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

religion

It has been reported that a father accused of withholding insulin from his eight-year-old diabetic daughter and relying on the healing power of God has been committed to stand trial for her alleged murder.

Jason Richard Struhs, his wife Kerrie, and 12 others from a fringe religious group have been charged over the death of type 1 diabetic Elizabeth Rose Struhs. Police alleged she had gone days without insulin and then died. The police prosecutor detailed statements from witnesses and experts, including pediatric consultant Dr. Catherine Skellern, who said Elizabeth’s death “would have been painful and was over a prolonged period of days”.

“There is [also] body-worn camera footage at the scene … where Jason Struhs has recounted the events of the week leading up to the death of Elizabeth,” said the prosecutor. “This details the decision that Jason Struhs has made to stop the administration of insulin, and he stated that he knew the consequences, and he stated in that recording that he will ‘probably go to jail like they put Kerrie in jail’.”

During the hearing, Struhs, who appeared from jail by videolink, mainly sat with his head bowed and hands clasped against his forehead as magistrate Clare Kelly described the evidence against him. “It is said that Mr. Struhs, his wife Kerrie Struhs, and their children, including Elizabeth, were members of a religious community… The religious beliefs held by the members of the community include the healing power of God and the shunning of medical intervention in human life.” She also described a statement from Skellern suggesting Elizabeth would have spent her final days suffering from “insatiable thirst, weakness and lethargy, abdominal pain, incontinence, and the onset of impaired levels of consciousness”. The evidence read into court was an attempt by prosecutors to firm up an additional charge of torture. She said a post-mortem found Elizabeth’s cause of death was diabetic ketoacidosis, caused by a lack of insulin. “It is a life-threatening condition, which requires urgent medical treatment,” Kelly said.

___________________________

Cases like these are tragic, all the more so because they might have been preventable with more information and critical thinking. They make me desperately sad, of course, but they also convince me that my work with this blog should continue.

Bioenergy (or energy healing) therapies are among the popular alternative treatment options for many diseases, including cancer. Many studies deal with the advantages and disadvantages of bioenergy therapies as an addition to established treatments such as chemotherapy, surgery, and radiation in the treatment of cancer. However, a systematic overview of this evidence is thus far lacking. For this reason, German authors reviewed and critically examined the evidence to determine what benefits the treatments have for patients.

In June 2022, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness, and potential harm of bioenergy therapies including the following modalities:

  • Reiki,
  • Therapeutic Touch,
  • Healing Touch,
  • Polarity Therapy.

From all 2477 search results, 21 publications with a total of 1375 patients were included in this systematic review. The patients treated with bioenergy therapies were mainly diagnosed with breast cancer. The main outcomes measured were:

  • anxiety,
  • depression,
  • mood,
  • fatigue,
  • quality of life (QoL),
  • comfort,
  • well-being,
  • neurotoxicity,
  • pain,
  • nausea.

The studies were predominantly of moderate quality and, for the most part, found no effect. In terms of QoL, pain, and nausea, there were some positive short-term effects of the interventions, but no long-term differences were detectable. The risk of side effects from bioenergy therapies appears to be relatively small.

The authors concluded that considering the methodical limitations of the included studies, studies with high study quality could not find any difference between bioenergy therapies and active (placebo, massage, RRT, yoga, meditation, relaxation training, companionship, friendly visit) and passive control groups (usual care, resting, education). Only studies with a low study quality were able to show significant effects.

Energy healing is as popular as it is implausible. What these ‘healers’ call ‘energy’ is not how it is defined in physics. It is an undefined, imagined entity that exists only in the imagination of its proponents. So why should it have an effect on cancer or any other condition?

My team conducted 2 RCT of energy healing (pain and warts); both failed to show positive effects. And here is what I stated in my recent book about energy healing for any ailment:

Energy healing is an umbrella term for a range of paranormal healing practices. Their common denominator is the belief in a mystical ‘energy’ that can be used for therapeutic purposes.

  • Forms of energy healing have existed in many ancient cultures. The ‘New Age’ movement has brought about a revival of these ideas, and today energy healing systems are amongst the most popular alternative therapies in the US as well as in many other countries. Popular forms of energy healing include those listed above. Each of these are discussed and referenced in separate chapters of this book.
  • Energy healing relies on the esoteric belief in some form of ‘energy’ which is distinct from the concept of energy understood in physics and refers to some life force such as chi in Traditional Chinese Medicine, or prana in Ayurvedic medicine.
  • Some proponents employ terminology from quantum physics and other ‘cutting-edge’ science to give their treatments a scientific flair which, upon closer scrutiny, turns out to be but a veneer of pseudo-science.
  • The ‘energy’ that energy healers refer to is not measurable and lacks biological plausibility.
  • Considering its implausibility, energy healing has attracted a surprisingly high level of research activity. Its findings are discussed in the respective chapters of each of the specific forms of energy healing.
  • Generally speaking, the methodologically best trials of energy healing fail to demonstrate that it generates effects beyond placebo.
  • Even though energy healing is per se harmless, it can do untold damage, not least because it significantly undermines rational thought in our societies.

As you can see, I do not entirely agree with my German friends on the issue of harm. I think energy healing is potentially dangerous and should be discouraged.

WHAT?

Biblical naturopathy?

Yes, it is not a hoax; it does exist!

It’s another so-called alternative medicine (SCAM) that is new to me.

