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Acupuncture: what's the point?

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The University of York has now become the first university in the UK to appoint a 'Professor of Acupuncture Research', after awarding the title to Dr Hugh MacPherson at the start of this month. Dr MacPherson works in the Department of Health Sciences and has a focus on researching acupuncture's effectiveness for various conditions, explanations for possible mechanisms that might explain its working, as well as its safety and cost-effectiveness in a clinical setting.

Image: Wikimedia commons. A standard acupuncture needle.
Image: Wikimedia commons. A standard acupuncture needle.

Increasingly popular in the UK, acupuncture is a major component of traditional Chinese medicine and involves thin needles being inserted into areas of the body. Techniques and practices vary from country to country, but the procedure is mostly used to treat pain. However in more recent years people have begun to claim that acupuncture has helped them with everything from weight-loss to allergies to quitting smoking.

Research into acupuncture in recent years has taken two approaches, use of "sham" needles (needles that withdraw into themselves so the patient is not receiving acupuncture but still believes that they are, placebo acupuncture) and trials on rats and mice. There have also been several large data reviews, such as that by White et al in 2002 who looked at 22 different studies of the effectiveness of acupuncture on smoking cessation and concluded it did not help smokers trying to quit.

However in 2010 a group from the University of Rochester Medical Centre in New York induced pain in adult mice and then inserted (and rotated, ouch!) needles just below the mouse's knee every five minutes for half an hour. These mice appeared to show a reduction in discomfort by 60%. Obviously this is somewhat different from the acupuncture that you or I would experience at a clinic, but, combined with some research from Kyung Hee University in Seoul that showed stimulation with needles reducing inflammation in rats with spinal cord injury, there is some data that drives more research into the medical viability of acupuncture.

Meanwhile, in humans, the placebo effect is a powerful thing, and hard to account for. A 2014 Nature Reviews Cancer review article published data showing patients reacting equally well to sham needles as to the real thing There is some debate as to whether "sham acupuncture" can ethically be used on elderly patients seeking treatment for osteoarthritis or if it is deception and thus unethical.

There are few dangers from acupuncture as such, as long as it is performed by a professional using sterilised needles. As such, some may argue that, even if the effect is purely placebo, perhaps for some patients as a pain management approach this would be more effective, safer and certainly cheaper than long-term drug treatment. Nonetheless until there is sufficient evidence to support the use of acupuncture in the place of conventional medical treatment, it should not be offered in its place.

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