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Yukinara
10-07-2012, 05:54 AM
Now this is what I'm having a hard time with. I plan to have one of my MC has treatment for an injury from a battle (multiple cracks on ribs, chest pain and leg pain). I plan to have him relieved the pain by using acupuncture, but I'm not sure if it is an appropriate method. I know acupuncture is good to relieve back pain, pain from heart disease and limbs pain. The thing is that I don't know if it is an acceptable method to relieve pain in general.

Any suggestion?

espresso5
10-07-2012, 07:55 AM
If nothing else there's potentially a placebo effect.

Fenika
10-09-2012, 01:13 AM
Acupuncture can relieve general pain, and pain in the areas you've mentioned, and the acupuncturist would want to know where it hurts.

But, like drugs, the effect is not a perfect cure all and does wear off.

You take a beating, you will suffer from pain and inflammation. There are lots of ways to reduce both, including acupuncture.

Fyi, 'general pain' is for pain throughout the body, or spreading beyond a certain area, sometimes with no obvious cause. How MDs exactly use the term, I don't know, but it wouldn't be for what you mentioned above. (okay, technically you said 'pain in general')

Battle pain would not be generalized. It would be specific to wear the trauma occurred.

Anninyn
10-09-2012, 01:18 AM
I've had acupuncture, and whether it was a placebo effect or not, it did really help with the back pain I was experiencing at the time. However, it did wear off. What I found is that as sessions carried on the wearing-off happened later and later, and as I found the whole process quite relaxing eventually it really improved. I'd like to go back.

But that was a long-term muscular pain I've had for years.

Callista Melaney
10-10-2012, 07:59 AM
I would say yes. I had a sprained ankle one time and it hurt like hell, even if I wasn't walking on it. The acupuncture relieved the pressure and the pain that I felt on it, but it was still too weak to be walked on. It didn't do anything for the actual sprain, just made me more comfortable.

Yukinara
10-11-2012, 02:35 AM
thanks for all of your valuable information. But what happen if you remove the needles? Will you get hurt immediately again or the effect still remains?

Drachen Jager
10-11-2012, 02:44 AM
Acupuncture = Alternative medicine.

Do you know what they call "Alternative Medicine" that's been proven effective through scientific testing?

They call it "Medicine".

It's bunk, but the placebo effect is strong when it comes to treating pain.

(Good thing I wore the flame-retardant suit today, I can see the angry replies flying already, nevertheless, like it or not, I speak the truth here)

Fenika
10-11-2012, 10:31 PM
Drachen, cite a source.

I actually started a course on Evidence Based Veterinary Acupuncture since posting. It is rather interesting and there are a lot of studies showing changes in the brain and body.

Placebo and it's opposite, nocebo, are very interesting, and more than simple trickery. There are real effects that occur with them.

As for the question of what happens when the needles come out- it depends on the type of pain and the type of acupuncture used (there are different ways to stimulate points, including electrical acupuncture)

So you can have various reasonable scenarios depending on what the stories need. Not that anecdotes are fact, but it would be good to read several to develop your story.

I'm happy to answer more questions as I continue my course.

One interesting aside- Traditional Chinese Medicine goes back thousands of years and is based on careful recording of effects. Western, Science based acupuncture goes back a few hundred years and is not always as scientific as the public believes.

Regardless, medicine is evolving constantly, so I wouldn't hang my hat on only the familiar or 'accepted.' (accepted by who, anyways??)

Fenika
10-11-2012, 10:41 PM
Some science-

http://www.scientificamerican.com/podcast/episode.cfm?id=mechanism-points-to-acupuncture-pai-10-05-30

http://www.sciencedaily.com/releases/2010/11/101130100357.htm

http://well.blogs.nytimes.com/2012/09/11/acupuncture-provides-true-pain-relief-in-study/

Drachen Jager
10-12-2012, 12:00 AM
Fenika:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099267/

"more that researchers eliminate bias from their trials, the greater the tendency for results to indicate that acupuncture is little more than a placebo." - http://books.google.com/books?id=TnDHoXyi388C&pg=PA39#v=onepage&q&f=false

"Also, when "placebo needles" (in which the needle retracts into a handle rather than penetrating the skin) were introduced to the study of acupuncture, the majority of studies conducted using these needles concluded the effects of acupuncture were due to placebo." - Wikipedia

Wikipedia has links to dozens of actual peer reviewed scientific papers, not Scientific American articles hammered out by writers who may or may not have any relevant experience.

I repeat, acupuncture is bunk. Yes, a magazine article may say otherwise, or a blog.... That's hardly conclusive evidence, and it is most certainly not "science".

