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Comment by neotek | Hacker News Reader

>But acupuncture and yoga are not the same as pixie dust, dung pills or what have you.

Okay, so why don't they show any efficacy above pixie dust in double-blinded studies?

Don't forget that pixie dust (or a saline injection) can actually be fairly effective. https://en.wikipedia.org/wiki/Placebo_effect#Pain

Do you have a cite for this? And efficacy in what? They are not medicines, they are lifestyles (just like lifting or diet as another commenter mentioned)

Unfortunately, double blind studies of acupuncture are impossible (the person doing it must know if they're putting needles in), and single blind studies are almost impossible (the patient can feel the needles, and tell how far in they are). The only thing than can be tested is the traditional Chinese medicine chi flow idea, and even assuming there's no chi flow along meridians, that doesn't mean the special locations it tries to explain aren't valid for some other reason. But it can't be tested.

It's all deeply frustrating. I tried acupuncture a few years ago (at a doctor's recommendation) and did a lot of reading. It didn't work for me, unsurprisingly - about the only thing it's been shown to have any effect for is some types of lower back pain, and my pain was (is) mostly in my hands.

> Unfortunately, double blind studies of acupuncture are impossible

It doesn't seem completely impossible. You could have someone put the same needles in randomly, instead of in whatever location acupuncture claims they should be put in.

That would be single blind (edit: actually, now I see what you mean, double WRT location), but yes, the locations can be tested - and they have been. The needle action itself is what can't be properly tested.

No it has been tested. It's only placebo.

Yeah I actually agree with that in theory because the needles would be mimicking the same side effect, the sensation of needle in skin, to a good effect.

The theory of acupuncture places rules and requirements on how the needles are placed. You can of course stick needles in wherever you want but that is not acupuncture in the same way that cracking my own neck is not chiropracy and cutting myself with a knife is not surgery. Any study that just says random needle sticking might work (in addition to being flawed due to the issues you've laid out) is not really any more compelling than a study that concludes "cracking your neck feels good".

Therefore single-blind studies of acupuncture are trivial; just find people who don't know where the needles are supposed to go. A double-blind study could be possible, if you trained two sets of people to perform the procedure (one incorrectly).

Yes, the locations can be and have been tested. The needle action itself is what can't be properly tested, though there have been plenty of attempts with various types of sham needle, etc. I'm not trying to claim it doesn't or can't work (since I don't know), just that it's frustratingly difficult to research important bits of it.

You can compare to to deeper (in safe) or shallower insertions, and not tell the patient which is official acupuncture. You can apply anesthetic s first. These give clues.

There are double-blind studies on acupuncture, by using "trick-needles" that don't penetrate the skin but look like they do.

This study introduces them and shows that acupuncturists can't well distinguish both types: https://www.biomedcentral.com/1472-6882/7/31

This study uses them to check for differences in pain-relief (there are no differences): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2765771/

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