Thursday, January 27, 2011

Part 1. Journal Studies

In my previous entry I talked about the treatment of pain with acupuncture and TCM.  Here are a sampling of research articles.


Study Shows that Acupuncture Effective in Treating Carpal Tunnel Syndrome
This study, published in the May 2009 Clinical Journal of Pain, showed that acupuncture was as effective as corticosteroids in treating carpal tunnel.


Low Back Pain
Acupuncture was proved to have a long-term pain-relieving effect in a randomized placebo-controlled study. The study found a significant improvement for the treatment group in return to work, quality of sleep, and analgesic intake, with effects lasting up to six months.  The results were published in the December 2001 Clinical Journal of Pain.


Another study examining Low Back Pain, published in 2006 by the American Medical Association, randomly placed patients into one of three experimental groups; full acupuncture treatment, minimal acupuncture treatment*, and no acupuncture treatment.  Results showed acupuncture was more effective in reducing low back pain intensity than no acupuncture in patients with chronic low back pain.  Most outcome variables tended to be slightly better in the acupuncture group compared with the minimal acupuncture group.   


The British Medical Journal in 2005 published an article reporting that adding acupuncture to standard treatment is superior to standard treatment.  



Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise.
This study showed that both raw and heated ginger reduced pain after an exercise induced muscle injury. The
New York Times covered this article, although I recommend reading the original abstract because it's shorter and more clear. Ginger is a common cooking and medicinal herb in TCM, although I've never heard of a TCM practitioner using it alone for treating muscle pain. We normally combine it with other herbs to make larger formulas, or use it in medicinal cooking.




The take home message is that acupuncture can be very effective in treating pain throughout the body.  And it is a very safe treatment method.  


Compare this with a common way that people treat their pain - using over-the-counter NSAIDS (non-steroidal anti-inflammatory drugs) such as advil, motrin and aleve.  A recent study in the February issue of the British Journal of Sports Medicine showed that while many athletes use NSAIDS on and before race day, most do not know about serious possible side effects, including kidney failure and gastrointestinal bleeding.    


While I am a huge proponent of advancing acupuncture research, I also want to remind people that we do not need to wait for further studies to know that acupuncture is a safe and effective treatment option that can not only help people recover from pain and injury, but can optimize training and performance.
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*You might be now wondering, "what is the difference between full and minimal acupuncture treatments?"  The answer to this question is contentious within the field of acupuncture research and deserves a blog entry of its own.  The short answer is that when designing a study, researchers would prefer that their patients (i.e., research subjects) do not know what experimental group they are being placed in.  This is half of the "double blind" design that is universally agreed to be the gold standard in research, with the other half being that the researcher delivering the experimental intervention (in this case, the acupuncturist) doesn't know which of the interventions she is delivering.   


Minimal acupuncture is a type of "sham acupuncture." And sham acupuncture is a type of intervention that is aimed at making the subject believe that they are receiving acupuncture while (in a perfect world) not receiving any benefits of a true acupuncture treatment.  In other words, sham acupuncture is intended to be perceived as an intervention by the subject but to have zero treatment affect.  The trouble is that most sham treatments affect acupuncture meridians in some way and therefore can't truly be considered the same as not receiving a treatment at all.  

From a practical standpoint, what you end up with is many acupuncturists on one side of the argument saying, "we understand the need for double blind studies, but the way they are currently being implemented is erroneously biased against showing acupuncture's efficacy" and some western trained researchers sticking to their point that "the gold standard of research ought to also apply to acupuncture research so that we can distinguish efficacy from placebo."

Harvard Medical School has looked into this, and if there's interest I can write more about this topic.  

In the end, the take home message is that while acupuncture research can't neatly fit into the double blind design model, acupuncture research is continuously providing us with a growing database of helpful studies that show that acupuncture is effective in treating many conditions.

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