"We are at a loss to explain why AT took it upon themselves to pit various types of practitioners against each other"
Dear Editor:
We, too, read the British Medical Journal's September 1, 2000 issue and the studies regarding the safety of acupuncture. The studies concluded that whether practice by physicians, physiotherapists or licensed acupuncturists, the rate of complications in acupuncture procedures was reported to be comparable among the groups, and remarkably low. (Note: see "Surveys Confirm the Safety of Acupuncture" in the November 2001 issue.)
We are therefore baffled by Acupuncture Today's unsubstantiated interpretation of the studies and are at a loss to understand why AT took it upon themselves to pit various types of practitioners against each other where the BMJ studies clearly did not. Your article drew comparisons that are significantly statistically specious. As you are aware, from the context of the studies, the method of data collection did not provide for independent objective corroboration. Additionally, Acupuncture Today's unilateral decision to compare the data from a group consisting of physicians and physiotherapists, whose education and acupuncture training differ considerably, with that of a "licensed acupuncturist" group is not only inappropriate and incongruous but borders on the provocative.
Rather than casting aspersions at each other's competency, we ought to band together to communicate that acupuncture is a safe and effective treatment option, and that both medical acupuncturists and "licensed acupuncturists" are doing a fine job of setting standards for their practices. This, in fact, was the conclusion of the studies reported in the British Medical Journal.
We must find ways to work together with the patients' best interests in mind to elevate the practice of acupuncture in the minds of Americans. We hope that in the future, AT will join us in this effort.
Marshall H. Sager, DO, DABMA
President, American Academy of Medical Acupuncture
Los Angeles, California
The following two letters were written in response to the article "Study: Acupuncture Better than Massage for Chronic Neck Pain," which appeared in the September 2001 issue.
Asian Bodywork Might Have Been More Effective
Dear Editor:
Thank you for sharing current research and study results. I was especially interested in the study of how acupuncture outperforms massage for the treatment of chronic neck pain. I am an Asian bodywork therapist; I practice amma, qi gong, nutrition and Chinese herbs in my practice. I also suffer from occasional bouts of neck pain due to an accident 16 years ago. Over the past 12 years, I have worked in several clinic settings. I have seen great success treating chronic neck pain with Asian bodywork therapy, as well as with herbs, qi gong and acupuncture.
I would love to see more studies done comparing Asian bodywork therapy vs. Western massage. I think meridian and point work in general may be more effective for myofascial pain syndromes than straight musculoskeletal work. When we practice Chinese medicine, whether with our hands or needles, we have a very different intention and perspective of the problem than someone practicing Western massage. I feel it is important to voice that the results of this study were the results of using a Western approach vs. acupuncture, but very well may not be reflective of what the results might have been if compared to Asian bodywork.
Rylen Feeney, BA, Dipl. ABT (NCCAOM)
AOBTA Director of Education
Boise, Idaho
Researchers May Have "Stacked the Deck" in BMJ Study
Dear Editor:
Your article on the trial published by the British Medical Journal comparing the effects of acupuncture and therapeutic massage on chronic neck pain was very interesting, but I do have a comment. All of the "conventional massage" techniques used in the study and cited in the article (petrissage, effleurage, tapotement, etc.) are those of Swedish massage and would be largely ineffective in treating chronic neck pain. Other massage modalities such as neuromuscular therapy and Oriental bodywork techniques work very well and have lasting results. When I was in practice as a licensed massage therapist, I treated many clients for chronic neck pain using both of those modalities, with results at least equivalent to those quoted for acupuncture in your article. Swedish massage was never designed to deal with chronic muscular pain of any kind, and I think it was "stacking the deck" if these techniques were the only ones used in the trial.
I am not maligning Oriental medicine; I am in fact entering an Oriental medical school in January as a natural expansion of my work in massage therapy. But, fair is fair! I'm sure that if an acupuncture practitioner were to engage in a study using acupuncture, that practitioner would like to have an effective trial treatment selected. I don't know who did the selecting of treatments for the British study, but the choices were poor, and any well-trained massage therapist would have told them so! Perhaps the choice of so many people to seek massage therapy for chronic neck pain reflects a reality that this study missed entirely.
Margaret Starsney, LMT
Albuquerque, New Mexico
Editor's note: The BMJ article in question states that patients were treated with "conventional Western massage"; that these massage techniques included "effleurage, petrissage, friction, tapotement, and vibration"; that the mode and intensity of treatment was chosen "in accordance with the patient's condition and diagnosis as usual in clinical routine"; and that "spinal manipulation and non-conventional techniques were not performed." Unfortunately, the article does not provide further detail on the techniques used in the trial.
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Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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