AcuTalks is back, with interview featuring Acupuncturist Bryan Smith.
We first asked him what Acupuncture was from both a Western and Eastern perspective. – From a Western perspective, we look at different systems. We do functional MRIs. We look at what’s happening with the brain when we needle a point. And some really interesting things have emerged. You would expect if you touch somebody that their cerebral cortex where they measure sense would light up, but when you get something called “de qi” sensation which is a dull, achy sensation, the inner parts of the brain, the limbic system, these auto-regulatory centers light up.
Where a needle is being twirled, there’s really interesting research about fibroblast production where we have these baby cells of connective tissue that have these tails, and they can move around, and this has implications regarding healing and drawing blood to the area that has with it the cell food in the water. And the things that are needed for anti-inflammatories for healing to take place. From a Western perspective, we have to look at different systems. A lot of the research that’s being done in addition to the nervous system and the endocrine system which are auto-regulatory systems, we’re also looking at connective tissue and seeing that, you know, connective tissue runs in long chains and if you needle one end of it, it can have an effect on the other end of it. What is Acupuncture from a Western perspective? What we can say about it is that it’s influencing auto-regulatory systems. We don’t have all the answers as to the method of action of acupuncture from a Western perspective, but we do have a lot of efficacy studies that show that it works for a lot of different health concerns.
From an Eastern perspective, the way that acupuncture works is that we have this vital energy that’s flowing through rivers in our body from our hands and feet to our thorax and head. You know, we call these meridians, and we can access them using points on those channels called Acupoints. And so those rivers intersect with organ systems and all the organs kind of dance with each other, right, to this sort of harmony that makes the body run the way it’s supposed to. And some of those organs promote, create qi and blood and when signs and symptoms emerge in these different systems, the acupuncturist can trace it back to where there’s an imbalance and use the needles to correct that imbalance.
And so as long as the qi is in the right amount and flowing smoothly, health ensues. That’s the Chinese; we call that a mythopoetic vision. It’s a metaphor. It doesn’t mean that it’s not true. It’s just the way that they’ve imagined it and there’s much more to it.
So let me turn then to what will prove to be a very similar story for acupuncture.
The first question we faced for acupuncture trials was, what should we use for a sham therapy? What would our control group be? And we decided we would test a strategy of using toothpicks as an alternative form of acupuncture where we put the toothpick inside a guide tube just as we would do with a real acupuncture needle. These are the guide tubes here, and the therapist would tap on the toothpick and create a sensation of a poke, but there’d be no skin penetration. And we decided to test this strategy to see how credible it was in a couple of ways. We first did a study with 10 acupuncture-naïve subjects who got six pokes with a toothpick, six pokes with real needles, administered in random order, and asked after each of those pokes whether this was a real needle or a toothpick that they were being poked with and asked the subjects to rate this on a 1-to-5 scale, where 1 was definitely real, and 5 was definitely fake.
I was a subject in that pilot study, and I can tell you that I was absolute, completely fooled. I was certain that some of the toothpicks were real needles, and I was certain that some of the needles were just toothpicks. So I came away as a believer that this was a fairly effective sham. The second study, we randomly allocated 52 patients to get real needling or the toothpick administration, and here are the results of these studies. I wasn’t the only one who was fooled in the first study. It turned out that toothpicks were perceived as being slightly more like real needling than the actual thing with slightly lower scores for the toothpicks than for the real needling– not quite statistically significant. And in the second study, 52 percent of the patients who were randomly allocated to get toothpick therapy thought that it was definitely or probably real compared with 65 percent in the real acupuncture group, a non-statistically significant difference.
So we came away believing that this was at least convincing and embarked on a randomized trial where we enrolled over 600 patients this time. And unlike the chiropractic trial with acute back pain, these were all patients who had chronic back pain. They were treated by one of seven acupuncturists who took part in the trial, and patients were given up to 10 treatments over the span of 7 weeks.
So, as I recall, they had two treatments a week for the first three weeks and then four subsequent weekly treatments. And in this trial, we had four arms. The first was real acupuncture with the individualized placement of the needles. So the therapist examined the patient, decided where he or she thought the needles would be most effective and used that needle placement. The second group got real acupuncture also.
