SOME RESEARCH COMMENTARY
(Posted 2010-06-02 13:13:13 by ArchPaladin)

Two days ago there was a publication [
http://www.nature.com/neuro/journal/vaop/ncurrent/abs/nn.2562.html ]
[nature.com] of a study in _Nature Neuroscience_ stating that acupuncture
works by the stimulation of adenosine - one of the body's many painkilling
drugs.  If you want a summary of the article but don't want to read the
obtuse science language, Ars Technica has a decent one [
http://arstechnica.com/science/news/2010/06/acupuncture-works-by-inducing-bodys-own-painkiller.ars?utm_source=rss&utm_medium=rss&utm_campaign=rss
] [arstechnica.com].

I was interested in reading some of the comments to the various mainstream
publications for this article (the Ars Technica one specifically), and not
quite surprisingly, I found not only the article but also the research and
entire healing practice lambasted by a number of skeptics.  Please note
that I'm not just talking about people who have a dose of skepticism in
them, but rather those who self-identify as skeptics or as part of the
skeptical movement.  Such people tend to respond agreeably only to things
that have been demonstrated repeatedly in rigorously defined scientific
studies, and only then for branches of science that are considered 'hard
science', by researchers who are well known, in peer-reviewed scholarly
journals that are widely accepted, and so forth often with a long list of
criteria.  (Personal disclosure here: I tend to find people in the
skeptical movement to be some of the most recalcitrant people on Earth.) 
In short, not the kinds of people you would catch actually trying
acupuncture, even if they were dead.

So, as an acupuncturist in training, let me give you a slightly more
informed opinion:  To date, most all research on acupuncture is poorly
designed, if not outright crap.

Why is that, you might ask?  The problem is that for any of the study
designs that exist, those that are considered rigorous involve comparing
what it is that the researchers want to test (eg. acupuncture), with some
other process whose effects and outcomes we know (eg. a drug, or physical
therapy, or a placebo).  In this way, we can identify how acupuncture
compares to the other method.  But there are a couple of problems when you
try and apply this approach to acupuncture.

The one most often encountered is when researchers try and compare
acupuncture against some placebo.  Researchers will spend a lot of time
trying to develop ways to fool people into thinking that they've been stuck
with needles, when in fact they haven't.  They'll use toothpicks, or
specially designed sham needles, or some other contraption.  The problem
here is that researchers who use a placebo of a fake needle have made the
assumption that the reason acupuncture works is because you're using a
needle in the first place.  But this is not true.  There are methods of
practicing acupuncture in Japan that involve using needles that don't
pierce the skin - effectively the same as using a toothpick or sham
control.  This makes comparing acupuncture against a placebo incredibly
difficult if not impossible, because anything you develop as a placebo is
likely going to be a valid treatment method somewhere in acupuncture's
history.

The second problem is that many other studies will try to identify a
mechanism of action for acupuncture that exists solely in the problem
domain of a single field of knowledge.  The study just released falls into
this trap.  Scientists will say that acupuncture works because it promotes
the release of a certain type of neurotransmitter or hormone, or that it
alters neural communication somewhere else in the body, or that it breaks
up tangled muscle fibers, or some other _single cause_ that describes the
whole of the therapy.  This is an understandable statement from research
specialists who are used to describing very specific things, but it is
incredibly shortsighted as a whole.  Acupuncture is likely (I say likely,
because we don't have any definitive mechanisms understood yet) working
through all of those functions plus many others that are yet to be
understood.  To try and break the therapy down into smaller pieces - as we
do in all other areas of knowledge - presents the risk that we will jump to
conclusions before all the facts are in.  I personally don't have much
trust in scientific study (particuarly when in the hands of the skeptical
movement) that we will avoid making such premature leaps.

So I admit that I'm not quite a fan of the study that was just released,
but I cannot agree with the comments of many others, and particularly from
those who shout the loudest.  For those who are legitimately skeptical - as
opposed to the staunchly skeptical - if you wanted evidence as to whether
or not it works, my advice is that the best way to learn is through
personal experience.

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