I have long been suspicious of chiropractors. Why? One reason is that the practice has a wobbly foundation. In 1895, D.D. Palmer declared that “95% of all diseases are caused by displaced vertebrate, the remainder by luck stations of other joints.” His conclusion is that most diseases could be cured by adjusting vertebrae that interfere with nerve vibrations flowing from the brain through the vertebrae. Recent studies have shown that while spinal manipulation can be helpful to treating some back pain, “there appears to be little evidence to support the value of spinal manipulation for non-musculoskeletal conditions.” (Shekelle, P.G. “What role for chiropractic and healthcare?” New England Journal of Medicine 339:1074-1075.)
Another reason for my skepticism regarding chiropractors is that I’ve heard too many tales of highly suspicious sounding chiropractors. I’ve heard, for instance, about the “need” to be treated two to three times per week for years on end for nebulous sounding conditions.
I’ve never before been to a chiropractor. Five weeks ago I would’ve assure you that I would not likely ever go to a chiropractor. That was before my pain got bad, however. For the past five weeks, I’ve been suffering from a pain on the left side of my upper back. It comes and goes during the day, ranging from a dull ache to a severe stabbing pain that makes it hard for me to concentrate anything else. The pain sometimes borders on disabling. Sometimes, lying down is the only thing that settles down the intense stabbing pain. I’ve tried working out more, resting more and stretching more. I’ve tried ibuprofen and, later, Naprosyn in various doses.
I arranged for a massage last week, from a woman who has given me massages a few times over the past few years. She exclaimed that I was holding my left shoulder much higher than my right and that she had never before seen such an extreme case. After working on my back for almost 2 hours, she gave me the business card of a chiropractor who did acupuncture. The massage gave me some relief, but most of the pain returned a day later. My medical doctor gave me a prescription to a double dose of Naprosyn (he diagnosed me over the phone). I considered that if I pursued my problem with a medical doctor, he or she would probably refer me to physical therapy. It occurred to me, however, that I’ve had two rounds of treatment from physical therapists in the past and that both of them were unimpressive due to the nonchalance of the therapists.
It was time to do something about my problem, because I was losing valuable hours of productive time because of the pain in my back. To make things worse, ibuprofen has been hard on the stomach, causing something bordering on nausea. Therefore, I picked up the phone and I called the chiropractor/acupuncturist to set up a visit.
Two days ago (Monday), I visited the chiropractor/acupuncturist. I felt it was worth a try given several discussions I’ve had with people who claimed that acupuncture brought substantial relief to them. Further, this particular chiropractor is well known for treating quite a few professional athletes, including Olympic athletes and members of the St. Louis Rams and St. Louis Blues.
I was impressed with this chiropractor during my first visit. He took a lot of time trying to determine what was causing the condition. This is in direct contrast to my own experience (and the experiences of others) regarding medical doctors, who typically try to treat symptoms with drugs or cortisone, without taking a detailed history to determine the root cause.
Not that the root cause was hard to determine in my case. My chiropractor quickly determined that I was locked over a computer keyboard many hours every day. And after I’m finished hovering over a keyboard at the office, locked like a statue, 10 or 12 hours per day at work, I do more of this hunching over a keyboard at home while writing for this blog. He explained that this unvarying posture is hard on the body and that the sort of pain that I was experiencing was common among people who spend many hours sitting in front of a computer. It was his theory that my pain emanated from my pelvis (even though my pelvis doesn’t hurt) which is fixed in a locked position on a chair hour after hour without relief.
He recommended two or three sessions of acupuncture a series of simple exercises that I could do at home or at the office. Then he would be done with me. His simple exercises don’t require any equipment and can be done in a couple of minutes every hour or so. He also urged me to take periodic breaks from sitting in front of the computer. I have been directed to stand up and do some simple stretches while at the computer (these one-minute breaks are to be taken every 15 minutes or so). I have carefully complied with the chiropractor’s instructions ever since I received them two days ago.
What is modern acupuncture? It’s quite different than traditional acupuncture in that it involves not only needles, but slight pulsing electrical current that is run through the affected tissue through the needles. The purpose of acupuncture is to relax the overwrought muscles and thereby reduce the pain. My chiropractor readily admitted that the mechanism for pain relief is not well understood, though it often works. He made it clear that others have lots of detailed ancient hocus-pocus theories for why acupuncture works, but he doesn’t rely on those teachings (many acupuncturists still do, however).
