How “Alternative” Is Acupuncture?

A local acupuncture—and “colon hydrotherapy”— clinic.

Here in British Columbia, acupuncture is a designated health profession. Our provincial medical services plan pays for acupuncture treatments, and because I attend the University of Victoria, I can also get acupuncture covered by my student plan. There’s a centrally-located part time acupuncture clinic right on my university’s campus, and according to Google Maps there are 15 acupuncture clinics within 5 blocks of my downtown apartment. This includes at least two acupuncture colleges whose students can receive government student loans. A few of my friends have trained to become acupuncturists; many of them have been acupunctured.

And yet acupuncture is also a form of “alternative medicine“—a term that usually describes something that is not backed up by medical science. How “alternative” could something as popular and accredited as acupuncture really be, you wonder? I did, too! So I visited 7 different acupuncture clinics in my neighborhood, collected brochures, and talked to staff. I asked four basic questions:

1. What is acupuncture?
2. What can acupuncture do for me?
3. How does acupuncture work?
4. How old is acupuncture?

And when I got home, I checked me some facts.

1. What Is Acupuncture?

According to my brochures:

Acupuncture is based on the recognition of a system of energetic pathways in the body called meridians. Meridians connect the body’s surface to the internal organs and contain energy called Qi. . .by inserting special needles at specific points on the meridians, acupuncture can correct energetic imbalances or blockages, which may be the cause of distress (1).

Acupuncture is the insertion of fine needles into the body at specific points shown to be effective in the treatment of specific health problems (1).

An acupuncturist will place fine, sterile needles at specific acupoints on the body. This activates the body’s Qi and promotes natural healing. . .(2).

But these are just rough descriptions—in fact, there are many different versions of “acupuncture”. For example, traditional Chinese acupuncturists use the tongue as a sort of “map of the body“, Korean hand acupuncturists use the hand as a map of the body, and auricular acupuncturists use the ear as a map of the body.

In addition, some acupuncturists use herbs, creams, “moxibustion“, massage, acupressure, or “cupping” (not as fun as it sounds). Sometimes, the needles are manipulated after insertion. Sometimes the needles are heated, or charged with electricity. Some acupuncturists use lasers.

As one of my brochures advises: different clinics can practice very different versions of “acupuncture”, so it’s important that patients “learn as much as possible about the treatment being proposed” (1).

But I soon discovered further reason to take this excellent advice.

 

2. What Can Acupuncture Do For Me?

Two of my local acupuncturists advertise the fact that the World Health Organization (WHO) has endorsed acupuncture as an effective treatment for a huge number of ailments, like anxiety, infections, pain of all kinds, and smoking addiction.

It’s hard to overstate how impressive such a ringing endorsement from the WHO can be. This is no fringe organization. And such an amazing diversity of medical applications suggests an endless sea of additional benefits just waiting for scientific approval.

Even more amazing, however, is that when I read the WHO’s acupuncture endorsement for myself, I came across the following passage:

In this publication the term ‘acupuncture’ is used in its broad sense to include traditional body needling, moxibustion, electric acupuncture, laser acupuncture, microsystem acupuncture such as ear (auricular), face, hand, and scalp acupuncture, and acupressure.

In other words, the WHO report authors didn’t distinguish between the different kinds of acupuncture. They simply pooled a collection of studies that examined very dissimilar procedures, and attributed any and all justifiable benefits to “acupuncture”.

This, in turn, means that acupuncture clinics in my community are promoting their services based on the outcome of studies that did not necessarily involve the specific procedures they are offering.

If you don’t the problem, consider this. Electric acupuncture involves applying a small amount of electricity to patients, and electricity has effects on your body that have nothing to do with acupuncture per se. In fact, electric acupuncture is very similar to a conventional procedure, known as TENS, that medical doctors use to treat pain. And the WHO report includes studies of electric acupuncture to justify its endorsement of all “acupuncture”—electrified or otherwise.

This, and some other criticisms of the WHO acupuncture endorsement, have convinced me not to take it seriously. However, I encourage the curious to investigate for themselves.

A brochure advertises the WHO endorsement.

A couple of the acupuncture clinics I visited had no use for the WHO endorsement, however. They had their own list of ailments, thank you very much. And theirs was even more impressive. These clinics didn’t need the WHO’s blessing to offer treatments for

AIDS, anemia, attention deficit, cancer, carpel tunnel, “computer syndromes”, Crohn’s disease, deafness, diabetes, ear ringing, epilepsy, emotional problems, eye problems, heart disease, hepatitis, herpes, “insufficient milk”, kidney disorders, liver disorders, lupus, menopause, mental retardation, menstrual disorders, pinworm infection, parkinsens [sic], reproductive problems, shingles, stroke, tuberculosis, thyroiditis, and yeast infections (2)(3).

Until recently, another local acupuncturist was offering “body-shaping” treatments. And yet another of my brochures says that “even after your symptoms have resolved, acupuncture can help you in maintaining your health, and possibly prevent future imbalances” (5).

 

3. How Does Acupuncture Work?

It’s simple, really.

