Dear Lynn:
A couple of weeks ago I read an article in Newsweek about a study that was done on people who had back pain. It seemed like they were saying that acupuncture worked because of the placebo effect. Is this true?
Confused
Dear Confused:
I saw that same article and found it really interesting on a number of levels. The study involved 638 adults who suffered from chronic back pain. The patients were split into four groups. Some received standard acupuncture, some received customized acupuncture (tailored to the individual), some received sham acupuncture (in which toothpicks were put into the acupuncture guide tubes to feel like real acupuncture), and some received standard Western care, such as anti-inflammatory drugs and massage.
What was surprising about this study is that 60 percent of the people who received either the real acupuncture or the sham acupuncture treatments reported a significant decrease in their pain, compared to 39 percent of the patients receiving standard care. This led the reporter Sharon Begley to conclude that the pain relief experienced by any of the acupuncture groups, real or sham, was due to the placebo effect.
My first reaction to the article was to question whether or not the sensation of acupuncture qualifies as a placebo or not. The sham patients were being poked with a toothpick, which means the selected acupuncture points were stimulated, regardless of whether or not the skin was penetrated. This is the same theory behind acupressure treatments and Shiatsu massage—both achieve relief through the stimulation of acupuncture points without inserting needles.
I then began to think a little more about the whole idea of the placebo effect. In many Western circles, a placebo is considered a bad thing—in effect you’re fooling your patient to get better. Furthermore, if this is how acupuncture works, it must be quackery.
However, there is a saying in Chinese medicine that the emotions are the cause of 100 diseases, which refers to the importance of the mind in the healing process. This has been supported by numerous studies that have documented acupuncture’s effects on changes in brain chemistry. Practitioners of Chinese medicine understand that the mind and body are one, and both must heal in order for the patient to truly get well.
Whether acupuncture works because of a placebo effect or not will likely continue to be studied, most importantly because the mechanism through which acupuncture works is still not understood by the Western medical establishment.
However in the meantime, I would ask: if my patient finds relief from acupuncture when all other treatments have failed, do I really care that their relief came from a placebo effect?
I would also ask that if acupuncture works through the placebo effect, then why does it also work on animals?
Lynn
