Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

The history of acupuncture research has followed a tortuous path over the last three decades, and more research papers will be published in the future, particularly making use of the relatively new telescopic sham needles and with a fuller evaluation of the German mega-trials. However, the research is already fitting together well, with a high level of consistency and agreement. Hence, it seems likely that our current understanding of acupuncture is fairly close to the truth, and we will conclude this chapter with a summary of what we know from the mass of research. The four key outcomes are as follows:

The traditional principles of acupuncture are deeply flawed, as there is no evidence at all to demonstrate the existence of Ch’i or meridians.

Over the last three decades, a huge number of clinical trials have tested whether or not acupuncture is effective for treating a variety of disorders. Some of these trials have implied that acupuncture is effective. Unfortunately, most of them have been without adequate placebo control groups and of poor quality — the majority of positive trials are therefore unreliable.

By focusing on the increasing number of high-quality research papers, reliable conclusions from systematic reviews make it clear that acupuncture does not work for a whole range of conditions, except as a placebo. Hence, if you see acupuncture being advertised by a clinic, then you can assume that it does not really work, except possibly in the treatment of some types of pain and nausea.

There are some high-quality trials that support the use of acupuncture for some types of pain and nausea, but there are also high-quality trials that contradict this conclusion. In short, the evidence is neither consistent nor convincing — it is borderline.

These four points also apply to variations of acupuncture, such as acupressure (needles are replaced by pressure applied by fingers or sticks), moxibustion (ground mugwort herb burns above the skin and heats acupuncture points), and forms of acupuncture involving electricity, laser light or sound vibrations. These therapies are based on the same core principles, and it is simply a question of whether the acupuncture points are pricked, pressurized, heated, electrified, illuminated or oscillated. These more exotic forms of acupuncture have been less rigorously tested than conventional acupuncture, but the overall conclusions are similarly disappointing.

In summary, if acupuncture were to be considered in the same way that a new conventional painkilling drug might be tested, then it would have failed to prove itself and would not be allowed into the health market. Nevertheless, acupuncture has grown to become a multi-billion-pound worldwide business that exists largely outside mainstream medicine. Acupuncturists would argue that this industry is legitimate, because there is some evidence that acupuncture works. Critics, on the other hand, would point out that the majority of acupuncturists treat disorders for which there is no respectable evidence whatsoever. And, even in the case of treating pain and nausea, critics would argue that the benefits of acupuncture (if they exist at all) must be relatively small — otherwise these benefits would already have been demonstrated categorically in clinical trials. Moreover, there are conventional painkilling drugs that can achieve levels of pain relief with reasonable reliability, which are vastly cheaper than acupuncture sessions. After all, an acupuncture session costs at least £25 and a full course may run to dozens of sessions.

When medical researchers argue that the evidence seems largely to disprove the benefits of acupuncture, the response from acupuncturists often includes five main criticisms. Although superficially persuasive, these criticisms are based on very weak arguments. We shall address them one by one: