MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

bogus claims

I know, I have mentioned my concerns before about research into so-called alternative medicine (SCAM) from China, e.g.:

In 2018, China became the country that produces more scientific papers than any other. At present, China’s output stands at over one million articles per year. Yes, I do find this worrying!

On 2/4/2024, I did a few very simple Medline searches. I feel that the findings are remarkable.

Clinical trials of TCM

Between 2000 and 2023 ~ 8000

2000 = 8

2010 = 157

2020 = 1 192

Systematic reviews of TCM

2000 = 1

2010 = 26

2020 = 1 222

This near explosive rate of growth could, of course, be good news. But it isn’t because – as shown here so often before – the findings of Chinese research are worringly unreliable.

As if to confirm my point about the dominance of China, this paper has just been published:

Background: Neuropathic pain (NP) is a common type of pain in clinic. Due to the limited effect of drug treatment, many patients with NP are still troubled by this disease. In recent years, complementary and alternative therapy (CAT) has shown good efficacy in the treatment of NP. As the interest in CAT for NP continues to grow, we conducted a bibliometric study of publications on CAT treatment for NP. The aim of this study is to analyze the development overview, research hotspots and future trends in the field of CAT and NP through bibliometric methodology, so as to provide a reference for subsequent researchers.

Methods: Publications on CAT in the treatment of NP from 2002 to 2022 were retrieved from the Web of Science Core Collection. Relevant countries, institutions, authors, journals, keywords, and references were analyzed bibliometrically using Microsoft Excel 2021, bibliometric platform, VOSviewer, and CiteSpace.

Results: A total of 898 articles from 46 countries were published in 324 journals, and they were contributed by 4455 authors from 1102 institutions. The most influential country and institution are China (n = 445) and Kyung Hee University (n = 63), respectively. Fang JQ (n = 27) and Evidence-Based Complementary and Alternative Medicine (n = 63) are the author and journal with the most publications in this field. The clinical efficacy, molecular biological mechanisms and safety of CAT for NP are currently hot directions. Low back pain, postherpetic neuralgia, acupuncture, and herbal are the hot topics in CAT and NP in recent years.

Conclusion: This study reveals the current status and hotspots of CAT for NP. The study also indicates that the effectiveness and effect mechanism of acupuncture or herbs for treating emotional problems caused by low back pain or postherpetic neuralgia may be a trend for future research.

China is increasingly dominating SCAM research and we all know – or should know by now (see above) – that the results of this research are misleading. I cannot understand why so few people seem to think this is alarming.

 

 

In the previous 3 parts of this series (see here, here and here), we have discussed 9 fake diagnoses of so-called alternative medicine (SCAM):

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications,
  • chronic Lyme disease,
  • electromagnetic hypersensitivity,
  • homosexuality,
  • leaky gut syndrome,
  • multiple chemical sensitivity,
  • neurasthenia.

Today I will briefly discuss three further fake diagnoses and list the treatments that SCAM practitioners might recommend for them.

Vaccine overload

Vaccine overload is a term for the notion that giving many vaccines at once may overwhelm or weaken a patient’s immune system which, in turn, is alleged to lead to adverse effects. Because children have an immature immune system, they are claimed to be afflicted most frequently.

There is no evidence that vaccine overload exists nor that it can lead to illness. This does not stop SCAM practitioners to apply or recommend all sorts of SCAMs for the imagined condition. Particular favourites are all sorts of detox diets, homeopathy and a wide range of dietary supplements. Such diets and supplements can be tricky for younger children. In this case, SCAM practitioners recommend, amongst many other things, smoothies or adding turmeric, ginger, and small amounts of Shillington’s adult supplements to the child’s food.

None of these recommendations are supported by anything resembling sound evidence, of course.

Vertebral subluxation

On this blog, we have discussed vertebral subluxations more often than I care to remember. Chiropractors claim that these figments of their imagination impair the flow of innate which, in turn, makes us ill. Straight chiros, those who adhere to the gospel of their guru DD Palmer, diagnose subluxations in 100% of their patients. They are undeterred by the fact that vertebral subluxations do not exist.

I can understand why! If they did aknowledge that the diagnosis is fake, they would have no reason to treat patients with spinal manipulations, and they would quickly go out of business.