But instead of individualizing the points, they were administered at standard points that we had set ahead of time-based on a consensus among the acupuncturists that these would be the most likely effective points for most patients on average. Then we had the sham acupuncture group with the toothpicks, and then we had a usual care arm. And we followed these patients, again out to one year in this case, and again happily had better than 90 percent followup at all of those time points. These two real acupuncture groups, I will tell you now, had virtually identical results. And so in a couple of the slides, I’ll show you of the results, I’ll just refer to them as “real acupuncture, combining these two arms.
So here’s a figure that looks a lot like what I showed you for the chiropractors. This is an improvement in the pain severity or bothersomeness. And what you see here is that at eight weeks of follow-up, everybody was getting somewhat better. The least improvement was occurring in the usual care arm. And here, you see the most improvement by a small amount was in the simulated acupuncture arm. But the three real and sham acupuncture groups tracked each other almost perfectly throughout the entire year and were indeed indistinguishable on a statistical basis from each other. There were differences from the usual care arm early on. But again, as you can see over time, there tended to be some convergence of the results between the usual care group and the acupuncture groups at a year. The same kind of graph this time for the Roland disability score, and again you see some separation here at eight weeks, a little bit of convergence over the span of a year. But again the three groups, the real acupuncture groups, and the sham acupuncture groups, are virtually indistinguishable regarding their effects over that entire year.
And here’s another way of presenting those results that I kind of like. It asks, instead of what are the average scores, what percentage of patients had a clinically important magnitude of improvement? And we chose 3-point improvement on the Roland Morris scale to represent a clinically important improvement and asked what percentage of patients had improvement by that amount.
And the answer was, for both the real and the sham acupuncture groups, 60 percent had that level of improvement at eight weeks– and you’ll recall that’s where the separation was the greatest– versus only 39 percent in the usual care arm. And one other secondary outcome measure that we looked at was the use of pain medications, and again you see that the real and sham acupuncture groups are virtually identical and had somewhat lower use of pain medications than patients in the usual care arm. These differences persisted at a significant level out to one year. So how do we interpret these results? Well, one interpretation would be that fake acupuncture was just as good as real acupuncture, so all the benefits of acupuncture seem to be placebo effects.
A second interpretation would be that both true and sham. Acupuncture really work, and you don’t really have to penetrate the skin in order to have them work, and you just need to cause some stimulation that maybe creates a counter-perception in the brain, and maybe they’re both actually having a better than the placebo effect. In either event, I think it’s fair to say that, from our trial, we sort of challenged the concept that the precise placement of the needles or even penetration of the skin makes an important difference– certainly a challenge to the concept of the traditional acupuncture meridians. And if you look at other studies, there are some interesting clinical trials of acupuncture. This is one of the most recent that is a meta-analysis of individual patient data from 29 randomized trials.
So these investigators went out to the original authors of 29 different randomized trials of acupuncture and tried to collect individual patient data from each of those trials. 10 of those trials were for back pain in particular. And the conclusion after analyzing, again, individual patient data was that acupuncture actually seemed to be superior both to sham acupuncture, and to the non-acupuncture control groups, but the difference over sham acupuncture was quite small, and the results looked quite similar whether you were looking at patients who had back pain or osteoarthritis or a headache or shoulder pain. And, again, as in our trial, they concluded from this individual patient data that the location of the points and the depth of the needling were not important.
More conventional systematic reviews of the clinical trials have a range of interpretations. Edzard Ernst is sort of a skeptic who concludes from the systematic reviews that are available that there’s little convincing evidence that acupuncture is effective. On the other hand, Brian Berman says it’s not clear whether acupuncture is superior to sham acupuncture, but [it] may be more effective than usual care. And again, on the safety side, it’s pretty encouraging. Serious adverse events are very rare.
One estimate again from observational studies is maybe somewhere in the range of one in 100,000 treatments there might be a serious adverse effect. So, again, a very safe treatment..
Did you realize there are over three hundred and sixty-five acupuncture points in the body?
