Acupuncture

The difference between acupuncture and dry needling explained

Traditional acupuncture uses pulse diagnosis and meridian-based needling to rebalance the body for pain and other conditions, while dry needling targets myofascial trigger points in muscles for pain relief. Some acupuncturists argue the two are very similar.

"Lots of questions, and I think the very first thing we need to clear up is: what is the difference between acupuncture and dry needling? Well, some would argue there's no difference. But acupuncture, if you're doing traditional acupuncture, you would do, for example, pulse diagnosis and traditional Chinese diagnosis. And it wouldn't just be for pain, it would be for other conditions as well."

Sham acupuncture studies show needling itself provides pain relief

Randomized controlled trials comparing real acupuncture to sham acupuncture (needling at non-meridian points) show both provide pain relief, with acupuncture slightly better. This suggests something about the needling process itself works for pain.

"So, in other words, they put needles into the body, but not into the traditional meridian points. And what these trials by and large show that when there's this kind of random needling compared to acupuncture, acupuncture is a little bit better, but they both work. So, there's something about needling which actually works in terms of pain relief, not necessarily hugely, but in some people really quite significantly."

Gate control theory and how acupuncture may reduce pain signals

The gate control theory proposed that acupuncture closes the gate to pain information traveling to the brain. While this theory is now considered incomplete, research shows superficial needling is not much different from deep needling of trigger points for pain relief.

"And the idea, the theory was, and it's developed over time, was And the idea here is that maybe something like acupuncture closes the gate to pain, pain information going to the brain, and that's how it works. It turns out the gate control theory is almost certainly wrong, or certainly only a very small part of the story."

Bottom line on evidence for acupuncture and dry needling

There is some evidence that both dry needling and acupuncture can provide pain relief, particularly for myofascial trigger points. Many acupuncture techniques work similarly to dry needling. The host is surprised the evidence landed more favorably than expected.

"There is some evidence that if you dry needle or massage myofacial trigger points, you Not huge necessarily, but you do get some relief. And some techniques in acupuncture will actually do the same thing, they'll needle your trigger points."

NIH studies on acupuncture and cancer treatment appear promising but lack rigor

A National Library of Medicine article claims acupuncture may strengthen the immune system during chemotherapy and reduce nausea and vomiting. However, the article was written by the chairman of the acupuncture committee and the NIH explicitly disclaims endorsement of published articles.

"studies conducted on both humans and animals suggest that acupuncture may strengthen the immune system during chemotherapy and can reduce the side effects of nausea and vomiting."

Sham acupuncture works as well as real acupuncture in clinical trials

A clinical trial on hot flashes in breast cancer survivors found acupuncture was safe and effective, but could not determine if real acupuncture worked better than sham acupuncture (needles intentionally placed at non-meridian points), suggesting placebo effects drive the results.

"it was not clear whether real acupuncture worked better than sham acupuncture."

Yale neurologist calls acupuncture an elaborate placebo

Dr. Steven Novella, a Yale University neurologist, states that thousands of studies show it doesn't matter where or even if you stick the needles. Random poking with toothpicks produces the same effect as traditional acupuncture placement.