This website explains what it is all about:

The Biblical Naturopathic Philosophy is based on the following principles:

Do no harm
God has designed the body to be self-healing
Recognize the healing power of nature as designed by God
Recognize the supernatural healing power of God
The natural and supernatural work together
God has made provision for recovery of sickness
Identify the cause and source
Involve the total person (body, soul, spirit)
Support the body rather than treat symptoms
Health is maintained through Biblical patterns and principles

What do we believe?

We believe the Bible is the inspired, inerrant Word of God. (2 Tim. 3:16-17; 2 Pet. 1-20).
We believe God is the Creator and Sustainer of the universe. (Gen. 1; John 1:3; Col. 1:16; Heb. 1:3).
We believe Jesus is both Lord and Christ, to the glory of God the Father. (Acts 1:9-11; 2:36; Phil. 2:9-11).
We believe that whosoever will confess with their mouth that Jesus is Lord and believes in their heart God raised Him from the dead shall be saved. (Rom. 10:9-10; Acts 2:21; 1 John 1:12).
We believe that the Holy Spirit is sent by Jesus to indwell, empower, teach, guide and comfort believers. (Luke 12:12; Rom. 8-11; John 16:13; Acts 1:7-8, 9:31).
We believe that the Lord Jesus’ death, burial, and resurrection from the dead provided for the healing of the spirit, soul, and bodies of all peoples.
We believe in the imminent return of Jesus Christ, who will come to rule as King upon the earth with the saints. (Acts 1:9-11; 1Thess. 4:13-5:2; Rev. 19:11-21, 22:20).

And this is what they offer in terms of coursework:

COUNSELING

CNS101 Christian Counseling
Covers ethics, foundations of faith, makeup of man, motivational gifts and personality, Faith-Based Therapy™, leading someone into salvation, identity / position / purpose / significance in Christ, scriptural concordance, basics of counseling, opening a counseling center, recognizing mental illness, initial forms and assessments, value of nutrition, and legal issues.

CNS102 Advanced Christian Counseling
Covers stress, co-dependency, self-esteem, anger, forgiveness, premarital and marriage counseling, divorce, family issues, blended families, depression, suicide, grief / loss, anxiety, obsessive-compulsive, sexual abuse, sexual addictions, and reality disassociation.

CNS103 Drug & Alcohol Recovery (GOD14®)
Provides an overview of drug and alcohol education, sin and disease of alcoholism, identifying the addict, AA and NA, scriptural steps, relapse and enabling, family dynamics, steps to breaking physical and psychological addiction, prescription drugs, screening, neurotransmitters, chemistry rebalancing, recovery flowchart, detox categories, and forms and assessments.

BIBLICAL

BIB210 Ministerial Ethics
All ministers should hold themselves above reproach. This course will challenge as well as encourage spiritual ethics beyond a secular view.

BIB220 Ecclesiastical Ordinances 
This course outlines the duties required of ministers such as baptism, funerals, weddings, etc. The course is designed to prepare the licensed or ordained minister to structure and carry out ministerial duties.

BIB230 Doctrinal Foundations 
The foundations of the Christian faith are scripturally established. Every minister should be able to give an account of what they believe and why. This course is designed to assist rather than to indoctrinate.

BIB270 Biblical Naturopathy
What is a Biblical naturopathic doctor; Biblical philosophy of healing; Creation and makeup of man; Scriptural principles for understanding and restoring health; Causes of disease; Things that block healing; History of naturopathy; Naturopathic tenets / axioms; Forefathers of health and healing; The mind & heart of God – It is God who heals; Health in America; Introduction to the techniques of health evaluation; Introduction to the healing modalities; Genetics, predispositions, generational curses; Biblical examples of natural healing; Physical to spiritual analogies; Foods of the Bible; Emotions and organs.

BIB280 Understanding & Improving Health
Health in America, History of Nutrition; Water and Sunshine; What is Protein?; What are Carbohydrates?; What are Fats, Oils, and Fatty Acids?; Issues with Sugar, Milk, Soy, MSG, Aspartame, and Genetically Modified Foods; Dietary Guidelines; Diets and Dieting; and Nutritional Deficiencies; Exercise; Biblical Principles and Perspectives; Confronting Sickness and Disease; Practical Support.

BIB290 How to  Pray for  Healing
Understanding who we are in Christ; The authority of the believer; The role of faith in prayer; The benefit of confession; Praying for guidance; How to pray for physical healing; Praying for Inner Healing; A balanced approach to understanding deliverance; Understanding spiritual warfare.

BIB300 Biblical Freedom Techniques
Forgiveness; Generational curses; Demonic influences; Demonic influences for sickness; Evil spirits as a cause of sickness; Biblical examples; Types of spirits; Strongholds; How do you know?; How to remove evil spirits; Inner healing.

DIET AND GENERAL WELLNESS

DGW310 Biblical Eating
Biblically speaking, are there certain foods best not eaten? What does the Bible have to say about diet and why? God has said plenty about the diet best suited for His creation.

DGW320 Biblical Health Principles
Times have changed, but the Bible and its principles have not. Learn basic principles that can be applied for maintaining health while understanding some of the changes to our foods. Have we become addicted to certain foods? This course teaches how to have a healthy diet and live healthy in a not-so-healthy world.

