Shannon Cogan
Acupuncture is a component of traditional Chinese medicine, which is also called TCM. It is unclear exactly when acupuncture originated, but it was being used for healing purposes in China by 100 BC.1 The practice involves putting thin needles into certain points on the body. In traditional Chinese medicine, these needles were used to balance the yin and yang energy forces in the body. However, modern practitioners now generally claim that acupuncture needles stimulate a specific site on the body to begin the healing process. While acupuncture is generally thought of as helping with specific bodily pain, such as back pain or cramps, many practitioners claim that it can treat nearly any ailment, including drug addiction and impotence. Acupuncture is incredibly popular in the United States, as over 10 million sessions are given each year.2
Believers in acupuncture can make many claims about why they choose to receive treatment. Acupuncture treatment in incredibly common, and is used by many well respected treatment centers, including the Ohio State Wexner Center. Studies have reliably found that acupuncture patients have differ significantly in pain reduction from a waitlist group, which is likely an important reason why this form of treatment is so widely used. However, many scientists have doubts about the standards of acupuncture research as well as the conclusions that have been drawn from the research that has been conducted. Many scientists suggest that research has been conducted poorly, tends to respond to biases and lacks good control groups3. Meta- analyses are often unable to draw conclusions about the effectiveness of treatment, leaving sceptics unconvinced about acupuncture’s ability to treat a variety of ailments.
Evidence for the efficacy of acupuncture is particularly difficult to evaluate. While many studies have been conducted on the use of acupuncture, they often produce contradictory findings. It is particularly difficult to develop a good control group when evaluating acupuncture, and it is nearly impossible to develop a test that is truly double blind, as a practitioner would know if they were practicing true acupuncture and might influence the patient. For this reason, many sceptics are critical of positive findings and believe that acupuncture’s effectiveness can be attributed to the placebo effect. When a sham needle was developed (patients feel like they are receiving acupuncture but the needle does not fully enter the skin) no significant difference in post operating nausea was found between the sham group and the acupuncture group,4 supporting the belief that acupuncture is entirely a placebo treatment.
While support of the effectiveness of acupuncture is not strong, the social context of the treatment is likely what sustains its practice. In some countries (such as China and Japan) acupuncture is trusted because it has been used as a treatment for thousands of years and is integrated into a cultural tradition. In the United States, acupuncture likely continues to be used because of the trust that individuals have in their healthcare providers. Doctors continue to recommend acupuncture to individuals suffering from a variety of ailments, particularly chronic pain, and these individuals of ten have no reason to question the knowledge of their doctors. Because the placebo affect alone can often be incredibly effective, patients may feel better after receiving acupuncture even if it has no essential healing qualities. For this reason, patients likely continue their belief in the treatment even if it is not really effective.
Overall, acupuncture is an interesting example of a belief that is maintained in spite of a lack of strong evidence. In this instance, people likely continue to believe that acupuncture works because they are not interested in or able to comb through a great deal of confusing and often contradictory data. At the same time, individuals trust the expertise of doctors who continue to promote the treatment. Perhaps most interestingly, the use of acupuncture might be a fairly effective treatment solely through its ability to create a strong placebo effect which can reduce mental stress and sometimes even physical pain.
https://academic.oup.com/rheumatology/article/43/5/662/1788282
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104560/
https://www.quackwatch.org/01QuackeryRelatedTopics/acu.html
http://www.blackwell-synergy.com/links/doi/10.1111/j.1365-2044.2004.03577.x/abs
It is amazing how long the treatment has taken place given the fact that evidence is lacking. Perhaps there has been just enough ” proof” it works acupuncture remains popular throughout time. What exactly are the needles intended to do? Is it just the prick that supposedly helps you? Does depth of the given needle matter? I am just unclear as to if its skin or muscular contact that is targeted.
With a fear of needles I would probably have a sense of relief after the treatment just because I may be tense while it happens.
