Wednesday, January 5, 2011

Not All Peer-Reviewed Meta-analyses Find Acupuncture Useless

During the new year a friend who was kind enough to host me while I visited Tha Bay Area(tm) stated that there is evidence that in some cases acupuncture has some efficacy. When I demurred, he sent me this meta-analysis from the peer-reviewed American Family Physician, and my friend is an MD/PhD, so I weighted his belief accordingly and read it. From the abstract: "Based on published evidence, acupuncture is most likely to benefit patients with low back pain, neck pain, chronic idiopathic or tension headache, migraine, and knee osteoarthritis. Promising but less definitive data exist for shoulder pain, fibromyalgia, temporomandibular joint pain, and postoperative pain. Acupuncture has not been proven to improve pain from rheumatoid arthritis. For other pain conditions, there is not enough evidence to draw conclusions." Of note: many (but not all) of the references the article draws from are RCTs (randomized controlled trials).

Compare to a round-up of evidence from Steven Novella that isn't so positive (mainly focuses on one article but links back through his previous writings).

I think healthcare practitioners would all love a cheap and safe treatment for these diseases, but the very most we can say is that it's still not clear what (if anything) is going on with acupuncture, when such divergence of opinion exists. After all, if Glaxo had this same evidence for a new pharmaceutical, I doubt the same people who consider acupuncture's efficacy proven would be demanding approval of the new drug.

Above: Pinhead. He states his temporamandibular joint hasn't felt this good in years. Come on, like I'm the first guy who's made this joke.

If you like you can read about "what I did last summer", or more accurately last May, when I went to an acupuncturist for a sometimes-sore runner's knee. Although I was honest about my skepticism, the acupuncturists were still nice to me, but bottom line, there seemed to be no effect either way. Then again - important point - one subject's anecdotal account is no way to evaluate the modality, and admittedly I did it mostly for rhetorical value so when I talk to someone who believes in acupuncture, I can say honestly that I tried it.

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