DGW330 Wellness with Weight Loss
For many, losing weight is a never-ending struggle — especially since our bodies are designed to keep weight on at all costs; it’s a matter of survival. But a medical revolution is under way, showing us how to work with our bodies instead of against them to ignite the natural fat-burning furnaces that lie dormant within us. Drawing on the cutting-edge science of nutrigenomics — how food talks to our genes — Dr. Mark Hyman has created a way of losing weight by eating the right foods, which in turn sends the right messages to our bodies.  In this easy-to-follow eight-week plan based on each individual’s unique genetic needs, Dr. Hyman explains how to customize your personal weight-loss program with menus, recipes, shopping lists, and recommendations for supplements and exercise. Ultimately, you will rebalance and stabilize your metabolism — an UltraMetabolism — to maintain weight loss and enjoy lifelong health.

NUTRITION

NUT410 Digestion & Enzymes
Digestion Enzyme therapy is an emerging successful alternative for restoring health. Learn the basics of digestion along with how enzymes work and the benefits to immune function, pain reduction, mood stabilization, and mental clarity, and more. Discover the inexpensive yet highly effective digestive enzymes needed to restore digestive, neurological, and behavioral health.

NUT420 Nutrition 1
This is a comprehensive course that will guide you to achieve and maintain a high level of health and fitness through careful dietary planning and nutritional supplements. The elements of health are discussed along with recommendations for a multitude of conditions. This course is also a guide to various alternative remedies and therapies.

NUT430 Nutrition 2
This course provides a thorough resource and reference to natural supplements, herbs, and homeopathic remedies as well as relating them to all the major ailments and health conditions. The information is thoroughly documented by scientific data and research.

NUT435 Biblical Eating and Clinical Nutrition
What is food?; Protein, fats, carbohydrates; Foods of today; Biblical foods and diets; Food sources of vitamins and minerals; Vitamins and deficiency symptoms; Minerals and deficiency symptoms; Amino acids; Enzymes; Neutraceuticals; Synthetic verses whole food vitamins; Nutritional deficiencies as a cause of diseases; Diets and individualism; Nutrition deficiency questionnaire; Therapeutic clinical nutrition

NUT440 Emotional Biochemistry
Learn how to screen for emotional and behavioral symptoms. Recognize the mental and physical clues that indicate biochemical imbalances, particularly in the brain. This course teaches natural ways of dealing with physiological causes of depression, anxiety, paranoia, anger, emotional instability, and addictions to prescription and non-prescription drugs.

NUT450 Hair Tissue Mineral Analysis
This course teaches more than just knowing the levels of good and toxic minerals in the body from hair tissue analysis. How do you balance the levels and what do the ratios mean? Hair analysis can also reveal immune system problems, emotional trends, cellular energy levels, glucose intolerance, kidney and liver stress, adrenal and thyroid activity and more.

BOTANICAL

BOT510 Herbs of the Bible
What herbs were used in Bible times? The herbs of the Bible are reviewed in light of their past and present uses. Precautions are also explained.

BOT520 Herbal Pharmacy
This is a comprehensive course reviewing the best herbs for healing, including complete herb forms, benefits, parts used, side effects, dosages and remedies for hundreds of ailments.

BOT530 Nutritional Herbology
This course teaches the nutritional components of herbs and how to determine an herb’s medicinal property. You will also learn the active chemical(s) behind an herb’s use that makes it effective. Classification of herbs and which herbs are commonly used for certain body systems is covered.

BOT540 Way of Herbs
This course blends the Eastern, European, and American Indian herbal healing traditions. Learn the three functions of herbs and the eight traditional methods of herbal therapy. Included are detailed descriptions and dosages of over 140 western herbs and 31 Chinese herbs.

BOT550 Herbals Systems
This course covers the Chinese and Ayurvedic classification of herbs and foods, and the classification of over 400 medicinal herbs available in the west, according to properties and actions. The preparation and processing of herbs is also covered.

BOT555 Leaves of the Tree (Revelation 22:2) Herbology
Comprehensive course covering the use of herbs; herb forms, benefits, parts used, side effects, dosages and recommendations for ailments; Classification of herbs and which herbs are commonly used for certain body systems.

BOT560 Aromatherapy
Science is now confirming that essential oils have healing properties for most physical and emotional conditions. This course is a hands-on guide to the understanding and use of essential oils.

ALTERNATIVE OR ANALYTICAL STUDIES

AAS610 Biblical Strategies
Is there a spiritual strategy for overcoming sickness? What choices are available when faced with terminal illnesses? This course reveals traditional as well as non-traditional natural strategies for defeating sickness and regaining health, particularly if facing death.

AAS620 Parasitology
How prevalent are parasites? What tests are available to determine if you have parasites? What role do they play in allergies, fatigue, bowel disorders, and immune function? What are the latest drugs, treatment, and herbal remedies?

AAS630 Energetic Testing
This course is a basic guide to bio-kinesiology and nutritional therapy using muscle response testing. Learn antidotal therapies using vitamins, minerals, herbs, amino acids, and homeopathic remedies.

AAS645 The Lamp of the Body 1 (Matt. 6:22) Sclerology (Basic and advanced)
Sclerology is easy to learn. Sclerology is the study of the red lines in the white of the eyes and how they relate to stress-patterns in a person’s health. What is a person’s predisposition to disease? What is the hidden cause of symptoms? What will the health challenges be five years from now? The lines in the sclera change as health conditions change. Thus Sclerology is an excellent way to confirm that a natural therapy is working. Are cold hands and feet a circulatory, thyroid, constitutional-vitality, or immunological    problem? What is the key to losing weight? Is it glucose metabolism, the endocrine glands, the liver, or an allergy pattern? Is chronic fatigue attributed to a chronic infection, a weak endocrine system (thyroid/adrenals), an exhausted immune system, a liver weakness? The answer is reflected in the sclera!

