Real or fake acupuncture works better than conventional treatments?

I was reading this article on CNN that is citing a study in Germany to the effect that both real and fake acupuncture treatments work better than whatever was the ‘usual care’ being done for patients.

My questions are: Is this true? Are conventional back treatments (one would presume this would be some kind of muscle relaxers combined with pain medicine and I presume some kind of therapy) really not effective? Or I guess are they really less effective than…acupuncture?!? Why would ‘real’ or ‘fake’ acupuncture preform better? I would again presume this has to do with the placebo effect, but I’ve never heard of it working THIS well before. What else might be going on here (the article goes into ‘competing stimuli’, but only to mention it)?

Personally I’ve always thought of acupuncture as on par with the 4 humours system of Medieval medicine. However, even if its just the placebo effect it seems like its more effective than conventional treatments…if the statment and study are true.

-XT

Acupuncture works as well as any other form of what is known in social psychology as ‘ritual magic’. Put in simplified terms, if you believe in the treatment or therapy, and if you believe in the authority of the practitioner, then the ritual may act as a sort of catalyst for the body’s own, natural healing mechanisms.

We don’t know precisely how and why this works when it does. All we can say is that there seems to be some connection between mind and body; between belief/expectation and one’s ability to trigger the body’s defences, and all the forms of ‘ritual magic’ are different manifestations of this intriguing phenomenon. One might take the view that it doesn’t really matter how it works - so long as the patient feels better, it’s good news.

There is, of course, no good reason to believe that acupuncture ‘works’ in any sense other than that outlined above. The so-called theory of acupuncture, involving chi and energy lines and meridians and so forth, is simply made up, imaginary stuff, not backed up by a scintilla of empirical evidence (although it could be argued that it is only to be understood as a metaphor or a model, not necessarily an actual description of what transpirs during treatment).

This can be demonstrated quite easily by any practitioner of acupuncture - if he or she intentionally administers the needles ‘incorrectly’, ie in a manner contrary to what is deemd the ‘correct’ way - it makes no difference at all to their percentage rate of success. Indeed, someone with no training at all can achieve exactly the same results… provided the necessary illusion of therapeutic authority is maintained, and is believed by the patient. As a corollary to this experiment, using the needles absolutely correctly has no effect whatsoever on people who don’t believe in it.

I understand that. I guess my main concern here is…why do the conventional treatments work so poorly (at least according to the article)? You would think the same ‘ritual magic’ thingy would happen for them…AND they are actually supposed to work (i.e. they have to be grounded in some kind of clinical study or whatever that shows it works better than the placebo effect…right?).

I can understand how the placebo effect can work…but I always thought conventional treatments were supposed to be rigorously tested so that they were effective ABOVE those of the placebo test groups. No?

-XT

I agree that the findings, as reported, seem surprising. However, some healthy caution is advisable. When it comes to scientific research, it is rarely possible for lay people to gain much understanding from the research itself, because we simply lack the relevant background of specialised knowledge or technical comprehension. It is even less easy to gain much understanding from the way such research is reported in the popular media. There are simply so many unhelpful factors that get in the way: selective quotation, selective focus, erroneous reportage, trimming and editing for production purposes, the journalists’s own lack of competence or comprehension… and so on.

If we take the CNN report at face value, the study seems to have been well-conducted and on a scale that should give significant results. However, even here we have to be cautious. The chosen focus was ‘lower back pain’ and subjective assessment of therapeutic relief. Subjective assessment isn’t much of a guide to anything - according to subjective assessment, I possess the ability to communicate with the dead (as I demonstrated on an edition of ‘Prime Time’ a few years back).

Of course, in the absence of any other factors, we should expect that subjective assessment is as flawed with respect to the real / sham acupuncture treatments as it is with respect to the ‘conventional’ treatments, but this may not necessarily be the case. It is often remarked that modern, Western medicine, while it has its great achievements and glory moments, is flawed because it lacks personal touch and personal warmth; that (as typically administered) it is too detached, clinical and lacking in what some refer to as the ‘holistic’ approach. In simple terms, it doesn’t do anything to engender ‘warm ‘n’ fuzzy’ feelings, when this is precisely what a lot of patients need more than they need anything else. This point is made as often by supporters of ‘western’ medicine as by its detractors. The so-called complementary therapies have their faults and their dangers, and are inherently guilty of spreading ignorance that can be costly. However, one point generally in their favour is that they involve a warmer sense of personal care and contact, and this can be a very significant factor in how people feel afterwards.

In other words, setting to one side the points already made about the way technical matters get reported in the popular media, it may be the case that conventional medicine confers is effective in a given percentage of trials, but any amount of ‘warm and fuzzy’ personal attention, allied to the ‘ritual magic’ aspect I referred to before, will produce even better results (whether sham or not).

We might find this surprising, but then again perhaps we shouldn’t. You can show me the finest, most pwerful drug yet devised for dealing with, say, general depression, and I’ll bet everything I own that it doesn’t make the patient feel as good as they do after a good, heart to heart chat with a good, caring friend followed by a reassuring hug. Perhaps the problem is that they don’t bother to do clinical trials pertaining to ‘a good, heart to heart chat with a good, caring friend followed by a reassuring hug’. Who knows? Maybe they should.

I haven’t got a cite, and I don’t recall where exactly where I’ve seen it, but I have seen studies in medical journals that say precisely the opposite thing – that acupuncture and “fake” acupuncture demonstrably worked not as well as conventional therapy. This would’ve been pre-1987.

And the thing to remember when asking “why are conventional treatments so ineffective?” is that these kinds of studies are usually only done on problems that conventional treatment isn’t very good at. I don’t recall many studies seeing whether acupuncture is better than conventional medicine at treating broken bones, or antibiotic-susceptible infections, or other things that we’ve already got a good handle on treating with evidence-based medicine.