Acupuncture, Alternatives To Narcotics (with a focus on injured members of the military)

[drokhole]

Excerpt from the movie Escape Fire: The Fight to Rescue American Healthcare:

"Fifteen years ago we did a consensus conference at the National Institutes of Health and we asked the question, 'do we have good evidence to show that acupuncture is safe and effective for any condition?' They said, 'absolutely its been demonstrated that acupuncture is safe and effective, especially with post-operative and injury pain.' Fifteen years later, you can't walk into your average hospital today and get acupuncture after an operation. The problem is not that it doesn't work, the problem is that we haven't figured out how to get it into the system so that we can make it widely available to the population."

Acupuncture is worth a try for chronic pain (Harvard Health Blog)

Acupuncture for Chronic Pain (JAMA Internal Medicine)

Efficacy Of Acupuncture For PTSD In Military Personnel (US Army slideshow presentation)

[Thinkingabout]

1. I have usef acupuncture on more than one occassion and recommend it to others.

My dog also had acupuncture for a pinched nerve in her neck and after three treatments she was back to herself. You can't get a little doggie to you a wrong answer on her pain relief.

[freshwest]

2. Thanks for last two links there. JAMA piece is interesting. And I've heard a lot about the second

from doctors. Not acupuncturists, chiropractors, massage therapists, but MDs trying to help them.

I have family who have long been suffering implacable pain and all that follows from that coming from service related injuries. They had deteriorated greatly for years and saw their lives slipping away. The just finally accepted their deaths.

Now their doctors are trying to find alternatives. They are getting better. The issue is always, not who is right or wrong or any vested interest, but that the patient recover.

It's not hocus pocus. The only issue of importance is the patient. It's lost in some discussions. I don't see the compassion or feeling for the person.

[longship]

3. Acupuncture is worthless.

It doesn't matter where you stick the needles. It doesn't even matter even if you stick the needles. So much for Xi.

http://www.sciencebasedmedicine.org/acupuncture-revisited/

http://www.sciencebasedmedicine.org/acupuncture-doesnt-work/

It's just like this:

[drynberg]

4. In 1988 I had a "spiral whiplash" to my neck from being hit in the auto rear

I had about 120 acupuncture treatments over 2 1/2 yrs. and regained a full night's sleep and range of movement. This ain't placebo effect and my initial MD. said I'd never walk again. Acupuncture is worth pursuing, as it is a chemical free method of not only pain relief but "rewiring the nerves". As a note, I also went to about a 120 chiropractic adjustments at the same time on alternate days. This stuff works if the person you are going to is competent.

[Quixote1818]

5. Acupuncture has been proven in peer review journals to work, the results were just not impressive

However, if I were in a lot of pain and it helped some that would be awesome. I would probably try it to see if it worked for me. This CNN link sums up the JAMA Internal Medicine study you have linked to: http://www.cnn.com/2012/09/11/health/health-acupuncture/

Snip> "Acupuncture does appear to have some very small benefit above and beyond placebo acupuncture or sham acupuncture," says Avins, who wrote an editorial accompanying the study. "But the effects really are pretty small, and the majority of the effect is a placebo effect."

Acupuncture skeptics will likely seize on this point, Avins says, but the study findings don't mean that acupuncture doesn't work, or that doctors shouldn't refer pain patients for the treatment.

Acupuncture, he suggests, should perhaps be viewed as a way of providing modest pain relief while also harnessing the placebo effect.

"In the past, people have viewed placebos as negative things, (but) they could have some real benefits for patients," Avins says. "I would be hard-pressed to tell a patient who says they're benefiting from something that's 'just a placebo' to stop using it."

End quote.

To be clear the difference beyond the placebo was so insignificant in the study many scientists didn't think it proved there was anything beyond a placebo. It was the difference of 0.5 on a 0-10 scale:

Snip> What Vickers et al are arguing is that a change of 5 on a 0-100 pain scale (which would be a change of 0.5 on a 0-10 pain scale), a subjective scale, is noticeable by patients. It’s probably not.

Here’s a hint: -5 (the difference between sham acupuncture and “real” acupuncture) is not clinically significant. The only way you can even approach clinical significance is to compare no-acupuncture controls versus acupuncture, in which case you’re adding placebo effects into any other effect observed, even if that effect is real (which I highly doubt it to be). Indeed, Vickers et al labor mightily to try to convince readers that this tiny effect, if it exists, is not just statistically significant, but clinically significant. They doth protest too much, methinks. In fact, I very much like how the grand master of the scientific analysis of “complementary and alternative medicine” (CAM), Edzard Ernst, put it:


Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said the study “impressively and clearly” showed that the effects of acupuncture were mostly due to placebo. “The differences between the results obtained with real and sham acupuncture are small and not clinically relevant. Crucially, they are probably due to residual bias in these studies. Several investigations have shown that the verbal or non-verbal communication between the patient and the therapist is more important than the actual needling. If such factors would be accounted for, the effect of acupuncture on chronic pain might disappear completely.”

http://scienceblogs.com/insolence/2012/09/12/can-we-finally-just-say-that-acupuncture-is-nothing-more-than-an-elaborate-placebo-can-we-2012-edition/

[rwsanders]

6. I'm in a physical therapy program and I've learned a lot about pain. I hope to learn a lot more...

especially spinal pain.
Pain has many forms. It can be a real pain, pain from other nerves that are mistakenly sending input through pain channels, normal sensations that can cause pain, or (real) pain that is generated from the nerves or central nervous system.
Instead of medication, each cause should be explored and proper treatment given.
There is a lot a good physical therapist can do for pain also. Of course I'm now biased, but I think PTs will more often work toward getting at the cause. Most other practitioners don't have the time or the understanding of movement patterns and musculoskeletal injuries.
Bottom line, don't forget your friendly local PT if you are trying to live pain free.