False hope would suck.
May 17, 2010 7:32 PM   Subscribe

ControversialFilter: is acupuncture a load of bunk?

So I posted this question a while back.

Brief update: 2 physiotherapists later, neither thinks I damaged my ligaments. Meniscus injury is possible, although they said it's unlikely if I haven't damaged my ligaments.

I had stupidly reinjured my knee playing with my boyfriend (forgot I couldn't bear weight on that leg while I tried kicking him) but have been good with ice, ibuprofen, compression, etc. However, even though the joint seemed to have settled down for a bit, after I stopped the ice and ibuprofen, it swelled again. I still have the pain in the joint line and the inner side of the knee.

GP took an X-ray, results will be out this week, although given what I've observed I don't think I fractured/cracked any bone. Physio suggested it might be a kneecap tracking problem, but taping the kneecap made it feel worse. I am in Canada, which MRIs are subsidized by the government (ergo my insurance doesn't cover it), but the wait is like half a year.

Anyway, sayeth the family, "5000 years of tradition can't be wrong" so I got taken to a Chinese doc. He felt the knee and found some tender points I didn't know existed, and pronounced I had injured my ligaments (medial and lateral, I think) and the meniscus. He verified this by using suction to induce a series of redness/bruises around my kneecap, where the redness was the normal bits and deep bruises were the injuries where there was internal bleeding. And he said he could fix this.

Okay. I was raised in the West and I admit I am biased against alternative treatments. But if it works, great. And I do admit that after his acupuncturing, the knee actually felt a little better (although it's sore again now). But I thought cartilage and ligaments generally...don't heal. I'm not sure how any sort of alternative medicine can make things that don't heal, well, heal.

Also, he gave me some medicated patches to use on said knee and some pills to swallow. I am slightly concerned if the pills will affect my birth control pills.

Does alternative medicine really win out over Western medicine and all its fancy imaging technologies, drugs, and surgeries, even some of the time? Is this a false hope, or might there be something to it? I am aware that the majority of MeFites probably are born, bred and raised on Western medicine (hey, so am I, I'm just as skeptical), but there're probably a good chunk who've tried alternative therapies as well. Tell me your stories!

(And whatever the case, I'll probably still push for that MRI. But it's a long wait...)
posted by Hakaisha to Health & Fitness (63 answers total) 4 users marked this as a favorite
 
There is a very, very good book called Snake Oil Science, by R. Barker Bausell, which reviews the high-quality, randomized, controlled, double-blinded (where possible), and peer-reviewed literature on the subject of acupuncture. His answer is that acupuncture has not been shown, by any standard acceptable to science, to have an effect over and above that of a placebo.
posted by overeducated_alligator at 7:38 PM on May 17, 2010 [3 favorites]


I am slightly concerned if the pills will affect my birth control pills.

FFS don't eat some pills some wackjob gave you. You wouldn't let your pet, child, or dementia-afflicted elder relative eat random stuff, would you?
posted by Inspector.Gadget at 7:39 PM on May 17, 2010 [2 favorites]


Does alternative medicine really win out over Western medicine and all its fancy imaging technologies, drugs, and surgeries, even some of the time?

It's not an either/or. There's a lot to be said for believing in the treatment you're undergoing, whether it's traditional or conventional. So if your first acupuncture session worked for you, then why not pursue it during the 6 months you're waiting for the MRI?

I've never had acupuncture and I'm rather skeptical about it, but I'm a big fan of bodywork in general (I'm a massage therapist) and I think it's best to start out with less invasive approaches before going for the knife.
posted by headnsouth at 7:40 PM on May 17, 2010


less invasive approaches

Sticking needles into someone's body with no demonstrable medical effect is "less invasive"?
posted by Inspector.Gadget at 7:41 PM on May 17, 2010 [2 favorites]


Response by poster: For the record, if it matters at all, this guy has a reasonably decent rep by word-of-mouth. At least in terms of this type of practitioner.

Seeing as I live at home and my parents don't know I'm on birth control (and I had very, very good reason not to tell them...), I'm not sure how to bring up this doubt either, since one of them comes with me to said appointments. I guess there's always condoms...?
posted by Hakaisha at 7:42 PM on May 17, 2010


For the record, if it matters at all, this guy has a reasonably decent rep by word-of-mouth. At least in terms of this type of practitioner.

That's how scams work.
posted by Inspector.Gadget at 7:43 PM on May 17, 2010 [13 favorites]


I am by nature pretty skeptical, but had a (similarly cynical) friend tell me that acupuncture helped her jaw pain. Nothing else worked for her, but that did.

I'd probably avoid taking pills if I didn't know what they were, but while you wait for your MRI, acupuncture couldn't hurt, could it? (Can anyone cite harmful affects of acupuncture?)
posted by too bad you're not me at 7:44 PM on May 17, 2010


what's the harm in acupuncture

also, from your description i'm not sure if this is what you're referring to with the suction and the bruising - but what's the harm in cupping
posted by nadawi at 7:46 PM on May 17, 2010


Seeing as I live at home and my parents don't know I'm on birth control (and I had very, very good reason not to tell them...), I'm not sure how to bring up this doubt either, since one of them comes with me to said appointments. I guess there's always condoms...?

