Why I Don’t Get Excited About Scientific Proof of How Acupuncture Works

Last week my good friend R told me that she’d come across an article detailing the recent scientific proof of how acupuncture works. My reply was “Well, thank god for that!” There was a pause, and then the query: “…was that sarcasm?”

It certainly was, and since R is a fount of fascinating story and insight and I never respond sarcastically when she shares potentially interesting information with me, I’ve unpacked it a little.

A couple of my classmates in acupuncture school exerted much energy towards “staying up-to-date” with the latest scientific research on acupuncture’s effectiveness; printing articles, posting them on the school bulletin board, in the window of the school’s clinic. The implication was that this was Good For The Profession because it would educate the public about our skills, which would mean more people coming to us for treatment. Alongside this was the expectation that increased scientific recognition would lead to increased coverage by the health insurance industry, which would also mean more people coming to us for treatment.

At the time, I hadn’t had enough clinical experience to be confident in my own skills, so I was tentatively pleased by validation from any quarter, including from the biomedical establishment (this was admittedly a bit of a conflict, as one of my main reasons for enrolment in school was to undermine the authority of Big Pharma by offering relief of pain & illness without the use of pharmaceuticals or the doctors who over-prescribe them) and certainly I believed that Chinese medicine should be covered by healthcare.

But I wasn’t on the educating-the-public bandwagon, and I’m still not. In fact, it instantly gets my back up, because while I am willing to wax eloquently about the efficacy of acupuncture to anyone who wants to listen to me, and to nerd out at great length about zang-fu organ theory (“…so, do you struggle with the inhale more than the exhale? Well actually, your asthma could be caused by adrenal depletion, the result of your kidney qi not being strong enough to ‘grasp’ the lung qi – by the way, let me know if you’d rather talk about something else, I can go on for hours”) the lament that If Only The Public Were Better Informed Of Our Skills drives me nuts.

It’s been said before, and it’s worth repeating: people will know that acupuncture works when we give it a chance to work. If we treat more people. If we quit waiting for insurance coverage, lower our fees, and allow more people access. There is absolutely no shortage of people who are sick, sad, anxious and in pain, and a heckuva lot of them are quite willing to try something as weird as inviting teeny tiny pins into their bodies in order to feel better. Even if they don’t know if it will work, or how it would work.

And if one more “healer” comments sorrowfully within my earshot that “People just aren’t committed to their health” I may temporarily forget that I am a gentle person.

My friend R told me of someone she knows who absolutely would not try acupuncture unless he knew that it had been scientifically proven to be effective, that after seeing this article, he would be likely to try it. Of course I’m pleased if someone gets treatment, and I hope she shows him the article. But I have my suspicions of any study that claims to have proven how acupuncture works. It’s probably approved acupuncture as somewhat effective for a few limited conditions, and left out the troublesome topic of qi altogether.

Acupuncture is a slippery beast. It has been practiced for thousands of years in so many places, there are a multitude of different systems of practice, and they all work, despite the fact that some of them disagree with each other. I feel quite at ease with these contradictions, but western science doesn’t. I’ve read a few studies using randomly selected “sham” acupoints, by which they mean points not included among the hundreds mapped out by the Traditional Chinese Medicine system, which is the theory rewritten to accomadate the political, economic and logistic necessities of providing for the medical needs of China's population during the 1950s. (Very interesting in light of “rebellious” qi diagnoses…but I digress.) But who’s to say that these “sham” points are not recognized and widely used in a different system less popular with Chairman Mao? Korean hand acupuncture, for example, or Master Tung’s acupuncture?

Some trials also use “sham needling” i.e. “too shallow to be effective.” This reminds me of one of my first year teacher’s exhortations to needle deeply: “Don’t let your needles fall over, like useless soldiers!” We needle very softly at Poke, but I don’t think he would he be aghast at the 20 patients who received my useless soldier needles today. He’d be nodding in solemn approval at how many people received effective treatment.

To continue on the topic of slipperiness: a central piece of any acupuncture theory has to do with qi, a word for which there is no English equivalent. It has been translated as breath, nourishment, vitality. It has been mistranslated as energy, which is an easy slip-up to make (and one that I am still sometimes guilty of!) Two things that acupuncturists agree on are that pain and illness at the most basic level are caused by stuck qi, and that acupuncture works by moving qi. But the flow of qi has not, to my knowledge, been quantitatively scientifically proven to exist, nor does anyone really know how needles inserted into the skin can encourage the flow of qi.

The best thing I’ve come across in my reading on the scientific research on acupuncture was this: “…it has been questioned whether research on acupuncture is a good use of limited research funding.” To this I’d add: wouldn’t it be lovely if some of the funding currently used on studies which try in vain to break down and examine the individual components of qi was redirected towards grants for new acupuncture grads with crushing debt loads to open community clinics? And as long as I’m making a wish list: I’d like to be having some conversations are around scientific proof and cultural difference, with non-defensive scientists.

I think western science has value, and it does interest me – some of my closest friends are scientists! – and it make sense to me that someone will try to understand something strange and new through their own cultural lens. But it seems that people often forget that what western science considers as proof is culturally created. Maybe I'm overly sensitive, but folks, isn't it kinda loaded for a white western scientist to contemptuously dismiss the existence of qi – something that countless people across the world have used in systems of healing for thousands of years – just because they can't measure it?? Scientific studies are created by scientists who are fallible humans shaped by their own cultural contexts.

As an aside: This post has taken me an unusually long time to write because of the two scientists figuratively glowering over my shoulder and picking apart my sentences: my father, the PhD in chemistry who doesn’t believe that human activity is altering the climate, and my mother’s father, also a chemistry PhD, who stockpiled DDT to ensure a lifetime’s supply for his vegetable garden when he heard that it was going to be banned. (No, I didn’t go to acupuncture school just to rebel against my upbringing.)

Something I struggled with in acupuncture school was the pressure to present ourselves as all-knowing Healthcare Professionals. At least one teacher counseled us not to tell our patients when we didn’t have an answer to something. Perhaps this is another example of my horrendous lack of professionalism, to out myself as an acupuncturist who doesn’t even know why needles work. But apparently I don’t need to know why the needles work in order to use them effectively within the systems I’ve learned. And just as I’m more likely to trust a doctor who’s aware of the limits of their knowledge, so too the scientists I appreciate the most are willing to admit that there are some things in this world not currently quantifiable by their instruments. I know they’re out there. Keep sharing the articles, R, I won’t be so snarky next time.

Lisa B.
Author: Lisa B.

Lisa prefers fireflies to fireworks, reverts to bluntness in stressful moments, would happily wear legwarmers year-round, and probably wants to be your friend.

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