Acupuncture: heals or cripples? Person

Acupuncture: heals or cripples?

Acupuncture is one of the key directions in traditional Chinese medicine, in which special needles are inserted into certain points of the human body. According to the proponents of this method, such an intervention should contribute to improving health and well-being. In some Western countries, such as the United States, acupuncture has been rapidly gaining popularity as a form of alternative medicine in recent years. Acupuncture is being used to treat a wide range of ailments — from pain and nausea (for example, after chemotherapy or radiotherapy for cancer treatment) to allergies, depression and infertility. Previously, it was believed that acupuncture can be used in the treatment of facial nerve paralysis, allergies, some skin and cardiovascular diseases and sciatica.

But before declaring something as a method of treatment, it is necessary to carefully check whether it helps or harms, to what extent and to whom it should be recommended, and most importantly, explain the principles of the method. The effectiveness of some methods is confirmed by newer and more accurate studies, the effectiveness of others is partially, and the third is not at all.

History knows many cases when modern scientific methods have confirmed the effectiveness of alternative medicine drugs. Hippocrates also suggested taking crushed willow bark to relieve pain and fever. For the same purposes, willow bark was used by some Indian tribes in North America. Subsequently, it turned out that the bark contains an active substance — salicylic acid.

Modern aspirin is a derivative of salicylic acid (acetylsalicylic acid), a less active form that turns into an active form (salicylic acid) during metabolism. Therefore, aspirin is a good example when alternative medicine was not wrong. That is why it is successfully used in modern medicine. Another example is the use by Europeans, since the XVII century, of the bark of the cinchona tree for the treatment of malaria. It turned out that this bark contains quinine — an effective remedy for malaria plasmodium, the causative agent of malaria. There are enough such examples in the history of medicine, but still they are the exception rather than the rule.

On the other hand, for thousands of years and up to the XX century, many doctors practiced bloodletting to treat practically any diseases — from asthma to cancer, from plague to scurvy. As we know today, in most cases, such treatment was more harmful than it helped. In the first half of the XX century, people actively used anti-aging cosmetics containing radium salts, and in general, recently discovered radiation was called the rays of life and was considered a cure for all diseases. Before the research of Marshall and Warren, who received the Nobel Prize in Medicine in 2005, it was believed that stomach ulcers were associated with stress or the use of acute. Now we know that the most important factor causing stomach ulcers is the bacterium Helicobacter pylori, and the ulcer is treated with antibiotics. Another Nobel laureate, Linus Polling, was an ardent supporter of the idea that colds can be prevented and even treated if you consume a large amount of vitamin C. However, when this statement was carefully checked, it turned out that the effect of vitamin C, if there is, is very small and has no therapeutic value.

Finally, more and more attention in modern medicine is being paid to the fact that, due to individual genetic characteristics, different medications may have different efficacy for different patients. The acetylsalicylic acid mentioned above seems to significantly reduce the risk of colon cancer, but not in all people, but only in people with certain variants of certain genes, as shown by a group of researchers led by Hongmei Nan from the University of Maryland School of Medicine.

Thus, scientific ideas about the effectiveness of medical interventions do not stand still. Do we need to revise our knowledge about the effectiveness of acupuncture in the light of new and more accurate scientific research, or perhaps they will confirm the previously formed ideas?

Over the past few years, we have become well aware that the placebo effect should not be underestimated. What is it? In short: a person expects that some medicine or exposure will give him relief, relaxes, his brain secretes special substances (for example, endorphins) that lift the mood and reduce pain. No magic — the usual physiology.

A number of studies have shown that the strength of the placebo effect depends on the method of administration of the pseudo-drug. For example, injections of saline have a stronger effect than sugar pills. In recent years, many studies have shown that the strength of the pills depends on their color, as well as on the stated price of the pills and even the persuasiveness with which the doctor talks about their effectiveness. Compared to the lack of treatment, and maybe even compared to some other forms of placebo, acupuncture can be quite an effective painkiller. Reviews of scientific literature indicate that it may be effective for the treatment of migraines and some other types of headaches, as well as for neck pain. On the other hand, it was not possible to demonstrate the effectiveness of acupuncture to reduce pain in the shoulder girdle, elbows, acute pain in the lower back (lumbago).

In 2013, the journal Anesthesia & Analgesia published an article by David Colquhoun and Stephen Nowell titled Acupuncture — a theatrical placebo. Why theatrical? An acupuncture session is much more difficult than taking a regular white pill. This is a lengthy procedure, which is done by an experienced, usually empathic specialist, following a strict set of rules. He devotes a lot of time to the patient, expresses interest in his problems, provides a sense of comfort. The seriousness of these procedures convinces the patient that something special and useful is being done to him. And this enhances the placebo effect.

Not everything we do, we do for the health of the body. We perform some actions simply because it is interesting, unusual, allows us to feel ourselves in the place of a person of another culture or era. And acupuncture, as an ancient ritualized practice, of course, is of cultural and historical value. In 2010, it was included in the UNESCO List of Intangible Cultural Heritage of Humanity. By attending acupuncture sessions, you support cultural diversity. What is not a form of leisure and charity?

A passion for acupuncture can give you a topic for conversation and even help you find friends. Millions of people use this area of alternative medicine, many books and articles have been written about it. There are groups of acupuncture lovers on social networks. Do you want to talk about your health with sensitive and attentive interlocutors? Join this rather big party. According to a study published in 1998 in the journal JAMA (Journal of the American Medical Association), in the United States, dissatisfaction with conventional medicine does not serve as a factor pushing people to engage in alternative medicine. The most significant factors of attraction to alternative medicine were holistic philosophical views on health (the health of the body, mind and spirit are interrelated), the presence of a transformative experience, some event that changed a person's lifestyle and his view of the world, as well as belonging to the creative class.

The original Chinese ideas about acupuncture assumed the existence of meridians through which the vital Qi energy circulates. Modern studies of human anatomy have not allowed us to find anything special in these places. One possible hypothesis was that the exposure signal propagates directly through the skin cells. Such an idea cannot be considered completely unscientific: in some organisms, skin cells are excitable and can transmit an electrical signal like nerve cells. Mechanical action on the skin of a tadpole causes the generation of an electrical impulse that spreads through all skin cells and is transmitted to the nervous system. If we were tadpoles, we would easily understand why skin irritation causes us physiological and behavioral reactions. But we are not tadpoles. Human skin cells do not have electrical excitability and cannot conduct a signal in this way.

According to a review published in the journal Pain in 2011, 95 people were seriously affected by acupuncture between 2000 and 2009 — five of them died. Most of the victims lived in Asia, but some incidents occurred in the United States, Great Britain and other European countries. A rare but most dangerous complication of acupuncture is pneumothorax, a puncture of the pleural cavity of the lung. Pneumothorax leads to respiratory failure and acute lack of oxygen, a person needs urgent medical care. The most common problem is infection with infectious diseases. In one of the recent reviews made by scientists from the Brazilian University of San Paolo, 295 cases of infections associated with acupuncture are described. Most of them were caused by the bacterium Mycobacterium abscessus, which is often found in dirty water, and when ingested can cause skin lesions, lungs, and suppuration of wounds. Infections can spread, for example, due to the fact that the therapist uses non-sterile needles or insufficiently clean towels. Considering that millions of acupuncture sessions are performed in the world per year, we can safely say that complications are very rare. But this does not mean that they are impossible.

There is a whole swarm of various superstitions, myths and misconceptions around acupuncture, such as stories about meridians, vital energy, etc. This is fine if you treat it with a certain amount of irony. But some people seriously begin to believe in magic points on the body, build strange unscientific theories around it, fixate on them. And when these theories are not taken seriously by the scientific community, they turn away from science and become adherents of esoteric, pseudoscientific teachings. Will you be able, having plunged into this culture, to stop in time and not switch to more dangerous forms of alternative medicine like cleaning from toxins or eating questionable oriental roots with an unknown effect?

Those types of pain syndrome in which acupuncture helps, as a rule, are not very serious. This means that they (like many diseases) can go away on their own, even without any placebo effect, just in the process of normal recovery of the body. Completely independent of acupuncture. If you are seriously ill, then you should immediately contact a real doctor to get the most effective medicine. If after that you have the time and money to go to an acupuncture session, it's okay. But do not try to treat serious diseases only with the help of acupuncture. You can miss precious time and pay with your health or even your life.

Whether acupuncture can boast of any mechanisms of action, in addition to the placebo effect, is still unclear. Of course, there are many studies of this procedure, but all this is empirical data on whether it helps or not. If we talk only about anesthesia, then a number of studies have accumulated demonstrating the effectiveness of the method. However, some of them show that acupuncture works just as well, even if the needles are not inserted into special points approved by Chinese medicine, but into any randomly selected area of the body — to the question of the placebo effect. Some studies show the possible effectiveness of acupuncture in some forms of allergies. But even here everything is ambiguous: these results, as a rule, cannot be reproduced in other studies. As for serious diseases, such as cancer, there is simply no convincing evidence of the effectiveness of acupuncture to combat them.

So does acupuncture work? And how dangerous is it? In most cases, acupuncture is safe. The atmosphere of the reception in the style of ancient Chinese medicine is an interesting experience. With a number of pain syndromes, acupuncture is more effective than the complete absence of treatment. Apparently, its effect boils down to the placebo effect. There are no theoretical prerequisites or experimental data that would justify the use of acupuncture for the treatment of serious and life-threatening diseases.