AAS655 The Lamp of the Body 2 (Matt. 6:22) Iridology (Basic and advanced)
Anatomy & Physiology of the Eye; Topography/mapping; Physical Integrity Evaluation; Color Constitutional Types & Subtypes; Specific Iris Structure Irregularities; Specific Iris Pigmentation Irregularities; Misc. Signs; Collarets Signs; Syndromes; Sclera & Conjunctiva Signs; Deviation in Contraction Furrows; Exceptions to the Rules; Case Studies; Combination of Signs; Introduction to Time Risk; Iridology practice suggestions.

AAS665 The Body Electric (Genesis 2:7) – Energetic Response Testing
Our bodies, made from the dust of the earth, are very electric. Using electro-magnetic principles it is possible to determine which areas of the body are stressed and what nutrients are needed. Step-by-step hands-on training is provided in how to use and integrate Energetic Response Testing. – Brief History; Preliminaries Before Testing; The Arm Technique; Ways of Verifying a Weak Response; Why Does it Work?; Twelve Things That Can Block the Body’s Ability to Heal; Terms and Techniques; Correcting “Reversed Polarity”; Correcting “Switching”; Correcting “Blocked Regulation”; Response Testing Points (organs, glands, systems, nutritional).

AAS670 Serum Blood Analysis
This course presents an analytical system of blood chemistry and CBC analysis that focuses on physiological function as a marker of health. Optimal values are presented that increase our ability to detect dysfunction long before disease manifests. This course covers an in-depth coverage of 52 blood tests, 62 patterns of functional disorders, and 11 nutrient deficiencies, as well as correlating non-invasive in-office functional tests.

AAS685 Functional Analysis
Functional testing without labs: pH, tongue, fingernails, face, and body signs; Functional testing with laboratory assessments: hair, blood, urine, saliva, neurotransmitters, and hormones; Heavy metals; Food sensitivities; Strategies and applications.

NATUROPATHIC

NAT710 Naturopathic Heritage and Future
This course is the primer on principles and practice of naturopathy. It covers the history of naturopathy, its philosophy, the laws of disease and cure, and explains the modalities used by naturopaths.

NAT720 Homeopathy
Homeopathy is a natural, safe, inexpensive, and highly effective complement to any modality as well as to conventional medicine. You will learn the laws of homeopathy, how to assess illness, identify clues that point to the right remedy, individualize the remedy, and how to know when medical treatment is required.

NAT730 Detoxification
We live in a toxic world. This course outlines the steps needed to thoroughly detoxify and cleanse your body through fasting, juicing, oxygen therapy, exercise, heat therapy, colon cleansing, kidney cleansing, liver cleansing, and herbal detoxification.

NAT735 Cleansing the Temple
Why detox?; A cause of disease; Elimination organs/channels; Levels of detoxification; Lymph system; Fasting/exercise; Detox side effects; Avoiding a healing crisis; Foods to assist/avoid; Heavy metals; Pathogens; Infrared sauna; Ionic foot baths; Coffee enemas.

NAT740 Anatomy
Illustrated with detailed colored drawings, this course is a road map to the human body. With descriptive text, this course will educate you about the position and basic functions of all the organs and systems of the body.

NAT750 Functional Anatomy
An advanced level of anatomy is presented with more detailed information of the organs and bodily systems. With 210 color illustrations depicting all organs and systems, this course covers basic principles with special emphases on function.

NAT755 Fearfully and Wonderfully Made – Anatomy and Physiology
Basic anatomy and physiology; Understanding the Pathology of sickness and disease, Common disease conditions (this course meets the requirements for certification with International Iridology Practitioner’s Association).

NAT760 Reflexology
Reflexology is a unique system of foot massage, which can treat and prevent a wide variety of ailments. This course covers the history of reflexology, interpreting the feet, basic techniques, the treatment sequence, and an understanding of the meridian system.

NAT770 Naturopathic Jurisprudence
This course covers the legal guidelines for unlicensed practitioners. Learn what your rights are, what the constitution has to say, and what to do if legal disputes arise. Some topics included are insurance, licensing verses certification, correct and incorrect usage of words, and legal consent and disclaimer forms.

NAT775 Establishing a Naturopathic Ministry
Starting a practice; Setting up a business; Operating as a ministry; Legalities; Ethics; Referrals; Evaluation forms; Assessments; Record keeping; Accounting and inventory; Taxes; Advertising; Vendors; Equipment; Business management, Practice management, Introduction to flower essences, Introduction to homeopathy, Introduction to essential oils, Conducting an evaluation, Disorders, Therapeutic Applications, Unusual conditions.

