5 ms·

There's loads of studies of acupuncture though showing no benefit.

vorpalhex 4y ago
You are way simplifying the studies. From what I understand: + We are pretty sure acupuncture, done correctly, won't cause any harm + It is on par or sometimes slightly exceeds placebo + Sometimes "things that seem like acupuncture but are not acupuncture" also give the same kind of results.. even though they shouldn't? I'd still be pretty skeptical about it, but the risk of trying it seems quite low
- light_hue_1 4y ago
  No. These junk "remedies" like acupuncture absolutely have risks. You can get infections from acupuncture. Your acupuncture "provider" could easily infect you with bloodborne diseases. People have even been documented to have died from acupuncture https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951167/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951167/ The benefits are zero. Potentially living with a chronic disease like Hepatitis C because of a lazy provider that reuses a needle or contaminates it in some way, is a serious risk. There's also the fact that by engaging in these activities you perpetuate junk science, just like Q anon people, just like climate change deniers, it's all the same insanity.
  - KptMarchewa 4y ago
    Agreed. On top of that, opportunity cost is a thing. If you pursue completely ineffective therapy - and spend time figuring out if your local acupuncture parlor uses dirty needles - you waste time and energy that would be spend pursuing worthwhile treatment.
  - vorpalhex 4y ago
    Let me try again, maybe with more caps. > We are pretty sure acupuncture, DONE CORRECTLY, won't cause any harm Yes, if you get stabbed with a dirty needle, you might get a disease. That's true for acupuncture, a tattoo shop, and even a vaccine. Don't get stabbed with dirty needles! I fully suggest not getting stabbed with dirty needles. Bad. Avoid. 0/10. > The benefits are zero https://pubmed.ncbi.nlm.nih.gov/3982837/ https://pubmed.ncbi.nlm.nih.gov/3982837/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984198/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984198/ It's probably about as effective as placebo? (Maybe?) That isn't zero, that's placebo - and that is an important difference > you perpetuate junk science, You're just wrong. This isn't even just a "you might have a different opinion". The absolute best science we have, the entirety of realms of research, is "well, it's probably placebo and maybe it's kind of an expensive placebo". The most scientific answer you can give is "we should do more studies and ask more questions", and it's part of why the medical industry has shifted from "Don't do acupuncture" to "Well, it probably won't do much for you, but sure if you like it, that seems fine".
    - xvedejas 4y ago
      One of the ways I avoid getting stabbed with a dirty needle is based on background rates. I think I'm safe in sticking with my priors that acupuncture clinics are held to less of a standard than vaccines are. Hypodermic needles necessarily come in sanitized packages, after all. There's more to science than just asking questions and collecting data though, there's also developing models. Without good models, you can't gain much insight from data, and in fact you'll sometimes gain incorrect understandings. If there's no supported mechanism for how acupuncture works, it's really not a good sign, and it seems dishonest to think it's at all in the same realm of safety as something like vaccines which do have known mechanisms of action. I think back to how much "data" we had in the 50s that tobacco was harmless. Is it ever a good idea to go for something so invasive to the body as needles without a strong reason, just because the dangers aren't readily apparent? Medicine passes the necessity bar, placebo does not.
      - azeirah 4y ago
        Dunno, I had some acupuncture sessions as recommended by my doctor. The accupuncturist's needles were each individually packed, he washes his hands thoroughly, then puts on gloves as well. Every needle gets thrown away immediately after use. Not sure how any of that is potentially unhygienic other than the room itself possibly being slightly dirty? (it was clearly well cleaned, but obviously not to surgical standards... why should it?)
      - vorpalhex 4y ago
        > If there's no supported mechanism for how acupuncture works, it's really not a good sign Acupuncture works as well as sham acupuncture (inserting needles at non-acupuncture locations). Which suggests to me that acupuncture works on the same basic principle that your doctor giving you sugar pills with a fancy name and strict instructions to take one every four hours with a glass of water works. > I think back to how much "data" we had in the 50s that tobacco was harmless. We had pretty good evidence it was bad for you, especially during pregnancy. This is maybe a better example for talking about peer review and conflicts of interest - which is still a real problem. We can never say "is dangerous" or "is not dangerous". What we can say is X esposure leads to Y harm. Water in sufficient quantities will kill you. Acupuncture, in a sterile environment, is pretty safe. We also know that skin deep needle penetration is pretty safe given that lots of people get tattoos. It still requires hygiene, but it is a safe activity. I'm totally sympathetic to "we should be doing health inspections of acupuncture, like we do tattoo shops". I think some areas already do this. It's probably a good idea.
- the_doctah 4y ago
  So its effectiveness is about on par with faith healing, got it.
  - shakezula 4y ago
    The placebo effect is a helluva drug
    - Broken_Hippo 4y ago
      No, it really isn't. Its help rate can be as low as 15%. Using anything that is only 15% effective as a drug is not only not effective, but can easily be mistreatment. Most of the time, you have to lie to the patient so they can get an effect (IF they get it at all) and then you often have a drug that is consistently more effective than the placebo. It isn't a helluva drug. It is a bad drug that often simply won't work for you.
      - Pyramus 4y ago
        It can be. And it's not all positive. The nocebo effect can be so strong, that people actually die because they think they are cursed (other examples: Covid vaccines, statins, ...). Any generalised statement about the effect of placebo/nocebo is difficult, because some portion of the effect is regression to the mean, and relatively little is known about the mechanism of action (e.g. there is some indication about a genetic factor). Not disagreeing with you that it may not work for you, but it may work quite well for some people. Acupuncture being a prime example.