Hi, my name is Christina Jergo. I’m an acupuncturist. I’m going to speak a little bit today, about how to locate proper acupuncture points. Acupuncture, a system of health modality, developed from China, over five thousand years ago. With the insertion of acupuncture points in the body, bring about health and wellness to the individual, and while I might use acupuncture needles to insert and stimulate the points for the desired effect. Pressure, what we call acupressure, is also an effective way to stimulate the points, so I’m going to speak about a few of them today. This first one, Large Intestine 4, is located between the thumb, and the first finger, in the web of the hand.
This acupuncture point is effective for the face. It sends energy to the face so that it can be helpful for the teeth, and dental health, as well as colds, cases of flu in the face, sinus congestion, helps keep the eyes clear and healthy, and also very good for headaches and migraines. Going up the arm and the elbow, we have an acupuncture point called Large Intestine 11. This point is located, if you bend your arm, follow the crease of the elbow, crease there to the end, and there’s a little divot there.
This is the place to apply pressure. Large intestine 11, is very helpful for clearing heat out of the body. This might be heating such as hot flashes, or it could be the fever. It could also be dental health, if a lot of cavities, is a sign of heat, as well. This is stimulating. This can be very helpful. Also as a large intestine point, it’s good for constipation, and getting things moving. A third point, we’re going to look at the head, next. At the top of the head, is called Governor Vessel 20, or byway. To find this point, you use your ears. Make a line from the bottom to the top of the ear. Follow it upwards, to the top of the head.
This is how you find the point, and this is a great point to use for increasing energy in the body. If there’s fatigue, you want to increase endurance. Also good for elevating mood, so for depression, we call it the happy point. The next point is on the leg. I’m going to bring up my leg here. Use the hand. Using the forefingers as a measurement of 3-sun, so we use that from the ankle, next to the bone, to the end of the forefingers. There’s a point called Spleen 6. This is a great point for women’s health. It brings blood and nourishment to the body. It’s also good for premenstrual cramping, or just for, because the spleen is associated with digestion. Also for strengthening digestion, helping with any bloating, indigestion, so as I mentioned before, there are over three hundred and sixty-five acupuncture points in the body. We went over a few today, that is very good for overall health, and longevity. Hope it’s been beneficial, and you can use it as part of your life, and maintenance.
The data looks like what’s on YouTube. So I’ve always wondered what it feels like to get an Acupuncture, you know you know those things with the needles and whatever.
And then it just put heels on you and it makes your nervous system feel great, so yeah I’m going to head over to acupuncture Ickx to meet up with tomorrow, and then she is going to give me my first acupuncture. So wish me luck! Hi, so, I’m here at acupuncture with Tamara, and she is going to be giving me my first Acupuncture so any advice before we get started to relax gonna be a lot a lot easier than you think it feels really good Okay, let’s go there. We go I Gotta take my shirt off for this one oracle, so we funnel my poppet okay, I’m friends for real Huh, I imagine that you’re nervous. I’m nervous! Thanks to this pairing a hedgehog alright new usually it’s impaired her babies in his off, but it’s again colleges work with Ben. We’re gonna put him right here okay, and he’s just relaxing with you all guys is very nervous, but serious here for me, and hopefully, everything will be okay. The person will wipe you down with alcohol, and the needles are really really tight whipping off with you, so your blood was drawn at the doctor I think a bit about 15 of my needle in there.
That’s cool They’re so what the benefits are of? Acupuncture, so acupuncture helps rebalance your whole nervous system, you have your sympathetic nervous system Which is your fight or flight, and then you have your parasympathetic nervous system your relaxed arrest is identical, So it helps to sing leave a lot your parents. I said, I’m nervous doesn’t help to relax, and it helps your own body create Chemicals that help you to kind of bounce back out and get back into like the ideal state for you. Oh lolz! So the meals are just a tool to help your own body fix itself, and it works for all kinds of things that works for pain. It works for stressed. Does it work for Insomnia? Having a little being close all of you migraine headaches, okay? Yeah Yeah, so it’s good to know I get migraines a lot and I just like what are the main reasons quiet doing this is to Help relieve it and make it go away, right yep, okay? Whew, comment down below to get migraines like meat.
