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More Nonsense

Simon Singh recently wrote a book (“Trick or Treatment? Alternative Medicine on Trial”) and a news article which examined the validity of chiropractic as a medical treatment. Because his conclusions didn’t suit what the chiropractors wanted to believe they are now suing him for libel. I have heard Singh talk on this subject and he is very careful about what he says. I’m sure the law suit is without any real basis and is really designed just to shut down discussion on the subject.

So does chiropractic actually work? Well it depends on what you mean by chiropractic and what you mean by work. That wasn’t very helpful, was it? The problem is that the original or “pure” form claims to be able to cure a huge range of diseases and there is no good evidence that it actually works. More moderate members of the “profession” stick to helping with back problems and are really just doing similar manipulation to what a physiotherapist or massage therapist might do.

So the reality is that chiropractic really doesn’t work. It can help with some back problems because it acts like physio or massage but that really isn’t chiropractic. The other problem is that some manipulations can not only fail to cure the original problem but also cause possible harm by injuring the patient or diverting the patient from seeking real medical help.

Pseudoscientific medicine exists on a continuum from total nonsense to reasonably effective. I would place chiropractic somewhere near the middle of this spectrum. It can work for a very limited number of problems but probably no better than other simple interventions might.

In case you are interested I thought I might list some treatments which exist at the extremes of the continuum. Remember that all interventions can have a placebo effect so I will ignore that. If I say something doesn’t work at all I mean it works exactly the same as a fake placebo (in other words nothing) would but that doesn’t mean there might not be some subtle effect or occasional positive outcome.

OK, so homeopathy is complete garbage. It does absolutely nothing and any effect is purely through placebo. The same applies to faith healing and prayer. There is no physical effect and any benefit comes purely from the mind of the patient. Note that psychological effects can be quite positive for some disorders though.

So what about stuff that does work? There is little doubt that some herbs do have a positive effect on health. The problem is the majority don’t and, even for those that do work, the dosage and purity of “natural” herbal remedies is rather hit and miss. I would be prepared to give herbal remedies a limited positive score though.

Acupuncture is a bit of a problem to me. It is taken seriously by many people who are medical professionals and some studies have indicated positive effects. But I am still skeptical because the evidence supporting it is mixed at best. There is no doubt that the superstitious nonsense about life forces and meridians is wrong but acupuncture might work through a more plausible mechanism such as nerve stimulation or blocking.

There are so many other alternative health treatments which are very unlikely to work. In many cases it doesn’t matter too much because all the person being treated is losing is some cash. Sometimes there are serious negative effects too though, such as poor medical procedures like unsterilised acupuncture needles and incorrect doses of herbal remedies or remedies with contaminants (ironic since they are advertised as pure and natural).

Most ironic of all is the fact that its the stuff that definitely doesn’t work which is safest. You can use as many homeopathic remedies as you want because all you are paying for is water (unless its the dried form where you are paying for some sort of filler). Be more careful with herbs though because some of those have serious side effects – but only the ones that work. Remember that anything that’s totally safe is also likely to be totally ineffective!

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