        deleted 4y ago
        [deleted]
      - donthellbanme 4y ago
        We need to throw out Allopatic medicine that does not work, along with Acupuncture, Chiropractic, Naturopathic, Osteopathic bad healing techniques that work slightly better than Placebo in an Indian village in studies with less than 100 poor souls, and a questionable Control group, and rumors of payola floating around. Meaning enough with the bullshit remedies that don't work. Most Psychiatry drugs are on my hit list. I can't believe these $450 a visit fancy boys are allowed to prescribe 90% of their bread and butter drugs. I'm not just picking on shrinks either, but they are an easy target. I am beyond disillusioned that our FDA has approved drugs that are harmfully and actually don't work. (Former Chiropractic student who walked out after hearing, "We have over 15 upper cervical techniques--and they all work Equally well.") Enough is enough.
- 2Gkashmiri 4y ago
  to start off, i do not "understand" the "homeopathy" to either dismiss it as mumbo jumbo and dangerous but my granddad was a medical practitioner and he is said to have used homeopathy but not in the sense people use it now. i'm told he strictly used it literally as a placebo ONLY when he knew the cause of the "problem" was not physical or something wrong because of infection or something. I'm told he would treat patients with depression by counseling without telling them (usually family members) and prescribing this "white medicine" to keep up appearances. i'm told he never treated anyone outside of this usecase because well, there are medicines for that purpose. remind you this is from 50 years ago when my town had 3 hospitals in total and there was no "medical equipment" like we have currently or that were available in major cities. Call it the neck of the woods so its not like there was modern medical care available but patients didn't seek it. He was the physician of his time and pretty successful at that.
sxyuan 4y ago
Here's one meta-analysis of RCTs showing benefit for pain in fibromyalgia patients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/ That's in comparison to a sham acupuncture placebo. And the placebo effect is already pretty powerful. Even in the "no benefit" studies, that's usually in comparison to a sham acupuncture placebo that has a real effect compared to waiting. In terms of pain treatment, I'd say even a safe non-addictive placebo treatment is pretty good, better than getting hooked on opioids at least. I wouldn't get acupuncture hoping for a cure to cancer. But it's not exactly a stretch to think that manipulating nerves with needles will help with pain.
- Traubenfuchs 4y ago
  It's very unfortunate that this "nerve treatment with needles" for which "some evidence" exists is mashed together with the "pseudo scientific magic spot acupuncture".
- scoopertrooper 4y ago
  According to that meta-analysis, none of the studies included were properly blinded. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/figure/f2-jpr-12-527/?report=objectonly https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/figure/...
  - sxyuan 4y ago
    Almost all of the studies blinded the participants in the outcome assessment. That avoids bias when asking patients about their pain. It's difficult to imagine how you would blind the acupuncturists performing the treatment. I suppose you could have one acupuncturist mark the needle location and another blinded one stick the needle in. But a skilled acupuncturist would probably be unblinded by their own knowledge of where it makes sense for the needle to go. So there is definitely risk of performance bias, but they're sticking needles into patients at predefined points - I don't think it's a very large risk.
- News-Dog 4y ago
  >fibromyalgia Transcutaneous electrical nerve stimulation (TENS or TNS) : https://en.m.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation https://en.m.wikipedia.org/wiki/Transcutaneous_electrical_ne... Fibromyalgia (FM) : https://en.m.wikipedia.org/wiki/Fibromyalgia https://en.m.wikipedia.org/wiki/Fibromyalgia
eyelidlessness 4y ago
My study isn’t peer reviewed or anything so it’s just like my life or whatever, but it helped me save my life. I don’t know why it was effective, I was skeptical throughout. I still am. But it was one of the most effective treatments for severe acute anxiety I’ve ever had, it not the most effective.
- TheSpiceIsLife 4y ago
  I was just talking to someone about this. Perturbations. Life isn't a double blind randomised placebo controlled study, mostly on rats / students / in a clinical setting / lab, and therefore there's a strong case to be made that we shouldn't necessarily use that model to model our behaviour. Back to perturbations, I mean in the astronomical sense: deviation of a celestial body from a regular orbit about its primary, caused by the presence of one or more other bodies that act upon the celestial body. You go to a one or more acupuncture sessions and your life is, in a very literal sense, changed. It's not just a placebo, you actually went and did something you otherwise wouldn't have, with the intention of seeking improvement, thereby setting your life on a divergent path to what it otherwise would have been. Over time, the divergence can be drastic. This a very under appreciate power of our ability.
  - eyelidlessness 4y ago
    My initial reaction to this was that it felt more woo than I like, but I get your meaning and I even think it was probably part of it. And it was one of several changes I made in that time, some more impactful than others. But placebo or not, I’ll also say that the physical impact was genuinely calming. And while the setting and circumstances might account for most of that—soothing music, dark room, being still for about an hour with no interruption—I also found different needle placements had noticeably different effectiveness. It’s not for everyone. I wouldn’t dream of suggesting anyone try it who wasn’t already open to it. But it did really help me, regardless of the science. And I’m grateful for it.
    - TheSpiceIsLife 4y ago
      Appreciate your response, thanks.
Pyramus 4y ago
That's a common myth. It has no benefit relative to placebo, i.e. needles placed at random. And needles placed at random do seem to have significant placebo effect for some conditions and people.
- carlmr 4y ago
  But if added inflammation through needles is how acupuncture works, that's not a good placebo, since maybe the placement is not as important as the body's response.

