I frequently come into contact with people who are managing pain in some way or another and often get asked for my opinions on various principles, treatments or theories.
I always start out by stating that ￼￼I really have no vested interest in any particular practice or theory. From both a personal and professional point of view, my only interest is critical thinking and syllogistic and deductive reasoning.
Here is a very concise and accessible summary of my thoughts on acupuncture.
Gate Control Theory of Pain
“The “gate control theory” posits that acupuncture may activate peripheral nerves to shut the “gate” on pain signals traveling through the spinal cord. The idea of interrupting pain signals is also the basis for another alternative therapy – transcutaneous electrical nerve stimulation (TENS).
Similarly, the principles of “counter irritation” and counter “stimulation” act in a way
Counter stimulation “A basic example is the practice of rubbing a fresh bruise, so that attention is paid to the sense of touch and pressure, rather than to the pain of the injury”.￼
Counter irritation “A substance which creates irritation or mild inflammation in one location with the goal of lessening discomfort and/or inflammation in another location“.
The Gate Control theory makes sense. If you bang your knee, you rub it to make it feel better.
If you’ve got a headache and I kick you in the knee really hard your headache soon goes.
Principles of Acupuncture
For the purposes of discussion, let’s lump dry-needling and acupuncture together – basically sticking metal pins in your body.
”The FSBPT paper states that the method by which acupuncture works is completely different, “based on a theory of energetic physiology”, focusing on the energy meridians or flows, and the unblocking of these pathways”.
Apart from the lack of scientific evidence to support acupuncture, it’s based on pseudoscientific principles, which are about as convincing as reiki.￼
I’m yet to come across an acupuncturist who has a grasp of basic scientific principles. Having said that I could say the same about personal trainers, massage therapists and many other occupations.
T￼here is an acknowledged level of scientific illiteracy within society that even expands into areas that require a reasonable level of understanding of the underlying principles, if not the specifics, of science (e.g. correlation versus causation, hierarchies of evidence, research validity etc).
This creates a breeding ground for pseudoscience and related beliefs. Acupuncturists often also offer other services that fall into the “alternative medicine” bracket￼￼￼; clear indicator/warning sign that their whole practice is based on, let’s not mince words, mumbo-jumbo!
Summary and Conclusion
There seems to be some evidence for short-term pain relief. My view is that it’s partly down to placebo, partly being in a relaxing / semi-clinical setting and partly the Gate Control theory of pain.
If short-term pain relief is the goal then I see no harm in receiving dry needling or acupuncture. There is, however, absolutely no evidence to suggest that these techniques work for long-term pain relief or recovery.
”It does work, long-term! I had acupuncture once a week for two months and my pain disappeared!”
Two months is a long time! The pain would have likely disappeared anyway! If the acupuncture sessions helped to manage the pain on a short-term basis that’s great but just because the pain disappeared, long-term, doesn’t mean it’s down to the acupuncture. Your toenails also got longer during the two months, was that down to the acupuncture? Remember, “correlation does not equal causation!”
Read More Here
https://www.scientificamerican.com/article/5-scientists-weigh-in-on-acupuncture. (Note that, of these five people, the acupuncturist is significantly less balanced in his evaluation of the science, research and evidence).