You could also just ask if it would interact with other medications. If you parent(s) ask, you could tell them you're thinking ahead or that you're worried about aspirin or other pain killers. You could also ask for a private moment with the practitioner, and if your parents ask, tell them that you had an embarrassing question.
posted by too bad you're not me at 7:46 PM on May 17, 2010


please don't stop taking birth control pills so your parents can keep taking you to snake oil salesmen for a treatment that will never fix your problem. do you know what's bad for your knees? pregnancy.

come up with some mumbo-jumbo reason why you can't keep seeing this "specialist". you can probably get out of taking the pills to your actual doctor, explaining the situation, and then telling your parents your doctor told you it would interfere with your "treatment" - they don't have to know your treatment is about your ongoing pregnancy prevention, not your knee.
posted by nadawi at 7:50 PM on May 17, 2010 [1 favorite]


Does alternative medicine really win out over Western medicine and all its fancy imaging technologies, drugs, and surgeries, even some of the time?

Not really. Because the second it can be shown to win out, it becomes Western Medicine. That's the whole point of Western medicine.

Alternative "medicine" can be actually be somewhat effective at helping with certain types of problems. Specifically, those problems most susceptible to placebo effect. That's got nothing to do with the alternative medicine and everything to do with the placebo effect, of course, but that doesn't make it any less effective. But capitalizing on placebo effects can hardly be said to be "winning out" over actual medicine.
posted by Justinian at 7:51 PM on May 17, 2010 [11 favorites]


to my knowledge, this sort of practitioner isn't bound by doctor/patient confidentiality. if you tell him about your birth control pills, be prepared for him to tell your family, or he'll tell someone else who will tell your family.
posted by nadawi at 7:51 PM on May 17, 2010


I'm not sure how to bring up this doubt either, since one of them comes with me to said appointments. I guess there's always condoms...?

Oh gosh, please do not compromise your sexual health / not-having-a-babyness so that you can take sugar pills without your parents knowing that you have sex.
posted by threeants at 7:53 PM on May 17, 2010 [1 favorite]


Response by poster: For the record, I'm sure the boyfriend will cheerfully give up sex for a few months if it means I'd heal any faster with this sort of stuff. I'm not very worried about pregnancy. I'm taking the pills just as much for pregnancy prevention as I am for skin treatment, and I'm worried that, if nothing else, the pills will have unhappy clashes with the med.

I mean, I've taken Chinese meds before and never really cared for it, but I wasn't on medication then. My parents have taken Chinese meds while on other meds (osteoporosis) and never had side effects. Maybe I'm just paranoid.
posted by Hakaisha at 7:55 PM on May 17, 2010


Does alternative medicine really win out over Western medicine and all its fancy imaging technologies, drugs, and surgeries, even some of the time?

Yeah, sure. It's very useful for some things; it's used widely for fertility treatment, for example, and there have been studies supporting its efficacy. But like that link says, "acupuncture is probably most effective for... a functional problem... rather than a structural problem."

You have a structural problem. As much as I'm the last person to dismiss acupuncture, in this case I'd wait for the MRI and pursue Western medicine.
posted by DarlingBri at 7:55 PM on May 17, 2010


I live in Korea, where acupuncture is considered a legitimate treatment for certain problems. It's even covered by the national health insurance program.

To the extent that acupuncturists claim it can help you quit smoking, help your allergies, cure your depression, etc., it's a bunch of hooey. However, to the extent that you're dealing with muscle soreness or spasms (waking up with stiff neck is what I tend to go in for), I've personally had very good luck with that, but that may be because treatment is different here. Usually, acupuncture itself comes after trans-dermal electrical stimulation of the muscles. Occasionally, electrodes are attached to the needles themselves (!).

The medicated patches we get here are called "PAS" (para-amino salicylic), which is pretty much the same as ben-gay or another topical anti-inflammatory ointment. Those have science backing them up, I'm sure.
posted by holterbarbour at 7:56 PM on May 17, 2010


Oh, the real problem here is that you're in your 20s and still acting as and be treating like a child. None of this would be an issue if you stepped up and owned your (young) adulthood. There is absolutely no reason for someone in her 20s to have to hide taking birth control pills, or to have a parent accompany insist on accompanying her to a medical appointment, or anything else along those lines.

So when you say "is acupuncture crap? Because my parents are insisting that I see an acupuncturist about my knee, insist on coming with me to the appointments, would freak out if they knew I was on the pill, and so I might have to stop taking the pill over this" the answer has nothing to do with acupuncture. The answer is: you should start asserting your adulthood by acting like an adult and being treated like an adult. Presto, this acupuncture problem no longer exists.
posted by Justinian at 7:58 PM on May 17, 2010 [7 favorites]


Why would you ask your acupuncturist about interactions between some pills he gave you and your birth control pill? That's like asking your grocery store clerk about the funny sound your car is making.

