What alternative health
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Practice, practitioner, or placebo? A multifactorial, mixed-methods randomized controlled trial of acupuncture

Study confirms acupuncture = placebo: "Improvements occurred from baseline, but acupuncture has no specific efficacy over either placebo. The individual practitioner and the patient's belief had a significant effect on outcome. The 2 placebos were equally as effective and credible as acupuncture. Needle and nonneedle placebos are equivalent. An unknown characteristic of the treating practitioner predicts outcome, as does the patient's belief (independently). Beliefs about treatment veracity shape how patients self-report outcome, complicating and confounding study interpretation."  White P, Bishop FL, Prescott P, Scott C, Little P, Lewith G., Pain (December 2011)

Animal acupuncture

"Veterinary acupuncture is a triumph of style over substance. Fortunately, most veterinarians haven't succumbed to offering needless needles to animals, in spite of the fact that there are apparently some people eager for such "options." But when you read the next article extolling the virtues of the practice, keep in mind that you're reading a level of journalism commensurate with what's seen on the entertainment pages, information that has essentially nothing to do with good science." Article by David Ramey, Science Based Medicine (8th June 2009)

Acupuncture Does Not Work for Back Pain — Part I

"A new study which randomized 638 adults to either standard acupuncture, individualized acupuncture, placebo acupuncture using tooth picks that did not penetrate the skin, and standard therapy found exactly what previous evidence has also suggested — it does not seem to matter where you stick the needles or even if you stick the needles through the skin. The only reasonable scientific conclusion to draw from this is that acupuncture does not work." Article by Steven Novella MD, Science Based Medicine (May 2009)

Acupuncture and Back Pain — Part II

"There remains no compelling evidence for any of the claims made for acupuncture. When the variables specific to acupuncture are properly isolated there is consistently no demonstrable effect…There is also a complete lack of scientific support for the underlying claims of acupuncture — for the presence of "chi" or life energy that flows through meridians that can be manipulated to influence health and illness." (May 2009)

Acupuncture anesthesia'

"For many Americans, the current wave of public fascination with "complementary and alternative medicine (CAM)" can be traced to a single event: New York Times columnist James Reston's appendectomy in China during the summer of 1971, which Reston reported in an interesting and amusing article on July 26 of that year. Many of those who noticed the publicity following this event erroneously concluded that Mr. Reston had undergone "acupuncture anesthesia"." Article by Kimball Atwood, Science Based Medicine (15th May 2009)

Acupuncture -Disconnected from reality

"…the disconnect continues. Proponents keep pretending that there is compelling evidence, or it has not been properly studied yet, or it does not have to be studied because historical anecdotes are enough — whichever argument suits the moment. Meanwhile the media keep breathlessly telling us that acupuncture is gaining ground, while the evidence is standing still. The premise of SBM [Science Based Medicine] is that support and resources should follow scientific support. In the world of CAM [Complementary and Alternative Medicine], however, support follows belief, and the science seems to be an afterthought or, worse, an obstacle." Article by Steven Novella MD, Science Based Medicine (18th March 2009)

Can we finally just say that acupuncture is nothing more than an elaborate placebo? Can we?

"The reason I ask this question is because yet another large meta-analysis has been released that is entirely consistent with the hypothesis that acupuncture is a placebo…..There's a reason why acupuncturists don't like sham-controlled studies. If you review them, you'll see that the preponderance of evidence from such studies shows that (1) it doesn't matter where acupuncturists stick the needles, and the effect is the same no matter where they are stuck; and (2) acupuncture produces no effects greater than placebo. That's because it is a placebo. It's an elaborate placebo, and the relaxation and attention given patients is the only real "healing" going on." Orac at Science Blogs (29th January 2009)

More nails in the coffin for acupuncture

"A new review appeared in the BMJ today. It is by Madsen et al., from the Nordic Cochrane Centre, Copenhagen…..The results confirm, yet again, that there is essentially no difference between "real" acupuncture and sham acupuncture. All that talk about meridians and Qi really is so much mumbo jumbo…..Madsen et al conclude "a consensus report characterised a 10mm reduction on a 100 mm visual analogue scale as representing a "minimal" change or "little change". Thus, the apparent analgesic effect of acupuncture seems to be below a clinically relevant pain improvement."" Professor David Colquhoun, DC Science (28th January 2009)

