Is acupuncture just a placebo?

We are always happy to answer any questions that people put to us about acupuncture. One of the ones that used to take me by surprise was “but it’s just a placebo, right?”
Really? What a question. I was surprised to consider it possible that anyone would believe that an entire profession, training colleges, regulatory boards and research bodies would be built on a treatment that was placebo. Where would the ethics and justification come from? Why would acupuncture still exist?

Placebo? Would the NHS prescribe, recommend and even pay for something that is merely a placebo; and would medical insurers reimburse and fund treatments on that basis?  Would hospital consultants send patients our way, and would vets use it on pets and prize race horses? One expects and hopes not.  But don’t just take my word for it, read on to find out the basics of how we know that acupuncture points specifically work in a measurable way.

Point specificity

Research has shown that specific acupuncture points have very specific functions and effects on the body. To be specific “hemodynamic, functional magnetic resonance imaging and neurophysiological studies evaluating the responses to stimulation of multiple points on the body surface have shown that point-specific actions are present [sic].” (Choi et al 2012).

Multiple studies of cardiovascular (heart and circulation) disease show that acupuncture points bring about significantly greater responses than do non-acupuncture points or inactive acupuncture points used as controls. The difference can be seen in brain scans – for the active heart points, stimulation of regions of the brain that regulate the sympathetic nervous system cardiovascular function has been demonstrated.

Studies that look at how acupuncture points affect the blood flow to different regions of the body as compared to non points, and points with other functions.  A point on the wrist, Pericardium 6, can for example decrease heart rate, and improve heart rate variability. This more than a nearby point that is not concerned with this function – although in the same nerve segment. Point specificity has also been shown in effective actions of acupuncture on the stomach, intestines and heart in research trials.

Measures taken in studies have used electrogastrogram (EGG) and heart rate variability (HRV) measures as well as functional MRI to investigate these findings. As Liu et al (2013) state ” Acupuncture at adjacent acupoints elicits distinct cerebral activation patterns, and those specific patterns might be involved in the mechanism of the specific therapeutic effects of different acupoints.” Meaning that the effects of acupuncture points can be proven to be specific and not in line with expected placebo.

MRI brain scans have also shown that different sets of points do elicit different responses in the nervous system, and different actions in the body. Some of these trials are done one animals in labs, and some of those animals are anaesthetised, which does not suggest placebo is likely to be at play. Xing et al (2013) conclude that “the evidence cumulated from brain imaging and many biological studies showed that the point specificity in acupuncture does exist”.


Aside from the point specificity, research is increasingly being designed to show that it is the action of a point that created the effect. Of course the treatment surrounding and holistic approach have some bearing on outcomes, and although it would seem interesting to work out the percentage contribution of this, it is worth considering that every therapeutic interaction, including with GPs, pharmacist and expert care will have a ‘pastoral’ side that does come in to play. This is part of what it is to build a rapport between patient and practitioner, but in acupuncture this is not what elicits that measureable treatment effects that research has shown.

The key matter to take away is that physical, measurable changes occur in the body through acupuncture that are predicted by the basis of acupuncture theory, and not by western biomedical science.  Research science continue to build physical and biological theories as to how acupuncture achieves this, and modern acupuncturists such as ourselves at Shaftesbury Clinic are interested in the research, reading, discussing and attending seminars, and taking part where we are able.

Curious for more of the science bit?

Take a look round the conditions section of our website, and the social media we curate. Our other blog entries also talk about other uses and research findings for all things acupuncture. If you’re looking for something and you can’t find it, drop us a line.

Questions?

We love taking about what we do, and remember we are just at the end of the phone.  If we are in clinic, our receptionists can schedule us for a call back to you, or you can email us with any questions you have.  If a free 20 minute consultation would help you to decide whether acupuncture is for you, then we can make it happen, by appointment, so feel free to get in touch.

Links, references and resources:

Emma M Choi, Fang Jiang, John C Longhurst Point specificity in acupuncture. Chinese Medicine 2012, 7:4,. Susan Samueli Center for Integrative Medicine, Department of Medicine, School of Medicine, University of California, Irvine CA. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311034/

Liu, Hua, Jian-Yang Xu, Lin Li, Bao-Ci Shan, Bin-Bin Nie, and Jing-quan Xue. “fMRI Evidence of Acupoints Specificity in Two Adjacent Acupoints.” Evidence-Based Complementary and Alternative Medicine 2013 (2013).  http://www.hindawi.com/journals/ecam/2013/932581/

Minagawa, Munenori, Yasuzo Kurono, Tatsuyo Ishigami, Atsushi Yamada, Toshinori Kakamu, Ryoichi Akai, and Junichiro Hayano. “Site-specific organ-selective effect of epifascial acupuncture on cardiac and gastric autonomic functions.” Autonomic Neuroscience (2013). December 2013Volume 179, Issues 1-2, Pages 151–154 www.autonomicneuroscience.com/article/S1566-0702(13)00065-9/abstract

Xing JJ, Zeng BY, Li J, Zhuang Y, Liang FR Acupuncture point specificity Int Rev Neurobiol. 2013;111:49-65. doi: 10.1016/B978-0-12-411545-3.00003-1 http://www.ncbi.nlm.nih.gov/pubmed/24215917

Yang, J; Fang Zeng, Yue Feng, Li Fang, Wei Qin, Xuguang Liu, Wenzhong Song, Hongjun Xie, Ji Chen, Fanrong Liang. A PET-CT study on specificity of acupoints through acupuncture treatment on migraine patients. BMC Complement Altern Med. 2012; 12: 123. Published online 2012 Aug 15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480944/
 

Helen
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