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Bold Claims in Press About Acupuncture

by Ryan Johnson, May 12 2009

Today, going through my Google news, I found an article that I thought made some interesting and bold claims:

Acupuncture, real or fake, helps aching back: study
Mon, 11 May 21:28 PM BST

By Julie Steenhuysen

CHICAGO (Reuters) – Acupuncture brought more relief to people with back pain than standard treatments, whether it was done with a toothpick or a real needle, U.S. researchers said on Monday in a study that raises new questions about how acupuncture works.

For many patients, that benefit lasted for a year, the team reported in the Archives of Internal Medicine.

“Our study shows that you don’t need to stick needles into people to get the same effect,” said Dr. Daniel Cherkin of Group Health Center for Health Studies in Seattle, who led the study.

“Historically, some types of acupuncture have used non-penetrating needles. Such treatments may involve physiological effects that make a clinical difference,” Karen Sherman of Group Health, who worked on the study, said in a statement.

The team, wanted to study the effects of different types of acupuncture in a large, carefully controlled study of 638 patients with chronic low back pain.

They divided patients into several groups. One got seven weeks of standardized acupuncture treatment known to be effective in back pain. Another group got an individually prescribed acupuncture treatment.

A third group was treated using a toothpick in a needle guide tube that did not pierce the skin as regular acupuncture does, but targeting the correct acupuncture “points”.

A fourth group just got standard medical treatment, which included medication and physical therapy.

After eight weeks, 60 percent of the patients who got any type of acupuncture reported significant improvement in their ability to function compared with those who got standard medical care alone.

But there was no significant difference in the pain relief people got from the acupuncture using needles or from toothpicks.

The researchers said there is some evidence that even needles were used 2,000 years ago in acupuncture treatment, and some imaging studies have shown that “superficial and deep needling of an acupuncture point elicited similar blood oxygen level-dependent responses,” the team wrote.

Another study even found that lightly touching the skin can induce some emotional and hormonal reactions, which could explain the benefit, they wrote.

Or, it may simply be the experience of visiting an acupuncturist for treatments that helps.

Regardless of how it worked, they said acupuncture appears to be a relatively safe and painless way of easing an aching back, especially when traditional medicine alone fails.

(Reporting by Julie Steenhuysen; Editing by Maggie Fox and Cynthia Osterman)

So the question now becomes, if a layperson was to read this article, there would be virtually no reason to doubt any of the conclusions that it draws. So the thought experiment that I propose here is this: How do we as Skeptics analyze something like this and work to clarify and certify what these types of press statements make?

Is there any use in doing so? And if not, why not? I realize that it’s practically fruitless to attempt to correct everything that is out there in the media, and furthermore, it’s a no-win situation, because many things are a matter of opinion or are very subjective. However, when an article comes right out and makes bold claims like this, from what seems to be a scientific “carefully controlled study” how do we corroborate the findings?

I’m interested in hearing your thoughts.

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20 Responses to “Bold Claims in Press About Acupuncture”

  1. Tuffgong says:

    Any one skeptic, unless part of a major scientific organization, will not hold any weight in terms of swaying society as a whole’s perception.

    However, the internet means we are as connected as ever and the new era of internet connectivity is feedback. A vast majority of people’s time on the internet is used for exchange. A letter to the editor never hurt anyone, and spreading the article’s fallacy through something like a blog or even a comment discussion is effective.

    The underlying problem with skepticism is that it’s not “ok” to be a skeptic and simply providing the skeptical questioning will at least slowly but surely sway the public’s perception.

    Being a high school student, I am often frustrated as I’m very often the only one who even feels the need to question and criticize various subjects in school.

  2. JonA says:

    This reporting is clearly highly flawed. They have ‘creatively’ interpreted the results to mean that because the placebo group did just as well as the acupuncture group, then the placebo is actually acupuncture! This seems to be the latest trend in CAM reporting, it’s a no-lose situation for them. They are actually doing properly controlled studies, but are misinterpreting the results! If the tested treatment is just as effective as the placebo, that means the treatment is no good! It does not mean the placebo works!! On the other hand, if the trial found out that acupuncture was more effective than just toothpicks (the placebo), then they’d be interpreting it differently saying that acupuncture works because it’s more effective than a placebo. They want it both ways, making acupuncture unfalsifiable, and therefore this is pseudoscience, not science.

  3. plob218 says:

    Can’t say it any better than JonA.

  4. MadScientist says:

    Pfff. It must be a slow news day; that’s a very old ‘study’ and the conclusions (though the authors will never admit to it) are the same as others:

    Acupuncture is as good as no treatment.

  5. Teeps says:

    With half a dozen or so grammar, punctuation and logical errors, it reads to me as if an amateur tried to write like a real reporter. He failed. That’s a press release; I don’t think it went through Reuters, unless Reuters is now in the business of forwarding press releases.

  6. Bob says:

    I think the first thing we as skeptics should do is point people to the actual study and not the article.

    I took a look at the report on the Archives of Internal Medicine website http://archinte.ama-assn.org/ to see what was really in the report, and I recommend it to everyone else. (Note: I only looked at the abstract, not the full-text, of the report since you have to pay to view the full-text version.)

    I’m wondering if their use of the Roland-Morris Questionnaire (which is self-administered) to determine “back-related dysfunction” is really all that useful in this study. I will need to have the “symptom bothersomeness” scale explained as well. And what specifically did they mean by “usual care”? Maybe their full-text version will clear things up, but I’m having trouble with their definitions at the moment. If anyone can answer these, please do so I can give a better opinion of the results.

