It probably won’t surprise you if I say I’m a huge fan of modern medicine. From a man in his 60s in cardiac arrest who was resuscitated with a defibrillator to a teenager with appendicitis who recovered through emergency surgery, I see every day how Western medicine not only works, but saves lives.
I used to think of modern medicine as the savior of all ailments and looked down on people who claimed alternative therapies like acupuncture helped them.
I would chuckle under my breath when patients told me that yoga, not sertraline, helped them relieve stress, and I would scoff at those who popped all sorts of vitamins and supplements.
Not only was alternative medicine not my thing, I considered it at best a waste of money and almost certainly harmful, but now I’m ready to take the plunge and say that I’m changing course.
Because for many patients, the approaches ingrained in our medical ethos are clearly failing: chronic pain patients who end up overdosing on addictive (and often ineffective) opioid painkillers, for example, and insomniacs who find themselves trapped in long-term dependency and health problems from sleeping pills.
There is evidence that acupuncture is effective in treating gastrointestinal pain, migraines, and menopausal symptoms.
And let’s not forget those patients who take multiple medications to treat heart failure, blood pressure or high cholesterol to combat the side effects of an unhealthy Western lifestyle filled with too much processed food and not enough exercise.
Although necessary, many of these medications have side effects that can be harmful.
A few months ago I treated a man who had suffered a fall and who was a perfect example of the shortcomings of our current treatment methods.
He was in his 80s, had dementia and was showing all the early symptoms of Parkinson’s disease, and also suffered from back pain and insomnia, for which he was prescribed the opioid painkillers codeine and zopiclone to help him sleep.
He had high blood pressure and was also taking amlodipine to lower his blood pressure, but standing up suddenly could make him dizzy.
At 3 a.m., he got up to go to the bathroom. The medication he was taking slowed his reflexes, and when he slipped on the rug, he couldn’t grab the banister in time. He fell, breaking several ribs, a broken arm, and severe bruising all over his face.
For a healthy person, these injuries would have been easily healed and there may have been no need for hospitalization, but for him, it made it very difficult to live alone at home. After three weeks in the hospital, he was discharged to a facility and lost his independence, due to side effects from the medication he was taking.
Now, the argument of modern medicine is that there is no alternative to these drugs, so we have to accept the side effects.
But over the last few years of my career, I’ve begun to question this orthodoxy. With a healthier lifestyle, my patient may indeed no longer need amlodipine, but without other medications, he would still suffer from pain and sleep poorly. At least, that’s what I thought.
Last month, the prestigious journal JAMA Network Open published a study showing how acupuncture can help improve sleep in people with Parkinson’s disease (two in three patients suffer from insomnia).
In the study, patients at Guangzhou University Hospital in China were given either acupuncture or sham acupuncture (using needles that do not penetrate the skin).
After four weeks of treatment, those who received real acupuncture had significantly improved sleep.
The effect then lasted for another four weeks. The quality of the trial was excellent, and statistical analysis showed that there was less than a 1 in 1,000 risk that the result was due to chance (for a drug, a result is considered effective if there is less than a 1 in 20 chance of it being due to chance).
Despite its surprising results, the study was published without much fanfare because pharmaceutical companies wouldn’t fund its promotion.
The new findings echo those of a 2017 study published in the journal Sleep Medicine that tested acupuncture in 72 people with insomnia, which showed similar results.
To be honest, I don’t know how that works, but does it matter?
Acupuncture has been used in China for thousands of years, and its results are now being replicated through randomized controlled trials, the best form of scientific experimentation.
That doesn’t fit into the medical model I was taught and teach, but the only conclusion we can draw is that the model I believed in is not entirely correct.
Reading about these studies prompted me to look into other places where acupuncture might work.
There is evidence that it is effective in treating gastrointestinal pain, migraines, and menopausal symptoms.
Importantly, this therapy could also treat the chronic pain that millions of people, including myself, suffer from, such as back pain, for which there are few effective treatments.
The first research review on acupuncture for back pain was published in the Annals of Internal Medicine in 2005 and summarized the results of seven trials. The review showed that acupuncture was as effective as other treatments, such as opioid medications, but without the side effects.
Yet as I read the medical journals and engaged in the continuing professional development that physicians must undertake, it was the for-profit drug trials that were thrust upon me, while the results of the acupuncture trials, which showed “no benefit,” were ignored.
But I was so impressed with the results of this acupuncture study that I decided to book an appointment later this week to try it out to see if it could help with my back pain.
And it’s not just acupuncture: at a meeting of the Royal College of Emergency Medicine this month, a report on a form of traditional Chinese medicine was published as one of the top 10 most influential papers published in the past year.
The result was so unexpected that it caused gasps of surprise among the audience.
The study, reported in JAMA, showed that taking tongshinraku, a traditional Chinese medicine extracted from plants and insects, after a heart attack reduced outcomes such as stroke and death by 36 percent compared to a placebo.
Because both the treatment and placebo groups also received standard care, we can only conclude that there was something about Doshinraku that caused such beneficial effects.
Again, we cannot dismiss these findings simply because we don’t understand how it worked.
Of course, it is important to remember that a herb is only a herb until it has been proven to have medical benefits, and only then can it be called a drug.
For example, the life-saving drugs digoxin and aspirin were originally extracted from digitalis and willow bark, respectively.
A UK-based randomized controlled trial is needed to see whether the results of this Chinese treatment can be replicated in the patients I treat.
This brings me back to my U-turn: I believe in medicine (mainstream medicine, and now alternative medicine) that works, as proven by the best available evidence.
This is not necessarily a randomized controlled trial, the gold standard. For example, we know the dangers of smoking and we don’t recommend smoking. This is not based on a randomized controlled study, it’s an observation of what happens to smokers and non-smokers.
But there are still some areas that are off-limits to me – for example, homeopathy has never been proven effective in scientific studies – in fact, many trials have shown it to be completely ineffective.
That’s why I’m taking paracetamol to treat my back pain, doing the exercises recommended by my physiotherapist, and now having my first acupuncture treatment.
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