The curious case of acupuncture

John Marino was the most driven man I ever met, a monomaniac on a mission to break the U.S. transcontinental cycling record — which he did in 1980, covering the 3,000 miles in 12 days, three hours. I wanted to be like John, so that year I took up serious cycling. In addition to pedaling hundreds of miles a week with him, I followed his training regimen of vegetarian meals, megavitamin dosing, fasting, colonics, mud baths, iridology (iris reading), negative ions, chiropractic, massage and acupuncture.

Although most of the nostrums I tried were useless, I noted with interest (because he beat me) that Jonathan Boyer, the winner of the 1985 Race Across America (co-founded by Marino and me), had a Chinese acupuncturist on his support crew. Given the successes of Marino and Boyer, it seemed possible that there might be a biomedical connection.

Traditional Chinese medicine holds that a life energy called Qi (“chee”) flows through meridians in the body; each of the 12 main meridians represents a major organ system. On these 12 meridians are 365 acupuncture points, one for each day of the year. When yin and yang are out of balance, Qi can become blocked, leading to illness. Inserting needles at blocked points — believed to number about 1,000 — supposedly stimulates healing and health.

This theory lacks any basis in biological reality, because nothing like Qi has ever been found by science. Nevertheless, a medicinal procedure like acupuncture may work for some other reason not related to the original, erroneous theory. Electroacupuncture—the electrical stimulation of tissues through acupuncture needles — increases the effectiveness of analgesic (pain-relieving) acupuncture by as much as 100 percent over traditional acupuncture. So says George A. Ulett, a practicing physician and acupuncturist (with both an M.D. and Ph.D.) and author of the 1992 Beyond Yin and Yang: How Acupuncture Really Works and the 2002 textbook The Biology of Acupuncture (both published by Warren H. Green in St. Louis). Ulett posits that electroacupuncture stimulates the release of such neurochemicals as beta-endorphin, enkephalin and dynorphin, leading to pain relief. In fact, he says, the needles are not even needed — electrically stimulating the skin (transcutaneous nerve stimulation) is sufficient. Ulett cites research in which, using this technique, the amount of gas anesthetic in surgery was reduced by 50 percent.

These findings might help explain the results of a study published in the May 4, 2005, issue of the Journal of the American Medical Association, in which Klaus Linde and his colleagues at the University of Technology in Munich compared the experiences of 302 people suffering from migraines who received either acupuncture, sham acupuncture (needles inserted at nonacupuncture points) or no acupuncture. During the study, the patients kept headache diaries. Subjects were “blind” to which experimental group they were in; the evaluators also did not know whose diary they were reading. Professional acupuncturists administered the treatments. The results were dramatic: “The proportion of responders (reduction in headache days by at least 50%) was 51% in the acupuncture group, 53% in the sham acupuncture group, and 15% in the waiting list group.” The authors concluded that this effect “may be due to nonspecific physiological effects of needling, to a powerful placebo effect, or to a combination of both.”

In my experience, “needling” (where the acupuncturist taps and twists the flesh-embedded needle) isn’t painful, but it is most definitely noticeable. If acupuncture has effects beyond placebo, it is through the physical stimulation and release of the body’s natural painkillers. Finding that sham acupuncture is as effective as “real” acupuncture demonstrates that the Qi theory is full of holes. The effects of being poked by needles, however, cannot be ignored. Understanding the psychology and neurophysiology of acupuncture and pain will lead to a better theory. And for all such alternative medicine claims, testimonials can steer us in the direction of where to conduct research; science is the only tool that can tell us whether they really work or not.