Millions Embrace Acupuncture, Despite Thin Evidence
Tuesday, March 17, 2009; Page HE04
Kaiya Larson pressed a small, thin needle against the patient's skin.
A licensed acupuncture practitioner, Larson focused intently as she felt for the right spot -- not here, not there . . . then ping, she pushed the needle in and turned it a little to the right, as though she were turning up the volume on her car radio.
The patient, a 31-year-old woman hoping that acupuncture would increase her energy level and relieve her occasional stomach problems, said she felt a brief "grab." Then nothing. She lay on the exam table for 20 minutes more while that needle, and four others, remained in place.
Larson, demonstrating the procedure at the Tai Sophia Institute outside Columbia, had already taken the patient's pulses; in Chinese medicine, there are six of them, which measure not heartbeats but energy flow, and are taken at two levels of pressure on both wrists. Besides having a discussion about the patient's general health, she had also examined the woman's tongue, finding diagnostic clues in its color and texture.
The process bore little resemblance to a visit to a conventional American doctor. But it's becoming familiar to an increasing number of Americans. A study published in December by the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health, found that 3.1 million adults and 150,000 children used acupuncture in 2007, seeking relief from ailments including headache or back pain, insomnia and attention-deficit disorders. That was about 1 million more adults than in 2002, when the last NCCAM survey was done. "In the consciousness of the American public, acupuncture has become white bread," said Joseph M. Helms, a physician who trains medical doctors in acupuncture techniques.
The people who go regularly for treatment swear by it. Some wouldn't miss a week. Others scoff that it's complete hokum and that you would get just as much help from a nap.
The American Medical Association takes no position specifically on acupuncture; the AMA groups it with other alternative treatments, saying "there is little evidence to confirm the safety or efficacy of most alternative therapies." It says "well-designed, stringently controlled research" is needed to evaluate its efficacy.
In 2007, NCCAM spent about $9.1 million on acupuncture research. While more is planned, Brent Bauer, an internist at the Mayo Clinic and director of its complementary and alternative medicine program, said the research is in its "toddlerhood."
"Some of the most interesting research on acupuncture is how it might impact brain functioning," said Richard Nahin, the acting director for research at NCCAM. He said magnetic resonance imaging observations during acupuncture have shown specific areas of the brain that respond to the treatment. The field of pain relief is getting the most attention in these studies, but they hold promise in many areas, said Nahin.
Bauer also said he has seen remarkable results in pain management, adding, "I don't fully understand how it works."
In 2004, researchers at the Center for Integrative Medicine at the University of Maryland tested the effects of acupuncture on 570 people over 50 with osteoarthritis in the knee. The patients were split into three groups: The group that received education about their condition recorded a 22 percent improvement in function; those who received sham acupuncture, a placebo-like process using real needles but not on known acupuncture points, improved 31 percent' and those who were treated with true acupuncture recorded improvement of 40 percent.