Sunday, June 13, 2010

Wellness and woo

I've recently taken up Yoga, for a number of reasons. First and foremost, it's a type of exercise I enjoy. And it is exercise -- it's basically gymnastics for old people, with a lot of emphasis on flexibility and strength. Plus, it helps with stress relief -- and is probably more healthful that some other stress relief options. So, given the positives, I figure I can overlook it if the instructor occasionally explains things in terms of chakras.

But sometimes I wonder...

I first got the idea to try Yoga from a colleague who was always raving about it. This same guy was horrified by Sarah Palin's young-Earth-creationism and her general anti-science outlook. So I got the impression that Yoga and critical thinking are perfectly compatible. Enough of it is real to be worth the effort.

More recently, however, this same colleague was talking about how he's been taking his dog to get alternative-schedule homeopathic vaccines (instead of real vaccines). Fortunately he doesn't have any kids to endanger. (Actually, I'm a little surprised it's legal to license a dog without real rabies shots -- I know people have a lot of leeway for using faith-based treatments on their own offspring, but it's not quite the same for animals.)

Then, last week, I met a lady who is currently working on some sort of diploma in "wellness." She is an intelligent lady, interesting to talk to, speaks several languages, has had a successful career in finance, and wanted to switch to something else. The first part of the wellness program was an intensive course in different types of massage. She explained that she had to learn quite a lot of anatomy for the class, not to mention learning about a variety of health conditions which might make some types of massage risky for some clients.

Then she explained that the next course will be acupuncture and acupressure.

And part of me wanted to ask, "Um, you know that stuff isn't real, right?"

Yet somehow that didn't seem like an appropriate thing to say, under the circumstances. Even though it's theoretically a secular "alternative" treatment, it's a little like religion. It's like the time I ran into one of my friends at the bus stop and saw that she was sitting there reading the Bible. Obviously it would be impolite for me to say, "Um, you know that's all a bunch of hooey, right? Much of it rather offensive hooey..."

So what do you think I said to the lady who told me she's going to be studying acupuncture and acupressure? Can you guess?

Naturally, my pathological desire to fit in under any circumstances struck again. I told her all about how I'm taking Yoga.


helensotiriadis said...

i once wanted to fit in.

i'm glad that's over.

Holly said...

OK, first of all, acupuncture is very real: it exists.

I assume what you mean is that "acupuncture produces no real results."

But a very recent study has demonstrated that it does produce real results in the treatment of pain:

Other studies have also demonstrated ways in which it actually produces real effects in the body.

I was really skeptical of acupuncture, particularly on my mission in Asia. But then, just for the hell of it, and because Western medicine failed to address many of my ailments, I tried it. It produces some remarkable results. I do not claim to understand how or why it does so, and I sort of shrug at some of the explanations. But it's not like using it requires me to formulate an entire world view where eastern hocus-pocus dominates and western science is bunk. My world view is, frankly, irrelevant to the effects of acupuncture, in the same that you don't have to have a particular world view to get results when you swallow a decongestant or an antibiotic.

Yoga and critical thinking and acupuncture are indeed compatible.

Also compatible with critical thinking is the distinct possibility that western concepts of embodiment, health and disease are incomplete in many regards, and very likely inaccurate in others. After all, it wasn't that long ago that women were told that menstrual cramps, morning sickness and migraines were mainly psychological.

Try focusing a little critical thinking on your own assumptions, C.L.

helensotiriadis said...

we could probably exchange links all day.

china has little health insurance to speak of and people in need resort to all manner of fascinating substances, cupping and acupuncture, as they can't afford real medicine... you know: the kind that is demonstrated to actually work.

some expat friends in china felt that cupping was awesome. i just rolled my eyes at the sight of their multiple bruises -- even in greece, our grandmothers were the last to actually think it did something.

C. L. Hanson said...

Hey TooManyTribbles!!!

lol, I would say it's more that I'd prefer not to alienate people unnecessarily. I'm interested in looking at different viewpoints, so my instinct is to start from the point of agreement rather than starting from the point of greatest conflict -- to open the door of discussion rather than closing it.

Hey Holly!!!

I'll grant that it's real in the sense that it exists. Thanks for the link to studies showing its effectiveness. I know, however, there have also been studies showing it to be no more effective than a placebo, not performing as well as fake acupuncture, etc.

Also, the underlying theory for why it supposedly works (regarding energy flows in the body) has not been shown to have any basis in reality. Ultimately, if it is shown to be more effective than a placebo, then it should be possible to examine why that might be. The energy flow theory should imply other predictions that can be tested. Or, if the energy flows aren't real, but if acupuncture works for some other reason, then it should be possible to figure out what it is.

DSimon said...

Holly, to complement toomanytribbles' link, here's another one looking at the same issue:

Executive summary: The study's effects are real, but only shown in mice; similar things have been tried with humans and it doesn't work as well. Also, it's only "acupuncture" in the sense that it involves sticking needles into the body to reduce pain; acupuncturists claim that it's necessary to stick the needles in particular spots for particular results, claim to be able to heal lots of illnesses, etc. Those claims don't hold up.

