Is There any Scientific Evidence for Acupuncture?

Acupuncture Doll

Acupuncture Doll

I have found acupuncture very difficult to research. Sometimes it has been like getting blood out of a stone; other times people have given a confident reply but the articles I have been directed to or told about have been very vague in answer to this specific question, especially to someone with no medical knowledge.

The Vagueness of Acupuncture Research

An acupuncture practitioner suggested I contact the BAC (British Acupuncture Council) but when I eventually received a reply I was told that this question was better forwarded to the BMAS (British Medical Acupuncture Society). The BMAS did not give me any answers either but referred me to two web links which also did not answer my question. However, the BMAS (whose members are all Doctors) is pro-active in integrating acupuncture into the NHS and trains Doctors in acupuncture. With the backing of clinical trials the BMAS has had a massive influence in regard to acupuncture being accepted by GPs and often under the umbrella of the NHS. In their publication, Acupuncture in Medicine 2005; 23(1):2-12 we are told that Alan Grant in his first editorial (1981) wrote:

“The objective of the society is to stimulate and promote the use of scientific acupuncture as part of the practice of medicine.”

This they have certainly endeavoured to do and, although I am not sure about the label ‘scientific’ acupuncture, they have been very successful in their aim.

Eastern beliefs in regard to the ‘Life Force’ and balancing of spiritual energy (the basis of traditional acupuncture in this country as well as the East) perhaps takes a back seat during clinical trials, but it is always there. But when trying to give validation to acupuncture from a clinical viewpoint, the eastern connection is simply used to point out that it has been practised for hundreds of years and relied on heavily for all kinds of ailments. So, in theory, it has stood the test of time.

It is easy for us to assume that if a GP refers us for a particular treatment it must be clinically proven.

I contacted the BMA (British Medical Association) who were very helpful and provided many web links. I was told that the BMA has assessed the efficacy of acupuncture in a book called, Acupuncture: efficacy, safety and practice and stated that:

“The provision of acupuncture treatment has flourished despite lack of widespread knowledge of its efficacy.”

This is a strange state of affairs. It could indicate a lack of faith in the NHS due to the side effects of conventional treatments, or the failure of western medicine to cure ongoing medical complaints – especially recurring pain.

A press release of the BMAS states that the BMA:

“… concludes that acupuncture works, is safe (safer than many drugs prescribed daily by doctors) and should be made available on the NHS.”

And many of BMAS’s GPs offer acupuncture free to their NHS patients.

But we are not clearly told which ailments it is most effective with or why. Sorting through articles on trials, and trying to understand the jargon of articles in journals, the underlying successes appear to me to be pain-relief, and (possibly as a consequence) a sense of well-being. Beyond this I have not come across any conclusive evidence of success in patients’ minds. Of course, pain relief can be brought about by many means, the mind itself having a profound effect on the degree of pain felt and how healthy we feel generally.

There are experiments that have been done to show insertion of needles (and manipulation of them – e.g. with electrical impulses) affect nerve sensation elsewhere in the body. But this is only for some parts of the body and the system of meridian lines and channels cannot be verified from theses findings. For example, in Acupuncture in Medicine, June 2000 Vol.18 (1)44 we are told:

“… referred pain patterns of some MTrPs [myofascial trigger points] are similar to the traditional meridian connections of acupuncture points. The consistent pattern of referred pain in a specific MTrP suggests that there are fixed connections between certain sensory neurons in the spinal cord. These are probably the same as the connections between acupuncture points along a meridian.” – (emphasis added)

This is typical of the vagueness of acupuncture research.

Anecdotal Evidence

On talking with one GP I have found that the promotion of acupuncture or homeopathy is basically down to the fact that patients say it helps them. Often western medicine can let them down, but acupuncture is used even with no knowledge as to how it can work scientifically. And even though there is a lot of debate over the validity of clinical trials for homeopathy this seems to be promoted more than acupuncture.

GPs do not generally use acupuncture to cure internal organs and processes as traditional practitioners would, but rather as an anaesthesia (pain relief). Even in this case, although the nervous system may genuinely be affected by the needles it is not known how it works. It is well attested though that the ‘placebo effect’ is a powerful anaesthesia (for example, if a person believes a drug or treatment is working he/she will have a sense of pain relief regardless of whether a particular drug is actually taken).