Yin/Yang imbalance

According to the assumptions of practitioners of Traditional Chinese Medicine (TCM), all health problems arise from an imbalaance of the two life forces , yin and yang. To restore the balance, they employ a range of therapies such as acupuncture, herbal mixtures, massages, etc.

But these life forces do not exist. Thus they cannot be out of balance, and consequently the imbalance cannot cause illness. TCM practitioners don’t want to hear any of this. Why not? You guessed it: if they aknowledged these facts, they would need to stop practising.

____________________

Fake diagnoses are the life-line of many SCAM practitioners:

  • they tell you that something is wrong with you (despite the fact that you are entirely healthy);
  • they make sure that this is a reason for serious concern;
  • they claim they can put the alleged abnormality right again;
  • they administer a lengthy series of treatments and/or sell you plenty of remedies;
  • when they have earned enough money treating you, they give you the good news: you are back to narmal;
  • gullible consumers are impressed by the unfailing competence of the SCAM practitioners.

My conclusion:

there is nothing easier and more profitably to heal that a condition that did not exist  in the first place.

 

As reported previously, the German skeptics (the GWUP) are in turmoil:

The current rift, many hope, will end imminently, when the GWUP membership elects the new board on the occasion of the ‘SKEPKON‘ (May 9-11). The members then have the choice between Holm Huemmler and Andre Sebastiani and their respective teams.

For many, the choice might be difficult, as they are bewildered (as am I) about what seems to be going on within the GWUP. Therefore, I will today try to provide an assessment according to objectively measurable criteria. For each team, I will calculate the

  1. Number of members with an H-Index (as a measure of the productivity and citation impact of the publications by each team);
  2. Number of members with a Wiki page (as a measure of public visibility).
  3. Number of members who are fellows of the CSI (as a measure of acceptance by skeptics internationally).
  4. Number of members who were active during recent months on social media in relation to the GWUP (as a measure of current engagement in the affairs of the GWUP).
  5. Number of female members (as a measure of equality).
  6. Number of members who are not German or who have been brought up in countries other than Germany (as a measure of internationality).

Please don’t get me wrong, I am not saying that these are validated measures of anything (for instance, I am not claiming that a H-Index is necessary for leading a skeptics organisation, yet I do feel that at least some members of the board should be experienced scientists); the measures might merely be rough indicators. But I still hope they might offer some crude guidance for those GWUP members who look for some guidance beyond the heresay, gossip and accusationst that currently circulate.

Let me first introduce the two teams:

TEAM HUEMMLER

  • Dr. Holm Gero Hümmler (Chair, management consultant, studied physics)
  • Dr. Stephanie Dreyfürst ( Deputy chair, director of adult education, studied German)
  • Dr. Jochen Blom (Bioinformatik, studied bioinformatics)
  • Dr. Claudia Preis (Treasurer, manager, studied European ethnology)
  • Ralf Neugebauer (Judge, studied law)
  • Annika Harrison (Teacher)
  • Sabine Breiholz (Behavioural scientist, studied biology)
  • Mirko Gutjahr (Director of a museum, studied acheology)

TEAM SEBASTIANI

  • André Sebastiani (Chair, teacher and consultant for media didactics)
  • Judith Faessler (Deputy chair, philosophy and Oriental studies)
  • Stefanie Handl (Deputy chair, veterenaty medicine)
  • Rouven Schäfer (Studied economics, adult education and psychology)
  • Stefanie Weig (Energy and construction industry)
  • Stefan Uttenthaler (Studied physics and astronomy)
  • Timur Sevincer (Studied psychology)
  • Stefan Soehnle (Treasurer, studied physics and economics)
  • Babro Walker (Science council, studied educational sciences and psychology)

And here are the findings of my evaluation:

  1. Number of members with H-Index: team Huemmler 2; team Sebastiani 4.
  2. Number of members with a Wiki page: team Huemmler 1; team Sebastiani 2.
  3. Number of members with membership in CSI: team Huemmler 0; team Sebastiani 0.
  4. Number of members active on social media: team Huemmler 1; team Sebastiani 4.
  5. Number of female members: team Huemmler 4; team Sebastiani 4.
  6. Internationality: team Huemmler 0; team Sebastiani 4.

