Advocates of so-called alternative medicine (SCAM) often sound like a broken record to me. They bring up the same ‘arguments’ over and over again, no matter whether they happen to be defending acupuncture, energy healing, homeopathy, or any other form of SCAM. Here are some of the most popular of these generic ‘arguments’:
1. It helped me
The supporters of SCAM regularly cite their own good experiences with their particular form of treatment and think that this is proof enough. However, they forget that any symptomatic improvement they may have felt can be the result of several factors that are unrelated to the SCAM in question. To mention just a few:
- Placebo
- Regression towards the mean
- Natural history of the disease
2. My SCAM is without risk
Since homeopathic remedies, for instance, are highly diluted, it makes sense to assume that they cannot cause side effects. Several other forms of SCAM are equally unlikely to cause adverse effects. So, the notion is seemingly correct. However, this ‘argument’ ignores the fact that it is not the therapy itself that can pose a risk, but the SCAM practitioner. For example, it is well documented – and, on this blog, we have discussed it often – that many of them advise against vaccination, which can undoubtedly cause serious harm.
3. SCAM has stood the test of time
It is true that many SCAMs have survived for hundreds or even thousands of years. It is also true that millions still use it even today. This, according to enthusiasts, is sufficient proof of SCAM’s efficacy. But they forget that many therapies have survived for centuries, only to be proved useless in the end. Just think of bloodletting or mercury preparations from past times.
4 The evidence is not nearly as negative as skeptics pretend
Yes, there are plenty of positive studies on some SCAMs This is not surprising. Firstly, from a purely statistical point of view, if we have, for instance, 1 000 studies of a particular SCAM, it is to be expected that, at the 5% level of statistical significance, about 50 of them will produce a significantly positive result. Secondly, this number becomes considerably larger if we factor in the fact that most of the studies are methodologically poor and were conducted by SCAM enthusiasts with a corresponding bias (see my ALTERNATIVE MEDICINE HALL OF FAME on this blog). However, if we base our judgment on the totality of the most robust studies, the bottom line is almost invariably that there is no overall convincingly positive result.
5. The pharmaceutical industry is suppressing SCAM
SCAM is said to be so amazingly effective that the pharmaceutical industry would simply go bust if this fact became common knowledge. Therefore Big Pharma is using its considerable resources to destroy SCAM. This argument is fallacious because:
- there is no evidence to support it,
- far from opposing SCAM, the pharmaceutical industry is heavily involved in SCAM (for example, by manufacturing homeopathic remedies, dietary supplements, etc.)
6 SCAM could save a lot of money
It is true that SCAMs are on average much cheaper than conventional medicines. However, one must also bear in mind that price alone can never be the decisive factor. We also need to consider other issues such as the risk/benefit balance. And a reduction in healthcare costs can never be achieved by ineffective therapies. Without effectiveness, there can be no cost-effectiveness.
7 Many conventional medicines are also not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence. So why do we insist on solid evidence for SCAM? The answer is simple: in all areas of healthcare, intensive work is going on aimed at filling the gaps and improving the situation. As soon as a significant deficit is identified, studies are initiated to establish a reliable basis. Depending on the results, appropriate measures are eventually taken. In the case of negative findings, the appropriate measure is to exclude treatments from routine healthcare, regardless of whether the treatment in question is conventional or alternative. In other words, this is work in progress. SCAM enthusiasts should ask themselves how many treatments they have discarded so far. The answer, I think, is zero.
8 SCAM cannot be forced into the straitjacket of a clinical trial
This ‘argument’ surprisingly popular. It supposes that SCAM is so individualized, holistic, subtle, etc., that it defies science. The ‘argument’ is false, and SCAM advocates know it, not least because they regularly and enthusiastically cite those scientific papers that seemingly support their pet therapy.
9 SCAM is holistic
This may or may not be true, but the claim of holism is not a monopoly of SCAM. All good medicine is holistic, and in order to care for our patients holistically, we certainly do not need SCAM.
1o SCAM complements conventional medicine
This argument might be true: SCAM is often used as an adjunct to conventional treatments. Yet, there is no good reason why a complementary treatment should not be shown to be worth the effort and expense to add it to another therapy. If, for instance, you pay for an upgrade on a flight, you also want to make sure that it is worth the extra expenditure.