Unless you have reason to believe that they are formally trained in pharmacology, stick to getting advice like that from a pharmacist or doctor. Make sure you know exactly what's in those things before you even consider ingesting them.
posted by drpynchon at 7:59 PM on May 17, 2010


Response by poster: Justinian, that was kinda...harsh. I don't feel like having an active sex life is anything criminal, but my parents disagree, and if they're the one currently footing all my medical bills (ranging from this Chinese med, even if it's useless, to possibly taking me to Taiwan to get accelerated, although not free and possibly very expensive, medical care), I'm probably not in the position to start screaming fights with them about my sex life.

If, after a few sessions I feel like this is absolutely useless, I can put my foot down and refuse to go. I'm asking here right now because I want to poll others to see if there's even any merit possible in this idea, not because I want to advertise that I'm a child.
posted by Hakaisha at 8:02 PM on May 17, 2010 [2 favorites]


Ok, after this I'll be done. Listen to Justinian. And don't give up sex for some pills which may or may not work, and may or may not harm you in some other way.
posted by too bad you're not me at 8:02 PM on May 17, 2010


I'm an American girl raised in the military with instant access to Western Medicine who's best friend happens to be a Chinese girl raised on Eastern Medicine.

I think I have a pretty open mind about holistic and alternative medicines. I use Valerian Root for my anxiety and I used yoga to lose the baby weight. That said, if I have a headache I take Advil, my kids get all their vaccines, and if they're sick I go to the doctor. I'm dealing with some issues with my health, and my first steps will be visiting my doctor. Once I've exhausted all those possibilities then I may seek an alternative opinion.

IMO Medical Science has made leaps in the last few decades, so many that I wonder what we still don't know. There is so much still unexplained. If sticking needles in specific parts of a person's body helps ease that person's pain, then I say great. If you aren't afraid of needles and you've researched the side effects then go for it. If it helps you then you're in less pain. If it doesn't help at least you know you explored every option.

P.S. I wouldn't take the pills without at least talking to a Pharmacist. Honestly, if I was on any meds I wouldn't be taking anything else at all. That's just me.
posted by TooFewShoes at 8:02 PM on May 17, 2010


it's used widely for fertility treatment, for example

Not a credible source. No citations, and draws a false equivalence between time spent receiving legitimate medical training and time spend pursuing the wooiest of woos. The site also assumes that acupuncture works and tries to shape non-existent evidence to support it (modern science can't explain "how it works" because it doesn't work). OP, please don't get medical advice from some crackpot's vanity/splog site.

The medicated patches we get here are called "PAS" (para-amino salicylic), which is pretty much the same as ben-gay or another topical anti-inflammatory ointment. Those have science backing them up, I'm sure.

No. PAS is an antibiotic. The science says something else entirely. OP, again, only seek medical advice from licensed and accredited medical professionals.
posted by Inspector.Gadget at 8:06 PM on May 17, 2010


I guess there's always condoms...?

Yeah, you should be using those already, regardless of what medications you are on. Don't stop the birth control, disclose everything to your actual medical doctor, and follow your actual medical doctor's advice regarding everything.
posted by The World Famous at 8:06 PM on May 17, 2010


TooFewShoes' post is mostly handwaving nonsense, I'm sorry to say. Being "open-minded" means considering real evidence, not presupposing that things work because someone is selling them.
posted by Inspector.Gadget at 8:08 PM on May 17, 2010 [1 favorite]


I'm asking here right now because I want to poll others to see if there's even any merit possible in this idea, not because I want to advertise that I'm a child.

Which I addressed in my first comment. If you have a structural problem with your knee, acupuncture will do somewhere between "nothing" and "nada" to help with the structural problem. It may temporarily relieve some discomfort. But walking three times widdershins around your house naked under a full moon might help relieve discomfort if you believed it would work.

As to the second point; there was a whole heck of a lot of information in your question that has nothing to do with acupuncture, so I guess I just assumed you put it in there for a reason.
posted by Justinian at 8:09 PM on May 17, 2010


You should also keep in mind that by asking this question here, the answer is sort of self-selecting. MeFi will skew very heavily to the left in Liberal vs. Republican, and very heavily towards science in "Clinical Trials or GTFO" vs alternative therapies.

Genuinely, I am a fan of western medicine. I just don't dismiss other options when western medicine has failed me.
posted by DarlingBri at 8:18 PM on May 17, 2010 [1 favorite]


Acupuncture has been practiced for at least 2000 years. It helped my Dad to stop smoking after nothing else worked. Acupuncture has also helped with my asthma.