_____________________________

Chad Hayes who has studied the subject in some detail has published an excellent article about Biblical Naturopathy which is well-worth reading. Here are his conclusions:

So what is biblical naturopathic medicine? It’s untrained, unqualified, unlicensed practitioners that believe their religion makes them immune from government oversight. It’s people that think two individuals signing a contract to call something what it’s not prevents them from being subject to laws designed to keep people safe. It’s delusional people that don’t want to be held accountable for the things they do, doing things they shouldn’t. It’s people that are so arrogant to think that their holy book, written thousands of years before we discovered germ theory, during a time when seizures and schizophrenia were attributed to demonic possession, by authors that never intended for it to be used as a medical text, gives them superior knowledge to those of us who respect our patients enough to spend years actually studying medicine and who are willing to be held accountable for our actions. It’s biblical literalists that disingenuously omit the abortion potion recipe provided by the LORD in Numbers 52 from their biblical naturopathy curriculum, while voting for legislators who put the lives of their constituents at risk by criminalizing abortion and putting a bounty on the heads of pregnant people and the physicians that have devoted their careers to caring for them.

__________________________

In a nutshell:

Biblical Naturopathy is yet another SCAM that I recommend avoiding.

Why?

Because it is dangerous nonsense.

Anyone who has been following this blog will have noticed that we have our very own ‘resident chiro’ who comments every single time I post about spinal manipulation/chiropractic/back pain. He uses (mostly?) the pseudonym ‘DC’. Recently, DC explained why he is such an avid poster of comments:

” I read and occasionally comment on this blog for two main reasons. 1. In my opinion Ernst doesn’t do a balance reporting on the papers his shares regarding spinal manipulation and chiropractic. Thus, I offer additional insight, a more balanced perspective for the readers. 2. There are a couple of skeptics who occasionally post that do a good job of analyzing papers or topics and they do so in a respectful manner. I enjoy reading their comments. I will add a third. 3. Ernst, from what I can tell, doesn’t censor people just because they have a different view.”

So, DC aims at offering additional insights and a more balanced perspective. That would certainly be laudable and welcome. Yet, over the years, I have gained a somewhat different impression. Almost invariably, my posts on the named subjects cast doubt on the notion that chiropractic generates more good than harm. This, of course, cannot be to the liking of chiropractors, who therefore try to undermine me and my arguments. In a way, that is fair enough.

DC, however, seems to have long pursued a very specific and slightly different strategy. He systematically attempts to distract from the evidence and arguments I present. He does that by throwing in the odd red herring or by deviating from the subject in some other way. Thus he hopes, I assume, to distract from the point that chiropractic fails to generate more good than harm. In other words, DC is a tireless (and often tiresome) fighter for the chiropractic cause and reputation.

To check whether my impression is correct, I went through the last 10 blogs on spinal manipulation/ chiropractic/ back pain. Here are my findings (first the title of and link to the blog in question, followed by one of DC’s originals distractions)

No 1

Chiropractic: “a safe form of treatment”? (edzardernst.com)

“It appears conventional medicine has a greater number of AE. This is not surprising.”
correct!
real doctors treat really sick patients

So the probability of an AE increases based upon how sick a patient is? Is there research that supports that?

No 2

Malpractice Litigation Involving Chiropractic Spinal Manipulation (edzardernst.com)

It would be interesting to know more about these 38 cases that weren’t included since that’s almost half of the 86 cases. What percentage of those cases involved SMT by a non chiropractor?

“Query of the VerdictSearch online legal database for “chiropractor” OR “chiropractic” OR “spinal manipulation” within the 22,566 listed cases classified as “medical malpractice” yielded 86 cases. Of these, 48 cases met the inclusion criteria by featuring a chiropractic practitioner as the primary defendant.”

No 3

Lumbar disc herniation treated with SCAM: 10-year results of an observational study (edzardernst.com)

there are three basic types of disc herniation

contained herniation
non-contained herniation
sequestered herniation

Some add a forth which are:

disc protrusion
prolapsed disc
disc extrusion
sequestered disc

where the first two are considered incomplete (contained) and the last two are called complete (non-contained) but they are all classified as a disc herniation.

You’re welcome

No 4

Multidisciplinary versus chiropractic care for low back pain (edzardernst.com)

Elaborate on what you think was my mistake regarding clinical significance.

No 5

Which treatments are best for acute and subacute mechanical non-specific low back pain? A systematic review with network meta-analysis (edzardernst.com)

An evidence based approach has three legs. If you wish to focus on the research leg, what does the research reveal regarding maintenance care and LBP? Have you even looked into it?

No 6

Meditation for Chronic Low Back Pain Management? (edzardernst.com)

CRITERIA in assessing the credibility of subgroup analysis.

https://www.nature.com/articles/s41433-022-01948-0/tables/1

No 7

Acute Subdural Hemorrhage Following Cervical Chiropractic Manipulation (edzardernst.com)

sigh, my use of the word require was pointing out that different problems require different solutions.

You confuse a lack of concern with my critical analysis of what some use as evidence of serious harm.

I have only used one other identifier on this blog. Some objected to my use of the word Dr in that identifier so I changed it to DC as it wasn’t worth my time to argue with them (which of course DC still refers to Doctor but it seemed to appease them).

In healthcare and particularly in manual therapy we look at increasing comfort and function because most come to us because…wait for it…a loss of comfort and function.

Yes, there is the potential to cause harm, I have never said otherwise. Most case reports suggest that serious harm is due to an improper history and exam (although other reasons may exist such as improper technique). Thus, most cases appear to be preventable with a proper history, exam and technique. That, is a different problem that, yes, requires a different solution.

So yes, spinal manipulation isn’t “required” anymore than physical therapy, NSAIDs, etc for most cases. The question is: does the intervention increase comfort and function over doing nothing and is that justified due the potential risk of harm….benefit vs risk.