11 In Switzerland it works, too
That’s right, in Switzerland, a small range of SCAMs was included in basic health care by referendum. However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.
I am sure there are many more such ‘arguments’. Feel free to post your favorites!
My point here is this:
the ‘arguments’ used in defense of SCAM are not truly arguments; they are fallacies, misunderstandings, and sometimes even outright lies.
51 Responses to ‘Arguments’ used to defend so-called alternative medicine
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While “safe and effective(™)” and the Faucian “I am the science(™)” has destroyed the world economy, led to excess mortality of over 10% in the highly vaccinated countries, and increased NHS and ambulance waiting times, I have been able to carry on preparing and drinking my own vegetable juices + taking ascorbic acid etc as usual, without interruption which is one of the advantages of DIY health care: independence.
“I have been able to carry on preparing and drinking my own vegetable juices”
and look where it has got you: you are a raving conspiracy theorist!
Old Bob says:
My uncle and his family of five did the same during first and second waves and did not get vaccinated, both times all five people caught covid. They learned their lesson and got vaccinated and did not catch covid during later waves. I wonder why DIY health care did not work for them. What do you think Old Bob? Maybe they didn’t pray hard enough to individual freedumb gods?
NHS and ambulance service waiting time increases are actually a result of all the budget and service cuts made by every government since 2010 (hint: I was a senior nurse and in receipt of all the internal trust documents detailing the level of cuts to clinical services, including my own job, we were exepected to make in the first few years of the Cameron government). Not to mention all the cuts made to training numbers of doctors and nurses and other clinical disciplines which were beginning to work through the system BEFORE Covid. And a whole heap of other mostly political factors which are nothing to do with Covid and ceertainly nothing to do with Fauci, who has sod all control over NHS decisions, and most of which were in place well before anyone heard of Covid-19.
Please try to use some facts.
Oh, not to mention the deliberate decision by our government to ignore the findings of one of its own exercises into pandemic preparedness from a few years before Covid hit – https://www.theguardian.com/world/2020/may/07/what-was-exercise-cygnus-and-what-did-it-find
Really, go and find out about the subject before trotting out your same old “talking points”.
In point 11 Edzard says.
‘However, it has been reported that the consequences of this decision are far from positive. It brought no discernible benefit and only caused very considerable costs.’
Please can you provide links to these reports.
sorry, I forgot to link my previous post on this subject; I now rectified my mistake.
Re point 6:
I think is in fact wrong, even when looking at just medicines. Many generic medicines are quite cheap, costing less than a euro per day even with chronic use – which is about the same as many supplements. Yes, there are some atrociously expensive medicines out there, but those aren’t used by large numbers of people. But even including those Big Pharma Money Makers, medicines only make up between 5% and 10% of total healthcare costs, depending on the country.
Most of of the healthcare budget goes to the actual people involved in providing healthcare – and SCAM practitioners are considerably more expensive than family physicians. One GP consultation here in the Netherlands costs €10 – €20. Most homeopaths and other quacks charge three or four times this amount.
So even if SCAM would be just as effective as regular medicine, it would still not be cheaper. As most of SCAM is totally ineffective, every cent spent on it is in fact a waste of money.
Thank you Edzard but your reference is to a previous blog post that refers to an article in Swiss the boadsheet Blick.
This is just an opinion piece with no references to any data.
Other articles i saw in this newspaper are similar to what you might get in ‘The Sun’. eg
https://www-blick-ch.translate.goog/?_x_tr_sl=de&_x_tr_tl=en&_x_tr_hl=en&_x_tr_pto=sc
So are you aware of any peer reviewed article on the use of CAM in Switerland as I would be interested to view this kind report.
that’s why I wrote, “However, it has been reported that the consequences of this decision are far from positive.”
rather than “peer-reviewed evidence has shown…”
Here is an article directly at the Santésuisse website (in German – French – Italian)
https://www.santesuisse.ch/details/content/teure-komplementaermedizin
thank you, that is most helpful
[I did not look for papers in German, but this one is nevertheless fine]
Paxlovid costs > $500 and does not work (e.g. in Faucci) whereas ivermectin costs pennies and works (e.g. for hundreds of millions in Uttar Pradesh), but “Fact Checkers” say “You’re not a horse…” etc. And MSM parrots this.
that’s enough
no more falshoods about Ivermectin or related subjects.