"Well, and you talk about foolish gamble. That's if you actually have a medical issue. Some people go for cosmetic reasons. They think it'll make their skin prettier or to get rid of eczema or something like that. And then they end up going and, you know, dying. You're going to look great when you're embalmed. Your skin's going to be beautiful. It's going to be very smooth. We're going to staple your neck down. You'll look great. You'll look 10 years younger. We're just going to take two acupuncture needles and just knit your flat skin back together. It's going to be great. Oh my terrible. Oh, my God. So you asked what the doctors are saying. When you say doctor, so chiropractors call themselves doctors. PhDs call themselves doctors. There are some attorneys who even do it because of the doctorate involved in the education. Oh, my gosh. I mean, a lot of people really don't want to be attacked or get involved with this debate. So naturally it just, it doesn't come up in your standard Google search for like, you're not going to have a bunch of neurologists speaking out against, you know, the horrors of acupuncture, mostly because it isn't seen as dangerous for the most part. I mean, at least statistically, like you said, it's pretty good numbers. It's not like it's an epidemic that we have to address and they're just acupunctures or just murdering people. Although we wouldn't really know if someone was dying a couple of days later. It's a very slow and agonizing way to die. So I bet you there are tons of people who have died from this and then just nobody just knows that they that they had a treatment. Sure. You know, like, oh, that's weird. Her liver just exploded and she had this toxic septic shock in her body. That's weird. No, she must've got hit by something and not noticed. Actually, a needle punctured it and then got removed. Ew. Yep. Or something genetic or, you know, or just unknown natural causes or something like that. And that's the reason I did the whole disclaimer at the beginning, because I've just commented on videos before of people doing acupuncture. And I've been like, the science doesn't really support any positive results from acupuncture other than a placebo. And I was told in the comments to keep my whiteness out of her culture. Jeez. So if it can become like about race or culture or considered hate speech to say a scientific fact, you have to weigh the odds and just pick your battles. And so I don't see how a lot of doctors would benefit from putting statements out on the internet, going after something that they see is relatively harmless other than a waste of money. But privately, nearly all of them will tell you it's nonsense. I had a few conversations with doctors privately when I was writing this and putting the notes together. And of course, they asked me not to mention their names, but they were like, there's absolutely no real science to it. There's no support for the practice. But if it makes someone feel better, then maybe it's not all that bad as long as they're not getting their lungs deflated. That's the common theme of a lot of these things, right, that we've debunked on Skeptical Sunday and even stuff we haven't touched yet. If the monster spray makes the kid sleep, then what's the harm and why is it your business, etc.? Right. And the skeptic is in the corner going, well, you taught the kid about the monster in the first damn place. You're the problem. Yeah. Not to mention the conflict of interest when the monster spray company is also pushing ads about monsters and kids videos on YouTube. Sure. But I did find a few people who would publicly address it. You're aware of Dr. Steven Novella. Of course. It makes sense he would talk about this. Yeah, yeah. So he's a Yale University neurologist. He's the author of The Skeptic's Guide to the Universe. And of course, he has a podcast by the same name. In a video for Tech Insider, he says, acupuncture is essentially an elaborate placebo. You get no effect out of the actual acupuncture itself. The clinical research clearly shows, after literally thousands of studies, that it doesn't matter where you stick the needles, it also doesn't matter if you stick the needles. You can randomly poke somebody with toothpicks, and some studies literally do that, and it's just as effective in doing all the things an acupuncturist is supposed to do. It's not science-based medicine. So this is precisely what I figured. You're better off just buying some of the crystals people charge on the back porch during a full moon or whatever and laying those under your pillow because at least the odds of you puncturing your lung or your heart with a freaking amethyst are pretty close to zero. Right. Yeah, you're spot on. So if you embrace both of those, I encourage you go the crystal route. I also came across Skeptic Doc. Her name is Dr. Harriet Hall, and she's a retired family physician and former Air Force flight surgeon who specifically writes about alternative medicine and what she calls quackery. And she gave a 40-minute talk on acupuncture for QED that's available on YouTube. And yes, I've also provided the link for that. She starts the talk by saying, when we stick pins in dolls, it's called voodoo. When we do it to babies, it's called child abuse. When we do it to prisoners, it's torture. But when we do it to patients, it's alternative medicine. I like that. And she makes a very strong point that we don't ever really need to debate these issues of whether or not alternative medicine works. Because she says, if it's proven to work, we don't call it alternative. Yes, we have a name for alternative medicine that actually works. It's called medicine. Right. So she goes on to talk about how acupuncture is not a method, it's multiple methods. And it changes over time. So it was originally 365 points because it was symbolic of days in the year. And now it's over 2000. And Korean acupuncture only has 300 points and they're all in the hand. There's ear acupuncture that started with 30 points and now they have like 130 or 140 or something. There's electro acupuncture, there's cupping over acupuncture points or. Um, and she actually jokes that when you add them all up, there's only one spot. There's never an acupuncture point in all of the traditions. And that's the penis. Convenient. Also, while I approve, I think there's a lot of leather clad dudes in San Francisco that are probably really disappointed to hear that. That's not going to stop them. That's true. It's acupuncture guys. Come on, try it out. You might like it. Now you just wait for the flow of my energy. Okay. Here comes the chi. Okay. And explicit tag at iTunes. Yeah, there we go. So she also gets into the meridians, which are supposed to be the pathways in which the energy flows or the chi flows to the body."

Rubber arm experiment shows acupuncture response is psychological

Studies using the rubber arm illusion with brain imaging showed that when acupuncture needles were inserted into a fake rubber arm, the brain responded as though it was happening to the person's real arm, suggesting the effects are driven by visualization rather than actual needle placement.

"when needles were inserted into the rubber arm, the brain responded as though it was happening to the person's actual arm, which means some of these reported feelings are happening due to visualization and suggestions from the acupuncturist or visualizing the needle going into the skin, which means actually inserting it is meaningless."

First-time acupuncture experience for carpal tunnel treatment

Tom describes trying acupuncture for the first time to treat carpal tunnel syndrome from too much typing, after finding that traditional doctors would just tell him to stop typing. He sought out a legitimate acupuncturist and shares his experience navigating the process.

"Well, speaking of which, Tim, so I went because I think I'm getting like a carpal tunnel syndrome in one of my hands. Too much computering."

Acupuncture described as traditional Chinese medicine practice

The hosts discuss acupuncture as a traditional Chinese medicine practice, with one host having previously tried it and the other being skeptical before finally trying it himself. They debate whether acupuncture qualifies as medicine.

"Tim, this week we're talking about acupuncture. The ancient."

Choosing an acupuncturist and the in-office experience

Tom researches acupuncturists on Yelp, specifically avoiding places that combine acupuncture with astrology. He describes the chaotic office environment with multiple patients being treated simultaneously and the acupuncturist rushing between rooms.

"And there were a bunch of places where it's like, oh, acupuncture and astrology. I'm like, no, I want like the real deal."

Acupuncture cured lazy eye more effectively than eye patching in children

A study published in the Archives of Ophthalmology found that children aged 7 to 12 who received acupuncture five times a week had a 41.5% resolution rate for amblyopia (lazy eye), compared to only 16.7% for the standard eye-patching treatment.

"The kids who had their eye patched, 16.7% had their amblyopia resolved. Really? 41.5% had their amblyopia resolved in the acupuncture alone group."