Wednesday, July 07, 2010


On my earlier post on wellness and woo, Eliza R. Snitch left a question that I think deserves a serious answer:

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?

I want to keep everyone guessing, so I'm going to have to say that that's a fairly reasonable solution in this particular case. To find out why, read this article.

In a nutshell, chronic pain (and back pain in particular) is something that's not as well-understood as other conditions. Some research indicates that retraining your brain's pain response is as effective as surgery or more.

Unlike prescription pharmaceuticals, surgical procedures aren't required to pass clinical trials to demonstrate that they're more effective than placebos. (It's not clear that it would be possible or ethical to give your control group sham surgery.) And just because surgery is doing something real, it doesn't mean it's necessarily doing something useful or relevant to your condition. The article explains how it's possible for a surgical procedure to become popular and widespread without ever really being proven effective.

For chronic back pain -- between acupuncture and disc fusion surgery -- here's the score: Acupuncture may be pure placebo effect or perhaps there's something about poking the skin that affects the pain response -- but either way, it's not going to do you any real harm. Disc fusion surgery is also not really demonstrated to help, but it carries a real risk of doing serious, permanent damage. So if you have chronic back pain that resists treatment, and you've decided you're going to try either acupuncture or surgery, the acupuncture may be the better choice. Of course physical therapy is probably a better choice than either of those two.

That said, in general there are serious ethical concerns and dangers associated with promoting "alternative" treatments which are fundamentally bogus. For a simple explanation, see this cartoon about Homeopathy and my new Rational Moms post about placebos.


Christopher Smith said...

The comic was interesting. I always thought of homeopathy as any kind of folksy and unproven remedy, but I guess it's more specific than that. I guess I'll have to stop calling my mom a homeopath!

C. L. Hanson said...

Hey Chris!!!

That's exactly what I thought Homeopathy was! I wrote about that in my Rational Moms post linked above.

Leah said...

I recently had my first Reiki session, which is the height of woo. It was done by a friend who wanted to do it for me pro bono. I don't care if it was placebo; I felt great when she was through! Maybe it was it was just getting to shut my eyes and relax for an hour in the presence of someone who cared about me, but I felt good and I'd go to her again.

C. L. Hanson said...

Hey Leah!!!

The researchers (in that placebo article that Mathmom linked last time) are studying exactly that sort of treatment, namely the effect of having a sympathetic person focus on you and your problems.

(Speaking of Reiki, Mojoey had an interesting personal experience with it.)

Unknown said...

Hey CL Hanson, it is Shah from the train ride to Paris. I lost that paper you wrote your blog on so I had to find your blog myself. It wasn't too hard... haha anyways it was really nice meeting you. We should stay in touch! I was trying to find a way to directly contact you from here but to no avail. my email is szkhan24 at gmail. Hope to hear from you!

C. L. Hanson said...

Hey Shah!!!

It was nice meeting you too -- I'm glad you tracked me down! I'll send you an email. (My email address is chanson dot exmormon at gmail dot com.)

JentheHumanist said...

I have these same concerns - but, as long as it isn't putting anyone's health in danger, like psychic surgury, I say, live and let live. If it is harmless physically, but has a good placebo affect, then I say go for it. People must think placebos work in order for them to work.

On the other hand, not getting real vaccines in favor of placebo vaccines is a real problem. So, yeah - how to balance the good of the harmless placebo against the harm done by real woo woo.

Darryl Cunningham said...

One of the main problems with Alt Meds is that it undermines rational thinking and make the scientific process look like just a matter of opinion.

Thanks for linking my comic strip. Darryl Cunningham.

C. L. Hanson said...

Hey Jen!!!

Yeah, I'm sometimes of that viewpoint. For example, the Mormons do faith-healings with the priesthood, but at least they would never suggest doing that instead of real medical treatment (unlike some religions).

That said, Tall Guy also has a point...

Hey Tall Guy!!!

Thanks for writing/illustrating the strip -- I find it very informative, and I'm happy to promote it from my own little corner of blogspace. :D