“no more falshoods about Ivermectin…”
Absolutely.
No Bob. It does NOT work. The studies which said it did are fraudulent and have have been retracted.
… and Bob knows it!
Ivermetin/Uttar Pradesh story is utter BS.
https://gidmk.medium.com/ivermectin-didnt-save-uttar-pradesh-from-covid-19-17684f49d8b3
Additional sources debunking the story.
https://www.newswise.com/factcheck/success-of-ivermectin-in-preventing-covid-19-in-india-has-not-been-proven/?article_id=761091
https://healthfeedback.org/claimreview/no-evidence-suggests-a-causal-link-between-ivermectin-recommendation-and-the-decline-of-covid-19-cases-in-the-indian-state-of-uttar-pradesh/
Arguments used to defend Conventional Medicine
1. It helped me
Suppressing/palliating symptoms helps temporarily. Long-term effects are bad..
2. My Conventional med is low risk
Studies show that conventional medical care is the third leading cause of death in the USA.
3. Conventional medicine has stood the test of time
See above
4 The evidence is not nearly as negative as skeptics pretend
See above
5. The pharmaceutical industry is developing new wonderful treatments all the time.
The Pharma goons have been fined billions of dollars on numerous occasions for fraud and defective products knowingly released on unsuspecting population with regulatory pats on the head, despite bad or incomplete evidence.
6 Conventional medicine is the best medicine money can buy
In the USA, the most medicated country in the world, medical care is the leading cause of bankruptcy.
7 Many conventional medicines are not evidence-based
Sure, there are some treatments in conventional medicine that are not solidly supported by evidence.
About half of conventional medicine willl never be evidenced based because the drugs are off-patent.
8 Conventional medicine is supported by clinical trials now
“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. As one participant put it, ‘poor methods get results’.”
Dr. Richard Horton, editor-in-chiefLancet, Apr 11, 2015 editorial
9 Conventional medicine doesnt need to be holistic; get rid of the llocal symptoms and you are good to go.
See above
10 conventional medicine is complete in itself.
Conventional medicine does not cure chronic diseases. If you want to be on a treadmill of drugs for the rest of your life, I guess that is your choice.
11 In India there are three systems of medicine: Conventional, Ayurveda and Homeopathic
This keeps medical care affordable because there is competition. People arent forced to stay on the treadmill of conventional medicine. People are given medical freedom of choice.. The skeptics on this site seem to want to take that away because of an arrogant assumption that they know best for YOU.
@stan
[snip list of untruths and straw men]
You forgot the most compelling one: conventional science-based medicine has dramatically improved our quality of life as well as our life span over the past century. No longer does one in every four children die before the age of five. We now live up to the age of eighty on average, and in pretty good health, at that. Bacterial infections are now a nuisance rather than a serious risk. Cancer patients survive in ever larger numbers for an increasing number of years. Heart conditions that were a certain death sentence only a couple of decades ago are now routinely fixed. We now know the cause of thousands of conditions that mystified doctors in the past. We know what is and what isn’t a healthy lifestyle, so we can actively work on lowering our chances of falling ill etcetera etcetera.
And oh, conventional doctors are required by law to keep up with latest scientific developments in healthcare. They are not allowed to treat patients based solely on ‘tradition’ and ‘personal experience’.
For all these things we have to thank medical science and the doctors who each spent ten years of their life learning the science, art, and practice of healing – NOT the medically incompetent alternative practitioners you seem so eager to defend.
No, conventional medicine is not perfect, and has its failings and even criminals – just like anything else involving humans. But the way to improve things is to address those issues, not to henceforth accept quackery as ‘medicine’. Unfortunately, India seems poised to do the latter, sending the country back in time a hundred years or so healthcare-wise. And those in India who can’t afford science-based medicine are forced to ‘choose’ 100% ineffective quackery such as homeopathy and ayurveda.
