6 ms·

http://sciencebasedmedicine.org/acupuncture-doesnt-work/ http://sciencebasedmedicine.org/acupuncture-doesnt-work/

by erentz 9y ago

siquick 9y ago
>>Acupuncture should, ideally, be tested separately for effectiveness for each individual condition for which it has been proposed (like so many other forms of alternative medicine, that is a very large number). Good quality trials have not been done for all of them, but results suggest strongly that it is unlikely that acupuncture works for rheumatoid arthritis, stopping smoking, irritable bowel syndrome, or for losing weight. There is also no good reason to think it works for addictions, asthma, chronic pain, depression, insomnia, neck pain, shoulder pain or frozen shoulder, osteoarthritis of the knee, sciatica, stroke or tinnitus, and many other conditions.18<< The key part of that paragraph being "Good quality trials have not been done for all of them". It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, rather than committing to running the same detailed trials that they do on profitable drugs.
- pavel_lishin 9y ago
  First, you're taking a god-of-the-gaps approach to acupuncture. "It hasn't been proven to be ineffective for condition X, so keep your mind open!" Second, they have run good trials on many of the conditions acupuncture claims to cure. You picked the one paragraph that might be interpreted to support your claim: > It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, rather than committing to running the same detailed trials that they do on profitable drugs. So here's a few quotes that contradict you, all from the same article: > after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant. > Large multicenter clinical trials conducted in Germany7–10 and the United States11 consistently revealed that verum (or true) acupuncture and sham acupuncture treatments are no different in decreasing pain levels across multiple chronic pain disorders: migraine, tension headache, low back pain, and osteoarthritis of the knee. > Vickers et al.14 did a meta-analysis for 29 randomized controlled trials, with 17,922 patients. The patients were being treated for a variety of chronic pain conditions. The results were very similar to those of Madsen et al.12Real acupuncture was better than sham but by a tiny amount that lacked any clinical significance. There's no reason to not try acupuncture, if you've got the money for it, I guess. It's not likely to hurt you. But don't disregard other treatments. And bitch all you want about "western medicine", but if you have a heart attack, or need a kidney transplant, or break a bone - you're probably going to choose the western system.
  - DougWebb 9y ago
    And bitch all you want about "western medicine", but if you have a heart attack, or need a kidney transplant, or break a bone - you're probably going to choose the western system. I think western medicine is excellent when it comes to determining specific details about many individual bits are supposed to be working, and fixing those specific things when they're broken or malfunctioning. It's not as successful when it comes to understanding how all of those specific bits fit into place as part of a larger complex system. There are too many variables and interactions, and we've only very recently had the computational power to create models of these systems, let alone understand them. Where western medicine takes a bottom-up approach, from details to system, non-western medicine usually takes a top-down approach, observing how the overall system behaves and reacts. With enough observations, it can become very good at predicting reactions, but still totally fail at being able to explain why the reactions happen. Take acupuncture: in western medicine, we know that the body has pathways and circulatory systems for blood, lymph, and other fluids, and that our cells communicate using electrical, chemical, and hormonal signals that are passed through the pathways and circuits. We know a lot about small details, like how one nerve cell uses ions to pass an electrical charge across a fluid-filled gap to the next nerve cell, but we don't really know how it all works as a whole. But it stands to reason that poking conductive needles into these pathways and using them to cause stimulation could insert signals into the system or interrupt existing signals. Western medicine can't model that, and it can't predict for sure what possible effects it can have. Without a theory, all we can do is perform random experiments in the dark and hope something noticeable happens. Chinese medicine, on the other hand, has done the random experiments over thousands of years, and has determined specific places to put the needles and how to manipulate them to get the desired effect. That's straight-up observational science. But to explain it the Chinese came up with the idea of qi as an energy that flows through the body, which is vaguely right as a very blurry view of western medicine's understanding of our nervous system and other systems, but mostly it's completely fictional. The point I'm trying to make is that different approaches to understanding can both be right and both be wrong, except they tend to be right and wrong about different parts. The top-down, systemic, wholistic approach is good for understanding the big picture and the 'what', while the bottom-up, componentized, analytical approach is good for understanding 'how'.
pcurve 9y ago
Sure it does, if not for most, for a lot of people anyway, even if it is hard to explain how. https://en.wikipedia.org/wiki/German_acupuncture_trials https://en.wikipedia.org/wiki/German_acupuncture_trials https://well.blogs.nytimes.com/2012/09/11/acupuncture-provides-true-pain-relief-in-study/ https://well.blogs.nytimes.com/2012/09/11/acupuncture-provid... The site you provided is run by a small group of doctors who seem to have beef with acupuncture, judging by their tone. https://sciencebasedmedicine.org/category/acupuncture/ https://sciencebasedmedicine.org/category/acupuncture/ A lot of western folks who get acupuncture treatment do so with great deal of skepticism. Despite that, it's gaining traction in the West. Why? Because it works pretty well for some people. I wouldn't dismiss it as a sham.