A modern acupuncture treatment lasts 15 to 20 minutes. The acupuncture was not painful, although it was a just a bit uncomfortable. It is done without any anesthesia. After receiving the acupuncture treatment on Monday, I thought that I felt some good relief from the sharp pains I have been experiencing in my back. At the same time, however, I was well aware of the placebo effect and I wanted to make sure that I was not simply psyching myself out.
I went back for a second acupuncture treatment today. My wife (Anne) attended with me because she is interested in knowing more about acupuncture. She brought a camera and took a couple of pictures so that I could show what acupuncture looks like. This first picture shows the chiropractor inserting a needle into my back.
He used a short straw looking sleeve, which he taps along with the needle, which distributes the sensation of the insertion so that it is not sharp or painful. For the first treatment, the doctor used eight needles. For the second treatment the chiropractor used six needles. It seems like I have also experienced some relief from the pain today, following today’s acupuncture treatment. I’m not certain of this, however.
Here’s a picture of the needles that were placed on my back today.
Here’s a picture of the needles hooked up (with alligator clips) to the current generator.
When that current is flowing, it flows in tiny pulses. You can actually feel these pulses, about one pulse per second. It’s almost like someone is slightly tapping all of the needles on your back, in unison, throughout the entire treatment, but the tapping sensation is caused by the electric current.
Here’s a picture of the current control box that was attached to the needles.
The jury is still out on whether this alternative treatment will be effective in the long run. I have to admit, however, that it seems that the treatment is working (the treatment consists of both acupuncture and various stretches and exercises). I’ve been struggling with this pain for over a month without anything working to relieve the pain. Also keep in mind that over the past two weeks, I’ve been taking fairly heavy doses of pain relievers, without much effect. Over the past two days, however, I’ve reduced my intake of ibuprofen from about eight tablets per day to two tablets per day. I have found that I am having many fewer episodes of sharp pain.
There are many traditional chiropractors that rely mostly upon spinal manipulation. The chiropractor treating me is not one of those chiropractors. His forte is strength and conditioning and his tools include nutrition, stretching, exercise and acupuncture. If his approach works, one big benefit would be that it doesn’t require me to pour any potentially dangerous drugs through my liver. As suggested above, if this treatment works, it would address the root cause of my problem, which would allow me to prevent future episodes by doing these simple stretches and exercises as a matter of course, even when I’m not feeling any pain.
I will continue to update this post to let you know what I’m experiencing. In case anyone is interested, here is the website of the chiropractor who is treating me (James R. Neuwirth).
Nice entry. I'm looking forward to your updates as I've always had mixed ideas about chiropractors.
A couple of comments.. for your specific pain, don't think too hard about whether the acupuncture itself or a placebo effect is making you feel better. If you feel better, relax your back and shoulder, and allow it to heal, it doesn't matter *why* it's getting better, does it.
Also, I've read about some interesting double blind studies on acupuncture–they trained people to properly insert the needles, but didn't train them on the theory of meridians and chi and all that nonsense. They were instructed where to insert the needles in the test subjects without knowing whether they were following traditional practice. The result: acupuncture works the same whether you follow meridians, or just stick the needles in at random.
You acupuncturist sounds good–"we don't know why it works, but it does" is honest, and not superstitious. Electrical nerve stimulation and some substances like witch hazel seem to work as a sort of counter irritant. Your nerves seem too busy with "hey, this new thing is mildly annoying" to spend as much time with "hey, that old thing really hurts!"
Also, some reports of homeopathic medicine in the UK have shown that homeopathic "doctors" there spend much more time with patients than regular doctors do/can, treating them with respect and real care–a real double blind study would have to take into account this excellent bedside manner, which I believe can relieve stress and lead to better health all by itself. So, your chiropractor sounds like a very nice guy, and that matters.