Another GP I spoke to who was a very keen supporter of acupuncture as well as other Alternative Therapies/Complementary Medicines was convinced of acupuncture’s success in anaesthesia, but did not know of clear evidence to suggest it would work on situations such as depression or curing the liver, etc.

An acupuncture practitioner I spoke to (not a GP) believed the acupuncture taught to GPs who have been on short courses was not the real thing – e.g. going on a course to treat back disorders was different to traditional acupuncture for which you need extensive training. GPs’ training is for pain relief rather than holistic health.

She pointed out that acupuncture treatments can stimulate nerves and cause release of chemicals/pain killers from the brain. I was sent articles on research from the Journal of Chinese Medicine in which there was no mention of any scientific or medical basis behind their observations of results of specific acupuncture treatments on patients.

Even for pain-relief it is not known why acupuncture works

On the efficacy of acupuncture the book by the BMA (Acupuncture: Efficacy, Safety and Practice) May 2002 tells us that results of clinical trials suggest that:

“acupuncture is more effective for…back pain, nausea and vomiting…migraine and dental pain. So far, results are inconclusive or uncertain for neck pain and osteoarthritis, recovery from stroke, tension headaches, temporomandibular joint dysfunction, smoking cessation and weight loss.”

So, we see that the BMA is only displaying a degree of confidence that acupuncture relieves pain and feelings of sickness, and nothing else.

In an appraisal of acupuncture by Adrian White in 1998 (from The Complementary Therapy Update Vol.2 Issue 5) he says:

“…there is not the slightest evidence to support the traditional ideas [of acupuncture]…nothing can be found to suggest that energy really does circulate in meridians, or that diseases can be caused (for example) by an attack of dampness.”

The Oxford Concise Colour Medical Dictionary (2002 – ed.6), OUP says acupuncture:

“… may work by allowing the body to release its own natural pain killers [endorphins].”

And that these endorphins:

“…occur naturally in the brain and have pain-relieving properties…Also responsible for sensations of pleasure.”

Again, this is a consideration of how acupuncture may work.

In the British BMA Medical Association Illustrated Medical Dictionary, (2002), DK, we are told:

“Acupuncture has been used successfully as an anaesthetic for surgical procedures and to provide pain relief after operations and for chronic conditions.”

Again, this is pain-relief reported by patients. Even for pain-relief it is not known why acupuncture works. The pain-relief may be a direct cause of needle insertion and manipulation, but we do not know. I do not see why this could not all be due to the ‘placebo effect’ coming into play. For example, you can experience pain-relief because you simply believe that the treatment will produce results. This conclusion could also be drawn in regard to other Alternative Therapies/Complementary Medicines too.

Electro-Acupuncture

This term is used for various techniques and there are different opinions as to the application of this name.

One definition is that it refers to electric pulses applied to needles during acupuncture treatment:

“… needles are inserted on specific points on the body, and the needles are then attached to a device that generates continuous electric pulses using small clips.”

In acupuncture it can be used as a continued stimulus to avoid tissue damage associated with manual needle manipulation, but apparatus cannot be connected with all the traditional acupuncture points.

Many would disagree that the term could be applied to TENS (Trancutaneous Electrical Nerve Stimulation) where pads are used instead of needles, and placed over the site of the pain. But some of these ‘electro-acupuncture devices’ are designed to be used over acupuncture points too.

Basically, if electrical pulses are used in acupuncture with needle insertion, it is to replace physical manipulation of needles, whereas placing electrical pads over the site of pain is not linked to acupuncture at all, although some practitioners may use it in connection with their treatments. The way it is used in acupuncture treatments does not add any scientific weight, but research may be done using electric pulses to aid consistency since using the manual approach may introduce too many variables.

How Does Acupuncture Work?

There are various theories as to how acupuncture might work, and as yet they remain theories. For example, the Pain Gate Control Theory which suggests that:

“…pain signals can be interfered with by stimulating the periphery of the pain site…”

And by:

“…stimulating the release of…pain relieving…chemicals…in response to pain stimuli.”

The Acuhealth Centre points out that:

“There have been several physiological changes observed but no real answer to the mystery of the healing power of acupuncture.”

Although the eastern perspective is that acupuncture restores the:

“‘…energetic balance of the body…the energy flow is restored therefore restoring health.”