The recent history of acupuncture

"…after 3 decades of intensive research, is the end of acupuncture nigh? Given its many supporters, acupuncture is bound to survive the current wave of negative evidence, as it has survived previous threats. What has changed, however, is that, for the first time in its long history, acupuncture has been submitted to rigorous science—and conclusively failed the test." Edzard Ernst, MD, PhD, The American Journal of Medicine (December 2008) [pdf]

Puncturing the acupuncture myth

"It's time the acupuncture myth was punctured — preferably with an acupuncture needle. Almost everything you've heard about acupuncture is wrong.….all the current evidence is compatible with this hypothesis: acupuncture is nothing more than a recipe for an elaborate placebo seasoned with a soupcon of counter-irritant." Harriet Hall, MD, Science Based Medicine (21st October 2008)

Acupuncture for Hot Flashes — Or, Why So Many Worthless Acupuncture Studies?

"Acupuncture has also been studied enough for the technology of acupuncture research to have matured to fairly definitive studies, and to conclude that there is probably no large or easily detectable biological effect from acupuncture. In addition, the popularity of acupuncture (while still small in absolute numbers) far outstrips the evidence for its effectiveness, making acupuncture a controversial treatment. This controversy is exacerbated by the existence of dedicated practitioners (acupuncturists), who have a vested interest in this one modality. For these reasons any further testing of acupuncture should aspire to the highest scientific standards. Pilot studies of acupuncture are worse than worthless — they do nothing to further the scientific question, and they are abused to promote a dubious treatment through the credulous media." Steven Novella, MD, Science Based Medicine (24th September 2008)

Why I am Skeptical of Acupuncture

"Taken as a whole, the pattern of the acupuncture literature follows one with which scientists are very familiar: the more tightly controlled the study the smaller the effect, and the best controlled trials are negative. This pattern is highly predictive of a null-effect — that there is no actual effect from acupuncture." Steven Novella, MD, NeuroLogica Blog (25th August 2008)

Staff attack science degrees in alternative health

Plans to offer new science degrees in acupuncture and Chinese herbal medicine at the University of Central Lancashire have met fierce opposition — from the university's own staff. Times Higher Education Supplement (7th August 2008)

Acupuncture 'no help for IVF'

A new study looking into whether acupuncture is useful in helping women undergoing IVF treatment to get pregnant has concluded that acupuncture has no effect on the success rate. After comparing real acupuncture to fake acupuncture and doing nothing, the pregnancy success rates were the same in all three groups. BBC News report (8th July 2008)

Acupuncture and Fertility: The Media Screws Up

"A study published early February in the British Medical Journal examined the link between acupuncture and successful in vitro fertilization…..The authors pooled the seven studies in a meta-analysis to find that the odds ratio — the odds of pregnancy through IVF and acupuncture divided by the odds of pregnancy through IVF without acupuncture — was 1.65. Here the word 'odds' is used in the statistical sense, not the layman meaning…..The media reported this figure as if acupuncture increases the success rate of IVF *by 65 percent*, misunderstanding what is meant by the odds ratio. The actual increase in pregnancy likelihood according to this meta-analysis is about ten percent. This alone makes the results far less impressive than they sound." Rebecca Goldin Ph.D, and Jenna Krall, STATS (3rd March 2008)

Are the concepts of ear acupuncture sound?

"Dozens of RCTs of auricular acupuncture have been published; many of them have generated positive results. Close scrutiny, however, reveals that most of these studies are methodologically weak. Whenever the totality of the evidence is critically evaluated, as for instance in the case of auricular acupuncture for cocaine dependence, the results are either cautious or totally negative: 'There is currently no evidence that auricular acupuncture is effective …..In summary, auricular acupuncture is based on a bizarre concept that has little or no biological plausibility. The trial evidence is mixed but, on critical assessment, far from convincing. Of course, we should keep an open mind — but let us be careful that in doing so our brains do not fall out." Professor Edzard Ernst, debate published in Focus on Alternative and Complementary Therapies [FACT] (March 2008)