Finally, if the acupuncture doesn't work out, try as different physical therapist. I've had trouble with spending too much time in front of a computer (my shoulder, elbows, and wrists suddenly start to fall apart every 5 years or so). Most doctors want to medicate or operate. A *good* physical therapist will do a very careful evaluation, discuss the ergonomics or your problem, perform some in-office treatments (massage, ultrasound, electric stimulation), and make you do a ton of exercises (properly!) every time you visit, and give you more exercises to do at home. If your visit lasts less than an hour and you aren't at least a little sweaty when you leave, you didn't see a good physical therapist. All that exercise will make you stronger which will keep you from hurting yourself.
As with you chiropractor, you could try to find someone who works on serious (though not necessarily professional) athletes. Serious athletes have to find treatments that really work.
Good luck, and feel better!
1. Colloidal Silver- (use sparingly)
2. Tanning salon
3. I think it is your neck, not your lower back. Try driving to work for a while, because biking causes you to lean forward. Avoid other activities where your head is not centered over your body.
4. Try raising your monitor 1 inch, sit a bit closer to the desk and keep your back a little bit straighter. Make sure you have room for your legs where you sit.
5. Hot compress, hot shower, 1 bottle advil.
6. Imagine how it felt when it didn't hurt.
7. Continue stretching. Light massage.
8. Vacation from blogging and or work. 🙂
Ouch! I second TJ's advice about getting someone who will actually look at the ergonomics of your workstation(s) and make suggestions. I did not have too much luck the one time I went to a chiropractor, it was just as you say, they were more interested in pushing pills and treatments than in what was going on with me. Then I went to a Sports Medicine MD who actually went through and analyzed the different kinds of movements I was doing and prescribed the right combination of exercises, rest, and ice, Anyway good luck, I will "send you some good energy" (Santa Cruz equivalent to prayer).
Erich, I have used acupuncture for allergy relief as well as pain relief and often found it far more effective than drugs. After a botched surgery some years ago, I was diagnosed with "chronic neuropathy (constant nerve pain)" which makes my right groin area feel 24/7 as though someone had just given me a hard shot there.
Doctors had prescribed many thousands of pain pills, some of which were narcotics (I BRIEFLY took oxycontin until I was so out of it my daughter asked my wife if she had fed me soap–I was foaming at the mouth!), which did little to ease my discomfort and add to my functionality (one medication kept me awake for three days and didn't impair my functioning, I crashed and after eight hours sleep went back to work!).
Alternatives such as acupuncture and meditative practices have supported me at living with chronic pain, even after a fall on an uneven sidewalk which broke my ankle, leg and tore ligaments and tendons (requiring reconstructive surgery) made such far worse. Good luck with your treatments!
9. And make sure your pillow is not too worn out or too thick. Also, your bed should be flat, not concave like a hammock.
I trashed my lower back in '92. I couldn't stand up straight, or sit down without wincing. I refused to take strong pain pills or to consider surgery, and so went to a neighbor who had just hung up a shingle as a chiropractor. After taking x-rays and a suite of range-of-motion tests, he did acupuncture, and electro-stimulation, and regular adjustments. He also showed me simple exercises and stretches, and taught me what to look for in terms of early warning signs.
It took a few weeks of 3 times a week, a few more of twice weekly, a couple of months of once a week, then a while of bi-weekly, and out.
The direct treatments may have helped. But the education on how to keep myself "adjusted" got me off of his regular patient roster in a few months. My insurance didn't cover it, you see. It may have cost as much as the surgery to get as well as the best possible outcome of surgery. But no surgical risk. No strong drugs. And I am armed with the know-how to keep myself generally pain free for 14 years.
Minor setbacks I can deal with on my own. So I now rarely get professionally adjusted.
Thanks for all of the advice, stories and encouragement, everybody! I didn't mean to have this be so much about me as about acupuncture and chiropractic, but it's fun to receive all of this personal attention.
Ben: I haven't actually been riding my bike much at all over the past month. It's been a series of problems: bitter cold or ice on the ground or cold rain or need for the car because I need to drop the kids at school or go to court in a suit that day. It has occurred to me that, perhaps, the lack of that exercise might be exacerbating the problem. For that reason (and for ecological reasons) I need to get peddling more often.
I am trying to get exercise in other ways though. For instance, we have a NordicTrak at home.
