Acupuncture Can Work, and It's Not Just Wishful Thinking
Why does acupuncture work for some and not others? Traditional Chinese accounts say acupuncture aids the flow of energy, called qi (pronounced chee), along pathways in the body. Barry Beyerstein, a professor of psychology at Simon Fraser University in Burnaby, British Columbia, dismisses that as "ancient nonsense," and many doctors agree.
Until recently, they tended to credit any benefits to the power of suggestion--the so-called placebo effect. Acupuncture treatments involve invasive needles, long sessions with a practitioner, and an aura of exoticism--all likely to provoke a strong placebo response. Last week's JAMA article, however, suggests that more is going on. The researchers studied 104 breast-cancer patients who were undergoing chemotherapy. Some were given standard antinausea medication; others got the drugs plus either electrically stimulated acupuncture or a "sham" treatment on acupuncture points that aren't meant to treat nausea. The sham group had fewer vomiting episodes than those who received no acupuncture at all--a placebo effect. But those who got electroacupuncture did better still, implying a real physical benefit.
Natural painkillers. Brain studies are beginning to show what that might be. One mapped brain activity with functional MRI and found that stimulating an acupuncture point on the little toe, used for eye disorders, triggers activity in the brain's visual cortex. "There is no question it is working through the nervous system," says Zang-Hee Cho, the study author and a radiologist at the University of California-Irvine. Other research suggests that acupuncture may trigger the release of endorphins, the body's natural painkillers, and other brain chemicals. That effect might explain how acupuncture fights nausea, say researchers in the JAMA chemotherapy trial. And Arthur Margolin of Yale University School of Medicine, an author of the August addiction study, says acupuncture activates the "parasympathetic" part of the nervous system, which has a calming effect that reduces cravings.
The new work is swaying some doubters. "I'm willing to concede that acupuncture is more than a placebo," Beyerstein says. Yet while it may offer real benefits for pain, nausea, and addiction, practitioners also tout it for many other conditions where studies are just beginning, including depression, carpal tunnel syndrome, and menopausal symptoms. "The claims are greatly overblown and oversold," says Beyerstein.
Still, most experts agree that acupuncture is safe when provided by a certified practitioner. Referrals can be found at www.nccaom.org, the Web site of the National Certification Commission for Acupuncture and Oriental Medicine, or through the AAMA, at 800-521-2262 and medicalacupuncture.org.
If you choose acupuncture, have a doctor, not an acupuncturist, diagnose your condition, and stay under a doctor's care while receiving treatments. Even Michael Smith, who is certain that acupuncture has benefited the addicts he works with, advises caution. "As a magic bullet," he says, "acupuncture is not much good."
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