The reason why I'm replying is because I don't want people that can be helped by Acupuncture to reject it based on a misunderstanding of the claim.

I think there are several specific reasons why both the article which you link to can be true and also that acpuncture worked in my specific case and can work in cases that are similar.

First of all, as another reply alluded to, the article isn't testing for effectiveness for a specific problem. In fact, I believe, and continue to believe personally, that acupuncture may not solve for general problems. My half-joking, poke your foot to fix your liver being an example.

I would also like to point out that of all the things I tried, I had the least confidence in acupuncture. In terms of placebo, I was expecting and perhaps even hoping that it wouldn't work to prove myself right. In fact, I tried it almost mainly as a way to say that, "Hey! I tried everything. Even acupuncture! That's how you know I tried everything."

I had much higher confidence in everything else I tried.

I would also like to point out that the specific thing I think it solves is in releasing a muscle locked in spasm (though I may be getting the language wrong). I think if you don't have a muscle locked in spasm, it probably won't help.

My initial reaction to the improvement was that perhaps it was a coincidence. Although this seemed unlikely given that I had been trying for months with different practitioners and there was a difference before and after the session. I also thought that it was temporary and that maybe a day later things would revert, which they didn't.

I also felt that this was becoming more mainstream because I had some rehabilitation for an injured knee a few years later. Apparently I had a muscle locked in spasm (not the knee) and they used a needle to unlock it. Basically, put the needle into the locked muscle, move it a little, there is a physical jerk, and the muscle becomes unlocked.

Edit: Weakened some points to better reflect my position

Anyway, the physical therapist put me through motions and he showed me on the skeleton how it was actually supporting muscles that were much weaker on one side of my body. He gave me basic exercises to do every day to strengthen those muscles, and in the end it worked beautifully. No more knee issues.

I'm glad you found something that worked, but I'm also curious if you tried out PT, and what they told you?

Posture can also be helped with muscle strengthening. Years ago a PT gave me a ton of exercises to combat sitting at a desk all day. I still do them at the end of my usual workouts.

Calling it a "medical technique" or even "alternative medicine" was ludicrous. It wasn't even coherent.

The key part of that paragraph being "Good quality trials have not been done for all of them".

It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, rather than committing to running the same detailed trials that they do on profitable drugs.

Second, they have run good trials on many of the conditions acupuncture claims to cure. You picked the one paragraph that might be interpreted to support your claim:

> It's a shame that Western science seems so intent on dismissing non-western treatments and techniques, rather than committing to running the same detailed trials that they do on profitable drugs.

So here's a few quotes that contradict you, all from the same article:

> after decades of research and more than 3000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant.

> Large multicenter clinical trials conducted in Germany7–10 and the United States11 consistently revealed that verum (or true) acupuncture and sham acupuncture treatments are no different in decreasing pain levels across multiple chronic pain disorders: migraine, tension headache, low back pain, and osteoarthritis of the knee.

> Vickers et al.14 did a meta-analysis for 29 randomized controlled trials, with 17,922 patients. The patients were being treated for a variety of chronic pain conditions. The results were very similar to those of Madsen et al.12Real acupuncture was better than sham but by a tiny amount that lacked any clinical significance.

There's no reason to not try acupuncture, if you've got the money for it, I guess. It's not likely to hurt you. But don't disregard other treatments.

And bitch all you want about "western medicine", but if you have a heart attack, or need a kidney transplant, or break a bone - you're probably going to choose the western system.

I always find it weird that people can't see alternative medicine is only used by advocates on problems than tend to come and go by themselves or are susceptible to placebo effect but any time something serious comes up like the problems you mentioned, people will turn to real scientifically backed techniques. Acupuncturist and chiropractors for example claim to treat much, much more than just back pain as well.

And here's a large, we'll run, study showing acupuncture is more effective than sham accupuncture

https://discover.dc.nihr.ac.uk/portal/article/4000672/acupun...

Obviously I think long term pain should be taken seriously but I would prefer people used existing scientifically backed treatments instead of promoting pseudoscience which definitively does lead to deaths (e.g. see the anti vaccination movement).

For headaches:

> Acupuncture is currently recommended for the prevention of chronic headaches, but not for musculoskeletal pain or osteoarthritis pain.

The first paragraph:

> This NIHR-funded systematic review shows that acupuncture is better than usual care and sham acupuncture for pain from musculoskeletal conditions, knee osteoarthritis and chronic headache.

And still not clinically significant.

Read the linked page, acupuncture shows a statistically significant difference to sham acupuncture or to nothing.

Make sure they wipe the injection sites with alcohol and use properly sterilized or disposable needles. (Give it with the same expectations you have for an injection.)

You don't want an infection.

Whatever "trauma and inflammation" is caused is caused by the needle displacing tissue.