@stan
That is the dumbest thing I have every had the pleasure of reading. It is not freedom of choice. It is more like people are to ignorant to understand what they are being sold. A large majority of people in rural India (to some extent in cities as well) do not have access to conventional medicine. Most of these people also happened to be un- or under-educated and do not know better. As a result, Govt. of India promotes quackery because it serves them politically and they can easily get away doing so. They even have a ministry to promote quackery, called Ministry of AYUSH
For example, ayurveda has its roots in Hinduism and majority of the people in India are Hindus and are quite religious. Political party that promotes ayurveda are seen favorably by Hindus. Despite warnings from medical community, the ruling party politicians routinely promote using cow dung and urine as cure for covid.
https://www.businesstoday.in/latest/trends/story/i-drink-cow-urine-every-day-so-dont-have-covid-bjp-mla-pragya-thakur-says-watch-viral-video-296262-2021-05-17
https://www.indiatoday.in/coronavirus-outbreak/story/bjp-mla-bairia-surendra-singh-cow-urine-gaumutra-to-stop-covid19-on-camera-1800129-2021-05-08
https://www.thehindu.com/news/national/other-states/assam-bjp-mla-prescribes-cow-dung-for-covid-19/article30967126.ece
Cow is considered sacred by Hindus and usage of cow excrement is a part of ayurveda: https://en.wikipedia.org/wiki/Panchagavya. Government organizations in India routinely promote bullshit (literally and figuratively) like this:
https://theprint.in/india/how-a-govt-body-plans-to-produce-highly-intellectual-children-with-help-of-cows/286680/
And I’ve asked you several times for evidence of homeopathy “curing” certain chronic conditions and you have not provided any, just some handy wavy “There is literature out there”, which I was not able to find, despite spending quite a bit of time looking.
Have you actually read the bit in the red box which appears at the top of the page here?
1. Is it not true to say that the reason for few or limited research studies into Alternative Medicine is because there is not the money in it whereas Big Pharma has fairly unlimited funding available for research?
2. Know it suits your purpose to use the sensationalist acronym SCAM but wouldn’t it be much nicer and fairer to use AM and drop the “so-called’ bit Edzy, thereby not terrifying those who have a fear of or have been unfortunate enough to experience genuine scams?
@Margaret Lamont
My thoughts on your questions:
No, that is not true. There are several fallacies in this single point.
The first fallacy is that Big Pharma is the single biggest party in terms of healthcare expenditure. Far more money is spent on doctors, patient care, hospitals and academic research. Some numbers: total worldwide expenditure on healthcare: ~10,000 billion dollars. Big Pharma annual turnover: ~1,200 billion dollars. Worldwide expenditure on quackery (including supplements): ~250 billion dollars. So there is more than enough money in the quack world to finance proper research.
The real reasons why so little research is done in quackery is that it is not in the interest of the quacks themselves: not only does it cost LOTS of money that they could otherwise put in their pockets(*), but far more problematic to them is that virtually every outcome proves their claims wrong, so they’d be sawing off the branch they’re sitting on. And since there is also no legal requirement for quackery to prove that their nostrums are both safe and effective (something that Big Pharma has to do to be allowed to sell its products), doing no research at all is the safest and most profitable way to stay in business.
Some countries that have invested heavily in quackery as a source of national pride have come up with an alternative (pun intended) strategy: they flood the world with fake research that ostensibly ‘proves’ the effectiveness of their favourite type of quackery (usually acupuncture, homeopathy and TCM).
*: Big Pharma spends on average 25% of their turnover on R&D. Big Quack Boiron (annual turnover ~600 million dollars) spends on average 0,6% on R&D ($3.5m). However, they DO spend a whopping 25% ($140m) on marketing, i.e. deception, convincing people that their inert sugar crumbs and shaken water products actually do something.
Then there is the implicit fallacy that the usefulness of quackery could be proven if only they got more money to do research. In 1991, the NCCIH was established to, in the words of then Senator Tom Harkin, ‘validate (NOT ‘study’) alternative medicine’. Over the course of the years, the NCCIH has spent almost 4 billion dollars in taxpayers’ money on research and promotion of all sorts of quackery, with no tangible results whatsoever. They did not succeed in
provingvalidating the viability of even a single type of quackery – yet they keep promoting it nevertheless.And of course or gracious host Edzard Ernst has spent many years doing scientific research into quackery in the UK. When he started out, he expected to find a fair amount of positive results. To his disappointment (and the wrath of one staunch quackery proponent by the name of Charles of Windsor), almost every study turned out negative.
And in spite of all this, a lot of research has been carried out in for instance homeopathy, over no less than 200 years. Even after all this time, not a single effective(**) homeopathic preparation has been identified. NOT ONE.
