News Bias A Pain in the Neck
Once again, another study showing that “real” acupuncture is significantly better than “sham” acupuncture. A single blind, randomized, sham-controlled trial was compared to use of standardized neck exercises aimed at chronic neck pain relief. Shame on the Associated Press, really.
Certain Media Outlets' Ignorance of the Evidence is a Pain in the Neck
It seems that the Associated Press has gotten down to publishing, not one, but a series of articles proudly proclaiming that “experts” say that the benefits of alternative medicine are due to placebo. A previous blog entry, “Associated Press Needs New Glasses” 11, Nov 2009, notes that these Associated Press-Big Pharma press releases proclaim that experts say that any beneficial effects of alternative medicine are due to placebo and that most studies that “prove” acupuncture effectivity aren’t worth reading because of lack of comparison of “real” acupuncture to “sham” acupuncture.
Before we cite another article that demolishes the “sham” sham, let’s examine some points (no pun intended) yet again.
Firstly, since it is obvious that alternative treatments do provide relief to patients, the powers-that-be can no longer use the “they don’t work” card. They grudgingly acknowledge that they do make patients feel better but attribute it to being no better than placebo – or that the patient feels better because they THINK they’ll feel better. The sheer irony here is that by that logic, we can also claim that western medicine works through placebo also. Yet, for some reason, people are turning to alternative medicine precisely because western medicine doesn’t seem to work for them and their particular condition. As my friend Noah Mckenna once told me, “just tell the naysayers that (our) placebo works better than (their) placebo”.
Secondly, since studies are indeed popping up proving that Chinese medicine (my thing) does have biomedical reasons for working, and has been shown to work, the next argument that “they” bring up is to critique the studies. Among the most common whines are “the studies aren’t blinded”, or my favorite “acupuncture wasn’t compared to sham”. My replies can be summarized in various previous blog entries. (This Time, Chinese Herbal Medicine May Have Cure for Diabetes, October 15, 2009). Sure, everyone has seen that back pain study that said sham acupuncture is the same as real acupuncture, but they have forgotten to note that sticking needles anywhere hypothetically can work because according to meridian theory, every square inch of the body is traversed by meridians and collaterals. The point of using acupoints is that they are more specific in effect than common locus dolendi points.
But the point of this particular blog article was my finding of yet another article comparing acupuncture treatment (albeit with electrostimulation) vs sham. Here’s the abstract:
Objectives: Chronic neck pain is a common problem and is treated using a variety of conservative treatments. This single-blind, randomized, sham-controlled trial investigated the value of adding electrical stimulation of acupuncture points on the wrist to a standardized program of neck exercises for chronic neck pain.
Methods: At initial recruitment 60 patients were randomly assigned to receive either active or sham electrical stimulation of acupuncture points on the wrist in addition to standardized neck exercise. Active or sham wrist acustimulation was given for 30 minutes 2 times/wk over a period of 4 weeks. A 30 minutes program of standardized neck exercises was also performed simultaneously.
Results: Forty-nine patients completed the study (22 active, 27 sham). Statistically significant improvements were found for acustimulation when compared with sham at immediate posttreatment and 1-month posttreatment for Numerical Rating Scale, Northwick Park Neck Pain Questionnaire and Pain Self-Efficacy Questionnaire. In active and sham electrical stimulation group 38.9% and 8.3% of patients reported a reduction of Numerical Rating Scale >50% at 1-month posttreatment follow-up, respectively. All patients tolerated acustimulation and no adverse effects were reported.
So there is a statistically significant difference in pain reduction measured by a standardized rating scale. I will save you the rant to follow by summarizing it again: real vs sham? real wins.
Source: Chan, et al. “Electrical Stimulation of the Wrist for Chronic Neck Pain: A Randomized, Sham-controlled Trial Using a Wrist-Ankle Acustimulation Device” The Clinical Journal of Pain: May 2009 – Volume 25 – Issue 4 – pp 320-326. Accessed 15 Nov 2009 <http://journals.lww.com/clinicalpain/Abstract/2009/05000/Electrical_Acustimulation_of_the_Wrist_for_Chronic.10.aspx>
Discussion: Electrical acustimulation of the wrist administered as two, 30 minutes sessions /wk added value to standardized neck exercise for chronic neck pain. A 4-week course of treatment produced effects lasting 1-month posttreatment.
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