Acupuncture Effects Not Just Psychological
Acupuncture Effects – just in your mind?
One of the knocks against acupuncture is that it’s effect is merely “psychological”. The patient thinks he or she will get benefits from it, and therefore gets some form of the placebo effect and receives some therapeutic benefit. Previous blog entries of mine have enumerated various scientific journal articles that debunk the myth of acupuncture being only placebo effect (http://acupuncture.net.ph/repost-definite-proof-acupuncture-just-placebo/). We would like to add another one.
A study published in the Chinese Journal of Integrative Medicine by Xiong, et al in 2012 shows that the effects of acupuncture are dependent more on the needling sensation more than just being “psyched” about it. I had previously blogged about another study that shows that the needling or Qi sensation is needed for effective treatment of Bell’s Palsy (http://acupuncture.net.ph/acupuncture-bells-palsy-de-qi-sensation/). This time the condition studied was dysmenorrhea.
Image courtesy of marin / FreeDigitalPhotos.net”
Acupuncture effects on primary dysmenorrhea were discussed in this article entitled “De-qi, not psychological factors, determines the therapeutic efficacy of acupuncture treatment for primary dysmenorrhea.” 
The scientists did the following:
The patients with primary dysmenorrhea were randomly assigned to a group of acupuncture with manual manipulation (manipulation group, n=67) and an acupuncture group without manipulation (non-manipulation group, n=64). Pain intensity and pain duration were used as measures for evaluating the therapeutic efficacy of the acupuncture treatment. De-qi, the sensations a patient experienced during the acupuncture treatment, was scored on a 4-point scale by the subjects. In addition, the psychological factors, including belief in acupuncture, the level of nervousness, anxiety, and depression, were quantitatively assessed. The personality of the subject was assessed using the Eysenck personality questionnaire (EPQ) and 16 personality factor questionnaire (16PF). 
What this means is that all the subjects got acupuncture, but one group received actual manual stimulation of the needles and the others did not. This reminds me of another article that I blogged about (http://acupuncture.net.ph/rotating-acupuncture-needles/).
The subjects were then asked to rate both the degree of sensation as well as the degree of pain relief. Among the factors used to study the psychological effects, notably, was belief (or non belief) in acupuncture. According to the skeptics, acupuncture works because the patient thinks it will. By that logic, patients who don’t believe shouldn’t have any effect.
The results were expressed as follows:
Complete data were obtained from 120 patients, 60 patients in each group. There were statistically significant differences in pain intensity (W=2410.0, P<0.01) and pain duration (W=3181.0, P<0.01) between the two groups. The number of De-qi acupoints (W=1150.5, P<0.01) and the average intensity of De-qi (W=1141.0, P<0.01) were significantly higher in the manipulation group as compared with their non-manipulation counterparts. The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy. 
In layman’s terms, there was a huge difference in the benefits received by both groups. What caused the difference? Was it the belief in whether or not acupuncture will work? No. It was the intensity of the needling sensations caused by manipulation of the needle.
I will re-emphasize:
The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy. (emphasis mine)
My personal take: my professor Wang Zicai in Nanjing always told me to make sure my needling technique elicited proper qi sensation. I owe him everything for that. I’ve seen so many patients say they tried acupuncture somewhere else but found no therapeutic effect, only to discover later that their experiences with acupuncture was basically put the needle in and put the electrostimulation machines on. They had never felt the Qi sensation before!
My personal conclusion: once again, acupuncture is not a pill, but a procedure. It is dependent on the manual skill of the practitioner.
 Xiong, J, et al. “De-qi, not psychological factors, determines the therapeutic efficacy of acupuncture treatment for primary dysmenorrhea.” Chin J Integr Med. 2012 Jan;18(1):7-15. (link)