Young Australian Skeptics

Today, after much prompting from those around me, I finally went to the doctor about some headaches and blurred vision I’d been having. The diagnosis was pretty much what I’d expected — tension headaches caused some combination of factors related to new glasses and irregular sleep patterns (only one of which I can actually do anything about). What I wasn’t expecting was the recommended treatment suggested by the doctor: Acupuncture.

Now, to be fair, he didn’t just suggest acupuncture — painkillers (though sparingly), massage to help relax and lifestyle change (which, as I said, can’t happen) were all on the list. But he did stress that some people find that acupuncture helps with tension headaches, and that it was an option to try.

My first thought was that if you search hard enough, you can find ‘some people’ who believe epilepsy can be cured by pressing on the philtrum during a seizure.

My next thought was, “Am I being too dismissive — is there actually anything to acupuncture working in this particular situation?” After all, when it comes to plausibility of method (not theory), sticking needles into people and getting a physical reaction doesn’t seem like something that should be immediately dismissed.

Naturally, that was being optimistic.

I did a search of the net, and all news articles pointed to the same 2005 study when it came to tension headaches and acupuncture — if you know of any other studies, please let me know about them.* This article is pretty representative of the bunch. Some interesting things about the article: (1) It is overwhelmingly positive — “Acupuncture Cuts Tension Headache Rates By Almost Half”, “Acupuncture is an effective treatment for tension headache”, and so on; and (2) the article seems to be ignoring what the study actuality says, in favour of what the researchers say it says.

First up is the fact that the control group for the study received no treatment. That’s all good and well, but it’s a little bit of a distraction as well. Certainly it would be important if the acupuncture groups performed no better than the control group — it would be surprising as well, given the often stress based nature of tension headaches and the fact that the non-​​control groups were getting time out every week to lie down and have someone play with their body.

A digression into analogy, if you’ll let me be a liberal arts student for the moment: Imagine you have a swimming pool full of drowning people, and you divide them into three groups. The first group you leave to their own devices, and refuse them help. To the people in the second group you throw a rope to pull them in. And finally, the third group also get thrown a rope — but this rope is magical because it is painted purple, and we all know that purple things are naturally infused with magic.

So the first group drowns, nearly entirely. Maybe a few survive by sheer good luck, but not enough to be significant. Needless to say, this establishes very little aside from the fact that our thought experiment probably wouldn’t get past an ethics board in real life.

But what about the second and third groups? Depending on what happens, we will be able to get some information on our various ropes. If both of these groups drown as well, our method of rescue is no more effective than no method of rescue at all. Bummer. If the majority of both these groups are saved, then our basic method of rescue (i.e. ‘Throwing a rope’) is clearly better than not attempting to help — but the purpleness of the rope doesn’t appear to play any part in that effectiveness. Good news for drowning people worldwide, but a bummer for purple rope proponents. And finally, if there is a statistically significant discrepancy between the number of people saved by the normal and purple ropes, we can draw some kind of conclusion about purple ropes — something about whether or not purple is good or evil magic, presumably.

So, how does the study measure up? Well, you won’t need to stock up on purple paint anytime soon, if you catch my meaning.

The news article would seem to suggest that the difference between sham and real acupuncture was somehow significant,

“Those receiving traditional acupuncture care saw their headache rates drop by almost half — suffering 7 days less headaches over the four weeks following the treatment. Those receiving minimal acupuncture had 6.6 less days of headaches.”

Sure, it’s not big, but the fact that they mention it seems to imply that the .4 of a day difference in headache is…well, newsworthy.

But with some fancy google-​​fu, I managed to find what I think is the study referred to in the story. What are their conclusions?

“The acupuncture intervention investigated in this trial was more effective than no treatment but not significantly more effective than minimal acupuncture for the treatment of tension-​​type headache.”

All this leads up to what I think is the conclusion we keep coming to time and time again when we look at acupuncture: It just don’t darn work. The same results keep popping up again and again — this article from the same site has a nice quote at the bottom:

“In conclusion, in our trial, acupuncture was associated with a reduction of migraine headaches compared with no treatment; however, the effects were similar to those observed with sham acupuncture and may be due to nonspecific physiological effects of needling, to a powerful placebo effect, or to a combination of both.”

The idea that acupuncture is somehow vindicated because random needling and sham acupuncture show improvements is bizzare and incorrect, yet it always seems to rear its ugly head. Put bluntly, acupuncture is NOT random needling — the theory behind acupuncture, related to meridians and the flow of qi, has failed to stand up to scrutiny time and time again, and this is no exception. Saying that randomly sticking needles in someone is acupuncture is like saying that randomly cutting someone is surgery — complete and utter crap. Recommending acupuncture for treatment of tension headaches (or indeed, anything where sham acupuncture has shown an improvement) is misleading at best, as it lends credibility to a treatment which has absolutely no basis in science, and that cannot stand up to evidence based inquiry.

Now if you’ll excuse me, I need to grab an aspirin and some rest.

*As is often the case, while searching for the actual journal article the news story was about, I came upon a bunch more studies about tension headaches and acupuncture. Check out this, this, and the google scholar search I should have done in the first place for more information and studies. Also, Quackcast has covered these topics before, and in much greater depth and detail than I have or even could — I can’t recommend that podcast enough.

Tags: acupuncture, CAM, headache, medicine, Richard Hughes

This entry was posted on Thursday, April 9th, 2009 at 10:28 am and is filed under Pseudoscience, Science, Skeptic. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.