the alternative fix

what is acupuncture?
the clash

·  What it is
Acupuncture treatment involves the insertion of special needles into various areas of the body, depending on what condition the patient is seeking to remedy. It is used for a myriad of purposes, including pain control, nausea and allergy relief, immune disorders, substance abuse recovery and depression.

·  How it works
According to traditional Chinese medicine, all living beings have a vital life energy called qi or chi which, in humans, qi flows through the body along twenty energy pathways, or meridians. In the Chinese tradition, illness or disease is attributed to a blockage or imbalance of qi somewhere in the body. By inserting needles into the appropriate points along the energy meridians, acupuncturists seek to restore the flow of qi throughout the body, a key to regaining health.

·  What critics say
Some Western experts argue that although acupuncture does work in some people for some conditions, its effectiveness is likely due to the placebo effect. Others contend that it temporarily relieves pain because the needles trigger the body to respond by releasing chemicals like pain-killing endorphins, which can affect a person's mood and energy. The bottom line is that the physiological mechanisms of how acupuncture works remain unclear.

Read more on the debate over whether acupuncture works in these excerpts from FRONTLINE's interviews with Marcia Angell and Stephen Straus.

·  Scientific findings
The week of Dec. 20, 2004, the results were announced of the longest, largest and most rigorous study done to date on acupuncture's effectiveness. It was conducted by the NCCAM office of the NIH and evaluated the usefulness of acupuncture in treating osteoarthritis of the knee, a common reason for individuals to seek acupuncture.

The study involved 570 patients over the age of 50 who were suffering from osteoarthritis of the knee and were in significant pain. The study showed that acupuncture significantly increased function by week 8 and by week 14 significantly decreased pain compared with the control group. By the end of the study, those who had acupuncture treatment showed a 40% decrease in pain and improvement in movement and function. (Check out the web site for NCCAM, listed below on this page, for future updates on this study.)

Dozens of studies have been conducted over the years on acupuncture, but many have been poorly designed. It is difficult to design studies that can evaluate acupuncture's effectiveness, because a methodologically rigorous study must include a treatment group (composed of patients who receive acupuncture) and a control group (patients who receive sham acupuncture), so that changes in the two groups can be compared side-by-side over time. Most people can tell if they are receiving sham acupuncture, because they can feel the needle not breaking the surface of their skin. This jeopardizes the integrity of the findings. Alternatively, the control group may receive sham acupuncture in the form of needle insertions in random spots (not along energy meridians), but critics contend even that can cause the release of endorphins. Nevertheless, multiple, usually small-scale studies have found that acupuncture can be as effective as conventional therapy drug therapy or no treatment, especially for the relief of dental pain and nausea.

In 1997, the NIH published a "consensus development conference statement" on the evidence in favor of acupuncture. After an extensive review of the existing research, the panel of experts convened by the NIH concluded, "While there have been many studies of its potential usefulness, many of these studies provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebos and sham acupuncture groups. However, promising results have emerged, for example, showing efficacy of acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. There are other situations such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, in which acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program. Further research is likely to uncover additional areas where acupuncture interventions will be useful."

·  Where to find more information

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posted november 4, 2003

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