Weighing in on the Toothpick Controversy

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Earlier this month, the Group Health Center for Health Studies in Seattle released the results of a clinical study on acupuncture for back pain. It became controversial almost instantly.

Here’s why: the results showed that acupuncture worked for back pain, better than conventional medical care. However, it also showed that “fake” acupuncture, where the acupuncture points were pressed with toothpicks instead of pierced with acupuncture needles, worked just as well as traditional acupuncture.

So, does this mean that acupuncture is a sham? Have I wasted years of education and practice?

I’m not worried.

The control group in a scientific experiment is supposed to be essentially the same as doing nothing (the reason why they don’t “do nothing” is to account for the possibility of the placebo effect– and that topic deserves a whole different blog article).

The problem with the study is that the scientists don’t understand the concept behind Chinese medicine. They assumed that true acupuncture always involves the insertion of needles through the skin. In reality, these toothpicks actually stimulated the same acupuncture meridians as needles would. That means that it wasn’t really a control group.

Instead, we call this non-insertive acupuncture. It is familiar to acupuncturists, acupressure practitioners, and shiatsu massage therapists, though it is not usually performed with toothpicks!

There are many conditions– like back pain– that might respond just as well to acupressure as to acupuncture, but we don’t have enough information to know that for certain. This abstract presents a possible explanation for why “fake” acupuncture sometimes performs just as well in research studies.

There are other reasons why I don’t put a lot of weight on these kind of studies, but that will have to be the subject of another post.

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