According to these figures, team Sebastiani seems better suited. Of course, these findings have to be interpreted with caution. Firstly, the differences are not large. Secondly – as already stressed – the parameters I used are at best indicators. Thirdly, it is possible that my evaluations were not 100% correct.

The main problem I faced when conducting this comparison was that objective measures which can easily be extracted from the data available to me are illusive, If anyone knows better ones, please let me know.

To be a useful board member of a skeptics organisation for German speaking countries, one should probably have qualities such as the following:

  • An ability to lead towards a common goal, meaning experience in heading teams and in tricky negotiations.  
  • Experience in organising events and projects.
  • Good connections to scientific organisations and academia.
  • Experience in public dissemination of science. 
  • A commitment to scientific skepticism and evaluations based on evidence.
  • An understand of how science works. 
  • Good international connections and co-operations.
  • Determination and ability to solve problems rather than just looking for problems and blaming others for them.

These qualities might be important, but they are not quantifiable – at least, I don’t know how to measure them based on the available material.

So, if you want to make an informed choice that is likely to be best for the future of skepticism in German speaking countries, I urge you to go on the Internet and inform yourself beyond my admittedly simplistic attempt to provide guidance.

This study aims to appraise the utility, accuracy, and quality of information available on YouTube on acupuncture for chronic pain treatment. Using search terms such as “acupuncture for chronic pain” and “acupuncture pain relief”, the top 54 videos by view count were selected. Videos were included if they were:

  • > 1 minute duration,
  • contained audio in English,
  • had > 7000 views,
  • related to acupuncture.

Each video was categorised as either:

  • useful,
  • misleading,
  • or neither.

Another primary outcome of interest was the quality and reliability of each video using validated instruments, including the modified DISCERN (mDISCERN) tool and the Global Quality Scale (GQS). The means were calculated for the video production characteristics, production sources, and mDISCERN and GQS scores. Continuous and categorical outcomes were compared using Student’s t-test and chi-square test, respectively.

The results show that, of the 54 videos,

  • 57.4% were categorized as useful,
  • 14.8% were misleading,
  • and 27.8% were neither.

Useful videos had a mean GQS and mDISCERN score of 3.77± 0.67 and 3.48± 0.63, respectively, while misleading videos had mean GQS and mDISCERN score of 2.50± 0.53 and 2.38± 0.52, respectively. 41.8% of the useful videos were produced by a healthcare institution while none of the misleading videos were produced by a healthcare institution. However, 87.5% of the misleading videos were produced by health media compared to only 25.8% of useful videos from health media.

The authors concluded that their analysis of the highest viewed acupuncture videos for chronic pain reveals only about half provide useful information, indicating a significant misinformation challenge for viewers. This underscores the urgent need for more high-quality, unbiased videos from healthcare institutions and physicians on complementary health practices like acupuncture.

This new analysis confirms what we and others have shown numerous times before: information about so-called alternative medicine (SCAM), which is abundantly available on the Internet, needs to be taken with a healthy pinch of salt. Whenever we studied the issue, our conclusions were even less optimistic than those of the present authors. In fact, most of the time we concluded that following such advice is a risk factor to our health.

In the previous two parts of this series (see here and here), we discussed the following SCAM diagnoses:

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications,
  • chronic Lyme disease,
  • electromagnetic hypersensitivity,
  • homosexuality.

Today, I will add three further fake diagnoses to the list.

Leaky gut syndrome

Leaky gut syndrome is allegedly caused by the passage of harmful substances from the gut wall into the body. SCAM proponents claim it is the origin of many conditions, including multiple sclerosis and autism. However, there is no evidence to show that these claims are true. SCAM practitioners nevertheless recommend many types of SCAM to treat the non-existing entity, e.g. SCAM diets, supplements, etc. It goes without saying that none of them have been shown to be effective.

Multiple chemical sensitivity

Multiple chemical sensitivity is allegedly caused by a hypersensitivity to commonly used chemicals. The symptoms are vague such as headache, dizziness, fatigue. Even those who believe that the condition exist are unable to offer a generally accepted definition of the syndrome.

