PAPupuncture? On the rebranding of regional anesthesia as acupuncture

Acupuncture has been a frequent topic on this blog because, of all the “complementary and alternative medicine” (CAM) modalities out there, it’s arguably the one that most people accept as potentially having some validity. The rationale behind acupuncture is, as we have explained many times before, little different than the rationale behind any “energy healing” method (like reiki, for example) in that it claims to redirect the flow of “life energy” (the ever-invoked qi). The only difference is that acupuncturists claim to bring this therapeutic qi rearrangement about by sticking thin needles into the pathways in the body through which this qi is fantasized to flow. These pathways, called meridians, are just as much a fantasy as qi itself or the “universal source” that reiki masters claim to be able to channel through themselves and into believers. Contributing to the popularity of acupuncture is its mythology as having been routinely practiced for over two thousand years, a myth that was the creation of Chairman Mao, who elevated what was a marginal practice at the time to a modality that the state supported and promoted (1,2,3,4).

In addition, because acupuncture involves sticking actual metal objects into the skin rather than simply laying on hands or making magical gestures over the patient, it retains some credibility, even among doctors. It doesn’t matter that, reviewing the totality of the research, one finds that it doesn’t matter where you stick the needles or even if you stick the needles in the skin. The results are the same and indistinguishable from placebo. The inescapable conclusion is that acupuncture is placebo medicine with needles. Personally, I’d prefer my placebo medicine without needles, but that’s just me.

Yet, the studies keep rolling in, trying desperately to demonstrate that acupuncture works or assuming that acupuncture works. I wrote about one of them just last week. It was a study that purported to show that acupuncture is a useful modality for reducing breathlessness and air hunger in patients with chronic obstructive pulmonary disease (COPD). As you might also recall, I found it underwhelming. I also recently became aware of a study that I just had to write about because it builds on the results of a study I wrote about two years ago that I characterized at the time as an interesting study whose authors seemed almost willfully to misinterpret their results. This one, thankfully, is not nearly as hyped as the study from two years ago, but it is very instructive how the original misinterpreted story is leading to a classic CAM “bait and switch” applied to acupuncture. Normally, we like it when science builds upon previous results, but it’s not so great when a scientists “builds” upon an inappropriate interpretation of a study designed to legitimize quackery. Before I get to the present study, first let’s look at the original study that inspired this followup.
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