Scientifically proving the effectiveness of acupuncture
Despite a long history of use in various parts of the world, acupuncture is a treatment that is also a source of a lot of controversy in the medical community. While acupuncture is better understood now than it has been in the past, both in terms of its possible mechanisms of action and its effectiveness in treating a variety of conditions, there are many questions surrounding the practice despite many years’ of research. This is largely due to difficulties in researching acupuncture that are a consequence of the nature of the procedure, and in this article we look at why acupuncture has proven to be difficult to research effectively.
The difficulties in studying acupuncture
Despite the many investigations performed into acupuncture’s effectiveness, no solid conclusions have been reached in most areas. Clinical studies have certain stringent requirements that need to be met if their results are to be deemed accurate and reliable, unfortunately the nature of acupuncture as an invasive procedure makes it difficult to meet these conditions, hence the uncertainties still associated with acupuncture.
All clinical trials need to have what is called a control group, this is part of the overall test and involves patients who are treated with a sham version of a therapy (called a placebo). The results from this group are compared to the actual test group, who are given the real treatment, and if a significant difference between the two is found then the results can be interpreted and conclusions drawn.
Controls are used to eliminate the chance of a result being due to probability or a phenomenon called the placebo effect. The placebo effect is the term given to an improvement a patient experiences as a consequence of their perceptions and beliefs, and this effect needs to be eliminated to ensure that a treatment is having a real effect on the patient’s body. Ideally, clinical tests are performed as ‘double blinds’, which means that neither the patient nor the therapist knows whether the treatment they are giving is the real or placebo version. This is to account for patient perceptions of how the therapist involved is behaving. In theory, if the person administering the placebo treatment is aware that it is not the real version of the treatment they might behave in a slightly different way that could be perceived by a patient, affecting the outcomes of the test.
It is difficult to design an effective control group for acupuncture studies, and it is almost impossible to perform the test as a double blind. An acupuncturist will be aware that a needle isn’t being inserted into their patient’s skin, or in the wrong spot, and will therefore be aware of the fact that the treatment is a placebo.
Whereas controls in drug trials are easy to produce because false tablets are easy to generate, it is much more difficult to reproduce a fake or sham acupuncture procedure. In many cases, sham acupuncture will involve using retractable needles. These will draw into their handle rather than penetrate the skin as an acupuncturist applies pressure, and can be difficult to hold in place during a session, which would in turn tell the patient that the treatment they are receiving is a sham.
These sham techniques have improved substantially in recent years, making studies more reliable and their results more likely to lead to sound conclusions. However there are still other factors which need to be taken into consideration when investigating acupuncture, and these can weigh in quite heavily on any interpretations of the results yielded by the study. These factors include the skill level of the acupuncturist involved and their particular style of acupuncture and many others.
There will always be obstacles involved in the study of acupuncture’s effectiveness, but as these are being overcome our understanding of acupuncture’s usefulness continues to improve. Studies in support of various applications of acupuncture have been published, and others have debunked some of the treatments’ purported results. It may be some time yet before we can have any definite proof of acupuncture’s effectiveness, but progress is being made towards that end.
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