mamcx 9y ago
Not work? But except for the parent and a lot of other people.
- grardb 9y ago
  Seriously. I always roll my eyes when somebody claims that acupuncture "doesn't work," because it's worked for me on multiple occasions. Typically, it comes from people who have never tried it. A little over four years ago, I had a ton of shoulder pain. I went to two doctors, had an MRI scan, and was prescribed physical therapy. After all of that, I was still in pain, and neither of the doctors could figure out why, so I decided to try acupuncture for the first time. I went to Chinatown, got needles put in me, and got some electricity sent to my shoulder. I left the shop about 30 minutes later, and about 70% of my pain was gone. I woke up with next morning with only a tiny bit of pain left. The pain didn't come back, even after months. I eventually found a doctor who figured out what was wrong, and through a better round of physical therapy, I was able to eradicate my shoulder pain permanently. Maybe acupuncture didn't solve my problems completely, and of course it doesn't work for everything (e.g. weight loss, cancer, etc.), but to simply say that it "doesn't work" is ludicrous.
  - seanwilson 9y ago
    Why after decades then has acupuncture not been shown to work in any rigorous high quality studies? It's not like it hasn't been studied and proper studies are significantly more reliable than acendotes.
    - DanBC 9y ago
      That's incorrect. There are a couple of recent studies showing acupuncture is better than treatment as usual for some musculoskeletal problems. https://discover.dc.nihr.ac.uk/portal/article/4000672/acupuncture-shown-to-have-benefits-for-treatment-of-some-chronic-pain?utm_content=buffered7fb&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer https://discover.dc.nihr.ac.uk/portal/article/4000672/acupun... (On mobile, apologies for the weird URL). For lower back pain I think the advice is, after seeing a doctor, to start exercising.
thesunny 9y ago
I'm the GP. The reason why I'm replying is because I don't want people that can be helped by Acupuncture to reject it based on a misunderstanding of the claim. I think there are several specific reasons why both the article which you link to can be true and also that acpuncture worked in my specific case and can work in cases that are similar. First of all, as another reply alluded to, the article isn't testing for effectiveness for a specific problem. In fact, I believe, and continue to believe personally, that acupuncture may not solve for general problems. My half-joking, poke your foot to fix your liver being an example. I would also like to point out that of all the things I tried, I had the least confidence in acupuncture. In terms of placebo, I was expecting and perhaps even hoping that it wouldn't work to prove myself right. In fact, I tried it almost mainly as a way to say that, "Hey! I tried everything. Even acupuncture! That's how you know I tried everything." I had much higher confidence in everything else I tried. I would also like to point out that the specific thing I think it solves is in releasing a muscle locked in spasm (though I may be getting the language wrong). I think if you don't have a muscle locked in spasm, it probably won't help. My initial reaction to the improvement was that perhaps it was a coincidence. Although this seemed unlikely given that I had been trying for months with different practitioners and there was a difference before and after the session. I also thought that it was temporary and that maybe a day later things would revert, which they didn't. I also felt that this was becoming more mainstream because I had some rehabilitation for an injured knee a few years later. Apparently I had a muscle locked in spasm (not the knee) and they used a needle to unlock it. Basically, put the needle into the locked muscle, move it a little, there is a physical jerk, and the muscle becomes unlocked. Edit: Weakened some points to better reflect my position
- legohead 9y ago
  Did you try a physical therapist? I had knee pain from rock climbing, and the usual "treatment" in this sport is just to rest and heal, but after 4 months I had no improvement. I had little faith in PT because I was convinced I had some kind of tear, or maybe a bone spur, etc. Anyway, the physical therapist put me through motions and he showed me on the skeleton how it was actually supporting muscles that were much weaker on one side of my body. He gave me basic exercises to do every day to strengthen those muscles, and in the end it worked beautifully. No more knee issues. I'm glad you found something that worked, but I'm also curious if you tried out PT, and what they told you?
dang 9y ago
We detached this subthread from https://news.ycombinator.com/item?id=14699090 https://news.ycombinator.com/item?id=14699090 and marked it off-topic.
sntdoaeu98 9y ago
Yeah, my wife was sent to an acupuncturist as a sort of last resort when everything else had failed. She was more than happy to go and assumed it would help. She was sent to the UCLA East/West center, which is supposed to be top-of-the-line in the field. The instructions they gave her didn't even make sense. In addition to getting poked with needles, there was a lot of very vaguely described things she was supposed to do. It was so weird I can hardly remember most of it, but they had a special diet they wanted her to start. It involved such specifics as "avoid foods that invite dampness." We didn't know what that meant, but they had a helpful chart of examples, like lettuce. WTF? What does that even mean? They also suggested she take orange rinds, but didn't specify how she was supposed to take them. Should she just eat them raw? Put them in tea? Grind them up in something? And what type of oranges? Calling it a "medical technique" or even "alternative medicine" was ludicrous. It wasn't even coherent.

