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Sat Jun 13 18:21:56 BST 2009

There is probably more than one form of sham acupuncture - the form I was
referring to consists of "fake needles" which retract when put in contact
with the skin so not penetrating it but appearing the same to the patient
(and possibly the operator I'm not sure on this point) but obviously there
will be some pressure exerted to push the fake needle back inside its
sheath.

 Again it comes back to what are you trying to control for with your control
(position as per genuine acupuncture but in the wrong place, or skin
penetration with false needles in which case you may produce acupressure.

 At the end of the day even "objective science" is only as good people
believe it to be. In my own opinion,  I've seen enough objective science to
suggest that the patient's brain activity implies that they are not
experiencing as much pain as they otherwise would be.  Besides we know low
levels of neuropeptides associated with depression also increase perception
of pain (hence the use of antidepressants in chronic pain) if the patient
feels better as a result of their treatment they may well perceive less
pain, I'm not sure if that makes it snake oil or treating the patient
holistically:-).

Thomas Riley

2009/6/13 LouIs N. Molino, Sr. <LNMolino at aol.com>

> Ok I understand the why of not allowing sham treatments in lieu of true EBM
> etc. But if somelike acupuncture make me feel better and does not cause harm
> nor interfere with the true treatment process what is the harm?
>
> Is this not akin to prayer which many believe in?
>
> Moreover of the above is in play what right does the medical profession
> have telling a Patient no?
>
> Do we tell Patients not to pray? I think nor.
>
> Louis N. Molino, Sr. CET
> FF/NREMT/FSI/EMSI
> Typed by my fingers on my iPhone.
> Please excuse any typo's
> (979) 412-0890 (Cell)
> LNMolino at aol.com
>
> On Jun 13, 2009, at 9:35, Richard Wigle MD FACS <rlwigle at yahoo.com> wrote:
>
>  while I'm no expert on the subject I would think that sham acupuncture, at
>> least for terms of testing, would consist of insertion of acupuncture
>> needles at nontraditional sites rather than pressure at traditional
>> acupuncture sites (for those of us who remember the 60s this was called
>> "acupressure")
>>
>> When I was a fellow we had a visiting professor who in his real life was
>> chairman of surgery in Beijing and he and I became quite friendly. I helped
>> him with the-then modern-audiovisual portion. His presentation, given to a
>> large number of scoffers, was on acupuncture anesthesia. I'm a firm believer
>> in the placebo effect, and to be fair there was some sedation involved with
>> the procedure he presented, but there is no way you could placebo or sedate
>> me enough to remain awake and still have my thyroid taken out. I have to say
>> that this individual was no rabid supporter of the then Chinese Communist
>> government nor an exponent or exporter of their policies. In other words I
>> don't think this was a propaganda piece, I had a year to get to know him.
>>
>> As an aside he told me that even as a full professor and chairman he still
>> had to see general clinic once a week and when I asked him what was most
>> common thing he saw he said "lower back pain to get off of work". guess it's
>> not quite the workers paradise portrayed.
>>
>> I think the thing that has to be separated here is whatever factor is from
>> the acupuncture itself from the "interrupting or changing the flow of yin
>> and yang"- not a whole lot different from channeling life forces or moving
>> life energy, or again for that matter, healing hands.
>> all traditional therapy's whether valid or not have to be separated from
>> the New Age nonsense that always seems to come with them. We do have to keep
>> an open mind, not a vacuous mind. Remember that toxicity of the black widow
>> spider was considered to be folklore by the scientific community until 1928.
>> I am sure there is even some symptomatic relief given by Quackapractic
>> manipulation, but certainly not for the reasons they cite.
>>
>> The late, great, Isaac Asimov said, along these lines and if anybody can
>> find me the exact quote I'd appreciate it, "we have to keep an open mind but
>> crap is still crap"
>>
>> R Wigle MD FACS
>> LSUHSC
>>
>> --- On Sat, 6/13/09, Tom Riley <tom at tomriley.co.uk> wrote:
>>
>> From: Tom Riley <tom at tomriley.co.uk>
>> Subject: Re: Alternative therapies (OT)
>> To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org>
>> Date: Saturday, June 13, 2009, 7:27 AM
>>
>> At the risk of inviting trouble, surely the question is whether the
>> "sham-acupuncture" is actually a placebo and therefore there is no
>> difference between the placebo and the treatment. Sham acupuncture does
>> involve applying pressure to the skin in a particular place and may not be
>> a
>> genuine placebo, as we don't know what it is about accupuncture that is
>> meant to be therapeutic designing a true placebo becomes difficult. I'd
>> ask
>> similar questions of cholesterol lowering drugs that lower cholesterol
>> relative to an olive oil placebo.
>>
>> My anatomy lecturer at medical school was convinced that acupuncture works
>> -
>> there are small FMRI studies showing that acupuncture generates activity
>> in
>> the periaquaductal grey matter which is a region involved in mediating
>> analgesia. Additionally studies in people with nerve damage, doing
>> accupuncture in insensate areas produced no benefit. Unfortunately having
>> graduated from medical school I can no longer get hold of the references,
>> but it would seem perfectly reasonable to me that mildly stimulating
>> nocireceptors could produce some inhibition of stronger pain signals.
>> Afterall perception of pain can be influenced by an enormous number of
>> other
>> factors (fear, anxiety etc.).
>>
>> I suspect accupuncture may end up being something like phantom limb pain,
>> allodinya or RSD that was treated as nonsense for years but once the
>> mechanism is understood suddenly becomes reasonable.
>>
>> Dr. Thomas Riley
>> FHO
>> Derriford Hospital, Plymouth.
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>>
>>
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