Another Acupuncture Study — On Heartburn

"These researchers learned something, but not what they think they learned. They learned that doubling the PPI [Proton Pump Inhibitor] dose is pretty much useless, and that providing a placebo intervention is much more effective. To my mind, the next logical step would be to find the simplest, most effective method to help the patient in the same way that they were helped by acupuncture placebo, but without any make-believe about imaginary meridians and qi. If the authors' speculations about light touch are correct, it's quite possible that some form of light massage would be equally effective. And perhaps personal attention, relaxation, and reassurance would do even more good. We may be able to learn a great deal from alternative medicine practices, but not necessarily what they would like to teach us. All the acupuncture research to date is compatible with the hypothesis that it's nothing more than an elaborate placebo with maybe a touch of counter-irritant thrown in. No one has seen a meridian or measured the qi. Isn't it time to stop doing junk science and Tooth Fairy research, to discard needles and meridians and mystical nonsense, and to try reality-based approaches to improving patient comfort and satisfaction?" Harriet Hall, MD, Science Based Medicine (12th February 2008)

Acupuncture and hot flashes in breast cancer patients: No effect

"In the end, this is a negative study, no matter how much its authors may try to spin it as anything other or speculate that acupuncture might have worked if they had continued the treatment longer. It's also the reason why you probably haven't heard about it, as you can bet that a major study like this from a research powerhouse like Memorial Sloan-Kettering Cancer Center published in a very widely read, high impact journal like the Journal of Clinical Oncology would have been trumpeted to every news outlet in the land if it had shown a statistically significant decrease in hot flashes in women in the "true" acupuncture group. It didn't; so it wasn't." Orac at Science Blogs (19th December 2007)

Acupuncture and Misdirection

Yet another study has been published allegedly showing that "acupuncture works." The study is published in the journal Anesthesiology and looks at post operative nausea and vomiting. There are many problems, however, with the conclusions drawn from the study and it does not support the claims of acupuncture… I do not find this one study compelling. The acupuncture and nausea literature is generally negative and inconsistent. The acupuncture literature in general tends to be negative and is solidly negative with regard to the reality of chi, meridians, and acupuncture points. The literature is also contaminated by many studies, like this one, that are not actually looking at acupuncture but at other things, such as electrical nerve stimulation. The net effect of such studies is not to improve the practice of medicine or increase our knowledge of biology or medical treatments, but as a source of misdirection in order to promote demonstrably false and unscientific beliefs to the public." Steven Novella, MD, NeuroLogica Blog (10th December 2007)

Does Acupuncture Work or Not?

"I think it is important to dispense with the superstitious nonsense that still surrounds acupuncture so we can focus on these remaining questions. Is there any benefit to acupuncture above the placebo effect? Is the needle insertion a necessary component of the acupuncture treatment? (So far I find the evidence unconvincing on these questions.) If it does work, what is the underlying physiological mechanism and are their easier and less invasive ways to exploit it? Acupuncture must free itself from its superstitious roots to more effectively address these questions, to be taken seriously, and to avoid the chronic problem of CAM where positive findings in a very narrow area are used to justify a large system of pseudoscience." Article by Steven Novella, MD, academic clinical neurologist at Yale University School of Medicine, NeuroLogica Blog (25th September 2007)

Alternative medicine doesn't exist and acupuncture is useless'

"I look at it this way: what if acupuncture didn't exist?…Would medicine or society be any worse off? If no one knew about it, nothing would change. You would still have ways to apply counter-irritation, through massage or rubbing." Article by Wallace Sampson, clinical professor emeritus of medicine at Stanford University and editor in chief of the Scientific Review of Alternative Medicine (San Francisco Chronicle — 31st August 2006)

Ancient Wisdoms?

Four-minute video clip of the BBC2 'Alternative Medicine: The Evidence' episode on acupuncture which shows a young woman having open-heart surgery aided by acupuncture. Programme presenter Kathy Sykes does not explicitly state that the patient was also receiving three powerful conventional sedatives — midazolam, droperidol and fentanyl — along with large volumes of local anaesthetic injected into her chest. (You Tube) [See the link immediately below]

BBC2 series on Alternative Medicine (Acupuncture)

A critical review of part one of the BBC2 series 'Alternative Medicine: The Evidence' which looked at acupuncture. By David Colquhoun, FRS, A. J. Clark Professor of Pharmacology, University College London (January 2006) [Also see the link immediately below]

The BBC Board of Trustees upholds two complaints made by scientist and broadcaster Simon Singh regarding the BBC2 'Alternative Medicine: The Evidence' episode on acupuncture

The committee concluded that "The programme, while making reference to the clinical drugs administered to the patient in the open-heart surgery, did not accurately reflect the effect of acupuncture on each occasion that the operation was referred to and implied incorrectly that acupuncture was being used as the sole source of pain relief. It agreed that this could have misled the audience and upheld the complaint with regard to accuracy". [pdf]

Full of Holes — The curious case of acupuncture

"If acupuncture has effects beyond placebo, it is through the physical stimulation and release of the body's natural painkillers. Finding that sham acupuncture is as effective as "real" acupuncture demonstrates that the Qi theory is full of holes." Article by Michael Shermer, Scientific American (August 2005)

What's the point?