You are way simplifying the studies. From what I understand: + We are pretty sure acupuncture, done correctly, won't cause any harm + It is on par or sometimes slightly exceeds placebo + Sometimes "things that seem like acupuncture but are not acupuncture" also give the same kind of results.. even though they shouldn't? I'd still be pretty skeptical about it, but the risk of trying it seems quite low

light_hue_1 4y ago
No. These junk "remedies" like acupuncture absolutely have risks. You can get infections from acupuncture. Your acupuncture "provider" could easily infect you with bloodborne diseases. People have even been documented to have died from acupuncture https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951167/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951167/ The benefits are zero. Potentially living with a chronic disease like Hepatitis C because of a lazy provider that reuses a needle or contaminates it in some way, is a serious risk. There's also the fact that by engaging in these activities you perpetuate junk science, just like Q anon people, just like climate change deniers, it's all the same insanity.
- KptMarchewa 4y ago
  Agreed. On top of that, opportunity cost is a thing. If you pursue completely ineffective therapy - and spend time figuring out if your local acupuncture parlor uses dirty needles - you waste time and energy that would be spend pursuing worthwhile treatment.
- vorpalhex 4y ago
  Let me try again, maybe with more caps. > We are pretty sure acupuncture, DONE CORRECTLY, won't cause any harm Yes, if you get stabbed with a dirty needle, you might get a disease. That's true for acupuncture, a tattoo shop, and even a vaccine. Don't get stabbed with dirty needles! I fully suggest not getting stabbed with dirty needles. Bad. Avoid. 0/10. > The benefits are zero https://pubmed.ncbi.nlm.nih.gov/3982837/ https://pubmed.ncbi.nlm.nih.gov/3982837/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984198/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984198/ It's probably about as effective as placebo? (Maybe?) That isn't zero, that's placebo - and that is an important difference > you perpetuate junk science, You're just wrong. This isn't even just a "you might have a different opinion". The absolute best science we have, the entirety of realms of research, is "well, it's probably placebo and maybe it's kind of an expensive placebo". The most scientific answer you can give is "we should do more studies and ask more questions", and it's part of why the medical industry has shifted from "Don't do acupuncture" to "Well, it probably won't do much for you, but sure if you like it, that seems fine".
  - xvedejas 4y ago
    One of the ways I avoid getting stabbed with a dirty needle is based on background rates. I think I'm safe in sticking with my priors that acupuncture clinics are held to less of a standard than vaccines are. Hypodermic needles necessarily come in sanitized packages, after all. There's more to science than just asking questions and collecting data though, there's also developing models. Without good models, you can't gain much insight from data, and in fact you'll sometimes gain incorrect understandings. If there's no supported mechanism for how acupuncture works, it's really not a good sign, and it seems dishonest to think it's at all in the same realm of safety as something like vaccines which do have known mechanisms of action. I think back to how much "data" we had in the 50s that tobacco was harmless. Is it ever a good idea to go for something so invasive to the body as needles without a strong reason, just because the dangers aren't readily apparent? Medicine passes the necessity bar, placebo does not.
    - azeirah 4y ago
      Dunno, I had some acupuncture sessions as recommended by my doctor. The accupuncturist's needles were each individually packed, he washes his hands thoroughly, then puts on gloves as well. Every needle gets thrown away immediately after use. Not sure how any of that is potentially unhygienic other than the room itself possibly being slightly dirty? (it was clearly well cleaned, but obviously not to surgical standards... why should it?)
    - vorpalhex 4y ago
