That journal review article out of China (red flag waves in the background)* citing the GRASP study re acupuncture supposedly benefiting chronic shoulder pain, is a reminder that meta-analyses are only as good as the papers they analyze. And that one isn’t so hot.
There’s limited comeback, even on the Dope, to posts saying “well, it worked for me!” (or my relative or friend.)
We’re strongly wired to accept anecdotes.
Though why acupuncture would work for a couple types of pain but not myriad others is a mystery.
*it’s been noted for a long time that acupuncture studies out of China are almost always positive.
I’m familiar with the issues concerning review papers from my own researches. Deciding what to include and what to ignore is crucial. The writers of the review are VA doctors from Los Angeles. We have no way of knowing what their biases are concerning articles from China. We can note that they found the overwhelming majority of the studies lacking for support for acupuncture, but did let through ten studies for a variety of pain treatments listing moderate or better results.
Where should the line be drawn when looking at studies? Eliminate out of hand all studies from China? That’s going to be increasingly problematic in the future as Chinese science grows in depth and stature. Better to re-examine studies and conduct newer and better ones. That’s happening. A quick look at Google Scholar finds newer studies on shoulder pain. A quick look at these finds footnotes for a series of other studies along with several other review articles, apparently favorable. Actual researchers need to go down these rabbit holes and individually evaluate each one.
I’ll only go so far as to say that condemning acupuncture as woo in the same sentence as saying that peer-reviewed studies have found it effective should not fly. That’s exactly what supporters consistently accuse skeptics of doing. We need to be better than that.
They cite a single review paper as supposedly validating acupuncture for chronic shoulder pain.
The paper in question is:
Yuan QL, Wang P, Liu L, et al. Acupuncture for musculoskeletal pain: a meta-analysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep. 2016;6:30675
And when such analyses depend on papers like the one described here, there’s room for substantial doubt about their conclusions.
Maybe at some point, papers published about acupuncture and other elements of TCM by Chinese researchers will become more reliable. It’s difficult to see that happening in the near future, given the emphasis placed on TCM as part of the “national heritage” of China and its embrace by Chinese government officials dating back to Mao Zedong.
I’m always in favor of studies. Science and understanding grow with more understanding.
But by what method is acupuncture supposed to relieve pain? If the concepts of qi and meridians et al are woo, but acupuncture still works, then what is it actually doing? One can’t make a valid study without a hypothesis to be tested. And it would need to show positive results in people that think it is junk medicine.
Which part is real? An altered state of consciousness? Sure, anybody that’s drove through long desert highways knows that.
But hypnotism that puts you in a trance, makes you do things, makes you forget you were in a trance after, allows for active post-hypnotic suggestions, helps you to quit smoking, or to remember forgotten things, all that stuff TV tells us hypnotism can do - that’s all happy hooey.
My point is “hypnotism”, as it is commonly accepted to be, is bunkum. Hooey. Woo. Humbug. Hypnotism does not do ANYTHING that people believe it does.
If people want to investigate it as an altered states of consciousness, go ahead. Don’t tell me it will find repressed memories, or find my lost car keys.
I don’t know what bringing defibrillators etc into this has to do with anything. They work, and some shows actually show them being used correctly. Hypnotism does not work on TV or in reality.
I’m not a believer, but there are other possible mechanisms. In particular it could be something similar to how capsaicin works, where stimulation of one pain pathway blocks the activation of a different pathway.
Prick a needle at any part of the body. Endorphins are released. There are about 20 varieties of them and they all are opiates. The mechanism is straightforward, unless you believe that tissue damage will not produce natural painkillers.
I have what I imagine to be a Reader’s Digest version of this, Mysteries of the Unexplained, which was owned by my grandmother and which I insisted on keeping when she started giving away her stuff. I spent a lot of my childhood reading this book.
It has some stuff that’s been validated, like ball lightning. Stories of meteorites crashing into houses and stuff.
It has some stuff that’s plausible, like rains of frogs and other weird weather phenomenon, or extraordinary coincidences.
And it has stuff like the Loch Ness Monster and spontaneous combustion. (Spontaneous combustion used to scare the hell out of me.)
There’s other stuff I’m not sure of, like unexplained total darkness on a certain date in a certain town.
It’s not actually claiming the stuff is true, I don’t think. It’s like, “Here’s some weird shit people reported that we can’t explain.”
I loved just living in that mystery as a kid. So maybe some adults do too.
Nice link. Evidence for electro-accupuncture releasing endorphins dates from the 1970s. Evidence for the non-electrical kind releasing endorphins is non-existent according to the author. I didn’t know that. There’s a western procedure called transcutaneous electrical nerve stimulation (TENS) which also produces endorphins. Sometimes.
Time for an anecdote! I think my one and only acupuncture treatment was elecrical: I’m not certain. I did feel a little dizzy afterwards, which I chalked up to endorphins. I didn’t book a 2nd appointment as I didn’t think the treatment matched effectively with my underlying condition.
I once was knocked halfway across the room when attempting to change the channel on a knobless Admiral portable black-and-white TV with a pair of pliers.
The endorphin rush from that electrical impulse alleviated a bad headache I was having at the time. Or the shock unstuck my qi. Hard to say.
