Acupuncture and back pain

So a couple of weeks ago I was having a look at the BMJ infographic Low back pain and sciatica: a summary of NICE guidance. I noted the following, “do not offer acupuncture”:

Looking through the “rapid responses”, my interest was piqued by this particular comment, particularly the following:

… [acupuncture] was banned in China in 1929, and resuscitated in 1949 when Chairman Mao sought a pragmatic solution to a political problem. A revival of ancient Chinese medicine allowed him to offer a form of health care to the vast rural population of a country where most of doctors trained in 20th century medicine worked in the cities.

Wait, what?

But it’s true: in the article “Retconning the story of traditional Chinese medicine”, published by Dr David Gorski in 2014, he summarises the issue thusly:

Contrary to popular belief (particularly about acupuncture), TCM [Traditional Chinese Medicine] does not go back thousands of years into antiquity, when the ancient healing wisdom of the Chinese was supposedly first discovered and codified and acupuncture discovered. In actuality, very few people are aware that the single person most responsible for the current popularity of TCM was not an ancient Chinese healer but rather Chairman Mao Zedong, as described in an excellent summary by Alan Levinovitz in Slate.com last year (link)

So there we have it? Well, not quite. This morning I found the following pop up in my Twitter feed: “Bilateral pneumothoraces after acupuncture”, courtesy of @SkepticalScalpel. It makes for grim reading:

A woman in New Zealand suffered bilateral pneumothoraces (collapsed lungs) after undergoing acupuncture treatments for arm and wrist pain. Needles had been placed at Jian Jing points … in both shoulders followed by immediate shortness of breath.

How common is this type of adverse event? Just yesterday, I was at the Surgeon’s Hall in Edinburgh, where by chance I came across two examples of sternal foramen and had two thoughts:

  1. How common are sternal foramina?
  2. What are the implications for those receiving acupuncture ’treatment'?

Wonder no longer: recounting the death of a woman from just this very ’treatment’, The Lancet had the following to say:

A needle was inserted in the sternum at the level of the 4th intercostal space, at the acupuncture point called Ren17 (ref). Shortly after the insertion, the patient complained of chest pain and demanded that the needle be removed immediately. She … was taken by ambulance to the nearest hospital [and] was dead on arrival, about 2 hours after the insertion of the needle. Attempts at resuscitation were unsuccessful … At necropsy … the pericardial cavity was distended by 320 mL of blood.