Should You Try Acupuncture? Consumers Reports Gets it 99% wrong

Should You Try Acupuncture? Consumers Reports Gets it 99% wrong

I am truly expert in one area of medicine, that of Infectious Diseases. Day in and day out I see the work of other, less expert in infectious diseases and it is often lacking. But then, that is why they call me. They recognize they need help. I would be equally unhelpful with a heart attack or stroke and certainly I don't know nothing about birthing babies.

Those of us in the science-based medicine world also have an expertise in not only pseudo-medicine of all types, but in the almost too numerous to count reasons that the standard approach to medicine fails when applied to pseudo-medicines. Unlike the hospital, rather than investigate deeply and get expert opinion, so many take the easy route and regurgitate the standard narrative.

As an example, Consumers Reports with Should You Try Acupuncture?

and their brief and almost completely incorrect answer.

Acupuncture, the traditional Chinese technique of inserting thin needles into the body at specific spots called acupoints,

Ignoring the dozens upon dozens of other forms of the pseudo-medicine, from ear to electro and more.

It is based on the belief that blocked qi, or energy, causes pain, and that stimulating some of our more than 300 acupoints, each believed to affect a specific body part or organ, can unblock energy and relieve pain.

No mention made that this belief has zero basis in anatomy or physiology. It's basis is as valid as treating demon possession or prescribing unicorn tears. And more than 300 acupoints? There is no point on the human body that does not have an acupuncture point except the eyes, under the nails and the genitals. Hmmm. Wonder why that might be.

Proponents claim it can ease back pain, neck pain, and even treat ills such as allergies and hot flashes.

Proponents yes, but any effect beyond bias and poor methodology is as yet to be seen in half a century of clinical investigation.

But does it work?

No.

And is it safe?

No.

A number of people who use acupuncture for chronic pain do report benefits. For example, an analysis of 29 studies with a total of 17,922 participants with back and neck pain, osteoarthritis, chronic headache, and shoulder pain found that people with those conditions experienced significantly more relief with acupuncture than those who had no treatment.

This a classic example of reporting it the standard acupuncture narrative and applying no SBM, or other, critical thinkings skills. Every intervention is effective for subjective symptoms when compared to usual therapy. Always. The question is it any better than placebo.  It is not.

People also reported less pain after real acupuncture than they did after fake acupuncture (for example, with needles placed in spots that were not acupoints), but the differences were small.

Small as in clinically irrelevant differences. The preponderance of the literature is clear it doesn't matter where you put the needles (hence the TNTC forms of acupuncture) or if you use needles at all (twirled toothpicks in the skin are just as effective). And you get the same effects if you mime acupuncture or perform acupuncture on a rubber hand.

One possible reason for the benefits of acupuncture: Studies show that it causes us to release feel-good hormones, called endorphins, that suppress pain.

So what they are saying is with a noxious stimulus the body responds to counter the noxious stimuli? Wow. What a concept. And most of the endorphin literature I can find is electroacupuncture, you know, giving people an electric shock. (This was kind of a surprise to me and warrants more research, but I can't any studies on traditional acupuncture (what ever that might be) and elevated endorphins).

"Acupuncture, real and sham, also might make you feel better simply because you feel cared for or because you expect it to work—the placebo effect," says Consumer Reports' chief medical adviser, Marvin M. Lipman, M.D.

And of course, deliberately giving a placebo is unethical at best and fraud at worst.

For back and neck pain, acupuncture is safe as long as sterile needles, such as single-use disposables, are used by a trained practitioner.

Yes. Just ignore the 2253 hits on PubMed for "Acupuncture Complication." Eyeball penetration anyone?

But skip it for conditions other than pain; there's no conclusive evidence that it will help.

The one correct sentence in the whole article. So sad.

If you do decide to try acupuncture, make sure that your practitioner has the appropriate credentials.

As if being trained in nonsense makes the nonsense safer and more efficacious.

Most states require at least 1,600 hours of training and that acupuncturists are certified by, or pass an exam from, the National Certification Commission for Acupuncture and Oriental Medicine.

1600 hours is 200 days. Not impressive training. Read the sample questions for exam: it will not inspire confidence if you want your treatment based in reality.

And they end with

Have you tried acupuncture?

Tell us about your experience below.

Just what we need, more anecdotes for implausible pseudo-medicines. Medicine isn't a soft drink or washing machine to up or down vote like a Yelp page. Health, life and peoples finances deserve better.

It is always the question. If Consumers Reports are so completely wrong in an area about which I have expertise, can I trust them on other topics? 

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Points of Interest 07/14/2016