| Acupuncture: the lie of the needle Mon 12th May 2008 | Acupuncture is gaining credibility in medical circles, but Simon Singh is not convinced by the evidence
This weekend there was yet another piece of research trumpeting the benefits of acupuncture; in this case, needling was said to relieve hot flushes in breast cancer patients by up to 50 per cent.
Acupuncture: just a placebo?
The new study, unveiled at a conference in Berlin, follows similar claims that the ancient treatment can benefit those with arthritis, back pain, migraine and infertility. But is acupuncture really the miracle treatment it seems?
It appears to have become a fashionable cure-all, with 3,000 practitioners now regulated by the British Acupuncture Council. Earlier this year the highly respected British Medical Journal (BMJ) reported that acupuncture could increase IVF success rates by 65 per cent, based on analysis of seven separate trials involving 1,366 women. This research put me in an embarrassing position: I had just sent a book about alternative therapies to the printers.
Co-written with Edzard Ernst, the world's first professor of complementary medicine, we had concluded that acupuncture works only as a placebo, except possibly in the treatment of pain and nausea. In the light of the BMJ study, should we be revising our opinion?
According to Chinese philosophy, acupuncture works by interfering at particular points along channels in our bodies, known as meridians, thereby enhancing the flow of life energy, known as Ch'i. Although the concepts of Ch'i and meridians make no sense in terms of science, medical researchers have been interested in testing the claims of acupuncture ever since the 1970s.
advertisementBut in order to test the impact of acupuncture, one must disentangle the placebo effect (which means that as long as a patient believes that a treatment will work, then they are likely to respond positively). The best clinical trials involve two groups of patients: one receiving the real treatment, the other taking something that feels real, but which is ineffective.
Researchers can then see if the new intervention offers any benefit beyond what is seen with the sham one. But how do you create a form of sham acupuncture? In recent years, researchers have developed three procedures. The first involves needling the patient at the wrong points on the skin, thereby missing the "meridians". In the second, acupuncturists insert the needles to shallow depths, again avoiding the meridian. The third procedure uses retractable needles: like theatrical daggers, the skin drives the needles back into the handle of the instrument, but the patient is none the wiser.
So how accurate were the trials analysed in the BMJ? The problem is that four out of the seven trials did not include a "sham" acupuncture group, but merely compared the effect of acupuncture with no acupuncture at all; any benefit could be due to the placebo effect and therefore these trials should be ignored. When focusing on the remaining three trials which had included such a sham group, the results are less than impressive. Two out of three failed to show that real acupuncture offers any significant benefit (in terms of likelihood of pregnancy) beyond the fake treatment.
The sensible conclusion is that acupuncture is still unproven in terms of increasing IVF success rates. So it is worth avoiding acupuncture in the context of IVF, since 10 per cent of patients complain of pain, bleeding or bruising, and some even experience fainting, dizziness, nausea or vomiting. These adverse effects are not serious, but the known risks outweigh the unproven benefits.
'Trick or Treatment? Alternative Medicine on Trial' by Simon Singh and Edzard Ernst (Bantam) is available from Telegraph Books for £14.99 + £1.25 p&p. To order, call 0870 428 4112 or go to books.telegraph.co.uk
The needles helped me conceive, says Lydia Slater
AS A doctor's daughter, I was brought up to despise alternative medicine. But then, about five years ago, I found myself struggling with a variety of conditions that my GP seemed unable to treat. I had developed irritable bowel syndrome; I had put on weight, was unable to sleep and full of unspecified rage at my unexplained failure to conceive. All that modern medicine seemed to offer was a course of soporific antidepressants.
Then I met a friend who was being treated for polycystic ovary syndrome by a Harley Street acupuncturist, a practitioner who, incidentally, specialised in unexplained infertility. I booked myself in, without telling my parents.
The weekly sessions weren't cheap - some £80 a time. Initially, I was scared of the needles, but the acupuncturist was so skilled I felt nothing. I soon had them sticking out of my ears and in my finger joints.
As the needle went in, I sometimes felt a violent jolt of electricity in one limb, or flashing along my body's nerve networks. Often, I would be visited by a burst of exhilaration or was suffused with a feeling of calm.
The experience was positively addictive. I increased the sessions, sometimes to twice a week, which I could ill afford. Instead, I gave up shopping and eating out.
The effects were startling: first, the IBS cleared up; then I ceased to comfort-eat and lost weight. I booked sessions to coincide with difficult situations, such as prior to a work meeting at which I had to negotiate a new contract.
The acupuncturist told me that he would arrange the needles so as to boost my oestrogen levels, reduce stress and thus improve my chances of conceiving. It sounded like mumbo jumbo, but although I'm normally diffident, I found myself storming into the office and insisting on precisely the deal I was after. It was about the same time that I discovered I was pregnant. I now have two daughters, Asya, nearly four, and Rosie, two.