The SCAMs recommended include:

  • Nutritional supplements
  • Digestive aids
  • Hormone balancing
  • Detoxification
  • Desensitization
  • Eliminating occult infections
  • Oxygen
  • Immune stimulation

Naturally, none of them is supported by sound evidence.

Neurasthenia

In 1869, physician George Miller Beard developed a diagnostic profile for a mental disorder that appeared to be common in the US. Neurasthenia was allegedly characterised by migraines, fatigue, depression, and digestive problems.

The cure, according to Beard, was to flee the city – because it was the stresses of city life that caused the condition. Women were encouraged to rest, while men were asked to engage in outdoor activities. By the early 20th century, this mental disorder had become a status symbol, and it soon spread to other parts of the world. But this pandemic was short-lived: by 1930, neurasthenia had virtually disappeared from conventional medicine.

In SCAM, however, neurasthenia is still a well-establisged money earner. SCAM practitioners do not hesitate to recomment virually every SCAM under the sun for it. They all have one thing in common: they do not work.

 

It has been reported that a former model almost died trying to cure her cancer with a juice diet. Medics tried to get Irena Stoynova to use conventional cancer treatments after she was diagnosed with non-Hodgkin lymphoma in June 2021, but she ‘shut them out’. Instead of chemotherapy, she sought out so-called alternative medicine (SCAM) online and took the advice of a social media influencer who claims the body can ‘heal itself’ with help of a radical lifestyle and diet changes.

Ms Stoynova thus followed various diets and holistic therapies for two-and-a-half years, which left her emaciated and with fluid on her lungs.

Doctors said she was on the verge of death when she was taken to Frimley Park Hospital by ambulance in May last year. She was told by Dr Clare Rees that she would likely die without treatment for her stage three cancer. But Ms Stoynova continued to refuse for a number of days before finally agreeing to receive chemotherapy. Ms Stoynova then spent 50 days in the hospital’s acute dependency unit.

She said when she was first diagnosed that she decided against traditional treatments after ‘reading about and watching many doctors and professors talk about the success rate of alternative therapies online’. The 39-year-old, who now works in sales, said she did a juice diet for two-and-a-half years, but also tried a raw diet, intermittent fasting, boiling herbs and special teas.

Speaking about her diagnosis, she said: ‘I was devastated, the whole world just closed around me and I felt really alone.’ She said that she was advised to start chemotherapy, but instead turned to the internet to find alternative advice. ‘I found an American guy who has millions of followers who promoted holistic treatment,’ she said. ‘He had a podcast where he interviewed very knowledgeable doctors and professors who are talking about holistic treatment and they called standard treatment “outrageous”. ‘They said that people who had chemotherapy are “lazy” and don’t want to put in the hard work of holistic treatment.’ Ms Stoynova continued: ‘The guy has three or four books on how to heal cancer holistically – how to make salads, use different herbs, juicing, intermittent fasting – there were so many testimonials, so many people that did it. ‘I spent £2,000 on juicers – one for smoothies, one for carrots, one for citrus and one for everything else. I spent two to three hours a day making juice for the next day.

_________________________

The ‘juice diet’ seems to have been the Gerson therapy or a variation of it. We have discussed this particular SCAM several times before, e.g.:

I just wish Irena Stoynova had read my blog instead of following the criminal quackery of the ‘American guy’.

My conclusion:

reading this blog and telling others about it can saave lives

The BBC stands for reliable information, at least that’s what I used to believe. After reading a recent article published on the BBC website, I have my doubts, however. See for yourself; here are a few excerpts:

On a holiday to Kerala on India’s south-western Malabar Coast, Shilpa Iyer decided to visit Kotakkal, a town that became famous after the establishment of Arya Vaidya Sala, Kerala’s best-known centre for the practice of Ayurveda, in 1902. Seven days later, she left the historical treatment centre after completeing panchakarma, a cleansing and rejuvenating programme for the body, mind and consciousness.

“There was nothing really wrong, but I was always busy with the demands of modern life and plagued with continual aches and pains. So, I decided to focus on my own health,” Iyer says.