So yes, acupuncture works. It just takes a little longer than Western medicine.
posted by KokuRyu at 8:22 PM on May 17, 2010


Mod note: few comments removed - stop making facile jokes please
posted by jessamyn (staff) at 8:29 PM on May 17, 2010


So yes, acupuncture works. It just takes a little longer than Western medicine.

This statement is simply not born out by the evidence, and in fact contradicts any reasonable summation of clinical trials so far performed.
posted by Inspector.Gadget at 8:37 PM on May 17, 2010 [7 favorites]


There have been some fairly dumb comments in here - obviously the OP is asking if acupuncture works beyond the placebo effect, and some of the comments don't demonstrate anything more than that it might have been a placebo.

The evidence for acupuncture is reviewed in Trick or Treatment. As I recall, there's some evidence that it might help with knee problems, but you'd have to take a look at the book.

Even if it's useless, it won't interfere with birth control pills - those work through a hormonal mechanism that will be totally unaffected by any nerve or muscle stimulation that acupuncture might trigger.

Finally, I have to agree that you have bigger problems if you're in your twenties and aren't assertive enough to tell your parents that they can't dictate your medical treatments, to say nothing of following you to your appointments. If you can't see that it's irrelevant that they pay for treatments THAT YOU DON'T WANT, that that doesn't actually give them leverage over you, then you have some growing up to do.
posted by Dasein at 8:43 PM on May 17, 2010


A whole lotta crazy shit has been practised for thousands of years; doesn't make it right. Look at it this way, acupuncture is unlikely to make your knee (or anything) worse.

Be very careful about taking alternative, especially chinese, medicines in pill form. Supplements like this are not regulated to anything approaching the rigor of "real" medicine, and the idea that natural=good is a fallacy. Some of these medicines can have strong contraindications with other pills (not just birth control), and can also put a very heavy load on your liver and/or kidneys.

Worst case scenario: take the needles, not the pills. Expect little to no improvement.
posted by smoke at 8:55 PM on May 17, 2010 [1 favorite]


Response by poster: I think I'm coming off as a little defensive in this thread, and I apologize; I realize these comments are generally made with good intentions.

With regards as to why my parent accompanied me: the practitioner was known by a friend of my mom's, and neither me nor my mom know where or how to get to this place, ergo, said friend took both of us. I don't usually tend to take my parents to my medical appointments (since that's how I got my BCP in the first place), but given the above and that my knee is bothering me enough right now, it's kind of an exceptional time. Usually, even for my GP appointment and my physio I go alone with the car. Just...this time, I couldn't.

I called the pharmacy, and the pharmacist said he can't comment since he doesn't know what's in the pill. I expected that.

I called the practitioner directly and he said it's just some mix of things (lots of things) that improves circulation and gets rid of internal bruising faster, but that if I'm worried, I don't have to take it.

As for why I didn't protest the pills at first...I honestly just forgot in the moment.

Thanks for everything, everyone. And Justinian, I apologize for snapping at you.
posted by Hakaisha at 9:09 PM on May 17, 2010


I called the practitioner directly and he said it's just some mix of things (lots of things) that improves circulation and gets rid of internal bruising faster, but that if I'm worried, I don't have to take it.

Well, OK, but why ask the snake oil salesman whether the snake oil works? That he capitulated so easily is proof positive that his whole set-up is bullshit. He's a quack. Don't waste a second more with him and his fakery.
posted by Inspector.Gadget at 9:11 PM on May 17, 2010 [2 favorites]


True story - take it for what it's worth:

At the end of the Vietnamese war, a high ranking official who was a veterinarian in South Vietnam fled to the US to start a new life. In order to be licensed to practice as a vet in the US he enrolled at a good university in their vet program and became good friends with our vet.

Our vet, being inquisitive got to talking about using acupuncture to treat animals and the visiting vet volunteered to demonstrate. We were offered the chance to have our cat treated as he was suffering from multiple illnesses and the prognosis was not good.

Aside from having to live on a diet of tomato juice and cottage cheese because of his problems dealing with fat and protein in his diet, he took nitro pills for his heart along with five other pills for various and sundry things every day. His coat was dull, his eyes weepy, and he was becoming very lethargic (I know, tomato juice and cottage cheese might affect me that way too.)

Long story a little less long, following three treatments the cat went off all medications and lived a happy energetic shiny-coated clear-eyed four years eating regular cat food.

Some will say the medicine and diet were what was doing the cat in but our vet was an honors graduate of veterinary school and had (still has) an excellent reputation state wide.

The cat never once believed in a placebo effect.