I can't believe that my return to health can be attributed to a placebo effect. So many people I know can attest to the benefits of acupuncture: it has helped friends with everything from healing torn muscles to boosting low self-esteem.
These days when I'm ill, I still go to my GP. But if a problem is nebulous or intractable, I'll be straight back to the needles.
Source:Telegraph | | Why flat-screen TVs are dangerous but frozen peas are a cooling treat Wed 7th May 2008 | You may never think about this but the neck is highly complex and is one of the body's most important structures.
It is also prone to injury as a result - not surprising given the average human head weighs about 12lb and constitutes around eight per cent of your whole body mass.
The neck comprises seven bony vertebrae that sit in concave-shaped and cushioned intervertebral discs.
It is one of the most common sites in the body for stress to accumulate. And unfortunately, up to 70 per cent of us will suffer neck pain at some point in our lives - there are a number of potential causes from, simply, poor posture to the more debilitating whiplash.
Agony: Up to 70 per cent of us will suffer neck pain at some point in our lives
One of the most common reasons for neck pain is repetitive strain from prolonged sitting where the head is held in a fixed position.
I have recently seen a massive surge in patients - young and old - with quite acute neck pain, which isn't necessarily physical in origin.
Neck tension can reflect underlying stress factors caused by today's pressurised lifestyles. And while the neck is a highly erogenous zone, sadly, not all neck pain can be kissed better.
The key to effective treatment for neck pain is to be able to isolate which structures are involved in the pain and whether there are any other contributing factors.
STRETCH YOUR NECK EVERY DAY - SIX WAYS
It's important to understand how the neck works - it's pretty simple in that it moves in only six directions.
It flexes (bends forward), extends (bends backward), side bends and rotates - left and right.
Stretching, which maintains a good range of movement of the neck, is imperative for everyday neck health.
To improve mobility in your neck you should stretch the muscles by assisting the movement.
For example, to improve flexion bending forward, place your hands behind your head, tilt your head towards your chest and when you reach the end of your natural range apply light pressure to take it that little bit further.
At the end of the range of movement, just add a little more pressure to achieve a thorough stretch. It is this stretch at the end of the range of movement that makes the difference.
To strengthen the same muscles, you resist the movement: For example, to strengthen the muscles that flex your head, rather than put your hands behind your head, put them in front (on your forehead) and resist the movement.
This causes the neck muscles to contract and in so doing it increases the strength of those muscles. It is important to do this for all the muscles of the neck - in all six planes of movement.
YOUR FLAT-SCREEN TV HAZARD
I've also been treating more patients with neck pain triggered by new hazards - by that I mean injuries I would not have seen 20 years ago.
Today's neck problems seem to be caused by working at computers for extended periods with monitors at awkward angles placed on tables at the incorrect height, combined with poor posture on non-ergonomic chairs.
Then there are large-screen TVs positioned too high on walls, meaning the head gets locked back in a fixed position; using laptops and computer games where the head is held in an abnormal, stretched position; and, curiously, people who have been leaning
As one of the country's foremost practitioners of osteopathy and acupuncture, Garry Trainer's A-list clients include Gwyneth Paltrow and Robbie Williams.
Here, he explains why we don't give our necks enough attention but that with basic knowledge and his practical advice we can avoid injury and pain. back over sinks at the hairdresser's.
Even sitting in the blast of an office's cool air-conditioning causes neck muscles to contract, which can cause pain and stiffness.
The age-old cricked neck is often due to sleeping in a different bed or with different pillows and is one of the top ten causes of neck pain.
WHY WHIPLASH PROTECTS YOUR BODY
Road traffic accidents are a common cause of neck pain, namely "whiplash", which takes several months to improve.
It is caused by a sudden forced movement of the head or neck in any direction and the resulting "rebound" in the opposite direction gives it its name.
The sudden whipping motion causes injury to the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue resulting in pain and stiffness.
Muscle spasm is a way the body protects itself and so reduces movement through the painful area. Inhibiting movement allows the body time to heal.
Severe whiplash can also involve injury to the intervertebral discs, joints, ligaments, muscles, and nerve roots.
If you've had a head injury, more than likely your neck has been affected, too - even if you don't feel it right away. So it's wise to seek medical attention immediately.
WHY WON'T MY PAIN IN THE NECK GO AWAY?
If you've had neck pain for a long period, it's a good idea to consult your GP and a physical therapist as some modern diagnostic techniques may be needed - namely an X-ray or MRI scan - as a positive diagnosis is imperative before treatment starts.
Given time, neck pain can self-regulate or get better by itself. However, treatment assists the natural healing processes and should also ensure a more rapid recovery.
WHY DO I GET PINS AND NEEDLES?
The nerves that supply the fingers, and the muscles of the arms and hands have their origins in the base of the neck.
It seems bizarre, but if you trap any of these nerves, through injury to the neck, then pins and needles and numbness can manifest in the arms or hands.
You can also get pins and needles in the fingers due to an inadequate blood supply - by lying on your arm or sleeping with your arm above your head.
