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Sat Jun 13 04:54:42 BST 2009

>From Medscape Medical News

Actual or Simulated Acupuncture Therapy May Be Effective for Chronic Low 
Back Pain CME/CE
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd

CME/CE Released: 05/20/2009; Valid for credit through 05/20/2010

May 20, 2009 - Actual or simulated acupuncture therapy appears to be more 
effective than usual care for chronic low back pain, according to the 
results of a randomized controlled trial reported in the May 11 issue of the 
Archives of Internal Medicine.

"Acupuncture is a popular complementary and alternative treatment for 
chronic back pain," write Daniel C. Cherkin, PhD, from the Center for Health 
Studies in Seattle, Washington, and colleagues. "Recent European trials 
suggest similar short-term benefits from real and sham acupuncture needling. 
This trial addresses the importance of needle placement and skin penetration 
in eliciting acupuncture effects for patients with chronic low back pain."

In this study, 638 adults with chronic mechanical low back pain were 
assigned to receive individualized acupuncture, standardized acupuncture, 
simulated acupuncture, or usual care. All acupuncture groups received 10 
treatments administered by experienced acupuncturists during a 7-week 
period. The main endpoints of the study were back-related dysfunction 
measured with the Roland-Morris Disability Questionnaire (scored 0 - 23) and 
symptom bothersomeness (scored 0 - 10), evaluated at baseline and after 8, 
26, and 52 weeks.

At 8 weeks, improvements in mean dysfunction scores were 2.1 points for 
those receiving usual care, 4.4 points for individualized acupuncture, 4.5 
points for standardized acupuncture, and 4.4 points for simulated 
acupuncture (P < .001). Compared with participants receiving usual care, 
those receiving real or simulated acupuncture were more likely to achieve 
clinically meaningful improvements on the dysfunction scale (60% vs 39%; P < 
.001).

In the usual-care group, symptoms improved by 0.7 points vs 1.6 to 1.9 
points in the treatment groups (P < .001). Clinically meaningful 
improvements in dysfunction persisted in the treatment groups vs the 
usual-care group after 1 year (59% - 65% vs 50%, respectively; P = .02), but 
symptom improvements were not significantly different among groups (P > 
.05).

"Although acupuncture was found effective for chronic low back pain, 
tailoring needling sites to each patient and penetration of the skin appear 
to be unimportant in eliciting therapeutic benefits," the study authors 
write. "These findings raise questions about acupuncture's purported 
mechanisms of action. It remains unclear whether acupuncture or our 
simulated method of acupuncture provide[s] physiologically important 
stimulation or represent[s] placebo or nonspecific effects."

Limitations of this study include restricting treatment to only the needling 
component of traditional Chinese acupuncture, predetermined number and 
duration of treatments, limited conversation between the acupuncturists and 
the patients, and lack of a medical care comparison group.

"The reduction in long-term exposure to the potential adverse effects of 
medications is an important benefit that may enhance the safety of 
conventional medical care," the study authors write. "The number of patients 
who would need to be treated with insertive or superficial acupuncture 
stimulation to result in 1 person achieving meaningful improvement in 
function ranges from 5 (for short-term benefits) to 8 (for persisting 
benefits)."

A National Institutes of Health Cooperative Agreement with the National 
Center for Complementary and Alternative Medicine funded this study. Lhasa 
OMS, Inc, Weymouth, Massachusetts, donated the Seirin acupuncture needles 
used in this study. The study authors have disclosed no relevant financial 
relationships.

Arch Intern Med. 2009;169:858-866.

Open minded means being open to evidence.
  Being open minded to things with no evidence means you've let your
brain fall out.

Note: the 'open minded' defence is the classic tactic of alties. It
signals that you have no evidence and therefore no argument, but just
want to try and make the other person look bad. It's the equivalent of
saying 'can't you take a joke' to someone you've just insulted.

Acupuncture has been extensively studied, as has the 'life force' and
auras. See the James Randi Educational Foundation website, and more
importantly, follow the challenge link on the site and see what
happens when this stuff is put to the test.

I'm open minded - offer me reproducible positive studies, and
falsifiable data, and I will change my mind in an instant. Belief
should be reserved for religion, if you are that way inclined.

Fiona.

On 12/06/2009, at 6:50 PM, Lorick Fox, MPAS, PA-C wrote:

> Absence of proof is not proof of absence.
> I tend to suspect that you are right, but as it has NOT been studied
> (although there is some work comparing reports of "aura" among
> people who
> claimed to able to perceive such and it was neither consistent nor
> supportive of their claims).
>
> I therefore reserve judgment.
> I view keeping an open mind is the scientific approach.
>
>
> Lorick Fox, MPAS, PA-C
> Gianaclis Support Complex
> +20-3-448-2335 or +20-45-240-9450
> Fax +20-45-243-1191
> Mobile +20-18-230-4448
>
>
>> -----Original Message-----
>>> To: Trauma-List [TRAUMA.ORG]
>> Subject: Re: Alternative therapies (OT)
>>
>> There is no such thing as 'life energy' except the stuff that comes
>> out of defibrillator paddles (and then only when it works)
>>
>>
>
>
> --
> trauma-list : TRAUMA.ORG
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