by Jaclyn Musci
Acupuncture is an alternative form of medicine that has been around for ages. It originated in China around the time of the Common Era, however, back then sharp stones and bones were used, rather than needles. The first official document that mentioned acupuncture was The Yellow Emperor’s Classic of Internal Medicine, which dated back to 100 BCE (1). This traditional Chinese medicine has been used to most commonly treat pain, but has also been used to treat overall wellness, stress management, and discomfort from various diseases. The treatment consists of inserting very thin needles into one’s skin at different points of the body. Traditional Chinese medicine views acupuncture as a way to re-balance one’s life force or “qi”, which flows among meridians in the human body. However, Western practices view acupuncture as a way to stimulate nerves, tissue, and muscles in order to enhance the body’s natural painkillers (2).
Acupuncture has been a popular and widely used alternative medicine since it started to be a common practice in China. Now acupuncture is used still today as an alternative medicine in the United States, although practitioner’s views on the mechanisms of acupuncture differ. A 2007 NHIS data survey found that about 6.5% of Americans report using acupuncture at some point in their life. Additionally, another survey of Chinese Americans in a mental health program found that about 25% of them used acupuncture, which suggests it may be more popular among diverse cultures (3). A plethora of information about acupuncture can be found on the web. A simple google search results in thousands of, credible and non-credible, sources explaining what acupuncture is, how it works, research on it, and where to find a practitioner. Because acupuncture is still relatively popular, it is important to analyze the pseudoscientific aspects of this belief. Acupuncture is a controversial topic among medical professionals and has contradictory empirically-based research support, which makes this belief extraordinary.
There have been mostly contradictory findings in regards to the effectiveness of acupuncture. Some research has supported the effectiveness of acupuncture though. For example, acupuncture needles have been found to stimulate nerve endings, which leads to changing the pain inhibitory mechanisms in one’s body. However, the results could not explain if the needles were the true causal factor in pain inhibition. In addition, systematic reviews and meta-analyses over the past decade have given more reliable evidence for acupuncture helping dental pain, nausea, back pain, and headache. However, evidence for aiding in chronic pain has still been scarce. Although there is a variety of suggested mechanisms for acupuncture and how it works, there has been little valid data that explains how the mechanisms relate to clinical ideas and practices (1). Until recently, it has been difficult to study the mechanisms and true effectiveness of acupuncture because of the inability to employ a sufficient control group and carry out a true double-blind experiment. For obvious reasons, it is difficult for participants to be blind to whether or not needles are being inserted into their skin. However, when sham needles were recently invented, these needles allowed for a patient to feel the sensation of needles when the needles are actually not present. One study looked at the differences in nausea improvement between a control sham group and an experimental acupuncture group. There were no differences between these two groups found, which suggests the positive effects of acupuncture may be due to the placebo effect (4).
There are numerous cognitive factors that play a role in the belief and use of acupuncture. Despite the lack of solid research evidence to support acupuncture, it still remains popular and people still pay a substantial amount of money to receive this treatment. People who receive acupuncture might not necessarily be misinformed, rather they have an immense trust in their practitioners and those who recommend the treatment to them. People tend to trust practitioners, and they rarely ask about or explore the research support surrounding a treatment. However, an authority figure or practitioner is not always right and might not always be basing his/her practices off scientifically supported research. In addition, the placebo effect might play a role in the positive results seen from acupuncture. This is when a person experiences desired results from a treatment due to his/her positive beliefs and expectations about the success of the treatment – not due to the actual treatment itself. The research study mentioned previously in which the sham needle and the experimental acupuncture group experienced the same results for nausea treatment suggest the placebo effect is at play. In addition to the placebo effect, individuals might also be experiencing cognitive dissonance. People who use acupuncture put a lot of time, money, and other resources into the treatment, so they truly want it to work. If it does not work, they might experience cognitive dissonance and not be able to reason why they spent all their time and resources for no positive results. As a result, they might see positive results that are not there or fail to accurately assess the effectiveness of treatment. Furthermore, those who experience the desired effects of acupuncture might be experiencing confirmation bias. Confirmation bias is when one seeks only the confirming evidence and ignores the disconfirming evidence. This could be prevalent in acupuncture when one justifies acupuncture effectiveness because their pain subsides in one area of their body, but not completely. These cognitive factors might lead people to believe acupuncture is effective and worth seeking out.
Additionally, there are also contextual and social factors that contribute to this extraordinary belief. Those who use acupuncture come from a wide variety of communities and cultures. Acupuncture is used in both Western and Eastern parts of the world. However, some cultures might be more likely to use acupuncture because it aligns with their values, ideas, and traditions. For example, as stated previously, one survey found that 25% of Chinese Americans use acupuncture in a mental health setting, while 6.5% Americans overall have reported using it (3). This suggests there might be a cultural preference for it, and it might be used by more people of Eastern decent. Acupuncture might also be used by those who have rejected Western Medicine and decided to try a more alternative path. People who use acupuncture might have tried everything else for their pain or their problem and decided to look in a more natural area of medicine. There are many social influences that also help sustain this practice. One influence might be due to the sheer popularity of acupuncture. It is one of the most popular alternative medicines, and this alone might convince the public it is effective. The consensus heuristic might play a role here. This is when a person assumes that if the majority of people believe something works, it must work. However, this is often wrong and many people in our society can be swayed to believe an extraordinary belief all at once. Similarly, those who use acupuncture might be influenced by the anecdotes and stories from those around them. For example, one might hear that acupuncture worked miracles for their cousin, which convinces them acupuncture should work for them too. Lastly, people who use acupuncture might be falling victim to the natural commonplace misconception, which assumes that natural is always healthy and effective. This is not always true and can lead many people to not seek appropriate medical help.
Although acupuncture is an alternative medicine that is not fully supported by research, it is used frequently to treat many ailments, such as pain, reaching overall wellness, stress management, and discomfort. Acupuncture has been around for centuries and continues to be used today in both Easter and Western cultures. Research surrounding this topic has been mixed, and there has not been solid evidence for the overall use of acupuncture. Acupuncture is likely due to the placebo effect, which was shown with one study involving sham needles. In this study, there was no difference in nausea improvement in the group who thought they were receiving acupuncture but really were not and the group that was actually receiving it. In addition to the placebo effect, there is likely the confirmation bias and cognitive dissonance at play. Advocates also rely and trust in their practitioner’s opinion and do not question the effectiveness of the treatment they recommend. There may also be a cultural aspect at play, with many Chinese and Eastern cultures using acupuncture often. Furthermore, those who use acupuncture might be basing their opinion off anecdotal evidence or success they heard about through someone they know. Since acupuncture is popular, the consensus heuristic might have a role in people seeking it out. Lastly, because acupuncture is a natural and alternative form of medicine, people might seek this out and follow the natural commonplace misconception. There are many social, contextual, cultural, and cognitive factors that contribute to the popularity in use of acupuncture. However, it is important to consider the empirical research evidence so an extraordinary belief is not put into common medical practice.
- A brief history of acupuncture – https://academic.oup.com/rheumatology/article/43/5/662/1788282
- Acupuncture Overview – https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763
- How Popular is Acupuncture – https://sciencebasedmedicine.org/how-popular-is-acupuncture/
- The Online Scholar – http://www.blackwell-synergy.com/links/doi/10.1111/j.1365-2044.2004.03577.x/abs