Fenika
10-12-2012, 12:11 AM
The first link was actually rather interesting-


Authors’ conclusions
In the previous version of this review, evidence in support of acupuncture for migraine prophylaxis was considered promising but insufficient. Now, with 12 additional trials, there is consistent evidence that acupuncture provides additional benefit to treatment of acute migraine attacks only or to routine care. There is no evidence for an effect of ’true’ acupuncture over sham interventions, though this is difficult to interpret, as exact point location could be of limited importance. Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.

Of course, this is only about migrane pain.

veinglory
10-12-2012, 12:16 AM
It isn't bunk if controlled trials support it. A work mate of mine just finish blind scoring data that shows that acupuncture was effective as the best anti-nausea in preventing nausea. And there was a sham group where needles were put in but in the "wrong" places.

I think the data is stacking up for acupuncture in relation to nausea and many kinds of pain.

Fenika
10-12-2012, 12:21 AM
Here's one touching on physiology. I need to get the full article because it sounds interesting.


Acupuncture and some other forms of sensory stimulation elicit similar effects in man and other mammals, suggesting that they bring about fundamental physiological changes. Acupuncture excites receptors or nerve fibres in the stimulated tissue which are also physiologically activated by strong muscle contractions and the effects on certain organ functions are similar to those obtained by protracted exercise. Both exercise and acupuncture produce rhythmic discharges in nerve fibres, and cause the release of endogenous opioids and oxytocin essential to the induction of functional changes in different organ systems. Beta-endorphin levels, important in pain control as well as in the regulation of blood pressure and body temperature, have been observed to rise in the brain tissue of animals after both acupuncture and strong exercise.

http://www.sciencedirect.com/science/article/pii/0306987795901175

Fenika
10-12-2012, 12:23 AM
It isn't bunk if controlled trials support it. A work mate of mine just finish blind scoring data that shows that acupuncture was effective as the best anti-nausea in preventing nausea. And there was a sham group where needles were put in but in the "wrong" places.

I think the data is stacking up for acupuncture in relation to nausea and many kinds of pain.

This sounds very interesting. Are they working on an article for this? Do you have any more info?

Drachen Jager
10-12-2012, 12:42 AM
Individual studies often show screwy things. Sometimes due to an error in the testing scheme, sometimes due to intentional malpractice of science, and sometimes due to dumb luck.

Metadata analysis of multiple studies shows a much clearer picture and it clearly shows that the studies where acupuncture is more effective than misplaced needles are outliers, and do not represent the majority result.

You can't just cherry pick the studies that agree with you and say, "There, see, it works!"

That way lies belief in craziness like inoculations leading to autism (don't even try to argue this one, or I will have to write you off as a complete kook).

veinglory
10-12-2012, 12:57 AM
Rather than a meta-analysis of all studies I tend to look at the ones I know where carried out to the highest standard, and meta-analyses limited to those studies.

Currently I am not aware of any such meta-analysis, probably because the qualifying studies would amount to less than 10.

That's why I file it under 'looking good, but not there yet'. Way ahead of more mainstream stuff like velvet antler with arthritis where the analysis was done and was negative.

Drachen Jager
10-12-2012, 01:06 AM
As long as you at least file it under, undetermined. I'm okay with that. I'm just opposed to people spreading it as proven effective treatment when it's clearly not.

And... IMO it's been around long enough that if there was an actual provable benefit it would have been conclusively shown by now.

WildScribe
10-12-2012, 01:06 AM
Drachen, you're calling them out for supposedly cherry picking studies, and doing exactly the same thing, cherry picking ones with negative findings. Even if you don't believe it works, plenty of people do, so rather than arguing an irrelevant point, why not just let people answer the OPs questions?

OP, in my experience, the patient is asked to lie down on a table or bed like at the doctor's office, and needles are carefully inserted. They're very thin, and it feels like a thorn prick. The patient is left alone in a darkened room for a while with the needles in, then they are carefully removed. There are other, additional treatments or whatever that can happen, but that's the basics of it. And, yes, whether placebo or not, it is used for pain relief, and many people find it effective.

WildScribe
10-12-2012, 01:07 AM
Almost forgot, for severe or chronic pain, several treatments might be required.

Drachen Jager
10-12-2012, 02:32 AM
The thing is that I don't know if it is an acceptable method to relieve pain in general.


Drachen, you're calling them out for supposedly cherry picking studies, and doing exactly the same thing, cherry picking ones with negative findings. Even if you don't believe it works, plenty of people do, so rather than arguing an irrelevant point, why not just let people answer the OPs questions?

