Acupuncture 'works for headaches' - but so does fake version

[kropotkin]

For the record, there was zero 'ritual' involved and no bollocks mumbo-jumbo going down when I had my two NHS acupuncture sessions. I expected zero benefit and it was sold to me as quite likely to fail but 'worth a go seeing as it's free.'

I understand what you are saying, but I disagree.

The room you were in, the person doing it, the equipment, the process, you submitting yourself to the practitioner, the piercing of your body by someone else: all these are elements of a ritual. It is not just mumbo-jumbo that constitutes ritual. All medical encounters have an aspect of ritual involved- to some extent or other.

 

[felixthecat]

Is that a postulated mechanism, or one based on evidence?


Again: Is that a postulated mechanism, or one based on evidence?

The studies so far show no difference between sticking a needle somewhere, and sticking it in the 'right' place.
The assumption being that either
1/ The observed effect is due to the process of sticking a needle in the skin (anywhere) or
2/ The ritual of the intervention: equipment, practitioner, submission etc.


I tend to believe the latter in the absence of any evidence for the former.
Your suggestions above sound like plausible mechanisms- any evidence would be interesting to look at

Its difficult to link to full text articles without paying (as you no doubt know) but there is evidence that points towards analgesia caused by production of endogenous opiates - mainly that Nalaxaone reverses the effects of acupuncture analgesia. http://www.sciencedirect.com/scienc...serid=10&md5=2414d2ee1e1963237b6030336cb141f9
http://www.ncbi.nlm.nih.gov/pubmed/18582529 Sorry its just abstracts! There are a number of studies around - the neurohumeral model has been the major theory behind acupuncture analgesia for about 30 years.

Regarding the treatment of soft tissue inuries, RSI and the like - as physios we've used deep friction massage and counter irritants for donkeys years to convert chronic inflammatory conditions ito acute ones and therefore take advantage of the well documented acute healing process. I suppose there's evidence somewhere - I'll have a look around. Acupuncture does exactly the same thing but more precisely - you can target a specific spot more easily with a needle than with a finger. I can poke the chronically inflamed tendon with my finger, press hard and massage across the tendon - and watch my patient hit the ceiling as it hurts like fuck. After a few minutes it also hurts me like fuck as well. It'll hurt for a while afterwards, but when the pain goes its much less painful than before I treated it. Or, I can make life easier for me and my patient and stick a few needles into the area and move them around until the area goes numb. Does the same thing, less traumatic for the patient and for me.

As I said before, its a handy tool and it isn't helped by the mumbo jumbo surrounding it.

 

[fogbat]

I'd have thought it would work against them slightly, if they were placebo susceptible then conventional treatment should have had some of that kicking in.

It could depend on how much "ritual" was associated with the conventional treatment, maybe?

Like a doctor who sees a load of patients in a day, who can only spend 5 minutes per patient, vs a private alt-med person, who can give more personal attention.

 

[editor]

I understand what you are saying, but I disagree.

The room you were in, the person doing it, the equipment, the process, you submitting yourself to the practitioner, the piercing of your body by someone else: all these are elements of a ritual. It is not just mumbo-jumbo that constitutes ritual. All medical encounters have an aspect of ritual involved- to some extent or other.

Maybe to you, but not to me. I went there thinking it was all bollocks. I had no expectations of doing anything other than wasting my time and it was as 'ritualistic' as me waiting in the Post Office queue.

I am about as cynical as you can get but the treatment categorically worked.

 

[8ball]

Maybe to you, but not to me. I went there thinking it was all bollocks. I had no expectations of doing anything other than wasting my time and it was as 'ritualistic' as me waiting in the Post Office queue.

I am about as cynical as you can get but the treatment categorically worked.

If we could do this a lot more cheaply and without worrying about exactly where to stick the needles because of rules based on ancient misconceptions about biology, then that would seem to be a good thing to me.

Physiotherapy was once an 'alternative' thing and I'm not aware of many medics that dispute its benefits these days.

 

[editor]

If we could do this a lot more cheaply and without worrying about exactly where to stick the needles because of rules based on ancient misconceptions about biology, then that would seem to be a good thing to me.

It cost me fuck all as it was done on the NHS at my local doctor's surgery.

 

[felixthecat]

If we could do this a lot more cheaply and without worrying about exactly where to stick the needles because of rules based on ancient misconceptions about biology, then that would seem to be a good thing to me.

Physiotherapy was once an 'alternative' thing and I'm not aware of many medics that dispute its benefits these days.

It IS cheap! Needles cost very little and there's really not much else you need. Private practioners charge a fortune for their time, not the treatment.

 

[8ball]

It cost me fuck all as it was done on the NHS at my local doctor's surgery.

Well, yeah, but if you could have a regular nurse who just knew where it was ok to stick needles that would save a lot of time learning 'pressure points' or whatever guff they go on about.

Don't know how much the needles cost but a mate of mine who did it would only ever use gold-plated needles . . .

 

[editor]

Well, yeah, but if you could have a regular nurse who just knew where it was ok to stick needles that would save a lot of time learning 'pressure points' or whatever guff they go on about.

I know fuck all about pressure points, but I have to say that the first needle the doctor put in found. the. exact. spot.

I'd spent weeks doing all sorts of exercises and seeing doctors and things improved immediately after the acupuncture session.

Things had got so bad I'd invested in speech to text software because I was having trouble just typing (and as a journo, that's catastrophic). Two acupuncture sessions later and the improvement was truly immense and I've never used or even looked at the software since.

 

[8ball]

I know fuck all about pressure points, but I have to say that the first needle the doctor put in found. the. exact. spot.

The exact spot that was hurting or the exact spot to make it feel better?

Seems that in the trial that was done that it didn't matter too much where the needles went.

 

[felixthecat]

Don't know how much the needles cost but a mate of mine who did it would only ever use gold-plated needles . . .

Waste of money unless you have a patient who has a metal allergy. I've never had a problem with bog standard stainless steel needles and I've been practising acupuncture for years.

 

[8ball]

Waste of money unless you have a patient who has a metal allergy. I've never had a problem with bog standard stainless steel needles and I've been practising acupuncture for years.

Then you are very naughty!!!

<sends felixthecat to bed without any tea>

 

[kropotkin]

Its difficult to link to full text articles without paying (as you no doubt know) but there is evidence that points towards analgesia caused by production of endogenous opiates - mainly that Nalaxaone reverses the effects of acupuncture analgesia.

That is the same for the analgesic placebo effect more generally though: anything that shows a pain-reduction response as placebo can be reversed by giving nalaxone

The mechanism of placebo analgesia http://www.ncbi.nlm.nih.gov/pubmed/80579


i.e.- this just shows the placebo effect at work and not any mechanism particular to the way in which placebo is triggered (sham/acupuncture in this case)