Last week, there was yet another piece of research trumpeting the benefits of acupuncture; in this case, needling was said to relieve hot flushes in breast cancer patients by up to 50 per cent. The new study, unveiled at a conference in Berlin, follows similar claims that the ancient treatment can benefit those with arthritis, back pain, migraine and infertility. But is acupuncture really the miracle treatment it seems?
It appears to have become a fashionable cure-all, with 3,000 practitioners now regulated by the British Acupuncture Council. Earlier this year the highly respected British Medical Journal (BMJ) reported that acupuncture could increase IVF success rates by 65 per cent, based on analysis of seven separate trials involving 1,366 women. According to Chinese philosophy, acupuncture works by interfering at particular points along channels in our bodies, known as meridians, thereby enhancing the flow of life energy, known as Ch'i. Although the concepts of Ch'i and meridians make no sense in terms of science, medical researchers have been interested in testing the claims of acupuncture ever since the 1970s.
But in order to test the impact of acupuncture, one must disentangle the placebo effect (which means that as long as a patient believes that a treatment will work, then they are likely to respond positively). The best clinical trials involve two groups of patients: one receiving the real treatment, the other taking something that feels real, but which is ineffective. Researchers can then see if the new intervention offers any benefit beyond what is seen with the sham one. But how do you create a form of sham acupuncture? In recent years, researchers have developed three procedures. The first involves needling the patient at the wrong points on the skin, thereby missing the "meridians". In the second, acupuncturists insert the needles to shallow depths, again avoiding the meridian. The third procedure uses retractable needles: like theatrical daggers, the skin drives the needles back into the handle of the instrument, but the patient is none the wiser.
So how accurate were the trials analysed in the BMJ? The problem is that four out of the seven trials did not include a "sham" acupuncture group, but merely compared the effect of acupuncture with no acupuncture at all; any benefit could be due to the placebo effect and therefore these trials should be ignored. When focusing on the remaining three trials which had included such a sham group, the results are less than impressive. Two out of three failed to show that real acupuncture offers any significant benefit (in terms of likelihood of pregnancy) beyond the fake treatment. The sensible conclusion is that acupuncture is still unproven in terms of increasing IVF success rates. So it is worth avoiding acupuncture in the context of IVF, since 10 per cent of patients complain of pain, bleeding or bruising, and some even experience fainting, dizziness, nausea or vomiting. These adverse effects are not serious, but the known risks outweigh the unproven benefits.
The needles helped me conceive, says Lydia Slater. As a doctor's daughter, I was brought up to despise alternative medicine. But then, about five years ago, I found myself struggling with a variety of conditions that my GP seemed unable to treat. I had developed irritable bowel syndrome; I had put on weight, was unable to sleep and full of unspecified rage at my unexplained failure to conceive. All that modern medicine seemed to offer was a course of soporific antidepressants. Then I met a friend who was being treated for polycystic ovary syndrome by a Harley Street acupuncturist, a practitioner who, incidentally, specialised in unexplained infertility. I booked myself in, without telling my parents. The weekly sessions weren't cheap - some £80 a time. Initially, I was scared of the needles, but the acupuncturist was so skilled I felt nothing. I soon had them sticking out of my ears and in my finger joints. As the needle went in, I sometimes felt a violent jolt of electricity in one limb, or flashing along my body's nerve networks. Often, I would be visited by a burst of exhilaration or was suffused with a feeling of calm. The experience was positively addictive. I increased the sessions, sometimes to twice a week, which I could ill afford. Instead, I gave up shopping and eating out. The effects were startling: first, the IBS cleared up; then I ceased to comfort-eat and lost weight. I booked sessions to coincide with difficult situations, such as prior to a work meeting at which I had to negotiate a new contract. The acupuncturist told me that he would arrange the needles so as to boost my oestrogen levels, reduce stress and thus improve my chances of conceiving. It sounded like mumbo jumbo, but although I'm normally diffident, I found myself storming into the office and insisting on precisely the deal I was after. It was about the same time that I discovered I was pregnant. I now have two daughters, Asya, nearly four, and Rosie, two. I can't believe that my return to health can be attributed to a placebo effect. So many people I know can attest to the benefits of acupuncture: it has helped friends with everything from healing torn muscles to boosting low self-esteem. These days when I'm ill, I still go to my GP. But if a problem is nebulous or intractable, I'll be straight back to the needles.
By Simon Singh (The Telegraph, London, UK)
'Trick or Treatment? Alternative Medicine on Trial' by Simon Singh and Edzard Ernst (Bantam) is available from Telegraph Books for £14.99 + £1.25 p&p. To order, call 0870 428 4112 or go to books.telegraph.co.uk
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