Also, if (when!) this pain resolves, I could point to another potential cause–over the last few days I've been making use of a thin pillow that allows me to move around while sitting. Clever and simple device. Check it out. http://www.backvitalizer.com/main.php
I realize that I'm probably trying to do this all wrong. Perhaps I should be figuring out how to NOT sit in front of a computer so many hours per day. One way to do that would be to retire, but that would mean starving my children at this point in my career. Or maybe I could change careers and give up the blog, but I'm unusually lucky to enjoy these two activities to the extent that they aren't just things I do–they ARE a part of me. I would not be able to say that about some other phases of my life. I'm stuck sitting in front of the monitor if I want to do the things I'm doing. But thanks, Ben, for the reminder about monitor height. I've raised my monitors at work by about 3" and it feels better. I've also raised the height of the monitor at home.
Given all of this attention to my pain (as much as it does sometimes hurt and distract), it just isn't anything compared to the pain felt by many people going through chronic intense pain where there might not be a real and affordable escape. As I said, I'm feeling lucky.
That said, this post might segue nicely into other bits of advice for avoiding the kind of pains that occur when someone spends far too many statue-like hours in front of a computer monitor, day after day.
Actually, another thing that did help my back (when it was quite bad) was to use one of those odd "back chairs". I got one on casters for my computer. (I've got an original Swedish one to get rid of, should anyone want it.)
I gave that up after a couple of years because my right shoulder got a bad case of "mouse shoulder". So I got a chair that lets my arm rest on the chair arm as I use the mouse (conveniently just beyond the end of the arm). I also got a special narrow keyboard that has full size keys, all of them, but not those wide, blank areas between the sections. That way, my mouse isn't so far to the right. I've used this same keyboard now for at least 10 years. Here's it's image, and where I got it:
<img src="http://www.crystalvisions.com/images/KB-16RKME.jpg">
This keyboard predates Windows, so there are no Windows (or Mac) specific keys. I use ctl-esc for the window key.
Bad ergonomics is the leading cause of strain injuries. It also would be so easy to remedy, if only they taught body mechanics in "physical education" classes. But it is not too late to learn.
Erich, anything that eases the pain is good, but I'm glad the Chiropractor gave you advice about posture and exercise. The treatments you're getting might help short-term, but you need to plan ahead.
I've been in pain since, oh, the last 17 years or so. Mild scoliosis made worse by public school phys-ed "posture classes" finally took its toll. Vigorous spinal manipulation by one chiropractor brought me tons of relief, but required regular visits for years. I tried two different chiropractors in my new town who both used much more gentle maneuvers, including electrical muscle stimulation similar to what you're getting, but without the needles. Didn't work. I was so desperate, I was willing to sit two hours each way in the car to get an adjustment from my old doctor, then I got a recommendation for an orthopedist. He wasn't on my insurance (few decent doctors are, sadly) but he gave me a good discount for paying cash, and really spent a lot of time with me for that. He sent me to a physical therapist who really knew what he was doing, and he explained his philosophy, "The chiropractor wants to keep seeing you every week for the rest of your life. When you're done here, I never want to see you again." The exercises I got were specific to my pain, and strengthened the supportive muscles front and back, and if I keep them up, I'm pain-free. If I lapse, a few days back on the exercises and I'm better again. So, IMHO, keep up the search for a good ortho/PT team while you're getting relief from the acupuncture. They are out there, just hidden away among the mediocre ones.
I'm squarely with Dan on this one. Bad ergonomics is the problem here, and fixing that problem is almost certainly the long-term solution. Raise your monitor to eye level, so you're not hunched over. Invest in supportive, adjustable chairs. And, as the chiro suggested, take frequent stretch breaks.
Speaking of which, I would bet the effectiveness of Erich's treatment has a whole lot more to do with the stretching he's doing than with the accupuncture.
As regards chiropractors in general, I know one person (a family friend now in her 50s) who has spent a lifetime with permanent and severe spinal deformity because her parents took her (as a child) to a chiropractor instead of to a 'real' doctor. I know another person — a close relative — who nearly died last summer from a life-threatening spinal infection because a chiropractor utterly failed to recognize the seriousness of the condition. In my opinion, most chiropractors aren't just quacks, they are a danger to the community. Mostly, they appear to rely on the placebo effect and basic physical therapy (stretching, light exercise, massage, etc.)
