I was dismayed to see a headline from NPR today saying, “Military pokes holes in acupuncture skeptics’ theory.” Acupuncture is founded on the hypothesis that needles will redirect bodily energy to improve overall well-being. The problem? The bodily energy (called “qi,” pronounced chee) doesn’t exist. Acupuncture can’t work, just as antibiotics couldn’t work if germs didn’t exist. And so, with soldiers facing real medical issues and NPR being a reputable news source (normally), is there anything to this article?
In the NPR article, I looked for some evidence, maybe a double-blind placebo-controlled study, or a meta-analysis of such studies. What did I get?
Pain is an everyday occurrence, which is where the needles come in. “I’ve had a lot of treatment, and this is the first treatment that I’ve had where I’ve been like, OK, wow, I’ve actually seen a really big difference”…
Strike one and two. Anecdotal evidence of efficacy for pain. Anecdotes aren’t science. Also, while pain is certainly a real ailment, pain is well-treated by placebo medicine. (Placebo means there is no real medicine and the patient’s mind provides the cure based on the expectation of getting well.) So this is to say that acupuncture did nothing but help the soldier fool himself into ignoring the pain. Also, the pain may have naturally reduced over the course of treatments. He could have blown in a whirligig and had the same effect.
Army doctors have been told by the top brass to rethink their “pill for every ill” approach to treating pain.
We’ll call this a foul ball rather than a third strike. So there’s a real problem — too many pharmaceuticals. Well, that’s a real problem unless pharmaceuticals work. What they’re really saying is, “medicine is expensive.” To be fair, they’re also saying, “medicine has side-effects.” So it’s fair to look for alternatives. The alt-med advocates are also saying, “pharmaceutical companies are evil, so use something else.” That’s just conspiracy theory. Maybe there’s another reason:
Wasserman is the top doctor for the Warrior Transition Battalion at Fort Campbell, Ky. To her own surprise, she’s also now the unit’s physician trained to do acupuncture. “I actually had a demonstration of acupuncture on me, and I’m not a spring chicken,” she says, “and it didn’t make me 16 again, but it certainly did make me feel better than I had, so I figured, hey … let’s give it a shot with our soldiers here.”
This is strike three. As noted earlier, “It worked for me” is no scientific study. And this is the top doctor, and so she gets to try out her placebo affect on her patients. Again, this is no study. Just that it worked for her, and all of a sudden, she, as the only trained acupuncturist (whatever that means) gets to decide that is a real treatment. This prior bias from a top official puts this firmly in the realm of bad medicine.
New academic studies from places like Duke University back up acupuncture as an alternative to medication.
Oh we have an alibi, maybe… An academic study referenced, but uncited and unexplained. The article then immediately discounted the study as “quack-ademic.” They didn’t support that assertion any more than they provided an explanation of why the study should be accepted. I found a 2008 Duke study indicating headache relief. The meta-analysis found that in 17 studies comparing acupuncture to medication, the researchers found 62% of acupuncture patients reported relief, versus just 45% taking medication. I’m not sure what medication was only 45% effective in relieving a headache, but I’m no doctor. I just wanted to at least reference the one study, if I could. Maybe next time NPR will do us that favor.
The point here is that the military is pushing acupuncture, which is, Duke study notwithstanding, not effective beyond placebo. This hurts troops by keeping them from effective treatments and promotes an industry that is founded on dishonesty. You can find a good review of Navy acupuncture at Science-Based Medicine (definitely read this article), an acupuncture overview at SBM and Skepdic, and how acupuncture can be dangerous when prescribed for physical illnesses or when the pins are improperly pressed into the body.
The real question here is how humans can benefit from placebo medicine. Placebo medicine can recognize the effectiveness of reducing pain without lying to patients. People can mitigate their own pain (not diseases or broken limbs) with their own minds. The trick is to 1) relieve pain while 2) being honest with patients. What’s the line between “this treatment will work (because you think it will)” and “this treatment will work (because it’s magic)”? That is a line on one side of which is patient health and physician integrity and on the other side is snake oil sales.
Edit: Several commenters have recommended the book Snake Oil Science: The Truth about Complementary and Alternative Medicine (Bausell). I have read the book as well and recommend it as a fundamental primer for any medical skeptic.