I don’t give up my Saturday mornings easily because this is when I go for a long bike ride in the beautiful Yorkshire countryside. So, I faced a dilemma when the British Medical Acupuncture Society invited me to give a keynote lecture at their scientific meeting. I have a long-standing association with the British Medical Acupuncture Society dating back to the late 1980s, and so I decided to forgo my bike ride to speak at their meeting on 20 November 2021. 
 
I always enjoy speaking at British Medical Acupuncture Society meetings because the audience have an insatiable curiosity about how science determines whether treatments are ‘effective’ and if so, what their physiological mechanism is. My talk, ‘Resolving long-standing uncertainty about clinical efficacy of TENS - my Meta-TENS journey’, addressed both of these issues.

At the end of my talk, I challenged the audience by asking ‘Has 50 years-worth of research on TENS been futile, and should we give up trying to prove that treatments like acupuncture and TENS are  effective?'.

This certainly provoked a lively debate!

TENS and Acupuncture: Likely Bedfellows

TENS and acupuncture are similar bedfellows. Both treatments are age-old and have historical roots dating back thousands of years; using organic materials like thorns, sharpened bones, or bamboo needles to pierce the skin (nowadays using metal acupuncture needles) or electrical fish to deliver electricity to the body (nowadays using TENS devices). In the 1960s and 70s, interest in acupuncture and TENS was re-awakened and their use in Western medical practice has increased ever since. Nowadays there is a mountain of published research supporting the ability of acupuncture and TENS to influence physiological mechanisms involved with producing pain. Despite this, doubt remains whether the magnitude of pain relief for acupuncture or TENS in patients is greater than placebo controls. Recently, evidence syntheses published by our team at Leeds Beckett suggests that uncertainty about the effectiveness to alleviate pain still remains. 

Hand with acupuncture needles in it

The British Medical Acupuncture Society

The British Medical Acupuncture Society formed in 1980 as an organisation of medical practitioners interested in acupuncture, although nowadays, membership is available for Western-trained physicians and other health professionals. The British Medical Acupuncture Society is supported by an international, peer-reviewed journal called Acupuncture in Medicine, of which I am an Editorial board member. Acupuncture in Medicine publishes investigations into the neurophysiology, effectiveness, and use of Western acupuncture. I published one of my favourite articles in Acupuncture in Medicine in 2006: ‘The clinical effectiveness of acupuncture for pain relief – you can be certain of uncertainty’. It was my first attempt at writing about the dangers of establishing one-sentence statements about the effectiveness of treatments for pain relief. At that stage in my career, I had been an academic for over 15 years,  yet I felt the same trepidation about how the academic community would respond to my paper as I did when I published my first article as a PhD student in 1989. 

Legacies: Academic Giants

Dr Mike Cummings is the Medical Director of the British Medical Acupuncture Society, and a world leader on needling therapies in the treatment of myofascial pain syndromes. It was Mike who invited me to speak at their scientific meeting, and he is a prolific writer and Editor of the premier textbook Western Medical Acupuncture. Previously, Mike had invited me to co-author a chapter in his textbook with Professor John Thompson, a highly respected senior member of the British Medical Acupuncture Society. Professor Thompson was my PhD supervisor and I owe him an enormous debt of gratitude for introducing me to the curious and stimulating world of TENS and acupuncture. The book chapter was Professor Thompson’s last publication before he passed away.

Bald man wearing suit & tie

Dr Mike Cummings

Legacies: PhD Supervisors

I read for my PhD between 1987 and 1991 under the supervision of two physicians, Professor John W. Thompson, and Professor C. Heather Ashton. Professor Thompson was a pharmacologist who was at the forefront of integrating acupuncture into mainstream medicine. Professor Ashton was a psychopharmacologist who tackled benzodiazepine withdrawal by transferring patients to diazepam and then gradually reducing the dose in what became known as the Ashton method. Academics often speak highly of their PhD supervisors, and I am no exception. My supervisors were inspirational and left a lifelong impression on my academic career. 

I often say to PhD students that ‘reading for a PhD is like swimming in an emotional sea of uncertainty; my role as a supervisor is to help you to keep afloat and to teach you how to swim for yourself’. PhD supervisors need skills that go way beyond their field of study. My supervisors taught me how to swim in the academic sea by making me feel valued from day one. They made me feel that we were on the PhD journey as a team and that the research findings were critical to the field. They spent much time providing methodical and meticulous feedback on my written work, detecting every imperfection in my grammar and my thinking. By doing this I was assured that our research was ‘up to scratch’ when it was published in the public domain. My lasting memory of my supervisors  was the humility in which they delivered feedback, and this is something I hope I am able to impart in my daily encounters with staff and student colleagues. 

Black and white image of older lady

Professor C. Heather Ashton

Old smiling man in suit & tie

Professor John W. Thompson

Professor Mark Johnson

Professor / School Of Health

Mark is Director of the Centre for Pain Research and leads a vibrant team of researchers. He has published over 200 research articles and book chapters and supervises PhD students. Mark teaches across all levels of our taught course provision.

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