Panchakarma, a holistic Ayurvedic therapy, involves a series of detoxifying procedures. It integrates herbal medicines, cleansing therapies, personalised diet plans and wellness activities to eliminate the root cause of disease, revive and rejuvenate the body, and ensure health and longevity.

Iyer says she left “feeling lighter, healthier and better than ever before”. She isn’t the only one who signed up for an Ayurvedic treatment in Kerala; the holistic system of medicine is a way of life in this coastal paradise.

… Ayurveda translates to “knowledge of life” and originated in India more than 3,000 years ago. It is based on the ideology that health and wellness depend on a delicate balance between the mind, body, spirit and environment, and places great emphasis on preventive strategies rather than curative ones. The ancient system of medicine is centred on the idea of universal interconnectedness between prakriti (the body’s constitution) and doshas (life forces). Varied combinations of the five elements — aakash (sky), jal (water), prithvi (earth), agni (fire) and vayu (air) – create the three doshas.

Kerala Tourism Ayurveda places great emphasis on preventive strategies rather than curative ones (Credit: Kerala Tourism)

Dr Gaurang Paneri, an Ayurveda practitioner, explains every person has the three doshas, vatapitta and kapha, in varying strength and magnitude. “The predominant dosha determines their prakriti. Diseases arise when doshas are affected because of an external or internal stimulus (typically linked to eating habits, lifestyle or physical exercise). Ayurveda works to ensure harmony between the three,” he says…

The small state has more than 100 Ayurvedic government-run hospitals, 800 Ayurvedic pharmaceutical factories and 800 Ayurvedic medicine dispensaries. As many as 120 holiday resorts and private wellness centres offer specialised treatments such as kasti vvasti, an oil-based treatment for back pain and inflammation in the lumbosacral region; elakkizhi, a treatment with heated herbal poultices to tackles aches, pains and muskoskeletal trauma; njavara kizhi, a massage therapy for arthritis or chronic musculoskeletal discomfort; and shirodhara, a restorative therapy to ease stress and anxiety and that involves pouring warm, medicated oil over the forehead.

Most treatment centres offer therapies and treatments for a range of health issues, including immunity, mental health, anxiety, pain management, weight loss, skin and health care, sleep issues, psoriasis, eczema, eye care, arthritis, sciatica, gastric problems and paralysis. The treatments typically include dietary changes, herbal medicines, massage therapies, poultices, meditation and breath exercises…

___________________________

I find such advertisements disguised as journalism disturbing:

  • No mention that the treatments in question lack conclusive evidence of effectiveness.
  • Not a word about the fact that many can be outright dangerous.
  • No mention of the often exorbitant fees visitors are asked to pay.

Please do better next time you report about health matters, BBC!

I am not in the habit of publishing emails that I receive – even though I did occasionally post and discuss some of the most spectacular insults that came my way, e.g.:

Today, however, I feel like being a trifle indiscrete. The reason is an email I received yesterday from a German homeopath who calls him/herself ‘M. Magic’. After reading an article about homeopathy (I am not sure which one), he/she felt compelled to write to me. Here is (my translation of) the second half of this email which I find simply too funny to keep it to myself:

… I can explain WHY homeopathy works and can even tell you your personal so-called constitutional remedy.
I don’t do that. But I can tell you who you are based on the fact that I know your remedy:

You have no self-confidence. You may be competent in your field … even the best, but deep down you have been moulded in a counterproductive way. A parent has always made you feel like you can’t do anything right or well! This has undermined your self-confidence forever or most of your life, no matter how capable you may be!
You tend to despise women and/or think you are weak and incapable. A projection of your unconscious self-belief.
A typical symptom of your personality type is digestive problems! The background to this is that you do not allow and process feelings. This is reflected in a digestive weakness.

This in a nutshell … the correctly chosen remedy would give you a healthy self-confidence, which may have stabilised to some extent in the meantime. I could also explain to you why this is the case … I am analytically inclined and can determine any background. You are probably also ANALYTICAL … absolute head person and proud of it, right? There’s no reason for that, but fine … It shows how little idea you have of how humans really work and what they could use to cure themselves of everything … and what effect that has …
You clueless people … all of you!