Now, i shall excuse my self to prepare for a research presentation that deals with a possible new contraindication to cSMT (because I have a lack of concern, right?)

No 8

Double-sided vertebral artery dissection in a 33-year-old man. The chiropractor is not guilty? (edzardernst.com)

Hmmm, let’s change that a bit…

The best approach is to consider the totality of the available evidence. By doing this, one cannot exclude the possibility that NSAIDs and opioids cause serious adverse effects. If that is so, we must abide by the precautionary principle which tells us to use other treatments that seem safer and at least as effective.

So based upon the totality of the available evidence, which is safer and at least as effective: cervical spinal manipulation vs NSAIDs/opioids?

No 9

Chiropractic spinal manipulation is not safe! (edzardernst.com)

getting the patient to sign something describing the risks. This is apparently something chiropractors don’t do before a neck manipulation.

Apparently?

No 10

Vertebral artery dissection in a pregnant woman after cervical spine manipulation (edzardernst.com)

Most case reports fail on one of two criteria, sometimes both.

1. No clear record of why the patient sought chiropractic care (symptoms that may indicate a VAD in progress or not)

2. Eliminating any other possible causes of the VAD especially in the week prior to SMT.

I would have to search but I recall a case report of a woman presenting for maintenance care (no head or neck symptoms at the time) and after cSMT was dx with a VAD. Asymptomatic VADs are very rare thus there is a high probability that cSMT induced the VAD in that case, IMO.

Although not published I had a dialogue with a MD where a patient underwent a MRI, had cSMT the next day and developed new symptoms thus another MRI was shortly done and was dx with a VAD. I encouraged her to publish the case but apparently she did not.

There was a paper published that looked at the quality of these case reports, most are poor.

__________________________________

I might be mistaken but DC systematically tries to distract from the fact that chiropractic does not generate more good than harm and that there is a continuous flow of evidence suggesting it does, in fact, the exact opposite. He (I presume he is male) might not even do this consciously in which case it would suggest to me that he is full of quasi-religious zeal and unable to think critically about his own profession and creeds.

Reviewing the material above, I also realized that, by engaging with DC (and other zealots of this type), it is I who often gives him the opportunity to play his game. Therefore, I will from now on try harder to stick to my own rules that say:

  • Comments must be on-topic.
  • I will not post comments which are overtly nonsensical.
  • I will not normally enter into discussions with people who do not disclose their full identity.

 

You haven’t heard of religious/spiritual singing and movement as a treatment for mental health?

Me neither!

But it does exist. This review explored the evidence of religious/spiritual (R/S) singing and R/S movement (dynamic meditation and praise dance), in relation to mental health outcomes.

After registering with PROSPERO (CRD42020189495), a systematic search of three major databases (CINAHL, MEDLINE, and PsycINFO) was undertaken using predetermined eligibility criteria. Reference lists of identified papers and additional sources such as Google Scholar were searched. The quality of studies was assessed using the Mixed Method Appraisal Tool (MMAT). Data were extracted, tabulated, and synthesized according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines.

Seven of the 259 identified articles met inclusion criteria. Three studies considered R/S singing, while four considered R/S movement. In R/S movements, three studies considered dynamic meditation while one investigated praise dance. Although moderate to poor in quality, included studies indicated a positive trend for the effectiveness of R/S singing and movement in dealing with mental health concerns.

The authors concluded that, while R/S singing and R/S movement (praise dance and dynamic meditation) may be of value as mental health strategies, findings of the review need to be considered with caution due to methodological constraints. The limited number and poor quality of included studies highlight the need for further quality research in these R/S practices in mental health.

I am glad the authors caution us not to take their findings seriously. To be honest, I was not in danger of making this mistake. Neither do I feel the need for further research in this area. Mental health is a serious issue, and personally, I think we should research it not by conducting ridiculous studies of implausible modalities.

PS

I do not doubt that the experience of singing or movement can help in certain situations. However, I have my doubts about religious/spiritual singing and movement therapy.

The present study investigated the impact of a purposefully designed Islamic religion-based intervention on reducing depression and anxiety disorders among Muslim patients using a randomised controlled trial design. A total of 62 Muslim patients (30 women and 32 men) were divided by gender into two groups, with each group assigned randomly to either treatment or control groups. The participants who received the Islamic-based intervention were compared to participants who received the control intervention.

The Islamic-Based Intervention that was applied to the two experimental groups (i.e. one male, one female) has several components. These components were based on moral and religious concepts and methods, including moral confession, repentance, insight, learning, supplication, seeking Allah’s mercy, seeking forgiveness, remembrance of Allah, patience, trust in Allah, self-consciousness, piety, spiritual values, and moral principles. The techniques implemented in the intervention included the art of asking questions, clarifying, listening, interacting, summarising, persuading, feedback, empathy, training practice, reflecting feelings, discussion, and dialogue, lecturing, brainstorming, reinforcement, modeling, positive self-talk, evaluation, homework, practical applications, activation games (play through activities), emotional venting, stories, presentation, correction of thoughts, and relaxation. The two control groups (i.e. one male, one female) received the energy path program provided by the Al-Nour Centre. This program aimed to enhance self-confidence and modify people’s behavior with anxiety disorders, depression, and obsessive-compulsive disorder. Both interventions comprised 30 sessions over 30 h; two sessions were conducted per week, and each session lasted for 60 min (one hour). The duration of the intervention was 15 weeks.