Are you ready? Right, wait what you’re going to feel first is this plastic Tube. This is not being evil connect it like that Oh good okay, and that’s helping me guys in Sean’s place There you go me, Alvin, whoa. And again, it’s good. Oh Yeah, I’m not that way okay, so okay Yeah, sometimes there’s like a little little strong sensation in the beginning it like goes away, but we know what’s good about that Little song sensation, in the beginning, is that we know that your nervous system is paying attention so well and it’s going to work well okay, so Whoa? Oh yeah? Twelve hours ago got a ride with it. Is it a cool thing to know that like it’s getting in there and going to make some good changes Whoa watch? Without that one, but it’s both goods that’s the one you came in feeling a little bit sick today, and that one check up a little bit you have a lot of nerve endings in your hands and a lot of those nerves actually go right up to your clients and that such as way-O Was know what’s going you can do it you can stay right over here except Relax pointlessly, but all your Muster neck see you can even tell Yes, I oh, okay all that Good like legit.
I feel fine being angry there. It is awesome count on him. Acupuncture is really old like 4000 years old. Oh, Expunge turkey from China. Oh, okay There are earliest recorded books that we had or like around 2,000 years old Are there actual book and telling you about how to do it and what this what every six are pretty neat How did I figure it out help will put you here is what happened? I think probably yes, especially a lot but face what? They don’t push up Hmm interested That was cool, and we call that one yin tong And it’s a shipload it stimulates the pineal gland which makes Melatonin and helps to relax people You could know in fact most of most of my patients fall asleep right on the table.
Oh, man. I might do that I’m so tired right here. Yes Sometimes a little strong, but they work so nicely. Oh thought that like we put it in Vibrated by setting goals it came out. It did something goes yeah, look we what’s the migraine point? Well depends on you to tell me that you’re at my current owners have been there, So I’m going to simulate at that point, but also actually the ones in your hands of Really helpful profound a lot for a migraine. I know it sounds weird that something in your hand would help your head But you actually have nerves that are going up and down area so oh it all Reflects different parts of your body then so what I’m going to do is actually bring a tuning fork out It’s just a really cool way to kind of shift your consciousness to shift yourself into like Signaling that it’s time to relax and let them work focus They’re going to vibrate them on either side cool okay, and I’m going to move harry for second We have but one billiard okay gordo just want to do this one right here is called Rent 17, And it helps to simulate all your energy works like ginseng almost for the body, And it’s going to help you revive you okay? Which said your ass, maybe so Sorry low heat inhale and a positive huff hold it and then exhale and when you just come down and Relax you can kind of let your body sink under the table and The Needles are going to start working on your nervous system And them kind of starts as soon as they feel a little tingly sometimes you feel switching Or they almost feel like a pattern while your nervous system is working through the body is pretty cool So just kind of tune into that And let your body just laugh to hear it yeah Okay time for you to rest with you in about 20 minutes you Welcome back.
Did you fall asleep? Okay, okay Good a lot of people fall asleep. No hacking lesser because it really is no relaxing that way can you ask oh? Yeah, take some slow deep breath We get at costs already just sometimes because there’s a lot of nerves here. They might get a little positive like this one, so That one’s pretty cool people ask for it bru’s yeah, I like to have that one on my things Oh, yeah, that one. I felt the angriest relaxing like before this I felt like a balloon, so Goodbye starts random open Whenever the Needles came in Deflated it made me relax, but good and then in the end.
I felt my body Sink, it was working really smooth really body rich Quick shout-out to Harry comment down below if you want harry would have to come here meet him who do attend Tom better click right now like 15 minutes Is there like a technique people usually do absolutely getting one of these sessions that like make but make certain movements um Just stretching making fun of you, Brett feeling grounded Yeah, hello 3 months to water today.
I feel I could do a backflip even though I can’t I’m going to run like 10 miles all you do like anything. Wow, I have a big fan in the building come here Hey, come here. Oh, You want to say anything to all everyone watching right now? I’m an ex Ex car expect on YouTube, please subscribe Alright You, very sure Alright, well anyways. I hope you enjoyed today’s video That was extremely amazing special thing to tomorrow for giving me my first session It was great absolutely anything so if you want to experience an Acupuncture or a cupping session on the same table that I did in mind that you can book at www.hsn a Pu Pu + K Pri xcom and just mention guava juice And you’ll get $20 off your first session everything will be in the link in description below check it out.
This is cool Wow amazing. I feel like I could fly it out because you know okay. I gotta fly got a blast apply to you, okay.