http://sciencebasedmedicine.org/acupuncture-doesnt-work/ http://sciencebasedmedicine.org/acupuncture-doesnt-work/

by erentz 9y ago

http://sciencebasedmedicine.org/acupuncture-doesnt-work/ http://sciencebasedmedicine.org/acupuncture-doesnt-work/

>>Acupuncture should, ideally, be tested separately for effectiveness for each individual condition for which it has been proposed (like so many other forms of alternative medicine, that is a very large number). Good quality trials have not been done for all of them, but results suggest strongly that it is unlikely that acupuncture works for rheumatoid arthritis, stopping smoking, irritable bowel syndrome, or for losing weight. There is also no good reason to think it works for addictions, asthma, chronic pain, depression, insomnia, neck pain, shoulder pain or frozen shoulder, osteoarthritis of the knee, sciatica, stroke or tinnitus, and many other conditions.18<< The key part of that paragraph being "Good quality trials have not been done for all of them". It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, rather than committing to running the same detailed trials that they do on profitable drugs.

pavel_lishin 9y ago
First, you're taking a god-of-the-gaps approach to acupuncture. "It hasn't been proven to be ineffective for condition X, so keep your mind open!" Second, they have run good trials on many of the conditions acupuncture claims to cure. You picked the one paragraph that might be interpreted to support your claim: > It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, rather than committing to running the same detailed trials that they do on profitable drugs. So here's a few quotes that contradict you, all from the same article: > after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant. > Large multicenter clinical trials conducted in Germany7–10 and the United States11 consistently revealed that verum (or true) acupuncture and sham acupuncture treatments are no different in decreasing pain levels across multiple chronic pain disorders: migraine, tension headache, low back pain, and osteoarthritis of the knee. > Vickers et al.14 did a meta-analysis for 29 randomized controlled trials, with 17,922 patients. The patients were being treated for a variety of chronic pain conditions. The results were very similar to those of Madsen et al.12Real acupuncture was better than sham but by a tiny amount that lacked any clinical significance. There's no reason to not try acupuncture, if you've got the money for it, I guess. It's not likely to hurt you. But don't disregard other treatments. And bitch all you want about "western medicine", but if you have a heart attack, or need a kidney transplant, or break a bone - you're probably going to choose the western system.
- DougWebb 9y ago
  And bitch all you want about "western medicine", but if you have a heart attack, or need a kidney transplant, or break a bone - you're probably going to choose the western system. I think western medicine is excellent when it comes to determining specific details about many individual bits are supposed to be working, and fixing those specific things when they're broken or malfunctioning. It's not as successful when it comes to understanding how all of those specific bits fit into place as part of a larger complex system. There are too many variables and interactions, and we've only very recently had the computational power to create models of these systems, let alone understand them. Where western medicine takes a bottom-up approach, from details to system, non-western medicine usually takes a top-down approach, observing how the overall system behaves and reacts. With enough observations, it can become very good at predicting reactions, but still totally fail at being able to explain why the reactions happen. Take acupuncture: in western medicine, we know that the body has pathways and circulatory systems for blood, lymph, and other fluids, and that our cells communicate using electrical, chemical, and hormonal signals that are passed through the pathways and circuits. We know a lot about small details, like how one nerve cell uses ions to pass an electrical