True story
posted by leafwoman at 9:11 PM on May 17, 2010 [2 favorites]


Response by poster: Er, I meant to say: I went along because I figured poking needles at best might help the pain and at worst won't do anything. The problems with pills conflicting actually didn't occur to me until it was close to when I should take my BCP.
posted by Hakaisha at 9:11 PM on May 17, 2010


Clarification/correction: Although the medicated patches we have here in Korea are indeed called "PAS", and the name is derived from para-amino salicylic acid, the ones I have here contain menthol and methyl salicylate, which IS the same stuff as Bengay. I'll retract my assertion that science backs it up its efficacy as an analgesic.
posted by holterbarbour at 9:16 PM on May 17, 2010


Mod note: comment removed - please take conversation with the OP to email, this is not an anonymous question. go to MeTa if you object to any and all acupuncture questions
posted by jessamyn (staff) at 9:21 PM on May 17, 2010


Wow, this thread is kind of ridiculous.

Anyway, with this sort of question Wikipedia is your friend. The money quotes,

The development of the evidence base for acupuncture was summarized in a review by researcher Edzard Ernst and colleagues in 2007. They compared systematic reviews conducted (with similar methodology) in 2000 and 2005:

"The effectiveness of acupuncture remains a controversial issue. ... The results indicate that the evidence base has increased for 13 of the 26 conditions included in this comparison. For 7 indications it has become more positive (i.e. favoring acupuncture) and for 6 it had changed in the opposite direction. It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.[2]"...

There is conflicting evidence that acupuncture may be useful for osteoarthritis of the knee, with both positive,[88][89] and negative[90] results. The Osteoarthritis Research Society International released a set of consensus recommendations in 2008 that concluded acupuncture may be useful for treating the symptoms of osteoarthritis of the knee.[91]


If you want to read more follow the references in the article.

If I were you I would get the acupuncture. It is quite safe, and there is a lot of evidence that it helps in pain relief which is probably something you need right now.

As for the pills, I would just ask the TCM doctor who gave them to you to right down what is in them and then Google the ingredients.
posted by afu at 9:48 PM on May 17, 2010 [1 favorite]


There's a general placebo affect, which to the extent that it exists at all is a function of how the patient feels. If the patient is overall positive and upbeat, then in certain cases it means that certain kinds of injuries will heal faster.

If a patient takes sugar pills but thinks they'll help, it will help him feel positive, and thus healing can genuinely be (a bit) faster. In principle acupuncture can do the same thing -- but only for people who believe in it.

But it's critical to note that the pills, or acupuncture, themselves aren't doing a damned thing besides affecting the state of mind of the patient.

There's a more specific placebo effect having to do with pain relief. There are well-known cases where sugar pills have yielded astounding pain relief, and for a long time no one knew why. (I've experienced that myself. When I was in high school I broke my arm, and it didn't hurt at all. It just went numb. It only started to ache after a couple of hours.)

About 35 years ago some researchers discovered a class of hormones known as "endorphins". Endorphins can be released by the pituitary, and they have numerous affects all over the body, because there are receptors for them all over the place. They're part of the "fight-or-flight" system, for instance. One of the big things the endorphins can do is relieve pain.

It was eventually determined that the morphine (and the other opiates to a greater or lesser extent) is an analog of the endorphins, and it stimulates the natural receptors which are in place to respond to endorphins.

(There's a drug called Nalaxone which was developed for treatment of heroin addicts and opiate overdose. It binds to the same receptors, and will displace heroin and/or morphine, but it doesn't stimulate the receptors. They use it in hospital emergency rooms. When someone comes in with a heroin overdose, they give him a shot of Nalaxone and he's instantly on the ground, and in fact if he's an addict he'll be feeling opiate withdrawal symptoms. A clever experiment with patients who had just had wisdom teeth extracted showed that in cases where a placebo injection had caused pain relief, a subsequent shot of Nalaxone would bring the pain back to its previous level. The supposition was that the placebo pain relief was caused by endorphins, and Nalaxone was counteracting that.)

Which brings me to the point: it's been shown that acupuncture can sometimes cause endorphin release, leading to pain relief. Some researchers think that this is more likely if two needles are inserted and a low-voltage alternating current is run between them. It doesn't always happen, though.

And while endorphins are really good at relieving pain (they're sometimes referred to as an "endogenous opiates") it doesn't do anything at all about long term healing of physical injuries. Nor does it cure cancer, nor does it cure any diseases, nor in fact do much of anything permanent. All its effects are temporary.

If accupuncture works, and causes an endorphin release, the result is about the same as a codeine pill -- except that the codeine is more reliable.
posted by Chocolate Pickle at 11:03 PM on May 17, 2010 [5 favorites]


(I see that my editing of the above comment was a bit strange. I didn't take any sugar pills when I broke my arm. But it did go numb, and years later when I read about the endorphins I came to the conclusion that that was why I didn't feel any pain.)
posted by Chocolate Pickle at 11:05 PM on May 17, 2010


And I spelled Naloxone wrong.

(My kingdom for a five-minute editing window!)
posted by Chocolate Pickle at 11:09 PM on May 17, 2010


Just speaking up in favor of acupuncture. I've used it for joint pain and bronchitis. I found it to be very effective. I've read the scientific literature, there seems to be mixed results for it efficacy overall. One reason for this is that it is really difficult to develop a placebo for the control. (Like sugar pills in drug trials) You either get stuck with a needle or you don't. So I say go for it, it can't hurt while you wait for an MRI.
posted by Maude_the_destroyer at 11:13 PM on May 17, 2010


Acupuncture has been shown in many clinical trials to work about as well as treatment with a placebo. So it's fair to conclude that acupuncture treatment is in fact a form of placebo.