**: With ‘effective’ generously defined as ‘producing robust and independently replicable effects’.
A final fallacy is that being able to spend lots of money on research increases the chances of a positive outcome. While this is true to a certain extent (more money can lead to better science), the vast majority (well over 95% IIRC) of Big Pharma studies into new, promising substances ends up negative.
I think AM is an implicit lie, as ‘Alternative Medicine’ generally does not work and is therefore neither Medicine nor an Alternative for real medicine – so the prefix So-Called seems quite appropriate. But in acknowledgement of your sensitivities, I decided to refrain from using the SCAM acronym in this comment, and use another suitable term throughout.
Thank you for taking the time
@Margaret Lamont
Just to clarify things, and for the sake of a more respectful discussion: I am usually somewhat more sparing with the qualifications ‘quackery’ and ‘quack’. In many cases, I use ‘alternative medicine’ and ‘alternative practitioner’, just like you.
However, I was irked by your belittling use of ‘Edzy’, as well as the suggestion that alternative medicine is not a scam. In my opinion, a lot of alternative medicine is a scam, and quite a few alternative practitioners are not just quacks, but scammers as well. When a pig farmer or carpet salesman with no relevant education whatsoever one day decides to call himself ‘therapist’ and treat gullible people with health problems for $100 per hour, then those people are absolutely scammers. And, yes a lot of alternative practitioners start out this way. And let’s not talk about the people who design, build and sell equipment for bioresonance or the likes. They absolutely know that they are deceiving people.
OK, there are those who at least try to educate themselves on the subject (even though that education is usually best characterized as ‘tooth fairy science’). Most practitioners in this category genuinely believe in what they are doing, and that they’re helping people(*), so you can’t really say that they’re scammers. However, many of them not only stick their fingers in their ears and pretend they can’t hear whenever science-based information clearly shows that they’re wrong, but are arrogant enough to claim that they are right and scientists and real doctors are all wrong. IMO, this places them squarely in the quack category.
I also think that I gave valid reasons why far less research takes place in alternative medicine than in real medical science: the alternative world is doing just fine already selling their products and services without any science-based evidence to back up their claims. And, as said, any high-quality research in this area would most likely demolish their business instead of supporting it, simply because most high-quality research that has been carried out indicates that it doesn’t work. Add to this that high-quality research costs lots of money, and it is clear that good research is not in the interest of the alternative world at all – it would most likely end up destroying them.
*: Yes, I know that 80% of customers of alternative practitioners are quite satisfied and happy. But I also know that even a completely ineffective treatment can give a very strong illusion that it works, mostly because of the Post hoc fallacy for which almost nobody is immune. Throw in the placebo effect and a handful of typically human traits, and it is very difficult NOT to believe that a treatment actually did something. This is why we need science to establish if something is effective or not.
But is science as we know it up to it? ‘Science’ is changing all the time.
BTW was thanked previously by Edzard for the ‘nice nickname’. Perhaps you missed it.
Well, by definition a scam is illegal. I don’t think most alternative medicine sellers are breaking the law. Thus it’s not the appropriate label for most.
Scam: an illegal plan for making money, especially one that involves tricking people: (Cambridge)
“Well, by definition a scam is illegal [followed by cherry-picking dictionaries].”
scam noun infml US: a dishonest or illegal plan or activity, esp. one for making money.
— Cambridge Dictionary
scam noun: a fraudulent or deceptive act or operation.
— Merriam-Webster
scam noun infml: a dishonest scheme; a fraud.
— Oxford Reference
he has a special dictionary written only for chiros
@DC
Funny that you should mention this. Because many things that alternative practitioners do are illegal if real doctors and pharmaceutical companies do them.
For instance pharmaceutical companies receive fines up to billions of dollars if they promote and sell products for conditions without first testing those products for safety and efficacy for that particular condition(*). Alternative practitioners never test their products for efficacy and only rarely for safety.
And real doctors would be seriously disciplined or even lose their license if they were as incompetent in diagnosing and treating patients as, for instance, naturopaths or homeopaths or orthomolecular practitioners.
*: Even if that very same product has been found safe and effective for treating another condition.