charge across a fluid-filled gap to the next nerve cell, but we don't really know how it all works as a whole. But it stands to reason that poking conductive needles into these pathways and using them to cause stimulation could insert signals into the system or interrupt existing signals. Western medicine can't model that, and it can't predict for sure what possible effects it can have. Without a theory, all we can do is perform random experiments in the dark and hope something noticeable happens. Chinese medicine, on the other hand, has done the random experiments over thousands of years, and has determined specific places to put the needles and how to manipulate them to get the desired effect. That's straight-up observational science. But to explain it the Chinese came up with the idea of qi as an energy that flows through the body, which is vaguely right as a very blurry view of western medicine's understanding of our nervous system and other systems, but mostly it's completely fictional. The point I'm trying to make is that different approaches to understanding can both be right and both be wrong, except they tend to be right and wrong about different parts. The top-down, systemic, wholistic approach is good for understanding the big picture and the 'what', while the bottom-up, componentized, analytical approach is good for understanding 'how'.

pcurve 9y ago

Sure it does, if not for most, for a lot of people anyway, even if it is hard to explain how. https://en.wikipedia.org/wiki/German_acupuncture_trials https://en.wikipedia.org/wiki/German_acupuncture_trials https://well.blogs.nytimes.com/2012/09/11/acupuncture-provides-true-pain-relief-in-study/ https://well.blogs.nytimes.com/2012/09/11/acupuncture-provid... The site you provided is run by a small group of doctors who seem to have beef with acupuncture, judging by their tone. https://sciencebasedmedicine.org/category/acupuncture/ https://sciencebasedmedicine.org/category/acupuncture/ A lot of western folks who get acupuncture treatment do so with great deal of skepticism. Despite that, it's gaining traction in the West. Why? Because it works pretty well for some people. I wouldn't dismiss it as a sham.

mamcx 9y ago

Not work? But except for the parent and a lot of other people.

grardb 9y ago
Seriously. I always roll my eyes when somebody claims that acupuncture "doesn't work," because it's worked for me on multiple occasions. Typically, it comes from people who have never tried it. A little over four years ago, I had a ton of shoulder pain. I went to two doctors, had an MRI scan, and was prescribed physical therapy. After all of that, I was still in pain, and neither of the doctors could figure out why, so I decided to try acupuncture for the first time. I went to Chinatown, got needles put in me, and got some electricity sent to my shoulder. I left the shop about 30 minutes later, and about 70% of my pain was gone. I woke up with next morning with only a tiny bit of pain left. The pain didn't come back, even after months. I eventually found a doctor who figured out what was wrong, and through a better round of physical therapy, I was able to eradicate my shoulder pain permanently. Maybe acupuncture didn't solve my problems completely, and of course it doesn't work for everything (e.g. weight loss, cancer, etc.), but to simply say that it "doesn't work" is ludicrous.
- seanwilson 9y ago
  Why after decades then has acupuncture not been shown to work in any rigorous high quality studies? It's not like it hasn't been studied and proper studies are significantly more reliable than acendotes.
  - DanBC 9y ago
    That's incorrect. There are a couple of recent studies showing acupuncture is better than treatment as usual for some musculoskeletal problems. https://discover.dc.nihr.ac.uk/portal/article/4000672/acupuncture-shown-to-have-benefits-for-treatment-of-some-chronic-pain?utm_content=buffered7fb&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer https://discover.dc.nihr.ac.uk/portal/article/4000672/acupun... (On mobile, apologies for the weird URL). For lower back pain I think the advice is, after seeing a doctor, to start exercising.