I think western medicine is excellent when it comes to determining specific details about many individual bits are supposed to be working, and fixing those specific things when they're broken or malfunctioning. It's not as successful when it comes to understanding how all of those specific bits fit into place as part of a larger complex system. There are too many variables and interactions, and we've only very recently had the computational power to create models of these systems, let alone understand them.

Where western medicine takes a bottom-up approach, from details to system, non-western medicine usually takes a top-down approach, observing how the overall system behaves and reacts. With enough observations, it can become very good at predicting reactions, but still totally fail at being able to explain why the reactions happen.

Take acupuncture: in western medicine, we know that the body has pathways and circulatory systems for blood, lymph, and other fluids, and that our cells communicate using electrical, chemical, and hormonal signals that are passed through the pathways and circuits. We know a lot about small details, like how one nerve cell uses ions to pass an electrical charge across a fluid-filled gap to the next nerve cell, but we don't really know how it all works as a whole. But it stands to reason that poking conductive needles into these pathways and using them to cause stimulation could insert signals into the system or interrupt existing signals. Western medicine can't model that, and it can't predict for sure what possible effects it can have. Without a theory, all we can do is perform random experiments in the dark and hope something noticeable happens.

Chinese medicine, on the other hand, has done the random experiments over thousands of years, and has determined specific places to put the needles and how to manipulate them to get the desired effect. That's straight-up observational science. But to explain it the Chinese came up with the idea of qi as an energy that flows through the body, which is vaguely right as a very blurry view of western medicine's understanding of our nervous system and other systems, but mostly it's completely fictional.

The point I'm trying to make is that different approaches to understanding can both be right and both be wrong, except they tend to be right and wrong about different parts. The top-down, systemic, wholistic approach is good for understanding the big picture and the 'what', while the bottom-up, componentized, analytical approach is good for understanding 'how'.

First, you describe Western medicine as detail oriented, or bottom-up, but this creates a false contrast.

Western medicine studies all sorts of interactions between systems. Yes, there are tons of specialists, but they all have to study how all the different systems interact in early coursework, precisely because the West does value insights gained from how systems are plugged together, and borrowing techniques from some contexts/scales and applying them in others.

The real distinguishing feature between "Western" and traditional medicines, and this is really only a very recent phenomenon in the West, is just the recognition that we constantly, unwittingly, lie to ourselves about what is effective. So we design methods to test results, and throw out things that don't work.

If there's one dominant feature of "Western" medicine it's RCTs.

But note the scare quotes, included for two reasons:

First, the roots of Western medicine have nothing to do with scientific rigor. If anything, the West's medical history was so thoroughly unreliable with ramblings about demonic possession and poisonous snake oil that it made the abundance of quackery obvious, making serious practitioners demand proof for everything.

This idea isn't "Western," it's just a natural human reaction when you want better information. Make people prove what they claim.

Sure, there are specific tools that help, like randomization and extra controls (placebo, blinds, peer review, etc.). But those aren't "Western" anymore than fire or levers or wheels are regional possessions. They're just working tools anyone can use, and China is using them today.

And that gets to the bigger problem here, not the mischaracterization of Western medicine, but reducing China's medical research contributions to "traditional Chinese medicine." Most people unfortunately do this, but it completely undermines the brilliant scientific contributions of modern Chinese researchers, who use the best tools available (like RCTs) to contribute to humanity's scientific knowledge.

And note, these aren't traditional Chinese practitioners, just dabbling in Western methods, anymore than Watson and Crick were really exorcists who dabbled with chemistry.

It's true that some Chinese research may be inspired by traditional medicines, like Tu Youyou's pioneering work on antimalarial drugs. But what's the root of her contribution? It's not merely popularizing an old remedy that makes her brilliant. She's great because of all the thousands of possible old remedies, she conducted rigorous animal studies to identify one useful treatment. She sorted the chaff from the wheat, and she did the hard work to prove her result, and create conditions that could be replicated.

(It would be the wrong lesson to conclude her story validates folk remedies generally. Her story validates rigorous scientific testing. There are so so many worthless folk remedies. Rigorous scientific testing was the useful and unique ingredient here that led to a usable result.)

More and more often, others like Junjiu Huang, are conducting groundbreaking stem cell research (a field completely unrelated to traditional medicines).

Part of this discussion may stem from discomfort at comparing rigorous modern RCTs with Chinese traditional medicine, maybe a fear that this becomes a cheap way to make China look backwards. But the real problem is the comparison. There's no reason to compare those things.

Apples to apples would be to compare traditional Chinese medicine to bleeding and trepanning. Or more recently, while we were well past China's stage of economic development, we were using stuff like preorbital lobotomies and insisting schizophrenia was caused by bad parenting.

And those were doctors and hospitals. If you include hobbyists and folk remedies, you get people in the West swinging a dead cat over their head in a graveyard to get rid of warts. You get people faith healing on TV by shouting "demons out!"