Taylor’s manifest anxiety scale and Steer and Beck’s depression scale were used for examining the effects on depression and anxiety levels. The results revealed that the Islamic intervention significantly reduced anxiety levels in women and depression levels in men compared to the typical care control groups.

The authors concluded that religious intervention played a vital role in lowering the patients’ level of anxiety among women and depression among men. In general, religious practices prevent individuals from becoming subject to mental disorders, i.e. anxiety and depression.

The authors comment that the Islamic religion-based intervention (RSAFI) significantly reduced the levels of depression and anxiety among the participants. Also, there was a substantial improvement in the patients’ general health after the intervention. They were satisfied and believed that everything happening to them was destined by Allah. These results could be attributed to the different intervention practices that relied on the guidance of the Holy Quran and Sunnah. For instance, Saged et al. () confirmed that the Holy Quran significantly impacts healing patients who suffer from physical, psychological, and mental disorders. In this respect, Moodley et al. () concluded that having faith in Allah offers a relatively quick approach to healing patients suffering from heartache and depression. This goes hand in hand because the recitation of the Quran and remembrance of Allah help patients feel relaxed and peaceful. Muslims believe that the Quran is the word of Allah and that Allah’s words exert a significant impact on the healing of mental health patients, as, ultimately, Almighty Allah is the one who cures illnesses.

When discussing the limitations of their study, the authors state that the sample of this study was limited to the patients with anxiety and depression disorders at the Al-Nour Centre in Kuala Lumpur, so the results cannot be generalized to other samples. Furthermore, the treatment of anxiety was restricted to females, whereas the treatment of depression was restricted to males. Additionally, the selection of females and males as samples for the study was based on their pre-measurement of anxiety and depression, which serve as self-report measures.

The authors seem to be unconcerned about the fact that the 2 interventions (verum and control) were clearly distinguishable and their patients thus were not blinded (and neither were the evaluators). This obviously means that the observed effect might have nothing at all to do with the Islamic-Based Intervention but could be entirely due to expectation and persuasion.

Why might the authors not even bother to discuss such an obvious possibility?

A look at their affiliations might provide the answer:

  • 1Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia. saged@um.edu.my.
  • 2Academy of Islamic Studies, University of Malaya, 50603, Kuala Lumpur, Malaysia.
  • 3Faculty of Education, Universiti Teknologi Malaysia, Johor, Malaysia.
  • 4Faculty of Education, University of Malaya, 50603, Kuala Lumpur, Malaysia.
  • 5Islamic Banking and Finance, International Islamic University Malaysia, Selangor, Malaysia.
  • 6Department of Hadith and Associated Sciences, Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

 

Conversion therapy has been banned last week in Canada. These therapies – also known as sexual orientation change effort (SOCE), reparative therapy, reintegrative therapy, reorientation therapy, ex-gay therapy, and gay cure – rely on the assumption that sexual orientation can be changed, an idea long discredited by major medical associations in the US, the UK, France, and elsewhere. The new law makes “providing, promoting, or advertising conversion therapy” a criminal offense. It will also be an offense to profit from the provision of conversion therapy. In addition, the bill states a person cannot remove a “child from Canada with the intention that the child undergo conversion therapy outside Canada.” Prime Minister Justin Trudeau hailed the law’s Royal Assent: “It’s official: Our government’s legislation banning the despicable and degrading practice of conversion therapy has received Royal Assent — meaning it is now law.”

Conversion therapy is the attempt to change an individual’s sexual or gender identity by psychological, medical, or surgical interventions. Often, informed consent is insufficient or lacking. In conventional medicine, numerous treatments have been tried for this purpose, some of them dangerous and all of them ineffective. In alternative medicine, approaches that have been advocated include:

  • Homeopathy (see below),
  • Hypnotherapy,
  • Spiritual healing,
  • Prayer,
  • Eye Movement Desensitization,
  • Rebirthing,
  • and others.
Survey data imply that conversion therapy is still disturbingly popular, often leads to undesirable outcomes, and is most frequently practiced by:
  • Faith-based organizations or leaders
  • Licensed healthcare professionals
  • Unlicensed healthcare professionals

As previously reported, the German ‘Association of Catholic Doctors’ claimed that homeopathic remedies can cure homosexuality. Specifically, they advised 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 behavior, including sexual peculiarities such as anal intercourse. And a homeopathic remedy called ‘Dr. Reckeweg R20 Glandular Drops for Women’ was claimed to treat “lesbian tendencies.” The product is “derived and potentised from fetal tissues.”

Several countries are now in the process of banning conversion therapy. France has already banned it and so has Germany. The UK government intends to introduce a legislative ban on the practice of conversion therapy. The consultation on how to best do this is open until 4 February 2022.

In 2013, Zuckerman et al. conducted a meta-analysis of 63 studies that showed a negative intelligence-religiosity relation (IRR). Now a new meta-analysis with an updated data set of 83 studies has re-addressed the issue.

The new analysis showed that the correlation between intelligence and religious beliefs in college and non-college samples ranged from -.20 to -.23. There was no support for mediation of the IRR by education but there was support for partial mediation by analytic cognitive style.