thesunny 9y ago

I'm the GP. The reason why I'm replying is because I don't want people that can be helped by Acupuncture to reject it based on a misunderstanding of the claim. I think there are several specific reasons why both the article which you link to can be true and also that acpuncture worked in my specific case and can work in cases that are similar. First of all, as another reply alluded to, the article isn't testing for effectiveness for a specific problem. In fact, I believe, and continue to believe personally, that acupuncture may not solve for general problems. My half-joking, poke your foot to fix your liver being an example. I would also like to point out that of all the things I tried, I had the least confidence in acupuncture. In terms of placebo, I was expecting and perhaps even hoping that it wouldn't work to prove myself right. In fact, I tried it almost mainly as a way to say that, "Hey! I tried everything. Even acupuncture! That's how you know I tried everything." I had much higher confidence in everything else I tried. I would also like to point out that the specific thing I think it solves is in releasing a muscle locked in spasm (though I may be getting the language wrong). I think if you don't have a muscle locked in spasm, it probably won't help. My initial reaction to the improvement was that perhaps it was a coincidence. Although this seemed unlikely given that I had been trying for months with different practitioners and there was a difference before and after the session. I also thought that it was temporary and that maybe a day later things would revert, which they didn't. I also felt that this was becoming more mainstream because I had some rehabilitation for an injured knee a few years later. Apparently I had a muscle locked in spasm (not the knee) and they used a needle to unlock it. Basically, put the needle into the locked muscle, move it a little, there is a physical jerk, and the muscle becomes unlocked. Edit: Weakened some points to better reflect my position

legohead 9y ago
Did you try a physical therapist? I had knee pain from rock climbing, and the usual "treatment" in this sport is just to rest and heal, but after 4 months I had no improvement. I had little faith in PT because I was convinced I had some kind of tear, or maybe a bone spur, etc. Anyway, the physical therapist put me through motions and he showed me on the skeleton how it was actually supporting muscles that were much weaker on one side of my body. He gave me basic exercises to do every day to strengthen those muscles, and in the end it worked beautifully. No more knee issues. I'm glad you found something that worked, but I'm also curious if you tried out PT, and what they told you?

dang 9y ago

We detached this subthread from https://news.ycombinator.com/item?id=14699090 https://news.ycombinator.com/item?id=14699090 and marked it off-topic.

sntdoaeu98 9y ago

Yeah, my wife was sent to an acupuncturist as a sort of last resort when everything else had failed. She was more than happy to go and assumed it would help. She was sent to the UCLA East/West center, which is supposed to be top-of-the-line in the field. The instructions they gave her didn't even make sense. In addition to getting poked with needles, there was a lot of very vaguely described things she was supposed to do. It was so weird I can hardly remember most of it, but they had a special diet they wanted her to start. It involved such specifics as "avoid foods that invite dampness." We didn't know what that meant, but they had a helpful chart of examples, like lettuce. WTF? What does that even mean? They also suggested she take orange rinds, but didn't specify how she was supposed to take them. Should she just eat them raw? Put them in tea? Grind them up in something? And what type of oranges? Calling it a "medical technique" or even "alternative medicine" was ludicrous. It wasn't even coherent.