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Fact Check: What’s The Science Behind Acupuncture And Cupping?

Discussion in 'Hospital' started by The Good Doctor, Nov 17, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    The mystique surrounding traditional Chinese medicine both attracts and repels people, with some being seduced by the esoteric charisma of these alternative practices while others dismiss them as pseudoscience. Acupuncture and cupping are perhaps the most popular techniques associated with this tradition, with the latter being a famous yet controversial favorite of Olympic athletes.

    There is no scientific consensus on the validity of either among doctors and researchers, but there’s no question that acupuncture is held in higher regard than cupping, despite the fact that much of the science behind this prickly practice remains poorly understood. New research has begun to shed light on this enigmatic method, providing new insights into its potential plausibility as a treatment for a range of conditions.

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    Acupuncture – What’s The Point?

    While acupuncture is now employed fairly commonly by physiotherapists and other medical professionals, it is considered to be an alternative or complementary medicine, which means its efficacy remains unproven and hotly debated. In the UK, for instance, acupuncture was recommended by the National Health Service (NHS) as a treatment for back pain until 2016, when new research emerged indicating that the practice is in fact no more beneficial than a placebo for this particular condition. Despite this, the NHS does still cover the cost of acupuncture in rare cases, and many patients continue to pay for the treatment privately.

    It’s worth pointing out, though, that the techniques used by healthcare experts aren’t necessarily the same as those favored by more traditional Chinese acupuncturists. This is because Western approaches to the technique are rooted in a scientific understanding of the physical anatomy, while older versions of acupuncture tend to be based around mystical concepts such as qi (pronounced chi), which refers to an unseen energy force.

    In both cases, however, the basic principle centers around the activation of specific “acupoints” on the body, which supposedly have the ability to affect the physiology of distant body parts. For example, the insertion of needles into certain acupoints is said to be able to reduce bodily inflammation, and while the science behind this claim is not understood, a new study in the journal Nature may have pinpointed one of the underlying mechanisms.

    The new research builds on a previous study that revealed that electrically stimulating the sciatic nerve in mice triggers communication along the vagus nerve, resulting in an increase in dopamine secretion by the adrenal gland. This extra dopamine causes a reduction in the concentration of pro-inflammatory molecules called cytokines, thereby decreasing the chance of a so-called cytokine storm, which often drives severe, systemic inflammation and can be fatal.

    In the new study, the researchers show that certain acupoints are innervated by neurons that have the capacity to activate this vagal-adrenal axis in mice, and that stimulating these points can extinguish a cytokine storm and reduce inflammation throughout the body. In order to produce this effect, however, neurons must express high levels of a certain receptor called the prokineticin receptor 213.

    Based on their mice experiments, the study authors conclude that these neurons are highly abundant around a particular acupoint known as Zusanli, which is located in the hind leg. By activating this point, the researchers were able to suppress systemic inflammation after the rodents were exposed to a bacterial endotoxin. When the mice were genetically engineered to lack these receptors, however, acupuncture at the Zusanli point had no such effect.

    Acupoints that are not innervated by these neurons, meanwhile, are incapable of activating the vagal-adrenal axis and preventing cytokine storms from erupting. For example, the Tianshi point, found in the abdomen, was found to lack this function.

    This work provides the first neuroanatomic explanation for the function of different acupoints. However, it was carried out in mice, and larger-scale human studies are needed in order to investigate the role of each of these points and confirm the validity of the approach as a whole.

    “Cupping Therapy Near Me” – A Popular Yet Useless Google Search?

    Cupping became a huge point of contention during the 2016 Olympic Games in Rio de Janeiro, as athletes from multiple nations took to the track, field, and pool riddled with gnarly round bruises. These blemishes are the unmistakable hallmarks of this alternative therapy that originated in China and involves placing heated cups on various body parts, creating a vacuum that sucks the skin upwards. In "wet cupping", this approach is combined with blood-letting.

    Like a newly cupped athlete, however, the scientific basis for this approach is rather patchy. According to ancient traditional practice, the method improves blood flow, alleviates pain, and activates the immune system, although these claims are scientifically unproven and not supported by biology. The suction of the cups breaks small blood vessels in the skin, resulting in the characteristic red blobs users are left with. However, there is no scientific explanation or evidence for how this brings about any of the health benefits that have been claimed.

    A number of studies have been carried out on the validity of the alternative therapy, often alongside acupuncture, though none have found concrete evidence yet. A large review of 135 randomized clinical trials found no reliable evidence that the method brings any advantages. Intriguingly, though, some of the data analyzed in this study hint towards a possible application for cupping in the treatment of “herpes zoster, facial paralysis, acne, and cervical spondylosis,” although the authors point out that the trials supporting this evidence were of “low methodological quality”.

    Given the lack of evidence and that the logic behind the technique is scientifically flawed, it's hard to defend the virtues of this technique, although athletes who won gold after getting cupped may beg to differ.

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