The odd thing about placebo treatments is that they can work quite well even if the patient's rational opinions about them are negative. If the showbiz and woo-woo involved is sufficiently engaging, it seems to bypass your rational, critical faculties in much the same way as skilfully-designed advertising can.

Therefore, if somebody else is happy to pay for your placebo treatments, and you're not using them as a substitute for known-effective treatments for joint injuries (such as icing to reduce swelling, rest to avoid compounding the injury, elevation to minimize fluid buildup at the injury site, and keeping the joint continuously warm once it's showing no further tendency to swell, using an external support that makes it feel better, not worse - brace > tape), it may actually do you some good.

Ligament and tendon injuries short of complete rupture do actually heal - they're just grindingly, achingly, unreasonably slow to do so, and frustratingly easy to re-injure. Take it easy as much as you can until you don't hurt any more.
posted by flabdablet at 11:16 PM on May 17, 2010


This statement is simply not born out by the evidence, and in fact contradicts any reasonable summation of clinical trials so far performed.

It worked for me, and it worked for my father. How is that not evidence?
posted by KokuRyu at 11:25 PM on May 17, 2010


Kokoryu, almost everything that's ever been promoted as a cure for anything has most likely worked for somebody, sometime. The point of clinical trials is to make it possible to discover, with confidence, the probability that what's being tried will also work for some randomly-selected member of the public.

It's usually not reasonable to attach confidence to probability numbers derived from the assertions of small numbers of self-reported incidents. The fact that you and your father both consider that acupuncture worked for you doesn't actually say enough to be useful about the probability of it working for Hakaisha; your own experiences are in fact not evidence it's reasonable to apply to her case, regardless of the degree to which they shape your own opinion about your own case. They're simply not numerous enough; their information content doesn't rise sufficiently high above background noise.

You say it worked for you and your father; fine. I know several people who have tried acupuncture, acupressure, "laser acupuncture", moxibustion and assorted other treatments predicated on qi flow and blockage, which have apparently done precisely squat. Which of us holds an opinion that is "right"? Only well-conducted double-blind studies have a hope of answering that question.

The best available clinical evidence says that acupuncture is no more effective than placebo. I repeat that this does not mean that acupuncture is ineffective, since all placebo treatments are well known to be somewhat more effective than no treatment at all.

Personally, I would not be putting it high on my list of things to try. Presumably, you still would. Which gives rise to a possibly interesting question: are there well-conducted studies of the extent to which people's confidence in any given treatment is shaped by the attitudes of family, friends, personal acquaintances, advertising and media, rather than the outcomes of applicable clinical trials?
posted by flabdablet at 12:18 AM on May 18, 2010 [1 favorite]


If it's of any value, I do seem to recall having read a couple of studies a while back stating that, while acupuncture was shown to have an effect, it doesn't matter where the acupuncturist stuck the needles. In other words, it had an effect, but it was a placebo effect.

Take that for what you will.
posted by DoctorFedora at 12:57 AM on May 18, 2010


Here is a well argued rant against bad acupuncture studies.

I had several injuries that my doctor said would take about six months to heal. Around month four, I was getting really pissed off and wanted relief from the injury. I started looking around for acupuncture or some alternative measure that would fix the injury. My doctor wisely told me to wait it out, and lo and behold, two months later I was better. If I had gone to a chiropractor or acupuncturist at month five, I would be dead convinced that they had healed my injury. This is exactly the kind of wrong conclusion that well-designed (blinded, and with sham treatments) clinical trials are designed to avoid. It is also the bread and butter of alernative medicine practitioners, who love to treat mystery pain but aren't so good with HIV.
posted by benzenedream at 1:11 AM on May 18, 2010 [4 favorites]


is there a planned parenthood in vancouver you can call about possible interactions with the pill? those people know everything
posted by 5_13_23_42_69_666 at 1:18 AM on May 18, 2010


The comments here categorically stating that acupuncture has no effect beyond placebo are really overstating the evidence.

This looks like the one of the best and most recent review articles,

Acupuncture: Its Evidence-Base is Changing

The effectiveness of acupuncture remains a controversial issue. The aim of this article is to evaluate trends over time in the development of the evidence-base of acupuncture. A comparison of two series of systematic reviews was conducted. The first related to the evidence-base in 2000, the second related to 2005. Both employed virtually the same methodology and criteria for evaluation. The results indicate that the evidence base has increased for 13 of the 26 conditions included in this comparison. For 7 indications it has become more positive (i.e. favoring acupuncture) and for 6 it had changed in the opposite direction. It is concluded, that acupuncture research is active. The emerging clinical evidence seems to imply that acupuncture is effective for some but not all conditions.

posted by afu at 1:52 AM on May 18, 2010


It worked for me, and it worked for my father. How is that not evidence?