These disappear quickly when you change position, whereas pins and needles caused by trapped nerves will not resolve so easily.
In the long term, the best way to treat neck pain is via prevention and a good exercise and stretching. A strengthening regime can help, too.
Also be aware of your posture on a daily basis and explore ergonomic solutions within the workplace.
Remember, the majority of neck pain is not serious and simply mechanical in nature - you probably just made the wrong move at the wrong time. What a pain in the neck!
HOW TO TREAT LONG-TERM NECK PAIN
I would recommend the following choice of physical therapy as being effective for longer-term neck pain:
• Osteopathic or chiropractic treatments that concentrate on the joints, ensuring they are moving freely.
• Physiotherapy is the traditional treatment for physical ailments and focuses on exercises to strengthen muscles and prevent reoccurrence.
• Acupuncture can provide pain relief for significant numbers of those with chronic neck and shoulder pain, by releasing endorphins, which have a similar chemical structure to morphine, hence its pain-relief effect.
• Massage is an age-old technique that Hippocrates described as the "mother of all therapies". It stimulates blood circulation, which keeps the muscles supple and mobile.
• The Alexander Technique - a gentle form of exercise, not unlike yoga, aimed at aligning the spine - is good if the problem appears to be of postural origin.
• Yoga and pilates have a lot to offer in the treatment and management of neck pain as they concentrate on stretching and strengthening, but I would suggest refraining from headstandsas this may compress and compromise neck structures.
FIVE WAYS TO FIX YOUR NECK: DON'T STOP MOVING
When neck pain strikes, don't do activities that make your pain worse but do try to stay as active as possible by going to work and keeping up normal everyday activities.
Bed rest is not necessary and can actually make neck pain worse, particularly if you have a television in the corner of the room and you have to twist your head to watch it.
If you are given a neck collar try not to use this for more than one or two days.
You can even tie a scarf tightly around the neck to give a bit more support. This allows the neck muscles to relax as they do not have to work as hard.
FROZEN PEAS
For the first two to three days, you may get help by applying a homemade cold pack.
Simply place crushed ice in a plastic bag or, alternatively, use a bag of frozen peas or a chilled beer.
When you're ready to use the cold pack, wrap it in a towel or wet flannel. Place it on the sore area for up to 15 minutes a few times a day.
WARM THE PAIN
Once the acute symptoms are controlled in two to three days, you may get good relief using a heating pad - the padded packs containing wholewheat that you heat in the microwave, available at most health stores and online, are pretty good.
Check your skin regularly to make sure you are not getting too much heat.
You may find more relief by using a "contrast" of ice and heat. This is where you begin by placing a cold pack on the sore area for ten minutes.
Then place a heating pad on the area for another ten minutes. You can repeat the process a couple times, finishing with the heat.
Hot and cold will desensitise the pain, yet hot is best suited to stimulate circulation and cold is best suited if there are signs of inflammation.
STIMULATE THE NERVES
Try TENS - transcutaneous electrical nerve stimulation.
This is a small, pocket- sized device the size of a personal stereo connected by wires to sticky pads that are placed on the skin in the area of pain to deliver a mild electrical pulse.
If you've been treated with electrical stimulation, your therapist will have a good idea if this kind of treatment helps you.
Your therapist may choose to issue one of these, but only if you can't get good pain relief in other ways. They can also be bought from many healthcare websites.
EXERCISE
After you have completed your chosen therapy visits, your therapist will have a much better idea what types of exercise will help you control your pain. They should go over the exercises that will give you the best relief if you get sore again.
Remember to do the exercises only in the way your therapist has instructed. Overdoing them could make your pain worse.
Source:Daily Mail | | Mushroom extract may stop breast cancer growth Wed 23rd April 2008 | LONDON (Reuters) - Extracts from a mushroom used for centuries in Eastern Asian medicine may stop breast cancer cells from growing and could become a new weapon in the fight against the killer disease, scientists said on Tuesday.
Laboratory tests using human breast cancer cells show the mushroom called Phellinus linteus has a marked anti-cancer effect, probably by blocking an enzyme called AKT. AKT is known to control signals that lead to cell growth.
Phellinus linteus -- called song gen in Chinese medicine, sang-hwang in Korean and meshimakobu in Japanese -- has previously been shown to have anti-tumor properties on skin, lung and prostate cancer cells.
The new research on breast cancer, however, marks the first time that scientists have started to understand how it works.
Dr Daniel Sliva of the Methodist Research Institute in Indianapolis said the mushroom extract reduced uncontrolled growth of new cancer cells, suppressed their aggressive behavior and blocked new tumor-feeding blood vessels.
"We're not yet able to apply this knowledge to modern medicine, but we ... hope our study will encourage more researchers to explore the use of medicinal mushrooms for the treatment of cancer," he said.
The findings were reported in the British Journal of Cancer.
(Reporting by Ben Hirschler; Editing by Matthew Jones)
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