By contrast, I've had excellent results from physical therapists, on three different occasions I can think of. No, that's not a statistically significant sampling, but a perfect track record is not insignificant, either. In each case, my physical therapists were able to clearly explain what was wrong, as well as the rationale behind their treatment plan. I've yet to hear *any* chiropractic patient report that they received any sort of clear explanation of anything.
grumpy,
As a chiropractic physician, I take issue with several statements of yours as follows:
“who nearly died last summer from a life-threatening spinal infection because a chiropractor utterly failed to recognize the seriousness of the condition. In my opinion, most chiropractors aren’t just quacks, they are a danger to the community. Mostly, they appear to rely on the placebo effect and basic physical therapy (stretching, light exercise, massage, etc.)”
This example is truly sad indeed and said doctor should be held for their lack of quick referral to the proper specialty/treatment. However, the same can be said of any physician in such a case. The competence of a chiropractor should be question in such an example BUT so should the competence of any health care provider who makes such an error. Why generalize the profession as being dangerous when such erros are made by MDs, DOs, etc. as well? Do you hold them accountable profession-wide as well?
How about the example of a chiropractor (myself) referring a patient with low back pain (chronic) which changed in nature, to his oncologist (he had a history of prostate cancer which was “in remission”) only to find out it had returned AND thanked by his oncologist for the timely referral which potentially gave him more time than had it gone on much longer? Is this a “danger to the community”?
“I’ve yet to hear *any* chiropractic patient report that they received any sort of clear explanation of anything.”
Read and research. There are many well-spoken, very intelligent chiropractors who contribute much to literature and advancement of physical medicine, as an example. This is a very biased statement and one which bleeds from ignorance.
Finally, as a chiropractor who works in a neurology clinic, I wonder, after reading your blurb, why the neurologist (and an Internal medicine doctor) refers patients to myself for conservative treatment and physical rehab., mobilization/manipulation after evaluation?
I've stopped the acupuncture treatments. They gave me some relief, but it was only temporary relief (less then a day of relief, much like massage therapy) and they cost about $70 each.
I switched over to my GP, who took lots of x-rays and said that I had mild osteoarthritis in my neck. That doesn't really tell me why it all started hurting; after all, 2 months ago, I presumably had a similar cervical spine, yet no pain. He offered physical therapy and that's probably the route I'll pursue if the pain doesn't subside more.
It was an interesting adventure to go to a chiropractor to get acupuncture. Maybe it works for some people, but not for me.
The saga continues. I've switched to an M.D., and I'm scheduled for an MRI next week. It's interesting to compare the different styles of the different health care providers. But perhaps it's possible to know TOO much about one's own body: http://dangerousintersection.org/2008/03/06/hey-t…
I'm a little late to the party here, but I found the blog while looking for information about chiropractic. I hope you (and other posters with pain problems) are doing well and have found some relief. If not, please allow me offer unsolicited medical advice…
Consider looking into whether you might have trigger points that are causing your pain and mis-alignment. Trigger points are basically little contraction knots in the muscle fibers that shorten the muscle, interfere with range of motion, strength and cause pain (including referring pain to areas away from the point itself.). Bad ergonomics can perpetuate them.
I've had all sorts of muscular pain and trigger point therapy (not general massage) is the only thing that seems to have reliable results for me. There's a great book by Clair Davies called The Trigger Point Therapy Workbook, and by using that as a reference I've been able to manage without much professional intervention.
Great blog, BTW
Very Interesting
But there is one problem here, from what I see on the photo the acupuncture peformed was not only performed incorrectly but it also carried the risk of endangering the patients life via pneumothorax. The points shown in the photo are backshu points as well as other points. The needling technique was done perpendicular which is a very big no no with points in this area. The correct needling method would of been transverse oblique.
This is the problem with allowing other professions not just chiropractor to perform acupuncture with little or no training. Now that is not to take anything away from chiroprator as I do like them and have friends who are chiropractors. But acupuncture should be performed by Licensed acupuncturists who have gone to the complete 4 years of trainnig not only with acupuncture but also oriental medicine. If I knew I could add spinal manipulatioin to my scope with only a couple of hundred hours of training I would have to decline to do so as that is not enough training to perform it correctly as you should go to 4 years of chiropactic school if you want to perfrom spinal manipulation.
My dad once siad that if you need a plumber you would not call an electrician. So the same should be if you want acupuncture you should not see another doctor that is not fully trained.