And thus have generations of quacks been kept in business. The question is not whether a given treatment can be shown to have worked in isolated cases. The problem is that doing nothing will also work in isolated cases.

The question, therefore, is whether the treatment works better than doing nothing. Merely pointing to individual cases where the treatment worked tells us nothing at all.

(And that's why anecdotal evidence is useless.)
posted by Chocolate Pickle at 2:09 AM on May 18, 2010 [2 favorites]


Acupuncture has been practiced for at least 2000 years.

And they've been wrong for 2000 years.
posted by obiwanwasabi at 2:20 AM on May 18, 2010 [2 favorites]


Response by poster: Thanks, everyone.

I apologize again for the defensiveness I may have exhibited upthread; it hasn't been a good day. I cite general stressed-out-ness as an excuse, if not a reason, as to why I even forgot about pills possibly clashing. And although it may not sound like it, I have considered (most of) the stated points in some way or another--I have been, and probably will always be, a skeptic of alternative medicine. I guess I just...wanted some hope during a very trying day.

A brief update, if anyone really cares: I did end up eating 2 doses of the 3-per-day pills (because I actually wrote this question after I ate the second dose and realized, oops, it's only 1.5 hours until my BCP dose). I've gotten a feeling of bloatedness and a very mild headache that went away after about 15 minutes or so. My stomach feels a little weird, but that could just be worrying.

Given the timestamp of said comment is an hour which I totally should be asleep, either the pills or my general anxiety about said pills (and treatment overall) is enough to keep me up, so I think I'll cancel my next appointment anyway, irrespective of whether my parents think I'm being unnecessarily stubborn or not. I guess, even if this works, if I don't trust it to the point I'm worrying this much, it's not worth the anxiety to do it.

Thanks again, Metafilter.
posted by Hakaisha at 3:27 AM on May 18, 2010


I'm about as sceptical as they come, but my mother (a western medicine doctor) recently told a story to me about a friend of hers who had an appendectomy in China where they used acupuncture for pain relief during the procedure. She was allegedly conscious throughout the operation but felt nothing, similar to an epidural I guess.

Is this common/possible?
posted by knapah at 3:47 AM on May 18, 2010


So, what have the physiotherapists said to do? Have you done it? What are they doing in their appointments?

When you fuck up a heavily used and weight-bearing part of your body, it takes a while to heal. Having over-tight muscles in your knee hurts a lot and can make it clicky and achy and excruciating on occasion. There's no insta-cure for that but a gentle-handed person playing with it for a while will make it feel better, needles or not.
posted by geek anachronism at 4:22 AM on May 18, 2010


I had a very similar injury to yours--had to use crutches to get to the bathroom! I kept the affected leg elevated and iced almost 24/7 for three weeks while taking ibuprofen 2X a day. (I took the anti-inflammatory Voltarene for the first three days, and the pain abated quite a bit.) After three weeks of rest and icing, my knee totally healed, and I am much older than you are. I haven't had a scintilla of pain after resuming heavy-duty daily walking and hiking.

Okay, while you are resting and icing your aching knee religiously without horsing around with the boyfriend, look up the Cochrane Collaboration. This is a non-political international research group cited in Trick or Treatment. Over ten thousand science research volunteers examine the best organized studies of all kinds of alternative treatments. There's a lengthy section on acupuncture. Much of it is bunk beyond the placebo effect.

btw. I had MRI, X-ray. Nothing definitive. Suspected meniscus or lateral collateral ligament tear.
posted by Elsie at 4:25 AM on May 18, 2010


How about we stop citing anecdotal evidence and Wikipedia, and actually rely on, y'know, science. If you were to ask your doctor about this, he would probably turn to UpToDate for an overview of the state of the medical consensus on the subject. You probably don't have access to it from where you are, so I'll cut and paste and link you the papers they're citing: (Self-link ahoy)

(If you want full-text, MeMail me and I'll send you the full article)

Despite the difficulties discussed above, a number of trials have compared active acupuncture with a sham control procedure that allow evaluation of the efficacy of acupuncture compared with placebo.