    Also, before anyone assumes that the study states acupuncture is scientifically proven, this quote from their conclusions: “It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects.”

  7. MadScientist says:

    @bob: That’s what I found hilarious in the report, that the conclusion claimed “It remains unclear …” and yet I thought it was very clear that acupuncture is just as good as no treatment and the ‘fake acupuncture’ is equally good. Don’t pay to see the full article; it’s a waste of hard-earned money.

  8. Dr. T says:

    1. They start out with a false claim: “One [group] got seven weeks of standardized acupuncture treatment known to be effective in back pain.” There is no reliable evidence that acupuncture performs better than placebo for back pain.

    2. They make a meaningless efficacy statement: “After eight weeks, 60 percent of the patients who got any type of acupuncture reported significant improvement in their ability to function compared with those who got standard medical care alone.” What percentage of patients who received conventional medical treatment have improved functioning? 80%? 100%? And what about pain? Did pain go away with acupuncture, or was there only a perceived improvement in function?

    3. As others mentioned, the study actually proves that acupuncture did no better than sham acupuncture (placebo): “…there was no significant difference in the pain relief people got from the acupuncture using needles or from toothpicks.” It takes a lot of gall to claim that touching someone with toothpicks is the same as shoving needles through their skin. Perhaps I should tell phlebotomists that they can draw blood by touching a toothpick to the skin over a vein. That will make blood drawing much easier for the patients and the phlebotomists.

    Treating with nonsense therapies reaps greater profits for the so-called doctors than treating with medical therapies. Too many physicians suppress their medical school and residency training and convince themselves that pseudomedicine is medicine: having lessened their cognitive dissonance, they don’t feel guilty about taking money for quackery. And that’s all this poorly designed and incorrectly interpreted study was about: pretending that quackery works.

  9. Goyle says:

    I was able to get a copy of the full article through work. Their *ahem* positive control group, called the “usual care comparison group”, consisted of, literally, whatever the patient and their individual doctors wanted to do. Some took medication (type unspecified), some tried physical therapy, but we have no idea who did which, both, or neither. From the methods section of the paper:

    “Participants in the usual care group received no study-related
    care—just the care, if any, they and their physicians chose (mostly
    medications, primary care, and physical therapy visits). All participants received a self-care book with information on managing
    flare-ups, exercise, and lifestyle modifications.”

    That was the entirety of the detail they provided under the “usual care comparison group”.

    I can picture these yahoos bringing this article home. “Lookee here, ma!. I just done me some science!”

  10. gfunkusarelius says:

    meh, these “pain relief” studies are way too subjective for me to take too seriously.

  11. pamela says:

    has anyone contributing to this discussion actually tried acupuncture? or are you all talking about something that you know nothing about?

    • tmac57 says:

      pamela- What difference would that make concerning whether or not a procedure can produce a measurable clinical effect other than placebo,in a blinded study? Anecdotes are not useful in science except as a suggestion for some effect that might need studying. Acupuncture has been studied to death, and thus far,keeps coming up empty handed.

    • MadScientist says:

      We don’t need to have needles stuck in us to say that acupuncture is a load of nonsense; even (at least some) Chinese physicians from over 100 years ago knew it was a load of rubbish and would advise their patients not to go for it. How people today can still believe in the nonsense which previous generations had refuted is really quite bizarre. There are already a number of legitimate and almost-legitimate studies (like the one reported here) which show that acupuncture works just as well as no treatment.

      • Max says:

        “acupuncture works just as well as no treatment.”

        What do you mean by “no treatment”? No intervention? Even a placebo works better than that. In the study cited by Ryan Johnson, acupuncture worked better than standard medical care alone.

      • Correction in the study standard treatment was still supplied so Acupuncture/Fake Acupuncture + Standard Treatment worked better than just Standard Treatment.

        Pretty straightforward given what we know about the placebo.

        Standard Treatment + Elaborate medical ritual provides more relief than just Standard Treatment.

        Doesn’t make the elaborate medical ritual any less of a placebo.

    • I have. I found it very relaxing (they put a heater over me after the needles were in) and it made me feel better for a short time after. The problem I received treatment for (a shoulder injury) is still with me however and even if it wasn’t as a good skeptic I’m well aware that anecdotes don’t trump clinical evidence.

      Valuing personal experience above clinical studies is how we ended up with loads of medical treatments that either do nothing or are harmful in the first place.

  12. The Blind Watchmaker says:

    This really just shows that accupuncture has the same efficacy as the placebo effect since “sham” accupuncture seems to work too.

  13. saurab says:

    I hope you dont mind…… but if I were to suggest that you yourself take an acupuncture treatment from a good acupuncturist who has a good track record, for some problem that you may have (if you have one), then you may be able to better gauge the effectiveness of the healing modality.

    Without such a personal exposure to the healing modality, it would be left to the gathering of logic and evidence to deny or accept the usefulness of acupuncture. Is it not ?

    Why not be the evidence, instead of gathering some ?

    Thanks,
    Saurab

    PS: I have never taken an acupuncture treatment in my life, soi I have no personal agenda with regards to the same. I do however practice another form of healing, Reiki, which is also an alternative healing modality, and I personally know that it is effective.

    Just wanted to mention in this.