When I asked this question, I invariably received a reply that included the words “qi“, “meridians”, and “acu-points”—although one practitioner also mentioned “chakras”.

But everyone essentially said that acupuncture manipulates the flow of a “vital energy” (qi) that circulates around through the body. Poor qi circulation, they said, can cause pain and disease; acupuncture can correct that.

The qi/meridians philosophy is important to acupuncturists for another reason, too. Remember, this is acupuncturist’s explanation for how so many different complaints can be addressed with simple needles. Not only that, it is also the basis upon which they advertise, not mere relief from symptoms, but profound and lasting cures:

Not only can acupuncture treat signs and symptoms of pain and discomfort, it can also get to the root cause of the problem (4).

Your [acupuncturist] will … preform a physical exam to determine how and why your body’s vital energy, or qi, is out of balance, and what the root causes are contributing to the overall problem (4).

By inserting special needles at specific points on the meridians, acupuncture can correct energetic imbalances or blockages, which may be the cause of distress (1).

So what is this amazing “vital energy”? This “root cause” of so many different ailments? Unfortunately, one of my brochures explains that “modern Western medicine cannot explain how acupuncture works“, and that qi and meridians are “unfamiliar to the West” (1).

Now that is disappointing—especially considering that acupuncture has been an official health profession here in “the West” for the last 15 years now. I guess it could be an old brochure, though, because another clinic offered me a “computerized meridian analysis and diagnosis” (3). So can science explain how acupuncture works, or not? It turns out that acupuncture is fairly well-studied here in “the West“. But my brochures are correct in that qi and meridians have eluded us—indeed, they have yet to be detected at all. Because of this, qi and meridians simply don’t exist as far as modern biology is concerned.

There even appears to be evidence against their existence: some studies have found that acupuncture is equally effective when the allegedly “specific acupoints” on meridians are deliberately missed. In other words: it doesn’t seem to matter exactly where on the body the puncturing occurs.

One possible explanation for this is that acupuncture doesn’t work because of  qi and meridians, but rather because of something called “the placebo effect“.

Now here’s an explanation that is supported by modern science. Relative to qi, we know all about the placebo effect. It’s a fascinating phenomenon (or collection of phenomena) that can cause patients to improve even when they haven’t been given any real medicine at all.

But although the placebo effect can have real medical benefits, not one of my brochures mentions it. No one I talked to on my little “acu-tour” even brought it up. Instead, they speak of an arcane “vital energy” which they can use to cure people of almost anything.

 

4. How Old Is Acupuncture?

To be honest, I wasn’t looking for an answer to this question at first. But almost everyone I spoke to on my neighborhood “acu-tour” began by telling me that acupuncture is “ancient“. Even online, nearly every introduction to acupuncture I can find begins by describing acupuncture this way. And I think there’s a reason for that.

Saying that acupuncture is “ancient”, I would argue, is another way of saying that it’s “tried and true”. It implies that acupuncture is a venerable folk remedy that has been gradually perfected by centuries of trial and error. And for many people, that’s powerful testimony.

However, most of what modern acupuncturists do simply cannot have been done in ancient China. For one thing, most modern acupuncturists use needles made of stainless steel—a material was invented around 100 years ago.

This is important, because stainless steel makes great acupuncture needles. They can be simultaneously small enough to avoid causing too much pain and damage, and strong enough to resist breaking. Ancient acupuncture is unlikely to have been nearly so pleasant, and ancient acupuncturists are unlikely to have treated many emotional problems, ringing ears, or “future imbalances”.

Some ancient acupuncture needles (image source: orichinese.com).

In addition, they probably didn’t see too many cases of tobacco addiction, street drug highs, AIDS, attention deficits, diabetes, obesity, heart disease, “computer syndromes”, and so on, as acupuncturists do today.

Important details like this are lost when the venerability of acupuncture is so heavily emphasized. And acupuncturists don’t help when they tell people that

acupuncture is an ancient Chinese medical procedure that involves the insertions and manipulation of sterilized stainless-steel needles in the body (3).

Acupuncture does have a long and important history: originally, it seems to have been one of many techniques employed by practitioners of Traditional Chinese Medicine. But today, acupuncture explicitly presents itself as a complete system of medicine—a potential cure for almost any complaint. In fact, the Traditional Chinese Medicine Association of British Columbia actually opposed making acupuncturists designated health professionals, complaining that acupuncture is “only one part of the more broadly based practice of traditional Chinese medicine“.

Perhaps, like me, the version of acupuncture they see today is far more modern—and “Western”—than it professes to be.

My Short Answer: Like all things, whether or not acupuncture “works” depends largely on what you hope it will do. But what’s clear, I think, is that acupuncturists

1. make far grander claims about their healing prowess than science does,
2. predicate this prowess on the existence of a “vital energy” that is utterly invisible to modern biology, and
3. imply that acupuncture is thoroughly time-tested when many important aspects of its current incarnation are distinctly modern.

In other words, despite it’s popularity, acupuncture is still looks pretty “alternative” to me.

 

**This article is an adapted version of an article I wrote for The Martlet newspaper in 2011, entitled “In Acupuncture”.**

References & Further Reading