Low back pain — Well-designed clinical trials have found that both acupuncture and sham acupuncture are significantly superior to a control intervention for low back pain. (cite)

Knee osteoarthritis — Rates of success were similar for acupuncture and sham acupuncture and greater than with conservative therapy (53 and 51 versus 29 percent). Two other high-quality randomized trials that compared acupuncture with sham acupuncture found some added benefit with acupuncture, however some blinding breakdown appears to have occurred in these trials. A meta-analysis of randomized trials of acupuncture for knee osteoarthritis concluded that acupuncture may have had some additional measurable benefits compared with sham acupuncture but that the differences were too small to be clinically relevant(cite)

Migraine — Reduction in moderate-to-severe headache days were the same in the acupuncture and sham acupuncture groups, both of which were greater than in the waiting list control group (2.2 and 2.2 versus 0.8 days). (cite)

Summary — These studies suggest that there is little difference in the effects on pain between acupuncture and sham acupuncture. A meta-analysis of randomized controlled trials of acupuncture for pain that included both sham acupuncture and no treatment arms (three-armed trials) found that the superiority of acupuncture over sham acupuncture, if real, appeared to be too small to be clinically important.
posted by Mayor West at 4:44 AM on May 18, 2010 [1 favorite]


Response by poster: I didn't think it was super relevant to this post to write out what has happened to my knee, but since someone asked... (Please skip if not interested)

First week and a half from date of first injury I did nothing, figuring I just lightly sprained it as I would an ankle (although I did stay off of it as much as I could). Then it seemed like there was something really wrong, so off to the physio I went. He said my knee seems to be pretty structurally sound; might just be a mechanical thing.

Physio tends to consist of cold laser, ultrasound, electrical stimulation, and massage. Per his instructions, I started icing my knee. After about 3 weeks from date of injury, it started to slowly feel a little, little better.

Then, reinjured it playing with the boyfriend. (Rest assured it has not happened since.)

Back to icing, ibuprofen, elevating, icing, and more icing. It seem to have settled down a bit after about a week and a half from reinjury date.

I took the ice off and very carefully began putting weight on it; bit of walking around the neighbourhood after dinner. Usually I ate 200 mg of ibuprofen after, and this seemed to be okay for about two days, but once I took the ibuprofen off it stiffed and swelled up rather painfully again. Noticed a problem with someone occasionally shifting in the knee when I walked. Reported to physio (a different physio, since my original one had to take a day off. She agreed with his previous assessments, for what it's worth). Still thinking nothing is too structurally wrong with said knee, she taped my knee in the thoughts it might be a kneecap tracking problem. Knee felt worse, not better, so I took the tape off and kept on icing it.


Religious icing continued (pretty much the entire day, including when I was asleep) and painkillers. Which extended up 'til about now, in which the whole fiasco with the Chinese medicine guy came up..

Anyhow, at this point I'm nervous about the pills and the overwhelming opinion on acupuncture seems to be that it's harmless, but little better than a placebo, so... I guess I'll just stop going.
posted by Hakaisha at 5:24 AM on May 18, 2010


In reference to leafwoman's reply about the cat:

Is There a Placebo Effect For Animals?
posted by Laura in Canada at 5:42 AM on May 18, 2010


But walking three times widdershins around your house naked under a full moon might help relieve discomfort if you believed it would work.

I'm game if you are.
posted by widdershins at 6:28 AM on May 18, 2010 [2 favorites]


A number of traditional health care providers recommend accupuncture. It's one of the few non-traditional/non-western medicines with any credibility. I got nothing from it; a friend reports better success.

I would not take pills of any kind unless I knew what was in them.

My accupuncturist was certified, but also pushed to treat more than requested, and recommended additional remedies. I've had the same experience with chiropractors. This has seriously reduced their credibility for me.

I'm willing to believe that western medicine can and should investigate other treatments. My insurance doesn't cover acc., so I stopped going when I got no pain relief.
posted by theora55 at 7:27 AM on May 18, 2010


I don't know about acupuncture, but one of the important factors to keep in mind is what the end result of the western medicine solutions will be. In my case I fought for the PT, I fought for the MRI, and in the end the PA told me I could have surgery to repair the ligament now or wait. I chose to postpone surgery as long as possible through PT/yoga/stretching and am glad I did. If acupuncture would've helped with the pain to help the short term recovery, I'd have added that to my arsenal, as surgery was my least favorite of the options. Your injuries, and mileage, of course vary.
posted by ldthomps at 8:35 AM on May 18, 2010 [1 favorite]


acupuncture helped a lot with the pain i had from carpal tunnel in college. my parents are super into eastern medicine because they don't trust western medicine though, and some of the things they've been told to do by their practitioner i find a little fishy... YMMV

by the way, i'm also a (mostly) taiwanese woman who doesn't want her parents to know she's on bcp, so you aren't alone, though i'm in my mid20s and have my own insurance and stuff, so i just wanted to point out that this is a cultural thing and people being judgmental about the whole "act like an adult, who cares if your parents know that you're having protected sex" should try to be a little more understanding of our parents' generation's views on sex and birth control.
posted by raw sugar at 10:45 AM on May 18, 2010


I've had acupuncture for back pain and it was very effective. (Whether the effect was placebo-related or not is a question I can't answer.)

Though it's hard to imagine how acupuncture could help injured ligaments, if getting acupuncture helps your knee feel better while you're waiting on the MRI, why not do it? As they say, it doesn't matter if a cat is black or white as long as it catches mice. Good luck.
posted by hungrytiger at 2:03 PM on May 18, 2010


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