In the UK during the 1990s and continuing into this century, many newspapers and magazines carried a weekly Question & Answer column for readers interested in complementary and alternative medicine (CAM). TV and radio “phone-in” programmes had a regular CAM therapist to answer health queries.
During this period, public interest in CAM fuelled a growing demand for NHS access to non-drug therapies, such as acupuncture, chiropractic, herbalism, homeopathy and osteopathy(1).
Enlightened or open-minded NHS doctors referred patients to a CAM practitioner in cases where health problems did not respond to conventional medicine, or where unacceptable adverse reactions to drugs were experienced. Some surgeries employed a CAM practitioner to work alongside the NHS doctors. CAM was deemed to be cost-effective if patients needed fewer consultations and drugs.
However, for every patient whose quality of life is improved by CAM, there is a corresponding reduction in pharmaceutical profits.
Randomised Controlled Trials and Acupuncture
Opponents of CAM continually highlight the clinical randomised controlled trials (RCTs) that show no significant scientific evidence of benefit in any CAM therapy over the placebo effect: if the patient believes a treatment will work, then it will.
These trials “prove” that the widely-held belief in the benefits of CAM were “all in the mind” – with the result that media information and NHS access to CAM has all but disappeared.
A systematic review of RCTs involving a total of 3,025 acupuncture patients, published in the British Medical Journal in January 2009, concluded that it was unclear whether needling reduces pain independently of the psychological impact of the treatment ritual(2).
Yet, this review not only rejected thousands of years of acupuncture history throughout south-east Asia, it also ignored scientific evidence that acupuncture does have more than a placebo effect.
In 2005, researchers in the UK had used PET scans to show brain activity in osteo-arthritic patients receiving real acupuncture or a placebo (“sham” acupuncture using a retractable needle). Whilst patients’ expectation and belief regarding a potentially beneficial treatment increased activity in the “reward system” areas of the brain, only real acupuncture increased activity in the insula ipsilateral area of the cerebral cortex, which is associated with pain modulation(3).
Following the RCT review in 2009, American researchers demonstrated with PET scans (of the multiple pain and sensory processing regions of the brain) that traditional Chinese acupuncture evoked both short and long-term effects that were absent in the group who received the sham acupuncture(4).
Despite the fact that both these PET studies were published in the medical journal NeuroImage, the results of the British study were also broadcast by BBC News on April 30th 2005 and published in The Independent on the lst May 2005, and the American study was published in Science Daily(5) in August 2009, this research has been ignored by drug-based, mainstream Western medicine.
A 2006 review of complementary and alternative therapies for inflammatory bowel disease states:
“Encouraging results have been reported in small studies of acupuncture for Crohn’s disease and ulcerative colitis”.
(Langmead L, Rampton DS. “Review article: complementary and alternative therapies for inflammatory bowel disease”. Alim Pharmacol Ther. 2006 Feb 1; 23(3):341-9. Pubmed: 16422993)
Alimentary Pharmacology & Therapeutics is an international journal of gastroenterology and hepatology.
(1) The growing use of CAM in the United Kingdom. House of Lords Science and Technology: Sixth Report. Session 1999-2000.
(2) BMJ January 2009;338:a3115
(3) NeuroImage May 2005;25(4):1161-1167
(4) NeuroImage Sept 2009;47(3):1077-1085
(5) Science Daily, August 10 2009.