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Millions Embrace Acupuncture, Despite Thin Evidence

A study found that 3.1 million adults and 150,000 children used acupuncture in 2007 for such ailments as headache, back pain and insomnia.
A study found that 3.1 million adults and 150,000 children used acupuncture in 2007 for such ailments as headache, back pain and insomnia. (By Dominic Bracco Ii For The Washington Post)

The benefits of the actual acupuncture showed up over time, with most of those who got relief feeling it after 14 weeks of treatment.

Other preliminary research shows promise when acupuncture is used as part of treatment for infertility, obesity, post-traumatic stress syndrome, depression and pain relief. But many of those studies were small, and more work needs to be done for them to be validated.

However, other studies have found no difference between sham acupuncture and the real thing. An analysis of 13 studies of pain treatment with acupuncture, published online this month by the journal BMJ, concluded there was little difference in the effect of real, sham and no acupuncture.

Bauer said that patients are increasingly asking about incorporating acupuncture into their care and that doctors, especially younger ones, are more willing to give it a chance. "I would call it evolutionary," he said of physicians' attitudes. "Twenty years ago there was more antagonism and much more hard-core skepticism. Now there is a lot more of an open attitude."

Brian Berman, director of the University of Maryland center, came to acupuncture after feeling that something was missing in his practice of family medicine.

"I was well trained with acute problems such as an asthma attack, trauma, heart attack," he said. "But when it came to chronic pain, I didn't have all the answers. Eventually that led me to taking the acupuncture course in 1983, then further training in the U.K., and I incorporated it my practice."

When he first suggested it to his patients, he said, they were skeptical. They were looking for a "magic pill" that would cure them: "Sometimes we had tried the pill and they still had their problems, and I would ask, 'Would you consider acupuncture?' " Often, it worked.

Linda Lee, a gastroenterologist who is director of Johns Hopkins's new Integrative Medicine and Digestive Center, said it's very hard to find scientific support for acupuncture, but she sees anecdotal evidence.

"We have this double standard," she said of the medical profession. "We are completely comfortable using pharmacological therapies that have not been subjected to clinical trials for the purposes we use them, but we are super suspicious of alternative therapies that haven't been tested with randomized placebo trials. From a research point of view, I understand the criticism. But we physicians are in the healing business, and we have to go beyond the pharmacological solutions to understand the whole person," she said. "Acupuncturists start with the whole person."

At the Hopkins center, acupuncture is used in conjunction with more-conventional medical treatment, said Lee.

"I have been very impressed by how much the acupuncturists pay attention to everything else going on in the body," said Lee, who is not trained in acupuncture. "I'm a specialist. I've been trained to hone in on one system."

Elise Feingold, 51, a human geneticist from Silver Spring, began trying acupuncture seven years ago for chronic back and knee pain. Her father had gotten some pain relief from it, and so she felt it might be beneficial.

Feingold says she reaped unexpected benefits: dramatic and rapid relief from hot flashes that had been waking her seven or eight times a night, as well as relief from 11 months of coccyx (tailbone) pain that her doctors had been unable to help.

"You see benefits over a period of time," said Feingold. "You're not always going to have that home run like [with] the hot flashes."

She said she has also found relief for less tangible and perhaps more emotionally based issues such as sleeplessness and stress, some of which she attributes to the time the practitioner spends talking with her. "There's a therapy aspect to this, too," she said. While she has no acute issue, she gets acupuncture about once a month for general health maintenance.

"I decided to leave my science brain aside," she said. "I felt it had helped other people, and it might help me. I don't know how it works, but it's got 4,000 years of Chinese medicine behind it."

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