While running my acupuncture practice in Oregon, I was invited to lecture to the medical students on Traditional Chinese Medicine. These students had been groomed to be natural skeptics of medical practices outside of their training, so they were a shrewd audience, and I was always certain to prepare my sources. However, I found the charge of discovering randomized controlled trials (considered the pinnacle of contemporary research methods) with clear results a difficult task, because how does one "blind" a group to receiving acupuncture treatment or not? The trend in acupuncture research is generally as follows: while the treatment arm for acupuncture often shows far superior results to no treatment, a treatment control arm also generally shows benefit over no treatment.
Let's break this apart- A treatment control group is a tenuous data point to obtain in acupuncture research. Often, the control group receives either no form of treatment, or receives a different intervention: whether this is acupuncture points in areas of the body unrelated to the prescribed treatment plan, or a treatment consisting of fake needles that retract, rather than insert, into the skin. These intervention controls are called "sham acupuncture". Because acupuncture is such a complex medical system, the therapeutic benefit of sham acupuncture sometimes doesn't show significant reduction in benefit when compared to the acupuncture treatment itself. However, the non-treatment controls very commonly show little effect when compared to acupuncture. Acupuncturists have often disputed that this relative benefit of both acupuncture and sham acupuncture when compared to no treatment is expected, and is not an indication that acupuncture has reduced efficacy. They argue that non-insertion techniques still stimulate acupuncture points as acupressure would, and similarly, they dispute that insertion into non-prescribed points still stimulates meridians, allowing for therapeutic effect. While neither mechanism of benefit can be 100% proven, there is an additional possible answer- and that is the Power of Placebo.
Placebo has historically been thought of as a confounding result that impacts research outcomes. However, more and more, studies show that placebo has a true, measurable effect on physiology that should no longer be ignored.
If our minds are perceiving a therapeutic effect that was never administered, and this is resulting in true benefit, what does this mean? It means we are just scratching the surface in understanding our ability to heal ourselves. It means that in theory, harnessing the mind could be the most powerful cure-all for all illness, and working with a provider that understands this could be the key to moving from illness to wellness. So, should patients stop receiving alternative therapies with confounding results when compared to intervention controls? I would argue absolutely not. The benefits compared to non-intervention controls are generally clear, and until humans discover the key to unlocking the parts of the mind responsible for placebo healing, these alternative therapies are tools that provide patients with immense benefit. And furthermore, traditional medicines, such as acupuncture, energy healing, yoga therapy, meditation, and functional medicine not only recognize the importance of nurturing the landscape of the mind, but leverage this mind-body connection for enhanced results as part of their therapeutic principle.
While medical interventions such as surgery and medications have indisputable effects on the body, imagine if the administering medical providers also leaned into the powerful and free medical tool located within our mind? How radical is it to imagine a medical system that holistically treats patients, with the understanding that health and wellness is a complex balance of both the physical landscape of our physiology, as well as the psycho-social-spiritual arena of our mind? This in-between space is where integrative medicine shines. When patients receive care from providers that not only offer alternative remedies for treatment of the body, but also understand the impact of the mind, these patients are empowered by the knowledge they can feel better, and therefore, harnessing the power of placebo to its greatest benefit, they do feel better.
Chen H, Ning Z, Lam WL, et al. Types of Control in Acupuncture Clinical Trials Might Affect the Conclusion of the Trials: A Review of Acupuncture on Pain Management. Journal of Acupuncture and Meridian Studies. https://www.sciencedirect.com/science/article/pii/S2005290116301492. Published September 15, 2016. Accessed March 15, 2021.
DG; F. Placebo Effects: Historical and Modern Evaluation. International review of neurobiology. https://pubmed.ncbi.nlm.nih.gov/30146043/. Accessed March 15, 2021.
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