Greetings, M. Magic

_____________________

I replied thanking the author, mainly because I had not laughed so heartily for a long time. My response was followed by an instant secone email:

… a SO typical response for your constitutiona type.
You want to show me that you’re above it and ridicule me … (you’re not, of course; either).
Apparently I hit the nail on the head. (no, I’m not surprised; I know my trade)
And YOU are really a professor?
But nothing surprises me anymore! The blind leading the blind …

__________________________

I did not send a further reply.

 

This systematic review and meta-analysis investigated the effectiveness and safety of manual therapy (MT) interventions compared to oral or topical pain medications in the management of neck pain.
The investigators searched from inception to March 2023, in Cochrane Central Register of Controller Trials (CENTRAL), MEDLINE, EMBASE, Allied and Complementary Medicine (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO) for randomized controlled trials that examined the effect of manual therapy interventions for neck pain when compared to oral or topical medication in adults with self-reported neck pain, irrespective of radicular findings, specific cause, and associated cervicogenic headaches. Trials with usual care arms were also included if they prescribed medication as part of the usual care and they did not include a manual therapy component. The authors used the Cochrane Risk of Bias 2 tool to assess the potential risk of bias in the included studies, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to grade the quality of the evidence.

Nine trials  with a total of 779 participants were included in the meta-analysis.

  • low certainty of evidence was found that MT interventions may be more effective than oral pain medication in pain reduction in the short-term (Standardized Mean Difference: -0.39; 95% CI -0.66 to -0.11; 8 trials, 676 participants),
  • moderate certainty of evidence was found that MT interventions may be more effective than oral pain medication in pain reduction in the long-term (Standardized Mean Difference: −0.36; 95% CI −0.55 to −0.17; 6 trials, 567 participants),
  • low certainty evidence that the risk of adverse events may be lower for patients who received MT compared to the ones that received oral pain medication (Risk Ratio: 0.59; 95% CI 0.43 to 0.79; 5 trials, 426 participants).

The authors conluded that MT may be more effective for people with neck pain in both short and long-term with a better safety profile regarding adverse events when compared to patients receiving oral pain medications. However, we advise caution when interpreting our safety results due to the different level of reporting strategies in place for MT and medication-induced adverse events. Future MT trials should create and adhere to strict reporting strategies with regards to adverse events to help gain a better understanding on the nature of potential MT-induced adverse events and to ensure patient safety.

Let’s have a look at the primary studies. Here they are with their conclusions (and, where appropriate, my comments in capital letters):

  1. For participants with acute and subacute neck pain, spinal manipulative therapy (SMT) was more effective than medication in both the short and long term. However, a few instructional sessions of home exercise with (HEA) resulted in similar outcomes at most time points. EXERCISE WAS AS EFFECTIVE AS SMT
  2.  Oral ibuprofen (OI) pharmacologic treatment may reduce pain intensity and disability with respect to neural mobilization (MNNM and CLG) in patients with CP during six weeks. Nevertheless, the non-existence of between-groups ROM differences and possible OI adverse effects should be considered. MEDICATION WAS BETTER THAN MT
  3. It appears that both treatment strategies (usual care + MT vs usual care) can have equivalent positive influences on headache complaints. Additional studies with larger study populations are needed to draw firm conclusions. Recommendations to increase patient inflow in primary care trials, such as the use of an extended network of participating physicians and of clinical alert software applications, are discussed. MT DOES NOT IMPROVE OUTCOMES
  4. The consistency of the results provides, in spite of several discussed shortcomings of this pilot study, evidence that in patients with chronic spinal pain syndromes spinal manipulation, if not contraindicated, results in greater improvement than acupuncture and medicine. THIS IS A PILOT STUDY, A TRIAL TESTING FEASIBILITY, NOT EFFECTIVENESS
  5. The consistency of the results provides, despite some discussed shortcomings of this study, evidence that in patients with chronic spinal pain, manipulation, if not contraindicated, results in greater short-term improvement than acupuncture or medication. However, the data do not strongly support the use of only manipulation, only acupuncture, or only nonsteroidal antiinflammatory drugs for the treatment of chronic spinal pain. The results from this exploratory study need confirmation from future larger studies.
  6. In daily practice, manual therapy is a favorable treatment option for patients with neck pain compared with physical therapy or continued care by a general practitioner.
  7. Short-term results (at 7 weeks) have shown that MT speeded recovery compared with GP care and, to a lesser extent, also compared with PT. In the long-term, GP treatment and PT caught up with MT, and differences between the three treatment groups decreased and lost statistical significance at the 13-week and 52-week follow-up. MT IS NOT SUPERIOR [SAME TRIAL AS No 6]
  8. In this randomized clinical trial, for patients with chronic neck pain, Chuna manual therapy was more effective than usual care in terms of pain and functional recovery at 5 weeks and 1 year after randomization. These results support the need to consider recommending manual therapies as primary care treatments for chronic neck pain.
  9. In patients with chronic spinal pain syndromes, spinal manipulation, if not contraindicated, may be the only treatment modality of the assessed regimens that provides broad and significant long-term benefit. SAME TRIAL AS No 5
  10. An impairment-based manual physical therapy and exercise (MTE) program resulted in clinically and statistically significant short- and long-term improvements in pain, disability, and patient-perceived recovery in patients with mechanical neck pain when compared to a program comprising advice, a mobility exercise, and subtherapeutic ultrasound. THIS STUDY DID NOT TEST MT ALONE AND SHOULD NOT HAVE BEEN INCLUDED

