结束语 (Concluding Remarks)

This will be my last post in the acupuncture series.  I've learned a lot about acupuncture and traditional Chinese medicine and I have a new respect for both.  Though perspectives on what acupuncture is actually doing may be different in Eastern and Western medicine, I'm certain it is effective at treating some disorders.  Whether Qi is energy flowing in meridian lines, vital substances moving through vessels, or nerve signals connected by the fascia plane network, there is something going on that is responsible for undeniable results in various studies.  

Even if acupuncture is a placebo effect, it is a powerful one and takes full advantage of the mind-body connection to produce results that can be felt even by a skeptic like myself.  Just the relaxation experienced during acupuncture (regardless of whether the feeling is produced by the environment of the clinic or the actual procedure) is beneficial enough to warrant its use to treat stress related issues and disorders.  I would recommend acupuncture to anyone that suffers from chronic pain, stress, or anxiety, especially if Western approaches have failed to offer successful treatment.

I have to keep one thing in my mind as I'm concluding this experience: in my limited time studying acupuncture, I have learned that Eastern medicine is a much more holistic approach to healing and treatment and that acupuncture is only a very small part of a true Eastern medical treatment.  All the studies on acupuncture's effectiveness were limited to only acupuncture, meaning that despite the conclusion that acupuncture is only effective at treating a few disorders in a limited spectrum, it is quite possible that a holistic Eastern approach incorporating acupuncture as part of the treatment is just as effective as the Western approach in treating any disorder.  This is something I hope to be able to continue to explore in the future.

Placebos and Acupuncture

As I researched, I ran into several studies involving discussions about acupuncture's effectiveness being nothing more than a placebo effect. Many studies use what is called "sham acupuncture" in determining the effectiveness of acupuncture treatments. Sham acupuncture is done in a variety of ways, but typically it is the use of an acupuncture needle placed in incorrect or non-acupuncture points. Marcus (2010) conducted a survey of various studies in acupuncture pain reduction for osteoarthritis and back pain. Each was conducted by comparing traditional treatments with the use of sham acupuncture to act as a placebo. In the ten studies, only two reported strong evidence that traditional acupuncture was more effective than sham acupuncture; the interesting finding, however, was in almost all the studies, sham acupuncture was still better than no treatment.

This opens an interesting debate. After these findings, there is some support that claims that all acupuncture is merely a placebo effect. Colquhoun and Novella (2013) do not take long to state their stance in their article titled "Acupuncture is a Theatrical Placebo." They proclaim that if sham acupuncture is just as effective as traditional acupuncture, then it must be a placebo effect. Lundeberg, Lund, Naslund, and Thomas (2008) claim that sham acupuncture is not inert and therefore cannot be considered a placebo. Because most sham acupuncture still involves some sort of needle insertion, they claim that it still has a physiological, and psychological effect. Follow up studies confirmed this (Moffet, 2009) and made special mention that needles placed in non-points seemed to have the greatest effect (rating the same as traditional acupuncture in13 out of 22 studies). Instead of pointing at a placebo effect, this would call into question the current theoretical basis for acupuncture practices, as traditional acupuncture points were as effective as non-points in a majority of studies.

Personally, I'm not sure what side to take. From my small amount of research on dry needlers, I remember that their version of acupuncture tended to be effective even though they had little training and didn't always use traditional acupuncture points. I would also think there's some possibility that some of the practitioners in these studies didn't hit the correct acupuncture points in the treatment (or hit actual points in the sham condition). I remember feeling somewhat skeptical when Paula had told me that she just had to "feel" for the points and they could be in slightly different locations in different people. But I also have to take my own experience into account. I went in with an open mind, but a healthy amount of doubt as well and I felt some real effects from the treatment. It makes me wonder if I fell victim to a placebo effect or if it would have had the same effect no matter where the needles had been placed.

Works Cited

Colquhoun, D., & Novella, S. (2013). Acupuncture Is Theatrical Placebo. Anesthesia & Analgesia, 116(6), 1360-3.

Lundeberg, T., Lund, I., Näslund, J., & Thomas, M. (2008). The Emperors sham - wrong assumption that sham needling is sham. Acupunct Med, 26(4), 239-42.

Marcus, D. (2010, November). Is Acupuncture for Pain a Placebo Treatment? The Rheumatologist. Retrieved April 4, 2015, from http://www.the-rheumatologist.org/details/article/873613/Is_Acupuncture_for_Pain_a_Placebo_Treatment.html

Moffet, H. H. (2009, March). Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials. J Altern Complement Med, 15(3), 213-6. doi:10.1089/acm.2008.0356