Hi Lillian,
Generally, the needles are thought to increase the blood flow in affected areas in a way that decreases pain. I think many practitioners would say that a specific needle length is important for acupuncture to be effective. However, in the placebo condition I mentioned, needles were developed to appear as if they were going into the effected area when they actually just pricked the surface. In this case, improvements in this condition were not significantly different from improvements in the placebo condition.
Acupuncture was definitely one of those things I never really questioned and just kind of assumed it worked without an explanation of why. Reading this was really interesting, it’s shocking to me that people trust this process due to how long it has been around and/or just a general trust in doctors. But, all the questions Lillian asked are very valid and I think they are hard to answer due to the fact that test can’t really be done to get a solid answer for them.
Also had no clue this developed in China, I never would have guessed!
Hi Paige,
In response to the question about the depth of needles, I think the “placebo needle” development was really interesting. I think this is the most convincing evidence that acupuncture is primarily a placebo treatment. However, even in this case, it’s possible that patients are able to distinguish the authenticity of a “placebo needle” which would hurt the ability of this condition to be an adequate control.
Acupuncture and alternative medical practices such as “cupping” are something that have intrigued me over the past year due to the increase in popularity that they are receiving. Personally, I know a lot of elite level athletes who believe in acupuncture and cupping, even though evidence is lacking. It makes me wonder what they believe is the effectiveness behind it, is it possible that part of it could be a fulfilling prophecy? Could they be benefitting from it just because they believe that they are. Most individuals who do this do not know any of the science behind it (even though, there really is no science behind it) they just buy into the idea.
Hi Charlie,
I was also interested in cupping, as it’s pretty related to acupuncture (at least in its origin). I think cupping is particularly interesting because it’s currently used by really high profile athletes (including Michael Phelps). I had a hard time finding a good explanation for the mechanism that makes cupping effective according to trainers or doctors, but I would be interested to know what the research says about the effectiveness of cupping. Do you know anything about the research or proposed mechanism? I would love to learn more about this.
Hi Shannon,
I agree that it is interesting because of the caliber of people who use it. For instance, I do competitive crossfit and there are a lot of the top athletes who swear by it. In my opinion, just having professionals use it and encourage it makes it a little more credible. Also, it could just be a placebo effect and they might think its helping which could lead to it actually helping. I am not sure about research honestly, I do plan to try cupping though! I am not sure how much harm there is in it.
I think its interesting to see how acupuncture has become popular with the increase in social media, and I think just shows how much people trust the internet and media, also influential people rather than focusing on the lack of evidence that it provides on whether it is proven to work or not. I think the main point of the blog is how the social conversation of these types of treatments have changed in the past few years making them more popular.
Hi Lauren,
You make a really interesting point about how media influences how people evaluate different treatment. When researching this subject I found primarily information about practitioners around the city, rather than explanations for the mechanisms for or research about the effectiveness of acupuncture. I can definitely see how these search results would make it more difficult to evaluate wether or not to receive acupuncture.
Acupuncture is one of the most popular forms of alternative medicine, which is why it’s crucial to analyze its effectiveness and whether or not it truly benefits the patient. I found the study you cited very interesting, and I never thought about the problem of the control group in experimentation with acupuncture. It makes sense that for so long it was hard to have a true control group because it is hard for people not to know whether or not there is a needle inside of them .Now that sham needles exist, it’s interesting to know that there was no difference found between the control and experimentation group. I would not be surprised if acupuncture was related solely to placebo.
Personally I’ve done acupuncture before so this was interesting to read. I had a few sessions done to treat pain from microtears in my Achilles and had some success in pain reduction. After this reading I can’t help but wonder if pain reduction was all in my own head. I wouldn’t be surprised if it was half and half a placebo and successful treatment for my case.
Hi Meg!
Thank you for sharing your personal experience. When writing this, I talked with my mom and my roommate who have both had acupuncture done and told me that it definitely helped relieve their pain. It’s such as difficult treatment to evaluate, and many researchers argue that acupuncture is effective enough that it should be used, even if its only mechanism for success is a placebo effect.