As well as the Gate Control Theory and Endorphin Theory (already referred to) the western perspective has three other theories:

Augmentation of Immunity Theory – white blood cell counts, antibody and prostaglandin levels are increased. Neurotransmitter Theory – levels of Serotonin and Noradrenalin are increased during acupuncture treatments. Circulatory Theory – Acupuncture increases circulation through the release of vasodilators causing dilation of blood vessels.” – (http://www.acuhealthcentre.com/faq.html)

So why are these still theories? And why do they only relate to pain relief?

Practitioners themselves do not know a specific or group of specific scientific bases why acupuncture should work

The clear answer is that the only results that can be identified from acupuncture are anaesthesia (pain-relief) in patients. But there is as yet still no conclusive medical/scientifically-based/logical evidence that it is acupuncture itself that brings about pain-relief in the patients that report success as far as I can tell. It is difficult to find out when much of the evidence is written in technical jargon and using vague language (e.g. ‘may’, ‘probably’, ‘could’) and practitioners themselves do not know a specific or group of specific scientific bases why acupuncture should work. That in itself does not mean it does not work for pain relief in some situations, but no-one seems to be able to provide conclusive scientifically-based evidence.

Summing Up

Generally speaking, it seems to me that many GPs who recommend acupuncture do so because they are aware that many patients report pain-relief as a consequence. GPs do not use it because they have availed themselves of medical proof.

One other major factor is that pain-relieving drugs can have bad side-effects and be more dangerous than the risks associated with insertion of needles statistically speaking. And if patients feel benefit from it then it is logical to use acupuncture.

In the case of GPs, some will believe in the flow of Life-Force energy and others will practise it from a purely physiological confidence.

As far as ‘traditional acupuncture’ is concerned, practitioners base their practice on eastern ideas of balance in connection with the Life Force and have more intensive training in acupuncture than GPs. They not only treat patients for pain-relief but also for more major medical conditions too.

There is no conclusive evidence to support traditional acupuncture’s beliefs, practices, or results that I am aware of. There is some to suggest that pain-relief could be brought about directly by acupuncture but nothing conclusive enough to transfer results from a category of theory to one of conclusive proof.

So where does this leave us?

I suggest that it is unwise to seek cure or relief of any condition from a traditional acupuncturist because of its total reliance on a spiritual force (other than the Holy Spirit) called the ‘Life Force’ (common to most if not all Alternative Therapies/Complementary Medicines). There are too many connections with spiritual beliefs of eastern mysticism. You may gain too strong a link with unhealthy spiritual forces.

As far as GPs offering acupuncture under the NHS is concerned, so long as a spiritual belief system is not in operation, then there should be no spiritual link with false spirits. However, I have not managed to ascertain how much eastern belief systems are incorporated into the training of GPs by organisations such as the BMAS. It will inevitably have to be something for patients to consider if choosing acupuncture from a GP even if he/she has only done short courses. Of course GPs may refer you to a practitioner who is not a GP and will inevitably bring spiritual forces into the equation, so you must be careful.

If you find a Doctor who offers acupuncture his/herself and there is no link with eastern practices, then in theory that cannot be spiritually harmful, but even then be aware that there is no conclusive evidence that the treatment you are to receive will bring pain-relief. On receiving the treatment you may experience pain-relief and a sense of well-being due to release of endorphins. But also be aware that many other factors can bring this about too – e.g. confidence in the treatment, security with your GP, and being given attention for your particular difficulty. I would say the same for other Alternative Therapies/Complementary Medicines.

But we must beware the added spiritual dimension in Alternative Therapies/Complementary Medicines as I believe cure is possible through these forces sometimes, but they are not God’s Spirit! So your cure or experience of healing may bring with it other trappings such as a clouding of your discernment/relationship with God.

One thing I will say in closing is that it is easy for us to assume that if a GP refers us for a particular treatment it must be clinically proven. This is not the case. It is probably due to a combination of things such as, Alternative Therapy practitioners being pro-active, general awareness of the dangerous side-effects of many western medicines, and the NHS wanting to provide what patients feel they should provide.

One thing GPs are unable to provide due to time restrictions, and society has no excuse in not providing, is enough care and attention – i.e. giving enough time to show that each individual is valued, and doing everything possible to support one another at our point of need, ministering to the spirit, soul and body. The Church should continue to be the prime example of this. Families should also concentrate on unity, support and positive values rather than on job promotion to get the latest gadget!

This love is the greatest placebo effect of all. People have ended up having to seek Alternative Therapy practitioners (paying or otherwise) to receive the attention that should already be present in our society through daily relationships.

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