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As I am currently practicing my French in Quebec City, just a short post this time around. Think of it as a minor coda to Steve’s post from last week on a poorly designed and reported acupuncture study published in a respectable journal. Instead of the Journal of the American Medical Association, however, this ridiculous paper on self-administered acupressure for chronic low back pain was published in Pain Medicine, which represents the American Academy of Pain Medicine.

But before I get into the study, such as it is, I want to do some humblebragging. Just a bit though. It’s a minor achievement to be sure, but it’s one that that I am particularly proud of. I was featured in an editorial in the June 2019 Medical Acupuncture, which is edited by friend of the blog and battlefield acupuncture promoter Richard Niemtzow.

In the editorial, author Gerhard Litscher liberally quotes my 2016 satirical post on “robotically-assisted acupuncture“, although he fails to mention my reference to space herpes from the 1984 comedy classic The Ice Pirates. Don’t believe Rotten Tomatoes, people. 91% of critics are apparently dead inside.

When I stumbled upon the editorial, I really was hoping that he had fallen into my trap and mistakenly confused my post with a serious discussion. But alas, he knew it was fake news and merely used my clever concept in juxtaposition with advances in the actual development of robotic acupuncture. Here is a video demonstration (“What is matter with you?”).

The developer claims to have been inspired by Baymax from Disney’s Big Hero 6, but I’m not so sure that’s true. He states the following benefit from robot acupuncture:

Robots can free practitioners from exhaustive, repetitive labor so they can focus on designing better treatment plans.

From my satire post:

As science progresses, and we continue to scale down robot technology and improve treatment algorithms, the physical act of acupuncture will be taken completely out of the hands of the practitioner. The human mind will be set free, allowing full mental focus on diagnosis.

In regards to the safety of the proposed robot acupuncture, there are some limitations:

Xu conceded that robots cannot be trusted with crucial parts of the body, such as the head, neck and waist.

But in the fictional world created within my mind palace, anything goes:

The da Vinci Surgical System, a state of the art robotic technology, features a 3D high-definition magnification system and instruments able to maneuver with far greater precision than the human wrist and fingers. This is allowing specially trained acupuncturists to both locate and successfully target hard to reach acupuncture points, such as those on the eye, scrotum, and anal verge.

Now back to that acupressure “study“. 67 subjects with chronic low back pain were recruited in Southeastern Michigan using flyers and newspaper ads, so already this is a self-selected group that may consist of believers in acupressure or one of its many close relatives. They were randomly split into three groups, which included “relaxing acupressure”, “stimulating acupressure”, and usual care. There was no blinding.

After 6 weeks, the subjects were assessed for reductions from baseline in pain, fatigue, poor sleep, and overall disability. Pain scores were improved in both acupressure groups compared to usual care, and fatigue was improved in only the stimulating acupressure group. There were no differences in sleep quality or disability.

The results were, as expected, consistent with either the introduction of a novel therapy, and perhaps the expectation of benefit in primed subjects, without proper blinding. The acupressure was found to be safe, so at least there is that. It’s unfortunate that a legitimate journal published this study. After all, there are already thousands of preliminary studies out there showing weak results like this, even involving self-administered acupressure for chronic low back pain. If I didn’t know any better, I’d worry that the whole point is just to mass produce positive results.

C’est tout pour le moment. Je serai de retour dans deux semaines.

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Posted by Clay Jones

Clay Jones, M.D. is a pediatrician and a regular contributor to the Sivasucakbileti blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @SBMPediatrics and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey. The comments expressed by Dr. Jones are his own and do not represent the views or opinions of Newton-Wellesley Hospital or its administration.