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Notparticularlyrelevantnewsbot-Acupuncture and back pain

Discussion in 'General Issues and Discussion Forum' started by Robertisaacs, Nov 23, 2007.


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    Its been a while since we discussed acupuncture. I thought this was jolly interesting so i thought i'd share


    comments?

    Regards
    Robert
     
  2. gavw

    gavw Active Member

    Hello Robert-


    You do right bringing this to the attention of the Arena.

    No time for an in depth comment at the moment, suffice to say that Ben Goldacre writes lucidly, clearly, and carries out an excellent service to the public in spreading proper understanding about science.

    We have a constant struggle, particularly in the printed press, with poorly reported medical research time after time, which does nothing but confuse the public. Newspapers do have a tendancy to portray orthodox medicine as cold and uncaring (Nasty scientists!!), and at the same time show 'alternative' practitioners in an altogether 'friendlier' light.

    Writing like this goes a long way toward countering the effects of this, but unfortunately, the coverage of national newspapers will eclipse the coverage of writing like Goldacre's, and the public may easily be mis-informed.

    Thanks for sharing Robert - Spread the word!!
     
  3. jpb63

    jpb63 Welcome New Poster

    I cannot speak to the placebo effect on treatment of chronic pain. I can, however, speak to the chronic pain that was alleviated after acupuncture treatment for recurrent Morton's neuromae in both feet. I have had four surgical procedures to remove neuromae in the past five years, two on the same spot of the same foot! Each time the surgery was successful and removed a sizable mass. The pain never left and continues to be problematic. It has caused problems in my personal life and professional career. As a last resort I went to an acupuncturist —anything to stop the pain and to help me walk. I felt relief after the first session and have walked without a limp or major discomfort for nearly four months. I have been converted into a walking advertisement for acupuncture.

    I do not discount anything that my podiatrist did. He followed protocol each time and was as frustrated as was I with the recurrence of neuroma in my feet. Orthotics help and surgery was needed. But acupuncture has given me a quality of life that I had started to tell myself was no longer possible. It was no placebo, I watched the doctor insert the needles each time.

    How it works is a mystery. I am grateful to the Ancients for their study and their persistence that still works today.:hammer:
     
  4. W J Liggins

    W J Liggins Well-Known Member

    Whilst being delighted that you are now relieved of the pain from which you were suffering, unfortunately, your experience proves nothing in the overall picture.

    If the secondary mass which you describe was identified by a histo-pathologist as consistent with a neuroma then it suggests stump neuroma rather than re-growth which is not possible in these tissues. On the other hand it may have been a bursa or some other neoplasm. If the neuromata were fully removed then the pain may have been due to some other factor. Were these other factors fully investigated?

    You say that there was definitley no placebo effect becuse you 'watched the doctor insert the needles each time'. Might that not be a placebo effect per se?

    I am open minded about the effects of acupuncture, but I think from just these few remarks that you will appreciate that there are an enormous number of variables which have to be assessed. In the wider world of medicine it is simply not possible to state 'it worked for me, ergo, it is a fully recognised treatment with an accepted rationale'. We have to show how and why it works and the best method yet arrived at is a Random Controlled Trial. Sadly, many treatments which have been shown to be efficacious on individuals, rapidly fail at this hurdle, frequently because of the placebo effect.

    To put it crudely, if patient belief were the only criteria then like the Saxons we would still be hanging dog faeces around the necks of our patients to drive out infection. It proved to be effective because by and large people recovered and therefore created a belief system.

    Having said that, I am delighted that you have recovered, but instead of appealing to your sense of superstition (the mystery of the ancients to which you refer) wouldn't you really like to know how and why the treatment worked?

    Bill Liggins
     
  5. :eek:

    You mean that DOES'NT work?!?! Dammit:mad:. Well thats my bit of holistic medicine bu**ered then. I've been doing that for years! Its good for VP's as well apparently.:p

    Regards
    Robert
     
  6. Peter

    Peter Well-Known Member


    Tell that to Port Vale fans, they all do that!
     
  7. gavw

    gavw Active Member

    One anecdote deserves another-my father tried acupuncture for chronic back pain, and it didn't work.
     
  8. Shane Toohey

    Shane Toohey Active Member

    Thanks Robert,

    Every so often Robert starts up a thread on acupuncture and having used this modality for 16 years I usually rise to the bait and make a few comments
    (obviously I've not altered Robert's opinion yet).

    Well Robert you wrote:
    Some time ago during the "Cultural Revolution" Chairman Mao had umpteen thousand "bare foot doctors" trained up in acupuncture. Acupuncture changed from an art for which practitioners trained under masters for many years learning to palpate for tender points in the body and "energy balancing" points on fairly vague meridians (alternative spelling) which were only based on generalized gross anatomy into a rote learnt system of very specific points and meridians aligned with the modern anatomical skeletal system. The "real" ancient Chinese stuff (not as correct as you'd imagine) has survived in many places and emerging in the west. The very dogmatic TCM (Traditional Chinese Medicine) guys (who have been caught up in the point specificity system developed for mass education) will, I think, not prevail under scientific scrutiny.

    There is no doubt that the body is aware consciously and unconsciously of real needles being inserted into it. "Sham" acupuncture is becoming less favoured as a research method as western medical acupuncturists practice without meridians and some such as Felix Mann go about breaking all the rules. It is not surprising that "sham" acupuncture works about the same as TCM.

    What is today called "dry needling" and used for the deactivation of myofascial trigger points is still a acupuncture of trigger points as was done in the past. I just think that modern anatomy and myotomal charts have made it a lot easier to practice.

    So, I'm still very happy getting better than an enhanced placebo effect in my chronic pain patients, using this modality in combination with some manual therapy and orthotic therapy. Quite a complementary mix.

    Cheers, guys

    Shane
     
  9. :D

    You love it.

    I'm going to see martin harvey at a biomechanics get together in jan and we're going to have a play with prolotherapy (among other things) . I beleive he does dry needling, who knows perhaps he'll convince me.

    Regards
    Robert
     
  10. Shane Toohey

    Shane Toohey Active Member

    Hi Rob,

    I can't resist.

    I've not done any prolotherapy. From what I have seen, I'd say I could do the same with dry needling/acupuncture with far less trauma to the recipient for quite a bit of that, but they also do stuff that I don't do and so am interested in getting a closer look sometime.


    Also on the dry needling of trigger points: the results are so obvious and so quick that you'd be an easy convert.

    I've just run a workshop or 3 and with a larger group you will always have some good demonstrable results. I'll also say that "sham" dry needling will not go close to the expert location of a needle into a palpable trigger.

    If Martin has a copy have a look at Travell and Simons.

    Have fun - wait until folk pay you to just stick needles into them all day!

    Cheers
    Shane
     
  11. Admin2

    Admin2 Administrator Staff Member

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