If I were an expert witness to the above photo in a pnuemothrorax case I would have to say that from what I see it is clearly malpractice on the part of the person treating
Thats my two cents
Yin Tang: I believe that the acupuncture offered some relief for a few hours each visit. Then the pain came back to where it was before. I have not suffered any injury as a result of the acupuncture. Nor did it bring me any lasting relief.
BTW, I am largely OK now. I saw several additional doctors, all of them MDs. The most recent doctor indicated that my condition (which you can see at the links at the bottom of this comment) is "gray hair of the spine." My spine looks a lot like the spines of most people my age (52).
I will comment further because this sort of thing affects so many people, Basically, I'm taking Naproxen each day and my condition has stabilized. I even played a bit of racquetball. It is amazing to me that I can function normally because the pain was so incredibly severe in prior months.
My surgeons both discouraged surgery, and both suggested that I put off surgery until/unless things flame up again or if I start experiencing weakness or numbness. They both indicated that many of these pinched nerve conditions resolve on their own. Mine did. If I'm lucky the pain will stay away.
The surgeon I saw most recently said that "vigorous physical activity" is the best thing, NOT living a sedentary life. Therefore, I'm working hard to stay in shape and I'm actually pushing my neck through some stretches.
I bought a home traction device (for $25) and it seems to have helped. I've used it only a few times in the past two months.
I feel very good and very lucky that the pain mostly gone (though some days, it is . . . well . . . painful). Having that pain made me much more tuned to the problems of all of those people out there with chronic pain. It can interfere with your life greatly. It can get you depressed and it can even wreck your life.
BTW, Here's the traction device I bought. http://www.sitincomfort.com/ovtrsetcetrt.html I've only used it a couple of times, but I do think it helped. It was only $25 and it does the same thing that the physical therapists were doing for $200 per visit (much of that NOT covered by my insurer, somehow … though that is a separate story). It looks rather silly and I felt silly using it (my kids chuckle). But it actually did help.
http://dangerousintersection.org/2008/03/06/hey-t…
http://dangerousintersection.org/2008/04/08/getti…
Erich,
Glad to see your doing better. I would still highly reccomend that you give acupuncture a second try. I reccomend that you visit a fully trained acupuncturists in your area. In some states acupuncturists are allowed to also perform acupuncture injection thearpy which is also very effective for pain relief and a many more medical conditions. I know that you will see a major difference in the treatment from a real acupuncturist as opposed to someone with a couple of hundred hours of training or no training at all.
Acupuncture and oriental medicine (TCM) is a complete medical system capable of treating almost anything. Scientific studies are greater in numbers now. Just check out pubmed.gov which has many scientific articles on acunpuncture and its effectiveness.
For the average person TCM can seem strange with how it explains disease. Remember that a lot of terminology in TCM may seem strange but it has many of the same meanings as western medicine but just with a different name. You will find a growing number of MD's in support of acupuncture and oriental medicine due to that TCM has the same methology but with a different means to treat a condition.
One thing I would like to point out is that acupuncture has been around for over 3000 years. I do not think it would have lasted that long if there was not something to it. It provides real alternatives to condiitons that are not responding to conventional treatment. I also believe that if a person included TCM in there care earlier to complement conventional treatment then many conditions would respond better.
If you ever get a chance please read the book "Between Heaven and Earth" it is a wonderful book that answers a lot of questions with regards to Acupuncture and TCM
Good luck my friend and I hope that you find peace in your road to recovery.
In Health,
YinTang
Here's some good first-hand advice from a rugby player who dealt with the same type of pain that I've been dealing with. http://www.brooksvannorman.com/how-i-dealt-with-a…
BTW, things are much better–my pain is now typically a 1, 2 or 3 (out of 10), instead of 7 or 8. The last doctor I saw was a spine surgeon who advocated "vigorous physical activity," and absolutely not a sedentary life style. I'm taking one Naproxen per day, occasionally using neck traction (at home–a $25 device) and trying to stay active. I can't believe how much better things are.
Now we learn that even fake acupuncture is helpful. http://featuresblogs.chicagotribune.com/features_…
There is a lot of woo out there regarding acupuncture. It has been demonstrated, in certain cases, to effect pain sense and pain thresholds. It has also never been demonstrated to have any effect (beyond placebo) on non-pain related ailments.
