For thousands of years, a smattering of herbology, naturopathy, and non-pharmacologic treatment formed the mainstay of medical practice. With recent seismic shifts away from vaccines and other pillars of medical therapy – will we remember the 20th century as the apex of the pharmacologic era of medicine?
This is a randomized, unblinded trial comparing morphine against acupuncture for acute pain syndromes in the Emergency Department. Patients were recruited with, essentially, severe pain without serious underlying illness – sprains, low back pain, headaches, renal colic and dysmenorrhea. Patients were treated with either 0.1mg/kg morphine with additional 0.05mg/kg doses every 5 minutes or protocolized acupuncture performed by an experienced practioner (who also happened to be an Emergency Medicine physician).
There were three hundred patients included in this trial, and there were a few differences between groups – the morphine group tended to have more abdominal pain, while the acupuncture group skewed towards low back pain. Regardless, the acupuncture group achieved similar – or better – pain relief than the morphine treatment arm. There were no major adverse events in either arm, although a little more than half of the morphine cohort experienced the typical minor effects of drowsiness or nausea.
Could it be prime-time for acupuncture? Probably not – one, small, single-center trial does not generalized across all practice settings. Additional validation should be performed – and, most importantly, a placebo effect needs to be excluded. However, this is quite the powerful placebo effect – and, at a minimum, should inspire further research on methods for triggering these same perceptual effects within the context of our current treatment modalities.
“Acupuncture vs intravenous morphine in the management of acute pain in the ED”
http://www.ajemjournal.com/article/S0735-6757(16)30422-3/abstract
Without a sham acupuncture are of the study, there is no reason to believe that this is anything other than an elaborate placebo working on one of the rare conditions (pain, anxiety) for which placebo actually is effective.
If it is a placebo, wouldn’t our patients be better off with a much less invasive placebo that is not based on disproved superstition?
Having toothpicks, rather than needles, placed at non-chi points, and not even puncturing the skin was as good as, or better than, acupuncture.
The needles don’t matter.
The qi points don’t matter.
The penetration of the skin doesn’t matter.
Won’t somebody please think of the hemophiliacs 🙂
http://roguemedic.com/2016/08/acupuncture-vs-intravenous-morphine-in-the-management-of-acute-pain-in-the-ed/
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