Acupuncture: therapy or placebo?
First the disclaimers: I’m a PhD scientist with a well-trained crap detector. And I was a medical school (allopathic medicine) professor for 37 years. While I’ve never practiced medicine, I have a pretty deep understanding of evidence-based medicine.
“At a time when people are increasingly concerned about drug side effects, some consider acupuncture an attractive non-medication option. Unfortunately, many studies show that the potential benefits of acupuncture are short-lived. In my experience, I put acupuncture, massage, and chiropractic interventions in the same bucket. You may feel better for a day or two, but there is limited lasting improvement.”
It’s not like acupuncture hadn’t been examined by the same rigorous scientific studies that drug and vaccines are subject to.
“In one study, 249 people with migraines occurring two to eight times per month received either acupuncture, sham (fake/placebo) acupuncture, or were put on an acupuncture waiting list. The two treatment groups received treatment five days per week for four weeks. Twelve weeks after treatment, the acupuncture group had on average 3.2 fewer attacks per month, the sham acupuncture group had 2.1 fewer attacks per month, and the wait-list group had 1.4 fewer attacks per month. These results are modest at best, and carry an approximate treatment cost of $2,000 per month (estimating $100/session x 20 sessions). This figure does not include lost income from time away from work to attend appointments, travel costs, pain from the procedure, and recovery time.
“In general, the effectiveness of standard treatment (medication and injectable therapies) is supported by much stronger scientific evidence than acupuncture, including large clinical trials with thousands of subjects.”
On the one hand, placebos don’t have side effects, other than diverting patients from real therapy. Of course, when it comes to diseases like fake cancer therapy (Laetrile) or fake anti-virals (ivermectin), the placebos on offer can lead to harm or death. At the very least, they’re flushing lots of money down the toilet.
Acupuncture vs standard of care
“At a time when people are increasingly concerned about drug side effects, some consider acupuncture an attractive non-medication option. Unfortunately, many studies show that the potential benefits of acupuncture are short-lived. In my experience, I put acupuncture, massage, and chiropractic interventions in the same bucket. You may feel better for a day or two, but there is limited lasting improvement.”
It’s not like acupuncture hadn’t been examined by the same rigorous scientific studies that drug and vaccines are subject to.
“In one study, 249 people with migraines occurring two to eight times per month received either acupuncture, sham (fake/placebo) acupuncture, or were put on an acupuncture waiting list. The two treatment groups received treatment five days per week for four weeks. Twelve weeks after treatment, the acupuncture group had on average 3.2 fewer attacks per month, the sham acupuncture group had 2.1 fewer attacks per month, and the wait-list group had 1.4 fewer attacks per month. These results are modest at best, and carry an approximate treatment cost of $2,000 per month (estimating $100/session x 20 sessions). This figure does not include lost income from time away from work to attend appointments, travel costs, pain from the procedure, and recovery time.
“In general, the effectiveness of standard treatment (medication and injectable therapies) is supported by much stronger scientific evidence than acupuncture, including large clinical trials with thousands of subjects.”
On the one hand, placebos don’t have side effects, other than diverting patients from real therapy. Of course, when it comes to diseases like fake cancer therapy (Laetrile) or fake anti-virals (ivermectin), the placebos on offer can lead to harm or death. At the very least, they’re flushing lots of money down the toilet.
Acupuncture vs standard of care
LOL ~ I think it far the more likely vast interstellar slaughterhouses piloted by ravenous vaguely reptilian creatures* than some spectral being with whom they’ve entered into some kind of “special” contract floating down out of the sky to carry the faithful away to paradise
We did, afterall, invite them to Come! Eat!
*You know ~ hungry lizards …
I’m a PhD social scientist (so totally unqualified to pass on biology)…
The NYT had a Some discoveries change the way we view the human body. graphic piece in the magazine a few weeks back.
The format of the piece (all graphics, accompanied by text) emphasized the woo-woo aspect of this, but … is it at least plausible?
Marcel:
Can you converse with us in a discussion? Even if the topic is beyond your expertise and knowledge? If so, we except your comments. Joel knows more than I on medicines and healthcare. I am just a receiver of it.
Forgot the close bracket, dammit. So much for a PhD! Anyway, the gift link is
Some discoveries change the way we view the human body.
@marcel,
The ratio of speculation to evidence is too high for my taste.
I think I would want to know how many migraines the 249 people were suffering on average per month before the study. 2 to 8 per month only provides a range. How can we evaluate how effective the treatment might be from the data that the article actually presents?
@Jerry,
“A total of 249 participants 18 to 65 years old were enrolled, and 245 were included in the intention-to-treat analyses. One hundred eighty-nine (77.1%) were women. Baseline characteristics were comparable across the 3 groups. The mean (SD) change in frequency of migraine attacks differed significantly among the 3 groups at 16 weeks after randomization (P < .001); the mean (SD) frequency of attacks decreased in the true acupuncture group by 3.2 (2.1), in the sham acupuncture group by 2.1 (2.5), and the waiting-list group by 1.4 (2.5); a greater reduction was observed in the true acupuncture than in the sham acupuncture group (difference of 1.1 attacks; 95% CI, 0.4-1.9; P = .002) and in the true acupuncture vs waiting-list group (difference of 1.8 attacks; 95% CI, 1.1-2.5; P < .001). Sham acupuncture was not statistically different from the waiting-list group (difference of 0.7 attacks; 95% CI, −0.1 to 1.4; P = .07)." The Long-term Effect of Acupuncture for Migraine Prophylaxis
Thanks Joel. Still, with all this additional information I am a bit lost. What was the mean number of attacks for the group prior to the study? We have a range of 2 to 8 attacks, but no average number for the group. If the mean was 7 per month and was reduced to 3.8 that is not as impressive as if the mean was 4.2 and reduced to 1 per month. Or am I missing something that has been provided in this data already?
@Jerry,
I don’t think they sorted people based on mean number of attacks *before* the study. Instead, the graf I quoted says enrollees were randomized and “[b]aseline characteristics were comparable across the 3 groups.” If you read the rest of the graf I quoted, you’ll find the answers to your questions. Differences between acupuncture and sham and between acupuncture and the wait-list group were statistically significant at P<0.05, which is the customary cut-off for significance. Whether or not you're impressed is up to you. I certainly don't find it compelling, but I don't get migraines.
I provided a link for you to read the whole thing.