MADELEINE BRAND, host:
Alternative medicine isn't as alternative as it used to be. For example, a lot of people turn to acupuncture for all sorts of medical problems now. But does it work?
Here with the latest scientific assessment is Dr. Sydney Spiesel. He reviews medical studies for us and for the online magazine Slate. He joins us now from his practice in Woodbridge, Connecticut.
And welcome to the show, Syd.
Dr. SYDNEY SPIESEL (Yale Medical School): Thanks, always nice to be here.
BRAND: And Syd, this study was done on patients who suffered from osteoarthritis. And it was done to help insurance companies decide - in Germany - whether or not they should have to pay for acupuncture. And what happened? What did they find?
Dr. SPIESEL: One of the problems that docs, especially dealing with elderly patients, have to deal with a lot is osteoarthritis. It's painful joint inflammation, which is just the result of wear and tear. And as you get older, more and more people are affected by it. By the time you're 75 years old, I would say, maybe 80 percent of people have some degree of osteoarthritis, and particularly osteoarthritis of the knee, and it can be very disabling.
And the treatments for it of conventional medicine are things that we don't really like or we like to avoid if we can, because these are medicines that are often irritating to the stomach, like the non-steroidal medications. And so people have been talking about using acupuncture to help with that.
In acupuncture, it's a Chinese practice in which tiny little needles are inserted at a very shallow depth at very highly specific and defined places in the skin. And the question is, does it work? There had been some studies that suggested that it works.
Dr. SPIESEL: Well, in this study it was kind of interesting. They took three sets of patients and one set got acupuncture following the Chinese rules of exactly where you put the needle, precisely where you put the needles to treat this problem. Another group of people got the same needles but they were put in places that were definitely wrong. They were absolutely incorrect. And then a third group of people got no needling at all, although all of them had access, all three groups had access to all the physical therapy and all the anti-inflammatory medications that they wanted or needed.
BRAND: So, Syd, what were the results of the study?
Dr. SPIESEL: Acupuncture was clearly associated - that is needling, at least - was clearly associated with improvement in functional status and decrease or freedom from pain, compared with the effect of conventional medical treatment. But it turned out that it didn't matter much whether the treatment followed the traditional Chinese medicine methods or whether the treatment was with needles placed in absolutely the wrong locations. Both worked equally well.
BRAND: So you just stick needles anywhere and it would have worked just as well?
Dr. SPIESEL: Well, there was another difference between the groups treated with real acupuncture or with false acupuncture, where the needles went in the wrong place. In both of those there was a much longer and more intense relationship between the practitioner, the doc and the patients. And maybe the needles - and there are some theoretical reasons to believe that - stimulating nerves using needles placed in a shallow location, the skin, may indeed send messages to the brain that block out some kinds of pain.
But it also may be that there is something very important about the length and intensity of the relationship between the doctor and the patient.
BRAND: So that maybe because the acupuncturist just spend a lot more time, was a lot more attentive to the patient, that that proved to be quite medically beneficial.
Dr. SPIESEL: I actually believe in my heart that the main thing that I have to give my patients is my time and my attention and my focus, and that that's as therapeutic as any of the medicines in my bag.
BRAND: Opinion from Dr. Sydney Spiesel of the Yale Medical School and Slate.com. And Dr. Spiesel is also a practicing pediatrician.
Thanks again for joining us, Syd.
Dr. SPIESEL: Thank you, Madeleine.
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