Research into Acupuncture

There has been lots of research into acupuncture, but it can be quite hard to unpick and get further than the 'headline', which is often not representative of the full story. I have been fortunate enough to work on a couple of research clinical trials at York University with the late Hugh MacPherson, who was the first professor of acupuncture in the UK. While I don't claim to hold even a fraction of the knowledge base into acupuncture research as he did, I did learn a lot about how we present and interpret information. That said, I certainly do not claim to be an expert in this field and can only offer my own opinions based on my own experience.

As a starting point it's worth understanding that acupuncture treatments (and many other complementary therapies) are designed around an individual's specific needs, and selection of acupuncture points and inclusion of other methods and techniques can vary hugely. Research uses a complicated series of equations based on numbers generated from the treatments and outcomes. These methods are used to gauge acupuncture's efficacy in research and aren't usually a good fit to the flexible nature of treatment. Having to use the word 'efficacy' itself goes some way to explain this as while 'effectiveness' is a term we use to describe how well something has worked in the real world, 'efficacy' is a term used when measuring how well something has worked under ideal, and controlled circumstances. Even when treating the same issue, the approach can be totally different from one person to the next in the real world, so standardising the treatment for research purposes would massively disadvantage the outcome for some patients where the designed approach simply doesn't fit their needs.

Let's compare this to other types medical trials: as an example, if we think of a group of people all taking the same pill, at the same time, for the same issue over the same period we have fewer variables to contend with, and research doesn't like too many variables. With this example, the numbers will fit neatly into the equations, and the data is much easier to draw a conclusion from. With acupuncture, there's a lot more to take into account and therefore things don't fit so neatly into the equations. While the question of 'Did the patient get better?' is a big factor in making these calculations, the question of 'How easy it is to replicate this treatment in the real world?' is also an influential one, and the difference between - take 50mg each morning - and - generate a bespoke treatment using the best fitting methods and theory for this patient on this day - is a big one for a calculator.

So if these are some of the issues with measuring what we do to people, then measuring what we don't do to people is even more of a minefield. Research trials will often have a control group which is group of people who don't receive treatment. In an overly simplistic sense, it is a way to check that all those who had the treatment wouldn't have got miraculously better anyway. For the best results its better that the participants of a trial don't know if they are getting the real treatment or not to avoid any bias. For medication this is straightforward, give the control group a pill that looks and tastes the same, but doesn't have any active ingredients in it. For acupuncture, its quite the challenge. Methods have included selecting the wrong acupuncture points, poking people with cocktail sticks and theatrical stage dagger-esque needles that recoil into the handle rather than penetrate the skin. As fun as this sounds, it can't really be considered an inert, or fake treatment. Whether we do it right or wrong, penetrate or poke, we are still interacting with the body and the body will still respond in some way, thus adding more complications to our already confused little equation.

Thankfully there have been some developments in the way research into acupuncture is undertaken over the years, and these developments have, to some extent enabled researchers to analyse treatments more appropriately. Most acupuncture research is focussed on how much better people get when they have treatment, which is really what people want to know. There is some really strong evidence for acupucture being helpful for back pain, knee pain, neck pain and migraine, but here is much less research into how it works. There is however, some really interesting studies on how acupuncture effects the pain matrix in the brain which goes someway to explain why acupuncture can be an effective way of treating pain.

From my experience, research can be a complicated thing to get your head around. However, with a little knowledge it's possible to get past the techy words and get some good advice. Acupuncture has had plenty of research into it, some fantastically positive, some not so much. Thankfully though, patient's good experiences with being treated with acupuncture is most often the driving force in encouraging others to come for treatment. And with the limitations of the NHS's availability of treatment in the UK, this is only set to improve more.