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.
The Research Is Out There, If You Know Where to Look
At the beginning of each year, Acupuncture Today conducts a poll on its Web site that asks readers to choose what they feel is the most important issue facing the profession. One issue that always seems to register with people is research. In 2002, "research that validates the safety and effectiveness of acupuncture" was considered the most important issue; in 2003, it ranked second in the poll.
Interestingly, acupuncture research is also one of the most frequent questions people ask us about. "Why don't you publish more reviews of acupuncture studies?" they'll say. Another popular question is, "Do you have any studies on acupuncture and (insert topic here)? My insurance company won't reimburse for my services unless I can show proof that acupuncture works."
In the interests of helping out the profession, I decided to do a little amateur detective work. I visited PubMed, a search service maintained by the National Library of Medicine, which provides access to the MedLine database and abstracts from more than 4,500 biomedical journals published in the U.S. and elsewhere. I conducted a simple search for any studies published in the last 10 years that referenced any of the following terms: "acupuncture," "chiropractic" and "massage therapy." The results of that search are listed in the table below.
Results of PubMed/MedLine search for articles on acupuncture, chiropractic or massage therapy, 1995-2004 | |||
Year | Acupuncture | Chiropractic | Massage Therapy |
1995 | 177 | 159 | 4 |
1996 | 204 | 151 | 5 |
1997 | 170 | 134 | 11 |
1998 | 231 | 155 | 16 |
1999 | 263 | 160 | 24 |
2000 | 245 | 144 | 25 |
2001 | 323 | 144 | 16 |
2002 | 394 | 127 | 34 |
2003 | 382 | 122 | 16 |
2004 | 406 | 129 | 22 |
Totals | 2,795 | 1,245 | 173 |
Now, this is by no means a scientific analysis. For instance, my search didn't measure how many of the studies consisted of randomized, controlled trials, and it didn't exclude any simple case studies or trials that had low patient populations. Studies on herbs weren't included in the search. Chances are also good that some studies examined all three therapies, so there's probably some crossover in the results.
What this search does show, though, is that research on acupuncture is definitely out there - and that it's growing by leaps and bounds. Many of the studies on acupuncture are being published not only in Oriental medicine journals, but also in peer-reviewed medical journals. Research on chiropractic care, on the other hand, seems to be tapering off, while research on massage therapy seems to be going through growing pains - up one year, down the next.
So, how can you keep abreast of what kind of acupuncture research is being conducted? Here are a few suggestions:
- Visit the PubMed search service and bookmark it. You can access it via the National Library of Medicine's Web site (www.nlm.nih.gov). It is updated weekly, free, and extremely easy to use. Many of the abstracts on PubMed contain links to the full-text versions of journal articles. Some articles are free; others can be accessed for a fee.
- In cases where you can't access an article online, you can subscribe to a document delivery service. Two of the most popular ones are BioDocuments (www.biodocuments.net) and Infotrieve (www.infotrieve.com). Another good site is DocDel (www.docdel.net), which provides links to dozens of document suppliers. Some of the services can be expensive, so it pays to compare prices before settling on one supplier.
- The Society for Acupuncture Research is a nonprofit organization designed to "promote scientifically sound inquiries into the clinical efficacy, physiological mechanisms, patterns of use, and theoretical foundations of acupuncture, herbal therapy and other modalities of Oriental medicine." The Society has its own Web site (www.acupunctureresearch.org) and journal, and hosts an annual conference every fall. It's definitely worth checking out.
- Another good site is AcuBriefs (www.acubriefs.com), which was established by the Medical Acupuncture Research Foundation and is now supported by the Best of Both Worlds Foundation. The site contains a database of previous articles, links to various publications, and a quarterly electronic newsletter.
I hope you find these sites useful, and that they will add to the success of your practice. If nothing else, they will give you a better idea of what type of research is being conducted on acupuncture, and what areas need to be evaluated more closely. If you have any questions about how to use these sites, or if you know of any other good research sites that I didn't include in this article but that the profession should be aware of, please feel free to contact me at the e-mail address below. See you next month.