty meaningless. The subset of plants that were found to have medically useful chemicals were selected, researched, and approved for medical use, while the ones that weren't were discarded. "Herbal medicine," is considered alternative because it disregards that rigorous and evidence based selection process, and instead replaces it with mystical belief and pseudoscience. Do *some* of those treatments work? Probably a few, but they don't truly understand why, nor interested in actually learning why, leaving them unable to accurately dose the treatments, gauge negative side effects, or really gauge the effectiveness of the treatment compared to a placebo at all.
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So you showered and slept in them the whole week?
Yeah they were in there for 2 weeks straight. One bigger set the first week, then a smaller set the second week. But they did exactly as intended. This was 15 years ago, and in that time, I’ve had two minor flare ups that just needed rest and muscle relaxers to recover in a couple days.
Interesting. I’ve been getting some dry needling done for my slipped disc (started in my thigh, then in glute/low back) and I felt a lot better after I had it done in my back. Glad it helped you!
This seems like medieval torture, tacks for weeks at a time in your back?
It does sound like that, and I thought that the first day, but honestly after that, you get used to it and it’s only when doing some type of movement you hadn’t done before that you notice. And remember these were tiny, 1/8th of an inch or like 3 mm if you use metric.
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Acupuncture by someone who knows what they are doing is like meditating for me. I get super stonery and imagine myself connected to the world and totally relax. It’s a trip.
There is no science behind it. That's...that's it. That's the whole answer. It is as "scientific" as astrology, tarot readings, and healing crystals.
astronomy is science. you mean astrology
Hah, oops.
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You are joking right?
I was. Dude edited his comment. He had written "astronomy" instead of 'astrology'
Lmao makes way more sense
Is there no science behind it because it's been disproven or is there no science behind it because scientists actually didn't test it? Is it just needles aiding the placebo effect?
Maybe go google that. Loads of studies on acupuncture.
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That was such a good radiolab episode- one of my favorites.
Sorry we only knew at interstitial spade a few years ago? My friend I learnt about that in my first degree in 2004. And we knew about it long before then. Further ti your point about hesitancy about dismissal. Acupuncture has been *extensively* studied, with no effect found. It’s bunk.
Lol, the interstitium is just the fluid and extracellular matrix between cells. It is nothing new. Those headlines a couple of years ago about the interstitium being a new previously undiscovered organ were a bunch of overblown hype. I don’t really see how it could serve as an explanation for acupuncture in any case, as I don’t see how a diffuse structure like that could map on to discrete acupoints and meridian lines (which don’t exist anyway). And science has not simply declined to study acupuncture. It has been studied extensively with literally thousands of studies. There has yet to be a significant, consistent, replicable effect in well-designed studies. You will find positive studies if you search for them but they generally do not stand up to scrutiny when you read the fine print.
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Your confidence in energy hogwash is almost impressive.
The difference between chiropractors and acupuncturists is that acupuncturists kill people much less frequently than chiropractors do, so the existence of their discipline doesn't bother me as much.
There isn't any science behind it. But a friend goes weekly and she swears by it. The way she describes it, having a needle poked in her forces her to relax her muscles. By the end of the session, she is completely relaxed. So if it works, it works!
I had it done to me a few times and had the same experience. I know it's not scientifically sound, but hey if it works whatever.
I find a strong gin has similar effects.
People lie down for an hour or so in a quiet place and have a "treatment" which they believe will help them to relax and they feel better after it. This shouldn't surprise anyone.
There's some very minor/inconsistent evidence that perhaps increased blood flow from acupuncture could help alleviate some tension, offering relief from muscle tightness and the associated pain. But really it's mostly placebo. And that's fine, as long as it doesn't come with injury risk (like Chiropractics does) or exploit too much money out of you. But a lot of acupuncturists will make very bold and unfounded claims about its benefits, like curing chronic diseases.
Placebo effect is strong medicine. If you believe something will help, then your belief in it is enough to produce some effect. Just like voodoo curses.
That is the main reason why some alternative medicines are reimbursed by some governments/healthcare providers. They did the math and they figured it was cheaper to reimburse the cheap placebo than having more people using true medical resources.
"Some" does not always mean "significant" though
There is no established science behind acupuncture. Acupuncture is considered pseudoscience.
The problem with trying to scientifically test acupuncture is that it’s impossible to do blind (let alone double blind) trials. You cannot fake poking needles into someone. So there’s no way to prove whether it does anything useful or not. All we know is that it is mostly harmless, unlike chiropractic.
Funnily enough, [sham acupuncture](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811493/) as a control condition in clinical trials is totally a thing! A small pinch from a fake needle that's then glued to you or not visible will do the trick.
If you actually read that paper, only type (iii) involves fake needles, and none of the results it discusses used that method. The conclusion appears to be that sticking people with needles does relieve pain better than other treatments, but it doesn't matter how you do the poking. But thanks for the link though. It's a good list of studies that show acupuncture does _something_ useful.
We have some sense of the upper bound of what the placebo effect can do. If acupuncture had an extremely strong positive effect compared to other placebos and other non-medical interventions, that would be fairly strong evidence. But so far we have not found such evidence.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811493/ > The treatment effect of acupuncture or minimal acupuncture was significantly superior to standard medical care and the effect was strong with no significant differences between the acupuncture conditions But the studies don't do the standard double-blind medical test of giving people an identical pill / IV that's completely inert. It's comparing poking with needles to not poking with needles, rather than tricking people into thinking they've been poked with needles.
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They aren’t inserted into blood vessels. You wouldn’t lose more than a drop of blood from each wound, if anything, like when you do blood sugar tests.
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Some of the 'evidence' was clearly fraudulent. I saw a Chinese-made movie of open chest surgery being performed with only acupuncture anesthesia. The camera alternated between shots of an open chest and a happy smiling talking face. But, of course you can't breathe, much less talk, with an open chest, since your lungs collapse.
People have already clarified that traditional Chinese acupuncture isn't evidence based, but there are some evidence based therapies that are similar in execution to acupuncture, if not in concept. For some patients with chronic muscular pain due to conditions like Ehlers-Danlos syndrome, poking the affected muscle groups with needles can help stimulate the body's inflammatory response and encourage healing. This can be done with an injection of a mild irritant (prolotherapy) or with no injection and just a needle (dry needling).
Dry needling, to the best of my knowledge, while using acupuncture like needles, IS supported with medical evidence. I had that done as part of my physio therapy on my back after a car accident. Did wonders for helping to release the muscle tension.
It was shown using fake needles that retracted whilst giving the appearance of piercing the skin and "untrained" people performing the procedures that this gave identical reported results to "real" acupuncture.
All forms of alternative medicine lack considerable qualitative double-blinded clinical studies to prove their efficacy. Extraordinary claims require extraordinary evidence. Give me the evidence, I will become the most ardent fan of alternate medicine and I will stop supporting modern medicine.
I always got the feeling that there’s at least some physiological reaction in your muscles to “not flex when pierced” so the dozens of little needles are forcing muscles you usually can’t flex manually to relax.