      > If there's no supported mechanism for how acupuncture works, it's really not a good sign Acupuncture works as well as sham acupuncture (inserting needles at non-acupuncture locations). Which suggests to me that acupuncture works on the same basic principle that your doctor giving you sugar pills with a fancy name and strict instructions to take one every four hours with a glass of water works. > I think back to how much "data" we had in the 50s that tobacco was harmless. We had pretty good evidence it was bad for you, especially during pregnancy. This is maybe a better example for talking about peer review and conflicts of interest - which is still a real problem. We can never say "is dangerous" or "is not dangerous". What we can say is X esposure leads to Y harm. Water in sufficient quantities will kill you. Acupuncture, in a sterile environment, is pretty safe. We also know that skin deep needle penetration is pretty safe given that lots of people get tattoos. It still requires hygiene, but it is a safe activity. I'm totally sympathetic to "we should be doing health inspections of acupuncture, like we do tattoo shops". I think some areas already do this. It's probably a good idea.
the_doctah 4y ago
So its effectiveness is about on par with faith healing, got it.
- shakezula 4y ago
  The placebo effect is a helluva drug
  - Broken_Hippo 4y ago
    No, it really isn't. Its help rate can be as low as 15%. Using anything that is only 15% effective as a drug is not only not effective, but can easily be mistreatment. Most of the time, you have to lie to the patient so they can get an effect (IF they get it at all) and then you often have a drug that is consistently more effective than the placebo. It isn't a helluva drug. It is a bad drug that often simply won't work for you.
    - Pyramus 4y ago
      It can be. And it's not all positive. The nocebo effect can be so strong, that people actually die because they think they are cursed (other examples: Covid vaccines, statins, ...). Any generalised statement about the effect of placebo/nocebo is difficult, because some portion of the effect is regression to the mean, and relatively little is known about the mechanism of action (e.g. there is some indication about a genetic factor). Not disagreeing with you that it may not work for you, but it may work quite well for some people. Acupuncture being a prime example.
      - deleted 4y ago
        [deleted]
    - donthellbanme 4y ago
      We need to throw out Allopatic medicine that does not work, along with Acupuncture, Chiropractic, Naturopathic, Osteopathic bad healing techniques that work slightly better than Placebo in an Indian village in studies with less than 100 poor souls, and a questionable Control group, and rumors of payola floating around. Meaning enough with the bullshit remedies that don't work. Most Psychiatry drugs are on my hit list. I can't believe these $450 a visit fancy boys are allowed to prescribe 90% of their bread and butter drugs. I'm not just picking on shrinks either, but they are an easy target. I am beyond disillusioned that our FDA has approved drugs that are harmfully and actually don't work. (Former Chiropractic student who walked out after hearing, "We have over 15 upper cervical techniques--and they all work Equally well.") Enough is enough.
2Gkashmiri 4y ago
to start off, i do not "understand" the "homeopathy" to either dismiss it as mumbo jumbo and dangerous but my granddad was a medical practitioner and he is said to have used homeopathy but not in the sense people use it now. i'm told he strictly used it literally as a placebo ONLY when he knew the cause of the "problem" was not physical or something wrong because of infection or something. I'm told he would treat patients with depression by counseling without telling them (usually family members) and prescribing this "white medicine" to keep up appearances. i'm told he never treated anyone outside of this usecase because well, there are medicines for that purpose. remind you this is from 50 years ago when my town had 3 hospitals in total and there was no "medical equipment" like we have currently or that were available in major cities. Call it the neck of the woods so its not like there was modern medical care available but patients didn't seek it. He was the physician of his time and pretty successful at that.