Hey Meg,
Its interesting you mentioned the placebo effect, I just did the same thing in a previous comment. Do you think that there is any harm that could be caused by cupping? I am sure there is some but is it truly significant or is it hurting whoever is using it? Im glad you had a positive experience with acupuncture! Personally, I am terrified of needles but I am interested in trying cupping.
Charlie
My friend was born with spina bifida and since she was about ten she has been doing acupuncture to help with chronic migraines. She is a firm believer in the practice so it is really interesting to find out that it is almost entirely a placebo effect and maybe her results are from a strong belief in her treatment.
Hi Dahria,
I also have a few friends and family who have told me that acupuncture has helped greatly with their pain. I was conflicted about even writing this article because I don’t want to make those people feel like their own experiences aren’t valid. This example is really interesting, because it can be uncomfortable to question this treatment because we almost all know people who strongly believe in it.
Hey ! thank you for sharing, that is really unfortunate for you friend for her illness but at the same time i think it is good that she is getting acupuncture and it seems to be helping her. Whether it is a placebo effect or it is all in her head the fact she still has faith in her belief shows that something must be done right and maybe for the strong believers in this , they have similar experiences.
great post! I never really looked at acupuncture as an extraordinary belief. I always thought it was a common practice that a lot of people partake in. I know people who suffer from chronic illnesses and they say acupuncture is relaxing and helps their pain, but I guess I never thought about if its a placebo effect. It really makes me start to rethink my opinion on it!
Hi Marsha,
I totally agree! I had actually intended to write my post just on acupuncture for mental health issues, because I had always assumed it was effective in treating physical pain. It wasn’t until I started researching for this post that I started to consider the possibility that acupuncture is pseudoscientific as a whole.
I actually did not know that the practice of acupuncture was an extraordinary belief! It seems so widely practices and endorsed by so many physicians that I thought it must be effective. It’s interesting to read about how research in acupuncture isn’t very conclusive and many studies produce contradictory results. I can see how it would be difficult to conduct research on this as you mentioned that double blind studies are nearly impossible and it seems that placebo needles can be distinguished between actual ones, especially with how the acupuncture needles would puncture the skin.
I didn’t know that there was so little evidence for the effectiveness of acupuncture since it is so widely practiced. I’ve heard a lot about acupuncture and all the medical ailments that it can help with I thought there must have been a substantial amount of evidence for it. Growing up in a Chinese family, I’ve been recommended acupuncture and cupping whenever I have back pain, but the thought of people putting needles all over my body kind of freaks me out, but I know a lot of people who swear by it for their problems. I agree that it could be because of the placebo effect since there is so little evidence.
Hi Joy,
I think one of the things that is so interesting about acupuncture is how much culture influences how much people believe in its effectiveness. While I was researching this belief I found that acupuncture is accepted by most of the population in China and Japan, and it is slightly less accepted in the U.S. However, many people in other countries in Europe, South America, etc. tend to be a lot more skeptical of acupuncture.
I have obviously heard of acupuncture, but I never really looked into what exactly the benefits, outcomes, and expectations were, so this was an informative read! I am not the biggest fan of needles so I tend to avoid the topic, but I do know people who have received acupuncture and they sweat by it. I agree with the placebo effect being a strong helper of healing symptoms, but I also feel like it does provide some true physical results as well. It helps enough to keep the practice around, which is good that people are able to see results, placebo effect or not.
I could never get into acupuncture. It always seemed so dangerous to me. There are plenty of amateur acupuncture specialist out there and I’d hate to run into a case of misperformed needles in my body. This always makes me think back to the film Final Destination 5 and the massage parlor scene with acupuncture treatment. Makes me cringe with fear, the thought of those things just sticking off of your body.
I think the biggest problem with acupuncture or other forms of alternative medicine is that people believe these methods are curing/treating their illness or disease. In actuality, they only really have positive effects when it comes to treating or relieving symptoms of the disease/illness. If people understood this difference, I don’t there there would still be this extraordinary belief about how they work.