Thursday 21 May 2009

Acupuncture helps back pain

As recently covered in the Times, acupuncture is an effective treatment for back pain: http://www.timesonline.co.uk/tol/life_and_style/health/article6269247.ece

This study does bring up questions commonly asked when looking at the effect of acupuncture treatment: is it an effective treatment or is it just an effective placebo? Like with virtually any form of treatment or drug trial, the placebo group will show an improvement, which is the case here as well. However, in the design of this trial, the foour groups were defined as follows:
- individualised treatment was diagnosed by one set of acupuncturists and performed by another set
- the standardised group’s formula was derived from ‘expert’ opinion, meaning acupuncture treatment was not practiced as a treatment tailored for the individual, as it should be, but made standardised, in order to fit the requirements and expectations of Western medical trials
- the sham treatment used a cocktail stick in a guide tube (commendably cheaper than the special ‘placebo’ needles) to prick the skin at the same standardised points
- patients wore eye masks and lay prone the whole time
- no adjunctive procedures were allowed, just needling

Hence even the individualised acupuncture is far removed from what happens in normal practice and we don’t know from the paper how different the point choice was for this and the standardised group. The comparison against sham acupuncture here is akin to TCM acupuncture vs some styles of acupuncture where the point is only stimulated for a very short time, or where we use very superficial needling, in effect not practising "sham" acupuncture. It is encouraging to see that the overall conclusion is positive, although unfortunately Western Medicine style trials appply poorly to holistic medical systems such as that of Chinese Medicine.