I cannot bring myself to characterising this as an overall positive result for MT; anyone who can is guilty of wishful thinking, in my view. The small differences in favor of MT that (some of) the trials report have little to do with the effectiveness of MT itself. They are almost certainly due to the fact that none of these studies were placebo-controlled and double blind (even though this would clearly be possible). In contrast to popping a pill, MT involves extra attention, physical touch, empathy, etc. These factors easily suffice to bring about the small differences that some studies report.

It follows that the main conclusion of the authors of the review should be modified:

There is no compelling evidence to show that MT is more effective for people with neck pain in both short and long-term when compared to patients receiving oral pain medications.

 

Few of us are aware of the fact that there are such things as alternative diagnoses, i.e. diagnoses used by practitioners of so-called alternative medicine (SCAM) that have no basis in science. They are nonetheless popular with some SCAM practitioners and usually cause a wide range of non-specific symptoms.

In part 1 of this series of posts, I dealt with:

  • adrenal fatigue,
  • candidiasis hypersensitivity,
  • chronic intoxications.

Today I will briefly discuss three further alternative diagnoses.

Chronic Lyme Disease

Lyme disease exists, of course; it is a bacterial infection attained via the bite of a tick. By contrast chronic lyme disease is pure fantasy. It is often used to explain persistent pain, fatigue, and neurocognitive symptoms in patients without any evidence of previous acute lyme disease.

Once this diagnosis is given, prolonged treatment with multiple antimicrobial agents as well as a multitude of SCAMs are advocated. The range includes intravenous infusions of hydrogen peroxide, electromagnetic frequency treatments, garlic supplements, even stem cell transplants.

Unsurprisingly, none of them has been shown to work for chronic lyme disease.

Electromagnetic hypersensitivity 

Electromagnetic hypersensitivity (EHS) is a condition where individuals report symptoms attributed to exposure to electromagnetic fields. It is not a recognized medical diagnosis.

Symptoms of EHS include headache, fatigue, stress, sleep disturbances, skin prickling, burning sensations and rashes, pain, psychological distress and many other health problems. The true case seems psychosomatic and unrelated to electromagnetic fields.

Practitioners nevertheless recommend all sorts of SCAMs including chelation, detox, diets, tocopherols , carotenoids, vitamin C, curcumin, resveratrol, flavonoids, sauna, blue light therapy none of which have been shown to be effective.

Homosexuality

Yes, it’s true: some SCAM practitioners offer treatments for homosexuality which must mean that they consider it to be a disease.

As reported in a previous blog post, the German ‘Association of Catholic Doctors’, Bund Katholischer Ärzte, claims that homeopathic remedies can cure homosexuality. On their website, they advise that ‘…the working group HOMEOPATHY of the Association notes homeopathic therapy options for homosexual tendencies…repertories contain special rubrics pointing to characteristic signs of homosexual behaviour, including sexual peculiarities such as anal intercourse.

Say no more!

 

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