C. L. Hanson said...

This is quite fascinating and unexpected. As I said in my comment "if acupuncture works for some other reason, then it should be possible to figure out what it is," and the studies seem to lean in that direction. Apparently, the "puncture" aspect may possibly have some real effect on pain (from tmt's link, above):

These guys have found something interesting that may even have a potential clinical application. For instance, local injection of A1 receptor agonists works the same as the "acupuncture." Adding compounds that slow the removal of adenosine fromt the tissues improves the efficacy of the adenosine released into the tissues by minor trauma. Scientists can work with that. Scientists could take this observation and use it as a justification to work on better, more specific, and longer acting A1 agonists. Perhaps they could even develop oral drugs that are broken down into adenosine or A1 receptor agonists in the peripheral tissues. If this paper's conclusions regarding the importance of adenosine in pain signaling are correct, these would represent stragies that could very well work and very well improve pain control. One could even envision implantable pellets that could be placed in wounds or near relevant nerves to release A1 receptor agonists right where they're needed over a long period of time.

The "acu" part -- with its energy flows -- has not been vindicated. However, the "puncture" part may have real effects on pain that can be analyzed and used.

mathmom said...

Apparently there are studies showing that placebos are getting more effective over time. This is one of my favorite results!

(Note: this is not a comment on the effectiveness of acupuncture, only a comment on the complexity of the human body.)

Aerin said...

I love pilates, which is similar to yoga. I've found that I have additional strength (particularly arm strength) than I did before.

I thought I read somewhere that deep breathing and meditation can reduce stress, and have been shown to do so. When I was in college, one of my theater professors explained some of the chakras to us. I thought it was an interesting exercise as well, to think/focus on a certain area of the body (like the stomach or throat).

Now, whether or not it's been proven to do any good, I don't know. But I would assume it could help in pain management (focusing on a different area of the body than what's in pain). Also, a ritual type of practice, which would seem to be helpful as well. When a person's in pain, it's always nice to go through the familiar, the known - listening to a particular song, or reading a poem or phrase or what have you.

I'm glad that all these things are being studied and researched. I don't think we completely understand how the brain and body work - and I think it's worth studying.

Yet I don't think we should just accept that because something was ancient medicine (like cupping, or mustard poultices, both were common in Russia when I was there) that it might work, or it will just distract someone because it smells really bad.

sam-i-am said...

I've been diagnosed with fibromyalgia, although it's pretty well controlled with medication. In general it's like my nerve endings are shooting off without reason.

I find that massage and water both help. It's like my nerves don't know what to do without sensation, but if they have sensation to interpret they do just fine. I imagine acupuncture and acupressure would have the same effect.

And a reduction in pain reduces stress hormones, which can allow the immune system to function better.

So while the underlying "theory" may be hooey, when it has real results -- in addition to the placebo effect -- I'd hesitate to dismiss it. But I would like for science to continue to turn a critical eye to the practice and come up with more data.

sam-i-am said...

My massage therapist is into energies and auras and things like that, but she's also incredibly well-trained in myo-fascial massage and anatomy, with a healing touch. So I just mumble noncommittally to her comments about energies. I figure if the mumbo-jumbo helps her be mindful during my session then I'm all for it.

C. L. Hanson said...

Hey Mathmom!!!

Fascinating article! I agree that the placebo effect is really amazing.

I recently read a related article (about anti-depressants vs. placebo anti-depressants). The article proposed an explanation as to why placebos may be getting more effective in this case. In the earlier trials of anti-depressants, they put a test drug (with real side-effects) up against a totally inert placebo. So patients who experienced nausea, etc., had more reason to believe they were getting the real trial drug (not a placebo), which increased the real drug's placebo effect. When tested against placebos that cause mild but noticeable side-effects, the anti-depression drugs didn't fare as well.

Hey Aerin!!!

I agree that I like the part of yoga class where the teacher tells us to focus on different parts of the body, and imagine that that's where your consciousness is. It's an interesting mental exercise that can have a real effect in terms of calming your mind and getting in touch with your body. At the same time, that doesn't imply that the theory of "chakras" describes real energy sources or flows.

This is exactly the sort of fine dividing line I'm talking about -- separating real actions (that have real effects) from the unfounded mystic explanation. It's a little like the studies about acupuncture cited above. Poking your skin may have a physical effect, but that doesn't demonstrate the existence of meridians. If you don't care about that dividing line, that's fine -- but I'm curious about separating the real part from the imaginary part.

Hey Sam-I-Am!!!

Yes, this is exactly the sort of thing I'm talking about. It's like the way that the physical exercises of Yoga have real effects. So I don't want to dump the part I like just because of the unfounded claims that tag along...

Donna Banta said...

I have to admit, the legs up the wall yoga move has helped me immensely after long cramped plane rides. I've a good impression of it. (Even though they're now doing it at BYU.) ;)

gburnett said...

I really like Yoga as well - it's all I can do to remain quiet when they start blathering about energy and chakras. Sigh.

And yes, Holly, there have been some positive results using acupuncture - try Googling "placebo effect" if you want to know why.

Eliza R. Snitch said...

Acupuncture worked for me to get rid of terrible back pain. I'm a fan of alternative treatments. I don't really care if it's placebo-- whatever works, right?