Once you're satisfied that folk remedies have issues in every country, then compare modern with modern.

At the worst, you can criticize some Chinese schools as paper mills. But China's sheer number of researchers means its upper ten percentile is already twice the size of the US top ten, and the number of researchers and quality of research in China are both rapidly improving. The sheer potential is staggering throughout Asia, based on population and how rapidly countries are progressing economically (so they can move larger portions of society out of agriculture and basic industry and into more prestige fields like science).

Based on demographics alone, the smart money would be that China will develop more "Western" medical advances in the next 50 years than the West itself.

That's what we should be celebrating about Chinese medicine. Not stuff from a thousand years ago, a double standard when we consider Western medical advice from a thousand years ago to be laughable nonsense. But all the real stuff they're doing now, today, and what they will inevitably do in the near future, to push forward the frontiers of not Western but human knowledge.

https://en.wikipedia.org/wiki/German_acupuncture_trials

https://well.blogs.nytimes.com/2012/09/11/acupuncture-provid...

The site you provided is run by a small group of doctors who seem to have beef with acupuncture, judging by their tone. https://sciencebasedmedicine.org/category/acupuncture/

A lot of western folks who get acupuncture treatment do so with great deal of skepticism. Despite that, it's gaining traction in the West. Why? Because it works pretty well for some people.

I wouldn't dismiss it as a sham.

I've seen placebos work too - most of my childhood homeopathic medication was probably placebos.

For a single person, the important factor for treatment is outcome - not statistical significance. If something makes you feel better, the outcome is achieved. I've also seen doctors exploit it, because their goal is aligned with your outcome - not studying the causation.

However, the problem is when you offer advice to a skeptic, the placebo effect is out of the picture.

And it can be worse, the time spent with the placebo might be lost time to the sufferer where it plays out as "If only you'd come to us earlier" elsewhere.

There are long-term consequences, when you offer medical advice without the expertise beyond your outcome ... outcomes heavily bifurcate for people who trust you (strong placebo effect or time lost waiting for results).

A little over four years ago, I had a ton of shoulder pain. I went to two doctors, had an MRI scan, and was prescribed physical therapy. After all of that, I was still in pain, and neither of the doctors could figure out why, so I decided to try acupuncture for the first time. I went to Chinatown, got needles put in me, and got some electricity sent to my shoulder. I left the shop about 30 minutes later, and about 70% of my pain was gone. I woke up with next morning with only a tiny bit of pain left.

The pain didn't come back, even after months. I eventually found a doctor who figured out what was wrong, and through a better round of physical therapy, I was able to eradicate my shoulder pain permanently.

Maybe acupuncture didn't solve my problems completely, and of course it doesn't work for everything (e.g. weight loss, cancer, etc.), but to simply say that it "doesn't work" is ludicrous.

https://discover.dc.nihr.ac.uk/portal/article/4000672/acupun...

(On mobile, apologies for the weird URL).

For lower back pain I think the advice is, after seeing a doctor, to start exercising.

> It had moderate effect compared with non-acupuncture care for musculoskeletal pain (standardised mean difference [SMD] 0.55, 95% confidence interval [CI] 0.51 to 0.58), osteoarthritis (SMD 0.57, 95% CI 0.50 to 0.64) and headache (SMD 0.42, 95% CI 0.37 to 0.46).

Also, the comparisons to acupuncture vs sham acupuncture...is this implying that acupunture has some validity (meridians etc.) or just that the sham wasn't convincing enough? Why would acupuncture perform better when meridians have no scientific plausibility?

I've no doubt an elaborate procedure such as acupuncture produces a strong placebo effect but something that isn't better than a placebo shouldn't be considered as working in my opinion.

There, fixed it for you.

https://discover.dc.nihr.ac.uk/portal/article/4000672/acupun...

Acupuncture is a sham because sham acupuncture appears to do just as well. What matters is if you get stung by a real needle. All the acupuncture-specific things, like meridians, points, qi, are just tosh, which means pseudo-acupuncture can be performed by any nurse, and does not require a costly 'expert'. So "real acupuncture" is just, in fact, an unnecessary ornament that can be discarded.

Having been raised by your average new-age / alternative medicine parents, and having believed and used these things until my mid-twenties, I'm not surprised that needles do have an effect. I am also not surprised it does not come from acupuncture proper.

If you say 'having vague pain points stung by needles is better than placebo', then I would agree with you, but that's quite different than saying that acupuncture works.

You don't have to read the study, this point is made on the page I linked to.

Like chiropractic, there is "something" there, but it's mostly mild physical relief + belief/placebo effect.

That's not necessarily a bad thing, especially for pain relief where the alternatives are pretty high impact (surgery, ineffective narcotics, other treatments that lose efficiency over time). The problem is there are practitioners who claim to cure cancer, etc, and there's no way for anyone to vet that.