I always find it both funny and saddening that the alternative world craves to be treated as equal to real medicine, but does not want to be subjected to equal rules and regulations. (And notice that I didn’t mention the word ‘quack’ even once … oh, drat …)
@Margaret Lamont
Science is arguably the best thing we have to study disease and health, and find ways to achieve the latter as much as possible, also see
https://edzardernst.com/2022/10/arguments-used-to-defend-so-called-alternative-medicine/#comment-141380
Yes, that is the strongest point of science. And not only is science changing all the time, it is improving all the time – by not relying on tradition, unproven ideas, authority or popularity, but instead keep the things for which there is good evidence, and discard things for which no evidence can be found. Scientists actively work to find things that other scientists or even science as a whole is wrong about, in order to correct these things, and improve our body of knowledge. (And, of course those scientists who manage to prove important things wrong get a lot of fame and respect.)
If you would tell scientists that they are wrong about something, they would be mostly interested, and start asking questions, such as “Why do you think so? Do you have observations or evidence to back up what you say? Can we see it?”
None of this happens in the alternative world. If you explain for instance to homeopaths that they are wrong, they will likely become angry. I experienced this myself once: when I explained to the legal committee of a Dutch consumer authority that a particular homeopath (who was also present in the room) falsely claimed that vaccines caused serious damage in children, and that the “homeoprophylaxis” he sold to parents did not work for preventing disease (all supported with plenty of scientific evidence), the man became absolutely livid. He protested that he had never been insulted like this in his life, and how dare I contest his claims about homeopathy, what with me being not being a homeopath or even a scientist, and he demanded(!) that my evidence should be ignored in the committee’s deliberations.
Yet during his whole red-faced, furious monologue of no less than 45 minutes, he did not contribute proper scientific evidence for his claims, just the usual rubbish from homeopaths. He just kept going on about being the victim of a with hunt, and how all those so-called ‘scientists’ did not understand anything about homeopathy etcetera etcetera. I was quite glad there were two empty seats between me and him, as at several times, it almost seemed that he had trouble keeping himself from lashing out at me.
In the end, the committee found for me, and instructed the man to no longer advertise his “homeoprophylaxis”, and refrain from claims that regular childhood vaccinations regularly cause brain damage and death in children. Unfortunately, this consumer authority has no power to impose sanctions, so the homeopath has not complied with their verdict. Instead, the man keeps claiming that he is right after all.
This is in my opinion a good example of a dangerous quack and a scammer.
Fraud: the crime of getting money by deceiving people:
https://dictionary.cambridge.org/us/dictionary/english/fraud
Scam: an illegal plan for making money
https://dictionary.cambridge.org/us/dictionary/learner-english/scam
RR: Because many things that alternative practitioners do are illegal if real doctors and pharmaceutical companies do them.
Yes, that’s the way the law is written, at least in the USA. For products:
“If a dietary supplement label includes such a claim, it must state in a “disclaimer” that FDA has not evaluated the claim. The disclaimer must also state that the dietary supplement product is not intended to “diagnose, treat, cure or prevent any disease,” because only a drug can legally make such a claim.”
https://www.fda.gov/food/food-labeling-nutrition/label-claims-conventional-foods-and-dietary-supplements
For practitioner claims, well that depends on several factors such as it they are licensed or not, wording of the claim, etc.
He’s entitled to his opinion.
@DC
Colquhoun is not merely venting an opinion. He states a scientifically proven fact.
Which “fact” would that be?
Mostly placebo or similar to conventional medicine?
@DC
Both facts: most alternative medicine is no more effective than placebo, and the remainder offers no significant extra value over what that is already available in regular medicine.
Yes some appear to be placebo driven.
As far as “offers no significant extra value” well, that requires specifics on risk vs benefit vs cost.
One can take nsLBP as an example and compare the conservative chiropractic model vs the “regular medicine” model.
One would be hard pressed to find research which shows that the “regular medicine” model is superior in risk vs benefit vs cost.
particularly, if one does not look
@DC
Yes, nsLBP is a good example; the point is non-superiority. Chiropractic treatment is not superior in any way to physiotherapy – but it is way more expensive, so in all, it is an inferior choice.
By way of anecdotal evidence:
I have experienced recurring episodes of lower back pain, and at the first occasion, my doctor told me that the usual approach was pain-guided activity. This meant simply going about my business as usual, taking it easy with bending over and lifting things, and taking rest when the pain got worse. Maybe take a painkiller at night for better sleep.