There is a lot of mis-information out there. Much of it, as with homeopathy, written by people with the prospect of financial gain in mind. Of course they will confirm the efficacy of the treatment they sell.
One challenge with most 'alternative therapies' (especially traditional ones) is that acceptance of the part that works often results in the bundling of all the parts that don't work. Many of the studies that have investigated acupuncture were beset by poor (or nonexistent) controls. As better, more structured studies are performed, and more science is done to investigate why some acupuncture procedures work at all – we'll gain a better handle on pain in general, and on therapies to treat pain.
Therapies that work will get used and become conventional medicine. Those that don't will remain 'alternative'.
A good starting point for medical research is pubmed (for papers – be sure to confirm the rigor of the study – does it involve adequate controls, double blinds, etc).
I found Vanderbilt to provide a good (if ugly!) background on acupuncture, as well as some of the current theories on why it works at all (when it does).
Few things I like to comment on is that
1) I support Yin Tang's points that acupuncture should be done by well-trained acupuncturists.
2) There are a lot of methodological issues with current acupuncture studies. For example, when they NAME a control group called "placebo", they have not had any studies to prove they are really placebo. Let's pick Erich's example at "http://featuresblogs.chicagotribune.com/features_julieshealthclub/2009/05/even-fake-acupuncture-helps-back-pain.html", it mentioned that toothpick produced better result than conventional care. So who said toothpick does not or should not have effect? Also, by looking at the data, if you look at their study, they also show the so-called placebo group also produced pain reduction. So if it is meant to be placebo, why would it have effect? Just like in 2002, my colleague told me the result of a clinical trial on an anti-depressant drug. He said at the end of the trial, the result of the so-called placebo worked better than the drug, after the researcher told the participants that they received placebo, their depression were worsened and the drug group showed improvement. So who said their placebo pill should be ineffective? The data tell us that it worked. But when the researcher explained the placebo group received something ineffective, this made the participants depressed and hence their depression symptoms got worse. So in order to say "Something does not work" or "Something should not work", one has to have study to prove that is the case, otherwise the comparison is treatment vs. control of unknown effect.
The clinical trials do not reflect the practice of acupuncture. In clinical practice, acupuncturists do not just treat based on a fixed protocol like clinical trials do. They will find other ways to treat a condition if their treatment is not giving satisfactory result. This is different from clinical trials. So if you see clinical trials concluding that acupuncture is not effective to treat such and such condition, that doesn't mean acupuncture CAN NOT treat such condition. That means this acupuncture protocol is not effective to treat such condition.
3)Erich's treatment of the back. It is true that when needling on the upper back, one should not needle perpendicularly to prevent pneumothorax (puncturing of the lung) from occurring. Erich did not end up as pneumothorax. I can only say that he is lucky. But as a practitioner who really cares their patients, one should not do any treatment that will endanger or have high chance to endanger patient. I read a case in NSW, Australia. http://www.physioreg.health.nsw.gov.au/hprb/physi…
4) I would like to comment on TJ's comment on Chi or Meridian are nonsense. They are not nonsense. It's just that modern science speaks different language from traditional Chinese medicine. And hence modern science has difficulty to understand traditional Chinese medicine's language. But that does not make traditional Chinese medicine nonsense. Think about MDs used to say that traditional Chinese medicine treatments were psychological effects only. But more and more clinical researches are demonstrating that traditional Chinese medicine treatments work and work well, too.
5) MDs prescribe placebo pill sometimes for patients. If it's all "placebo" effects, what makes them to practice acupuncture? If acupuncture is purely placebo, why would they bother to spend another hundred hours to study acupuncture just so they can practice acupuncture? (I believe prescribe placebo pills do not require them to study further.)
I'd really like to hear a follow up to this procedure as I'm an Information Technology Manager and I too sit in front of the computer for hours, I also cross my leg often when sitting (bad for back), I sleep on my stomach (also bad for back and neck), and I have horrible posture. Sometimes I sit with one leg bent with my foot on couch. I just turned 30 and I swear it's like the day after my 30th birthday my body wants to break down. 🙂 Anyway, the jury is still out on acupuncture and chiropractors. Acupuncture reminds me of ridiculous taboo things like placing your belly on a leather strap and having a machine jiggle/vibrate it to lose weight. Then chiropractors are notorious for simply looking to milk the man (the insurance company). But I'm fine with seeing either once per month if that's what it takes to relief my neck and shoulder pain. Anyway…if you could let me know your final thoughts 2 years later I'd really appreciate it.