sxyuan 4y ago

Here's one meta-analysis of RCTs showing benefit for pain in fibromyalgia patients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/ That's in comparison to a sham acupuncture placebo. And the placebo effect is already pretty powerful. Even in the "no benefit" studies, that's usually in comparison to a sham acupuncture placebo that has a real effect compared to waiting. In terms of pain treatment, I'd say even a safe non-addictive placebo treatment is pretty good, better than getting hooked on opioids at least. I wouldn't get acupuncture hoping for a cure to cancer. But it's not exactly a stretch to think that manipulating nerves with needles will help with pain.

Traubenfuchs 4y ago
It's very unfortunate that this "nerve treatment with needles" for which "some evidence" exists is mashed together with the "pseudo scientific magic spot acupuncture".
scoopertrooper 4y ago
According to that meta-analysis, none of the studies included were properly blinded. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/figure/f2-jpr-12-527/?report=objectonly https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365227/figure/...
- sxyuan 4y ago
  Almost all of the studies blinded the participants in the outcome assessment. That avoids bias when asking patients about their pain. It's difficult to imagine how you would blind the acupuncturists performing the treatment. I suppose you could have one acupuncturist mark the needle location and another blinded one stick the needle in. But a skilled acupuncturist would probably be unblinded by their own knowledge of where it makes sense for the needle to go. So there is definitely risk of performance bias, but they're sticking needles into patients at predefined points - I don't think it's a very large risk.
News-Dog 4y ago
>fibromyalgia Transcutaneous electrical nerve stimulation (TENS or TNS) : https://en.m.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation https://en.m.wikipedia.org/wiki/Transcutaneous_electrical_ne... Fibromyalgia (FM) : https://en.m.wikipedia.org/wiki/Fibromyalgia https://en.m.wikipedia.org/wiki/Fibromyalgia

eyelidlessness 4y ago

My study isn’t peer reviewed or anything so it’s just like my life or whatever, but it helped me save my life. I don’t know why it was effective, I was skeptical throughout. I still am. But it was one of the most effective treatments for severe acute anxiety I’ve ever had, it not the most effective.

TheSpiceIsLife 4y ago
I was just talking to someone about this. Perturbations. Life isn't a double blind randomised placebo controlled study, mostly on rats / students / in a clinical setting / lab, and therefore there's a strong case to be made that we shouldn't necessarily use that model to model our behaviour. Back to perturbations, I mean in the astronomical sense: deviation of a celestial body from a regular orbit about its primary, caused by the presence of one or more other bodies that act upon the celestial body. You go to a one or more acupuncture sessions and your life is, in a very literal sense, changed. It's not just a placebo, you actually went and did something you otherwise wouldn't have, with the intention of seeking improvement, thereby setting your life on a divergent path to what it otherwise would have been. Over time, the divergence can be drastic. This a very under appreciate power of our ability.
- eyelidlessness 4y ago
  My initial reaction to this was that it felt more woo than I like, but I get your meaning and I even think it was probably part of it. And it was one of several changes I made in that time, some more impactful than others. But placebo or not, I’ll also say that the physical impact was genuinely calming. And while the setting and circumstances might account for most of that—soothing music, dark room, being still for about an hour with no interruption—I also found different needle placements had noticeably different effectiveness. It’s not for everyone. I wouldn’t dream of suggesting anyone try it who wasn’t already open to it. But it did really help me, regardless of the science. And I’m grateful for it.
  - TheSpiceIsLife 4y ago
    Appreciate your response, thanks.

Pyramus 4y ago

That's a common myth. It has no benefit relative to placebo, i.e. needles placed at random. And needles placed at random do seem to have significant placebo effect for some conditions and people.

carlmr 4y ago
But if added inflammation through needles is how acupuncture works, that's not a good placebo, since maybe the placement is not as important as the body's response.