In 2012, Canadian scientists tested the hypothesis that an analytic cognitive style is associated with a history of questioning, altering, and rejecting (i.e., unbelieving) supernatural claims, both religious and paranormal. In two studies, they examined associations of God beliefs, religious engagement (attendance at religious services, praying, etc.), conventional religious beliefs (heaven, miracles, etc.), and paranormal beliefs (extrasensory perception, levitation, etc.) with performance measures of cognitive ability and analytic cognitive style. An analytic cognitive style negatively predicted both religious and paranormal beliefs when controlling for cognitive ability as well as religious engagement, sex, age, political ideology, and education. Participants more willing to engage in analytic reasoning were less likely to endorse supernatural beliefs. Further, an association between analytic cognitive style and religious engagement was mediated by religious beliefs, suggesting that an analytic cognitive style negatively affects religious engagement via lower acceptance of conventional religious beliefs.

Some time ago, I reported about a study concluding that a higher religiousness/spirituality is associated with a more frequent use of supplements or additional therapies in individuals with endocrinopathies or metabolic diseases. As so-called alternative medicine (SCAM) has been shown to be associated with worse outcome, addressing religiousness/spirituality which stresses the responsibility of the person for his life might offer an additional resource and should be further studied.

On this blog, we have discussed many times, that advocacy of SCAM is associated with vaccination hesitancy; see, for instance here, here, and here)

Finally, the findings of a recent study suggest that beliefs in an engaged God were associated with greater mistrust in the COVID-19 vaccine. This association was amplified for Hispanic and lower-educated Americans. The authors argued that beliefs in an engaged God may promote distrust of science, reduce motivation to get vaccinated, and derive comfort and strength by placing control over one’s life in the hands of a loving, involved deity.

There are, of course, other factors involved in the complex relationships between intelligence, religiosity, SCAM, and vaccination hesitancy. Yet, it seems clear that such links do exist. I agree that it is well worth investigating them in more detail.

The purpose of this qualitative research was to explore whether pilgrims visiting Lourdes, France had transcendent experiences and to examine their nature.

For this purpose, the researchers traveled to Lourdes and spoke with 67 pilgrims including assisted pilgrims, young volunteers, and medical staff. About two in five reported a transcendent experience: some felt they had communicated or had close contact with a divine presence, while others reported a powerful experience of something intangible and otherworldly.

The authors concluded that visiting Lourdes can have a powerful effect on a pilgrim and may include an “out of the ordinary” transcendent experience, involving a sense of relationship with the divine, or experiences of something otherworldly and intangible. There is a growing focus on Lourdes as a place with therapeutic benefits rather that cures: our analysis suggests that transcendent experiences can be central to this therapeutic effect. Such experiences can result in powerful emotional responses, which themselves may contribute to long term well-being. Our participants described a range of transcendent experiences, from the prosaic and mildly pleasant, to intense experiences that affected pilgrims’ lives. The place itself is crucially important, above all the Grotto, as a space where pilgrims perceive that the divine can break through into normal life, enabling closer connections with the divine, with nature and with the self.

Some people can have powerful effects when they expect something powerful. So what?

To make any sense out of this, we need a controlled experiment. I am glad to tell you that Austrian psychologists recently published a controlled study of this type. They tested the effects of tap water labeled as Lourdes water versus tap water labeled as tap water found that placebos in the context of religious beliefs and practices can change the experience of emotional salience and cognitive control which is accompanied by connectivity changes in the associated brain networks. They concluded that the findings of the present study allow us to draw preliminary conclusions about the placebo effect in the context of religious beliefs and practices. We found that this type of placebo can enhance emotional-somatic well-being, and can lead to changes in rsFC in cognitive control/emotional salience networks of the brain. Future research is warranted to replicate the results. Moreover, future research should investigate whether the observed effects generalize across different religious affiliations. The idea of “holy water” (or blessed water) is common in several religions, from Christianity, Islam, Buddhism to Sikhism.

Placebo can enhance emotional-somatic well-being. Expectation can play all sorts of tricks on us. This makes sense to me – much to the contrary to the ‘qualitative study’ suggesting that transcendental experiences can be central to this therapeutic effect experienced by believers in Lourdes.

While working on yesterday’s post, I discovered another recent and remarkable article co-authored by Prof Harald Walach. It would surely be unforgivable not to show you the abstract:

The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and religiosity. A qualitative study was conducted interviewing ten Roman Catholic German adults who regularly practiced the Rosary prayer. As a result of using a tangible prayer cord and from the rhythmic repetition of prayers, the participants described experiencing stability, peace and a contemplative connection with the Divine, with Mary as a guide and mediator before God. Praying the Rosary was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness and devotion.

The article impressed me so much that it prompted me to design a virtual study for which I borrowed Walach’s abstract. Here it is:

The aim of this study is to explore experiences and perceived effects of train-spotting on issues around health and well-being, as well as on spirituality. A qualitative study was conducted interviewing ten British adults who regularly practiced the art of train-spotting. As a result of using a tangible train-spotter diary and from the rhythmic repetition of the passing trains, the participants described experiencing stability, peace, and a contemplative connection with the Divine, with Mary as a guide and mediator before the almighty train-spotter in the sky. Train-spotting was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness, and devotion.

These virtual results are encouraging and encourage me to propose the hypothesis that Rosary use and train-spotting might be combined to create a new wellness program generating a maximum holistic effect. We are grateful to Walach et al for the inspiration and are currently applying for research funds to test our hypothesis in a controlled clinical trial.

 

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