A pair of papers published recently in the Journal of Alternative and Complementary Medicine challenge the United Kingdom's NICE (National Institute for Health and Care Excellence) clinical practice guidelines for osteoarthritis of the knee, specifically the guideline's recommendation against the use of acupuncture as a treatment option for knee OA.
According to the abstract from the first paper,1 authored by Stephen Birch, PhD, of Kristiania University College in Norway, and colleagues, "[I]t is argued that this NICE guideline has limitations that lead to several potential biases in its evaluation of acupuncture, which were not addressed correctly … If the same criteria and methods that have been applied to acupuncture were applied to other NICE-recommended therapies for knee OA, including patient centeredness, patient education, self-management and weight loss, nonsteroidal anti-inflammatory drug (NSAIDs), and cyclooxygenase-2 inhibitor (COX-2 inhibitors), these too would no longer be recommended and opiates would become the first line of drug prescription."
The title of the second paper, a commentary authored by Hugh MacPherson, PhD, Department of Health Sciences, University of York (U.K.), makes the author's issue with the NICE guideline abundantly clear: "NICE for Some Interventions, But Not So NICE for Others: Questionable Guidance on Acupuncture for Osteoarthritis and Low-Back Pain." Dr. MacPherson's commentary appears in the same issue as the Birch, et al., review.
Both papers are available online (for a fee) through the journal's publisher, Mary Ann Liebert, Inc.; John Weeks, editor-in-chief of the journal and editor / publisher of the Integrator Blog, also has an interesting piece on the topic (including the papers' mention in Popular Science) in Integrative Practitioner.2
References
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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