Poking holes into the safety of acupuncture

Acupuncture treatment is not as safe as advertised – health – 06 September 2012 – New Scientist.

The first ever study of the adverse effects of acupuncture in state-funded acupuncture clinics in the UK has found that the procedure is largely safe, but not as safe as advertised. In extreme cases, it could even put lives at risk.

The investigators found 325 reports of adverse effects. There is no data for the total number of acupuncture treatments given, so the frequency of these events cannot be calculated. But other studies in Germany and the UK have found adverse effects following some 10 per cent of treatments.

Some of the reports were merely of sloppy practice. In 100 cases, patients were left with needles still in them, sometimes hours longer than intended or even after they or the staff went home. Some needles subsequently had to be surgically removed.

Of the 325 adverse reports, 309 were rated as involving little or no harm. This included 162 people experiencing dizziness and fainting when the needle was inserted.

Five people experienced lung collapse, or pneumothorax, caused by the needle puncturing the pleural membranes around the lung.

Tip: Edzard Ernst

While proponents of acupuncture will argue that in general it is safe, there is a flaw in this. The procedure itself has no real benefit, so ANY risk is unacceptable since there is no return. Many people think acupuncture is useful, it is even considered as medicine by the U.S. military. That many people utilize this does not make it any more viable as a treatment. The placebo effect is strong with this one. Sham acupuncture is just as effective as real acupuncture (negating the “meridians” and basis for energy flow, etc.), which is just as effective as any placebo. So, acupuncture? Not a real treatment.

Puncturing the acupuncture myth

There are plenty of studies showing that acupuncture works for subjective symptoms like pain and nausea. But there are several things that throw serious doubt on their findings. The results are inconsistent, with some studies finding an effect and others not. The higher quality studies are less likely to find an effect. Most of the studies are done by believers in acupuncture. Many subjects would not volunteer for an acupuncture trial unless they had a bias towards believing it might work. The acupuncture studies coming from China and other oriental countries are all positive — but then nearly everything coming out of China is positive. It’s not culturally acceptable to publish negative results because researchers would lose face and their jobs.

The biggest problem with acupuncture studies is finding an adequate placebo control. You’re sticking needles in people. People notice that. Double blinding is impossible: you might be able to fool patients into thinking you’ve used a needle when you haven’t, but there’s no way to blind the person doing the needling. Two kinds of controls have been used: comparing acupuncture points to non-points, and using an ingenious needle in a sheath that appears to have penetrated the skin when it hasn’t.

Why I Am Skeptical of Acupuncture

The lack of any advantage of real over sham acupuncture means that it does not matter where the needles are placed. This is completely consistent with the hypothesis that any perceived benefits from acupuncture are non-specific effects from the process of getting the treatment, and not due to any alleged specific effects of acupuncture. In other words, there is no evidence that acupuncture is manipulating chi or anything else, that the meridians have any basis in reality, or that the specific process of acupuncture makes any difference.

Taken as a whole, the pattern of the acupuncture literature follows one with which scientists are very familiar: the more tightly controlled the study the smaller the effect, and the best controlled trials are negative. This pattern is highly predictive of a null-effect – that there is no actual effect from acupuncture.