I ran across a press release on ScienceDaily.com this week that piqued my interest.
“Acupuncture Stops Headaches, But ‘Faked’ Treatments Work Almost As Well”
Really? Interesting headline, I thought to myself, and proceeded to ingest the release. I have a love-hate relationship with acupuncture, you see. I don’t believe that it actually works. The evidence certainly hasn’t piled up in acupuncture’s clinical favor. Yet, I have a friend or two (who I love dearly) who attend acupuncture school, and plan to make the craft their careers. So, I had to read on… maybe there is proof to my friends’ claims.
The release discussed two clinical reviews: one related to acupuncture and migraines, the other to acupuncture and tension headaches. The criteria for inclusion of trials in the review seemed fair enough. The reviewers looked at all randomized studies with at least two month long observation periods comparing acupuncture treatment to control, sham treatment or another intervening treatment, like massage or relaxation.
The review of studies related to tension headaches found that acupuncture was better than treatment for acute headaches or simple routine care, and that real acupuncture was better (marginally) than sham acupuncture. Interestingly, studies involving other treatments were considered too flawed to allow any conclusions to be drawn. I find this unfortunate because one of the main questions related to acupuncture is whether the relaxation and skin palpation that takes place during the process of acupuncture might have something to do with the perceived results.
The migraine review concluded that acupuncture was helpful to migraine sufferers, but that real acupuncture was no better than sham acupuncture. It is even questionable whether needle placement is important for positive results. This suggests that there are other processes at work in the migraine mitigation.
Overall, the suggestion of the authors is that acupuncture is a useful addition to any migraine or tension headache treatment regime. Alright, I thought, at least it doesn’t appear to have any negative effects (according to the reviews), and it might be better than dealing with the side-effects of drug-treatments.
Then I checked the authors’ declaration of interest:
“This review includes trials in which some of the reviewers were involved, as follows: Allais 2002 – Gianni Allais; Jena 2008 – Benno Brinkhaus; Linde K 2005 – Benno Brinkhaus and Klaus Linde; Streng 2006 – Klaus Linde; and Vickers 2004 – Andrew Vickers. These trials were reviewed by at least two other members of the review team. Gianni Allais, Benno Brinkhaus and Adrian White use acupuncture in their clinical work. Gianni Allais receives fees for teaching acupuncture in private schools. Klaus Linde has received travel reimbursement and, in two cases, fees from acupuncture societies (British, German and Spanish Medical Acupuncture Societies; Society of Acupuncture Research) for speaking about research at conferences. Eric Manheimer and Andrew Vickers both received an honorarium for preparing and delivering presentations on acupuncture research at the 2007 meeting of the Society for Acupuncture Research. Adrian White is employed by the British Medical Acupuncture Society as journal editor and has received fees and travel reimbursements for lecturing on acupuncture on several occasions. Benno Brinkhaus has received travel reimbursement and fees for presenting research findings at meetings of acupuncture societies (British, German and Spanish Medical Acupuncture Societies).”
Heh. They’ve all got a vested interest in the outcome of these reviews. However, who better to review acupuncture research than acupuncturists? The experts in the field.
In my view, there is a conflict of interest here, which should be better conveyed to the public. What do you think?