So, if the OP asks if it's an appropriate treatment, and I say, "No, scientific studies show it's not actually effective." I'm the one who's being argumentative and not answering the OP?

"Cherry picking" means only choosing the studies that agree with your point of view. If 75% of studies agree with my POV, and 25% agree with yours, I do not need to cherry pick, I can simply agree with the majority. I fail to see why you do not understand this.

Sometimes a plurality of studies can be overturned by later work, and I am open to correcting myself should that ever happen, but in this case it does not appear at all likely. Are you open to correcting your view in light of scientific evidence?

I looked at sources that examined the metadata, ie. studies that explicitly did NOT cherry pick their sources, but took a broad range of studies, and showed that far more studies showed that acupuncture was no more effective than a placebo treatment than showed it had an appreciable effect. Even those which showed better results with the actual treatment showed only slightly better results for the real thing.

Canotila
10-12-2012, 10:41 AM
"Also, when "placebo needles" (in which the needle retracts into a handle rather than penetrating the skin) were introduced to the study of acupuncture, the majority of studies conducted using these needles concluded the effects of acupuncture were due to placebo." - Wikipedia


One thing worth noting is that putting pressure on acupuncture points (acupressure) is considered a milder, less invasive procedure that still has benefits.

Without knowing whether the placebo needles were placed randomly or whether they were placed on actual points, it's impossible to tell if they acted as true placebos or if they delivered a mild stimulus to the point that the folks in the placebo group still benefited from.

In terms of sensation, for me it feels like a blunt tap with a needle and then it feels like there's a marble under the skin where the needle is placed, no pain. Once an apprentice worked on me, and if it's not placed just right it's a sharp painful feeling.

Buffysquirrel
10-12-2012, 02:32 PM
You could have your character use acupuncture to relieve pain and you could have them find it works for the pain you describe, yes. Whether it's attributable to the placebo effect or not.

backslashbaby
10-12-2012, 02:59 PM
thanks for all of your valuable information. But what happen if you remove the needles? Will you get hurt immediately again or the effect still remains?

I have chronic back pain with nerve pain (noted because different kinds of pain really respond differently to various treatments). Acupuncture did help, but I have to get it too frequently for my budget and schedule, because it did wear off after about 48 hrs, yes.

One thing that helped between sessions were these things like tacks that are placed by the doc onto the right points and then secured with a bandage. I could wear those for up to four or five days at a time before having to get re-poked. I wasn't allowed to try to restick them on myself, as you might imagine. They aren't very sharp, but they really seemed to help a lot. My pain was still there, as nothing completely helps it, but it was much more manageable.

I'd say it was as helpful as my pain-specific medicines, individually (nabumetone and tramadol are the ones I mean here). Better than the starting dose of each, too. I take the max. So definitely stronger to me than high-dose ibuprofen, etc. I know it's just anecdotal, but there ya go anyway ;)

RandomJerk
10-12-2012, 07:38 PM
Acupuncture is a sham. Period.

http://skepdic.com/acupuncture.html

tjwriter
10-12-2012, 08:07 PM
A Cochrane review is only as good as the studies used for the analysis. If the studies included in the review are crap, so is the meta analysis.

You see this all the time in the childbirth research. One review reported that risks increased in a homebirth and it was used to slam supporters of homebirth. But once you looked at the details, the studies included did not account for things like planned/unplanned births, training of care providers, and so on. So when homebirth supporters said that planned homebirths with a low risk mother and a trained care provider were safe, which is what homebirth supporters have said all along, this review did not support it. However, there were other studies out there that did support this position because they looked at these variables and these were not included in that review.

You may not care about all that, but the point remains that the selection of studies can skew the analysis.

And even if acupuncture is all placebo, does it really hurt anything if it relieves pain? As a chronic pain sufferer, that's all I care about. The pain goes away.

ETA: Just did some looking on Google and it appears a new Cochrane review says that all countries should look at homebirth options. It came out last month. I don't follow as much since I had my son 2 years ago.

ETA2: I just looked it up & my mistake, the flawed meta analysis wasn't a Cochrane review, but rather a Wax meta-analysis.

Buffysquirrel
10-12-2012, 09:53 PM
Eh, even if it is entirely attributable to the placebo effect, that means that acupuncture will benefit ~30% of people who use it. So my earlier statement stands, no matter how many studies are cited. Unless you can find a study that says the placebo effect itself is a sham.

boron
10-12-2012, 11:42 PM
I plan to have him relieved the pain by using acupuncture, but I'm not sure if it is an appropriate method.

WHY do you plan acupuncture? Who in your story decides about treatment?