A new study has found an unusual risk in acupuncture: tuberculosis, which kills over 1 million people each year. While pulmonary tuberculosis is the best known and most common form, the infection can also be spread through skin contact.

Acupuncture, the traditional Chinese treatment of placing of needles in the body, is said to cure people of various ailments. Proponents believe that the needles control energy fields in the human body and treat medical issues. However, the energies that acupuncturists claim to manipulate have never been proven to exist and cannot be detected by any scientific instrument.

The article was published last week on the open-access journal PLoS-ONE and titled "Analysis of 30 Patients with Acupuncture-Induced Primary Inoculation Tuberculosis." In it the researchers described "Seven confirmed and 23 suspected, total 30 patients (13 male and 17 female) with primary inoculation tuberculosis were selected from the same clinic in Wenzhou City, China that specialized in treatment of muscle and soft tissue pain and osteoarthritis of the knee.... Patients ages ranged from 31 to 71 years... had all undergone acupuncture and electrotherapy, administered by the same clinician, once every two days for about two weeks for the treatment of neck, back, elbow, wrist, hip, knee and ankle pain. The procedures took place between May 2011 and August 2011."

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About half of the patients came down with fevers, night sweats and other symptoms; several had open sores and skin lesions. The researchers were unable to pinpoint the exact route of transmission, whether the infections were the result of dirty needles, electrotherapeutic pads or other equipment. However, acupuncture was clearly the common factor; all patients received treatment and have since recovered.

Acupuncture: Risks Versus Benefits

This is not the first time that acupuncture has been implicated in the spread of disease. A 2010 study published in the British Medical Journal found that dirty acupuncture needles have caused dozens of serious infections, including hepatitis B and C.

Of course all medical treatments involve risks, so the question becomes one of a cost/benefit analysis: Do the benefits of acupuncture outweigh the risks? The fact is that there is real question in the medical community about whether acupuncture is effective at all.

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Consumer advocate Dr. Steven Novella of the Science-Based Medicine website explains that the scientific evidence for acupuncture is inconsistent. Some studies show some small effect for a limited number of conditions (such as pain relief and anxiety), but many others don't. Furthermore, the conditions that acupuncture is most effective for are those that respond well to the placebo effect.

In other words, acupuncture is no more or less effective than a sugar pill with no active ingredient. Patients feel slightly better because they expect to feel better, not because needles were inserted into special points on their skin to redirect unknown energies. When a drug or treatment works no better than a placebo, in the field of medicine that means it doesn't work.

Novella describes acupuncture as "theatrical placebo" and writes that

"Clinical research can never prove that an intervention has an effect size of zero. Rather, clinical research assumes the null hypothesis, that the treatment does not work, and the burden of proof lies with demonstrating adequate evidence to reject the null hypothesis. So, when being technical, researchers will conclude that a negative study 'fails to reject the null hypothesis.' In other words, clinical research may not be able to detect the difference between zero effect and a tiny effect, but at some point it becomes irrelevant.... After decades of research and more than 3,000 trials, acupuncture researchers have failed to reject the null hypothesis, and any remaining possible specific effect from acupuncture is so tiny as to be clinically insignificant. In layman's terms, acupuncture does not work—for anything."

If Dr. Novella and others are correct, then the benefits of acupuncture do not outweigh the risks because there are no proven benefits to acupuncture -- though there are proven risks.