He also said that some people benefited from physiotherapy – so I tried that as well (3 sessions, one per week). This, however did not make much of a difference. Yes, the pain and stiffness were slightly less right after a treatment, but that effect (placebo?) lasted an hour at most.
My back pain lasted for about 3 weeks, and then disappeared. Ever since, I simply ‘treat’ my lower back pain by pain-guided activity, as per regular medicine guidelines.
A business acquaintance of mine also suffered from non-specific lower back pain. His doctor gave him the same advice that mine gave. However, after a week he decided to consult a chiropractor, who treated him twice a week, and yes, that seemed to help a little, although he too found that any relief from a treatment was only short-lasting. After 4 weeks, his back pain was gone. And oh, the chiro advised the man to have his back ‘adjusted’ twice a year, to help prevent recurrence.
All my costs were covered by my health insurance, but if I had to pay for it myself:
1 x €20 (GP) + 3 x €30 (Physio) = €110
The chiropractor customer (chiropractic treatment not covered by his insurance):
1 x 2€0 (GP) + 6 x €60 (Chiro) = €380
Things become even more interesting when the back pain returns: I have zero cost, while this believer in chiropractic will likely shell out several hundred euros for new chiro treatments, with the exact same outcome.
Chiropractors are in other words completely superfluous – and worse: they try to suck even more money out of gullible customers by advising regular ‘preventive’ treatments for which there is no evidence at all. This latter makes them quacks and scammers in my book.
Start with this:
https://www.healthdata.org/news-release/low-back-and-neck-pain-tops-us-health-spending
And finish with this:
@DC
So every US citizen spends on average $400 per year on lower back pain treatments and diagnostics. That is quite a lot, even when taking into account that LBP is one of the most prevalent human health problems.
However, apart from being somewhat alarming, this statistic in itself is pretty meaningless. If it signals anything, it may be one of the following:
– Another worrying signal of the obesity epidemic in the US, as obesity is a strong risk factor for musculoskeletal problems, including LBP.
– That US healthcare is doing some things very wrong wrt. LBP – for comparison, here in the Netherlands, LBP cost is on average $50 per person per year. And note that we are the tallest people on earth here, which is a known predisposition for back problems – maybe even more so than obesity. So how is it that US expenditure on lower back pain is 8 times higher?
– That many people in the US visit expensive chiropractors instead of far cheaper physiotherapists – chiropractors who also sell people
preventive adjustmentscompletely unnecessary treatments.– That people might be better informed about lower back pain, i.e. that there are usually no effective treatments, and that most cases resolve naturally within a couple of weeks through pain-guided activity, without any (costly) interventions that don’t really help much.
So I’d say that this supports my notion that chiropractors are an inferior, expensive choice compared to physiotherapists. Maybe they should better be retrained as weight loss and lifestyle experts, and leave the bones-and-muscle busniess to physiotherapists? Correcting obesity and bad lifestyle habits is far more effective for people’s health than what chiros are doing now.
RR: Correcting obesity and bad lifestyle habits is far more effective for people’s health than what chiros are doing now.
What are most chiropractors doing now?
Manual therapy, promote exercise, healthy lifestyle, ergonomics, rehab…
“What are most chiropractors doing now?”
spinal manipulation
spinal manipulation
spinal manipulation
spinal manipulation
spinal manipulation
spinal manipulation
spinal manipulation
spinal manipulation
Use of attended physiotherapy modality…several times a day…45.1%
Use of unattended physiotherapy modality…several times a day…54.3%
Use of in office active rehab…several times a day…45.2%
Use of soft tissue techniques…several times a day…63.0%
Practice Analysis of Chiropractic, 2020
RR: see figure 2 regarding cost comparison
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423501/
In the United States, chiropractic vertebral subluxation (CVS) is the diagnosis chiropractors use for Medicare billing.
E.g., Chapter 500 – Michigan Legislature: “Manual therapy and other modalities to areas other than the spine, or that are for therapeutic purposes and not for the diagnosis or correction of a subluxation, fall outside the scope of chiropractic [care] as of January 1, 2009 and are not compensable per MCL 500.3107b(b).”
Pete, do you have a point?
Medicare definition: Subluxation is defined as a motion segment in which alignment, movement integrity and or physiological function of the spine are altered although contact between joint surfaces remains intact.