Derrick: Here's a rather complicated follow-up: http://dangerousintersection.org/2009/06/06/my-in…
I am a huge skeptic, and admitted hard head when it comes to alternative medicine (translation: extremely stubborn to the point of utter obstinance and disdain). I don't know who said it, but I like the phrase, "If it were real medicine, then it would be called…medicine."
And for that, I catch the wrath of my wife. Big time. (So we no longer "discuss")
I had intra-muscular stimulation (current through the needles) for recurring shoulder pain, performed by a Korea Navy doctor, when I was in Korea. He wanted to make it very clear to me that it was "American" and not Asian medicine, as he learned it at Emory University. A fellow officer had it done for back pain and claimed it worked. I never saw a difference, but it wasn't until I came back to the states that we learned through MRI that I had cysts inside the joint, and during surgery, that I had a spur "shredding the cartilage". So it wouldn't have worked for that anyway, thus my trial was a non-trial.
There are studies that show tradition acupuncture relieves back pain, but none to support any other benefits. I remain a skeptic (but a quiet one on this matter when around my wife!) It took me a while to accept osteopathy (my most excellent current family doctor is a D.O.), and have yet to accept chiropractic. Long ago, I read Martin Gardner's "Fads and Fallacies in the Name of Science" in which he did not treat either well. Osteopathy has come a long way since 1952. I'm not sure about chiropractic.
Jim: I love it (not really) when a believer in chiropractic/homeopathic/copper-bracelets accuses you of approving of EVERYTHING an MD has ever done in recorded history just because you criticize their favorite mode of alleged treatment. No, I don't think every MD is a great doctor or that all treatments approved by insurance companies are worthwhile! In fact, I think that there are tons too many ceasarians, knee arthroscopies and histerectomies (among other surgeries) performed by MDs, among many other abuses. Am I being clear? Good.
Now, I must also state that I've heard far more nonsense out of the mouths of chiropracters than most other "health care professionals." I've had chiropracters pathetically misdiagnose me based upon the lamest of electronic gizmos at outdoor fairs, for instance. I'm not suggesting that all chiropractors are that bad. But do consider that "subluxations," the gold standard for chiropractic, is fraught with conceptual and practical haze.
Bonus video: Take a look at James Randi's harpooning of homeopathy, another favorite of some chiropracters (and some MDs): http://dangerousintersection.org/2010/05/17/overd…
Love Randi's stuff. Someone put together a list of his top ten debunkings for his site. I'll look up the link and pass on.
Concur with your comments on MDs; after all, it is still a statistical science – "we're pretty sure this is what you've got and that is what we need to do to fix it." But there is science behind it.
I'm still recovering from an accidental homeopathic overdose of e. coli because some of the water I drank last week still had a memory of having been exposed to bacteria a couple hundred years ago. Fortunately, my symptoms were equally concentrated, thus I never noticed, and the cure was found in near nil concentrations in subsequent (or was it prior?) water I drank.
Randi and homeopathy – now THAT's a Dangerous Intersection!
As a chiropractor of 33 years, I need to comment here. I can’t even tell you how often people come to me after trying everything else and they are helped with chiropractic care. People come in who have abused their bodies for years and expect to be cured with one chiropractic adjustment. I try to explain that chiropractic isn’t like popping a pain pill. Chiropractic physicians are correcting the problem from within, we aren’t covering up the symptoms with a pill.
Yes, there are some bad chiropractors but there are unethical doctors in every profession. All people are in their profession to earn a living, including medical doctors and attorneys. Earlier someone mentioned chiropractors recommend natural methods because they want to make money. Do you think medical doctors aren’t rewarded when they recommend meds? I get really frustrated when all medical doctors do is recommend medications that are toxic to our bodies. Medications like naproxen may cover up the pain but long term use of most medications will damage the kidneys and liver.
So I will proudly stay with my profession. People have been making fun of chiropractic for years, but I know I provide a great service. My patients love me.