Critical Thinking on Acupuncture
How Does it Work?

1. Acupuncture
2. Scientific Studies of Acupuncture
3. Risks and Dangers of Acupuncture
4. Traditional Explanations of Acupuncture are Mumbo Jumbo
5. Slow Conducting Unmyelinated Afferents

1. Acupuncture

Acupuncture is a form of traditional Chinese medicine that is used to try to cure disease, infections and pain as well as curing psychological problems. Traditional practitioners say this is done by rebalancing the Yin and Yang, unblocking Chi, along with various other mystical explanations. In mainstream medicine, acupuncture is known to work as a form of pain relief. Headaches and migraines are the main reason that a GP might refer a patient for acupuncture₁. 6 million people in Britain suffer from migraines₂.

“[Acupuncture] is an ancient Chinese medical procedure in which long needles are inserted into specific points at the skin. The traditional Chinese explanation is that the needles bring Yin and Yang (which flow through [...] meridians) into harmony with each other.”

"The Oxford Companion to The Mind" by Richard L. Gregory

Scientific evidence on acupuncture does not discredit it entirely, only strict traditional forms of it. This page shows that acupuncture works, according to some studies, but also that sticking pins in "randomly" (ignoring traditional methods) is just as effective.

2. Scientific Studies of Acupuncture

• At least 26 randomized controlled trials have been published showing no convincing effect of acupuncture on headaches.₃

But three large studies have found statistically significant reductions in the amount of headaches suffered by acupuncture patients:

• A study involving 400 patients in 2004, by the Royal London Homeopathic hospital, found that headaches reduced sharply after 12 sessions of acupuncture, with lasting effects lasting at least a year.₃

The British Medical Journal reported on a 2 year study from 1999-2001 involving 401 participants. A 34% reduction in headaches from the baseline was achieved using acupuncture₁. Two studies found results which practitioners of alternative medicine and experts have suspected for a long time:

• "Researchers [in Germany] found that sticking pins in randomly over the body so they just penetrated the skin was equally effective". The study involved 270 patients over a period of 8 weeks by the Centre for Complementary Medicine Research at the University of Munich, and found that the incidence of headaches can be halved.₃

• "The study is the latest to suggest that 'minimal' or 'sham' acupuncture is as good as the real thing. A study last year of 302 mostly female migraine patients found [traditional and 'random'] acupuncture were equally effective in reducing attacks. An earlier study, published in the BMJ last year, also found evidence for the effectiveness of acupuncture as a treatment for headaches and migraines"₃

3. Risks and Dangers of Acupuncture

Dr Barrett summarizes:

“The adverse effects of acupuncture are probably related to the nature of the practitioner's training. A survey of 1,135 Norwegian physicians revealed 66 cases of infection, 25 cases of punctured lung, 31 cases of increased pain, and 80 other cases with complications. A parallel survey of 197 acupuncturists, who are more apt to see immediate complications, yielded 132 cases of fainting, 26 cases of increased pain, 8 cases of pneumothorax, and 45 other adverse results. However, a 5-year study involving 76 acupuncturists at a Japanese medical facility tabulated only 64 adverse event reports [...] associated with 55,591 acupuncture treatments. [...] The researchers concluded that serious adverse reactions are uncommon among acupuncturists who are medically trained.”

"Acupuncture, Qigong, and Chinese Medicine", Stephen Barrett (M.D.)₄

4. Traditional Explanations of Acupuncture are Mumbo Jumbo

Seven years before these significant findings, Adrian White wrote of the "reappraisal" of Western acupuncture:

“In the last 30 years, a fundamental reappraisal has been taking place in the Western world. This reappraisal has been occurring largely in the UK in the wake of Felix Mann's pioneering declaration that acupuncture points don't exist, acupuncture meridians don't exist, but acupuncture still works. He was expressing the secret thoughts of many people who were trained in both biomedicine and acupuncture, who could not come to terms with the traditional way in which acupuncture was applied but could see that it could be very effective.”

Adrian White (1998)₅

With the further revelations that sticking pins in randomly is as effective as acupuncture using traditional mystical practices, it seems that Felix Mann's sensible proclamation is now more comprehensively proven to be correct. What has been discovered by scientists is that the nervous system can be stimulated at myofascial 'trigger points' which are already known to Western medicine, and that this sometimes works as a neural pain inhibitor, in the same way that scientific procedures such as transcutaneous electrical nerve stimulation (TENS) works.

Combine this with the many studies into Traditional Chinese Medicine and acupuncture mentioned by Stephen Barrett₄ and it seems that acupuncture is an unacceptable practice, especially because those who are involved as patients are not informed of its dubious nature, but are actively encouraged to think of acupuncture in rose-tinted, supernatural terms. Until it is medicalized, it remains quackery.

5. Slow Conducting Unmyelinated Afferents

Part of the scientific process of controlled trials is a method by which you see if the treatment is making people better, or, if psychologically the people are getting better because they think they're getting treated. As a result, all trials should have a control where a similar "fake" placebo treatment is offered. This has shown to be the best technique for medical trials, especially when combined with "double-blinding" so that the experimenter himself does not know which treatment is true and cannot accidentally give away clues to the patients. Only the experiment controller knows, who has no contact with the patients directly. In studies of acupuncture, it has consistently been shown by scientists that real acupuncture is only as good as a placebo and there is certainly no advantage to actually having pins stuck in you: fake pins that look like they puncture the skin (but actually the retract inside themselves) have been just as good as real pins. The following extract shows why it is that this minimal skin contact can still have a positive effect on patients:

“Most controlled trials of acupuncture have used minimal, superficial, sham or 'placebo' acupuncture. It has recently been demonstrated that light touch of the skin stimulates mechanoreceptors coupled to slow conducting unmyelinated (C) afferents resulting in activity in the insular region, but not in the somatosensory cortex. Activity in these C tactile afferents has been suggested to induce a 'limbic touch' response resulting in emotional and hormonal reactions. It is likely that, in many acupuncture studies, control procedures that are meant to be inert are in fact activating these C tactile afferents and consequently result in the alleviation of the affective component of pain. This could explain why control interventions are equally as effective as acupuncture in alleviating pain conditions that are predominantly associated with affective components such as migraine or low back pain, but not those with a more pronounced sensory component, such as osteoarthritis of the knee or lateral epicondylalgia.”

Acupuncture in Medicine journal (2006)₆

Conclusion

At least 26 studies of acupuncture have shown that it has no significant effect. But, three large studies have found that acupuncture does reduce the incidence of headaches and migraines. But two of those have shown that sticking pins in randomly is as effective as using traditional Chinese methods. Scientists understand how the neural and hormonal stimulation of needles work in a biochemical way to sometimes produce the results of acupuncture. What is known now is what has been suspected by practitioners for a long time: the traditional talk of "energy channels", "meridians" and "acupuncture points" amongst other spiritual and mystical explanation, are all untrue, discredited and defunct explanations of how acupuncture works. Instances of punctured lungs, increased pain, internal bleeding and other side-affects occur in up to 1 in 5 cases especially if a practitioner is not a medically trained doctor. It works for pain relief for medically known reasons, but the traditional mumbo-jumbo associated with traditional acupuncture is best ignored.