"It's high time to conduct good trials to find if acupuncture is anything more than a placebo. In the meantime, there seems to be little reason for people to waste time and money on this elaborate ritual." David Ramey, New Humanist (7th January 2005)

Acupuncture: Researcher finds the haystack is full of needles

"A University of Maryland researcher, who has been touting acupuncture for the last 17 years, now reports it may actually work — sort of. Here's the picture: a few thousand years before it was known that blood circulates or germs cause disease, doctors who had never dissected a frog, claimed that yin and yang could be balanced by inserting needles into the right points, among the hundreds of points strung along 12 meridians. They called it "acupuncture," from the Latin acus, needle and punctus, prick. Which is odd, because they were Chinese. But if they figured out acupuncture, they must have been smart enough to learn Latin. Scientists today can't even find the meridians. A Maryland study of 570 elderly patients who suffer from arthritis of the knee, found that 6 months of acupuncture modestly reduced pain and improved agility. Six months? Why not take an aspirin? Scientists suggest the needles stimulate release of endorphins. Jalapeno peppers do the same thing. So it wouldn't matter where you stick the needles would it? Then who needs an acupuncturist?" Robert L. (Bob) Park, professor of physics and former chair of the Department of Physics at the University of Maryland, What's New newsletter (23rd December 2004)

Belief, Not Medicine

"A new study in the December issue of Contemporary Pediatrics recommends the use of acupuncture to treat children with chronic pain or nausea, claiming to have evaluated the effectiveness of acupuncture for children by examining its use in adults. However, the flaws in the research reflect ongoing problems in other acupuncture studies……[the authors] only recommend it [acupuncture] for patients with "values and world views consistent with acupuncture". This admission handily illustrates what years of research has shown — acupuncture is a matter of belief, not medicine." Howard Fienberg, Tech Central Station (December 2002)

A sceptic view on acupuncture

"Taken as a group, reviews of clinical studies published since 1990 on the clinical efficacy of acupuncture do not support the notion that acupuncture is effective for any variety of conditions and cast doubt on efficacy for some specific conditions for which acupuncture has been reported as effective." Report on 'A review of the evidence for the clinical efficacy of human acupuncture' by David Ramey and Wallace Sampson, Scientific Review of Alternative Medicine (2001) [Reported in Focus on Alternative and Complementary Medicine — FACT]

Chinese Acupuncture For Heart Surgery Anesthesia

In an operating room at the University of Shanghai, a 28-year-old female patient was prepped for "open-heart surgery" to repair her mitral valve. In lieu of standard anesthesia, her only anesthetic was an acupuncture needle in her right earlobe that was connected to an electrical source. Skeptical article by Gary P. Posner, M.D. and Wallace Sampson, M. D., originally published in The Scientific Review of Alternative Medicine (Fall/Winter 1999) [Includes links to photographs of the surgery]

Acupuncture: A History

Article by Stephen Basser, The Scientific Review of Alternative Medicine (Spring/Summer 1999) [pdf]

Acupuncture: The Facts

Detailed and comprehensive 139-slide PowerPoint presentation by the late Robert Imrie, DVM. It debunks many of the myths about acupuncture, including the idea that it has been around for thousands of years. (Click on the numbers on the left-hand sidebar of the link to view the slides).

Acupuncture: Nonsense with Needles

Includes acupuncture as a system of medicine, resistance to acupuncture in China, acupuncture quackery, "acupuncture anesthesia", acupuncture clinics and failed treatment in the United States, acupuncture and pain relief, adverse effects, and acupuncture teaching. Article by Arthur Taub, MD PhD, (Task Force for Veterinary Science website)

Acupuncture

In addition to providing an example of acupuncture practice, this article also looks at the benefits of acupuncture (proven and purported), its potential risks, and the controversy as to its effectiveness. (Wikipedia)

Acupuncture Watch

Provides information about acupuncture that is difficult or impossible to find elsewhere.