Archive for tag: chiropractic

Why There is No Such Thing as Sham Acupuncture

I get really annoyed when I'm reading the results of a scientific study about the effectiveness of acupuncture, and the author concludes that actual acupuncture was "not significantly more effective than sham acupuncture." What they seem to be saying is that acupuncture is not effective at treating X condition. What they are actual discovering is that needle insertion almost anywhere in the body will have an effect on the body's condition, often providing relief from X condition.

I like this part. As Dr. Kwon always told us in Point Location class, you can still help the patient even if you don't stick the needle in the exact acupoint. This realization saved my sanity on more than one occasion when trying to palpate and count thoracic vertebrae to locate the oh-so-important points of the Governing Vessel running up the spinal column. It's supposed to be located at T6, but T7 will be good enough? Awesome. Thank you for your flexibility, ancient wisdom.

So, back to the studies that drive me nuts. Here's how they commonly shake out:

Exactly 100 patients were studied for chronic knee pain, with 25 receiving no treatment, 50 receiving actual acupuncture (inserting needles at specifically proscribed points), and 25 receiving sham acupuncture (inserting needles randomly in the body). Guess what? The patients receiving no treatment did not experience improvement. The patients receiving actual acupuncture reported a 50% improvement, and those receiving sham acupuncture reported a 45% improvement.

I call that good news. The study concludes, instead, that actual acupuncture is not significantly more effective than sham acupuncture at treating knee pain. Wrong. What they actually did is prove Dr. Kwon right -- not that he needs any additional validation, seriously -- that even when needles are inserted at the "incorrect" location, acupuncture still has therapeutic benefits for the patient. Is the goal of an acupuncture treatment for knee pain simply to eliminate the knee pain? Not exactly.

Any time acupuncture happens, that patient's body experiences a shift in energy. We can usually feel a difference in the person's pulse after treatment, compared to before. The qi (energy) has moved, and in western terms, circulation usually improves. Sure, the knee pain is improved, but the patient might also sleep better than usual that night, awake with more energy than usual the next day, or even notice that a new head cold has resolved overnight.

Were these other effects coincidental? Maybe, but probably not. Any acupuncture is better than no acupuncture, and the results of studies comparing no treatment, sham acupuncture, and actual acupuncture will often reveal this truth. In fact, this little "secret" is why I'm not against other practitioners doing acupuncture on patients. We've all heard the buzzword "dry needling," which is when say, your physical therapist needles your arm when your elbow isn't healing as nicely as you'd like. I know several chiropractors who have completed the 100-hour certification in acupuncture, and they can often be seen sticking some needles into a sore back muscle.

Some acupuncturists are completely against this concept of non-acupuncturists needling patients, but I'm pretty much OK with it. I know the patient is probably receiving some benefit regardless of whether or not the needle goes in at an exact acupoints. What's important to me is that the patient is aware that dry needling or someone sticking some needles in where it hurts is not all that acupuncture has to offer. Those techniques have benefits, but not the full array of benefits that needling specific acupoints on specific meridians can produce.

So, if you know someone who's been needled before and didn't experience a great symptom reduction, it's still worth their time to try acupuncture from an acupuncturist. Crazy, I know. It's not that other providers are doing anything wrong; it's just that they aren't receiving the more complete system of treatment via acupuncture that we acupuncture students use.

Is Chinese Medicine Better than Western Medicine?

Is Traditional Chinese Medicine (TCM) better than conventional western medicine? Would a provider of oriental medicine and one of the ayurvedic traditions treat a patient the same way? Do naturopaths diagnose the same medical conditions as chiropractors do? 

The answer to each of these questions is probably a solid "sometimes."

2014-02-04_booksThe point is that one medical system is not necessarily better than another. Each of the above-mentioned categories exist as an entire medical paradigm, complete with its own unique way of diagnosing and treating an array of health-related issues. Did you know that your chiropractor could give you a pelvic exam, ladies? Did you know that your naturopathic doctor could give you a spinal adjustment? And what about those herbs? Why do western naturopaths have a different materia medica than we students of oriental medicine do? Is slippery elm awesome? I'll never know. And neither did the ancient Chinese, because it didn't grow there.

We've all heard that there is competition between the students, all graduating in Lombard at the same moment, as they get dumped out into a market that becomes more and more saturated every day. We all feel it from time to time -- a student of acupuncture who assumes her classes are 10,000 times more difficult than that of the massage student down the hall; the chiropractic intern who thinks he's way more important than any acupuncturist in the clinic; or the naturopath who points out that she can do everything a chiropractor can do and more!

Are they all right? Or are we all just egotistical jerks? Again, the answer is an unreassuring "sometimes."

2014-02-04_elmWhat I'm learning at NUHS is the unmistakable value of the various medical systems. My friends ask me if I scrape my tongue daily or if I've dabbled in oil pulling. No and no, I tell them. That's from the ayurvedic traditions of India, not the ancient Chinese medicine that I'm studying. Does that mean I don't think these practices have merit? Nope. I'm sure they do...I'm just not learning about them in my program. I've actually tried oil pulling, but I'm fairly certain I did it wrong, and I swallowed, which I learned later defeats the point. Whoops. I also love essential oils, and I frankly have no idea which tradition claims them.

What are we learning in the MS in Acupuncture and Oriental Medicine program at NUHS? I've memorized hundreds of acupoints -- well, a good chunk of them anyways -- and dozens of Chinese herbs, I finally realized that ginger and garlic are making it worse when I have a heat invasion, and I'm piecing together why a point on my inner wrist is so helpful for my heart palpitations. I finally learned how to spell "ayurvedic," and I hope I can pronounce "naturopathy" correctly most of the time these days.

2014-02-04_herbsMore importantly, I'm also learning that the "competition" chatter has a much bigger bark than bite. We students of oriental medicine like you students of chiropractic, naturopathy, and massage therapy, and I feel fairly confident assuming that you guys like us, too. In fact, the sheer number of students who dual enroll in more than one program at NUHS proves this point for me.

I value what the other practices and traditions bring to the overall health and well-being of the patient. I don't expect that I'll offer a patient the same knowledge and services that an ND or an MD does; I'll offer them something almost entirely different in fact. And that, my friends, is the point. We have a better shot at helping people if we work together, value each other's contributions and specialties, and keep an open mind to things that might sound crazy at first. Energy crystals...what?!