Friday, October 5, 2007

Complementary and alternative medicine - Spontaneous recovery from disease


Alternative and complementary medicine refers to products and practices which are not part of the standard medical procedure that you get when you go to a hospital. Though the terms are often used interchangeably, alternative refers to when a practice aspires to replace standard medical care whereas complementary practices only aspire to complement standard medical procedure. For sure, for sure, medical research is far from a complete understanding of the physiology and anatomy of humans, and there are almost certainly many effective remedies which are not a part of the standard repertoire today. In the future we will no doubt see many advances in science and in consequence, new therapies to treat disease.

Having said this, complementary and alternative medicine suffers from what I consider to be a much more serious problem. First of, many of the techniques and practices used in alternative and complementary medicine have never been tested, or have not gained any support, in controlled studies and hence they have never proved to have any "real effect" (as opposed to placebo effect which they probably do have). Even more serious, because alternative therapies have often not been tested properly, it is hard to tell whether they have any serious side effects. What is almost certain is that if a particular substance has any effect at all, then it is more than likely to have side effects as well (see table at bottom of this article).

Sometimes alternative practices turn out to be effective and when they do they are eventually assimilated into standard medical practices. To be fair, this assimilation process can sometimes be agonizingly slow and some doctors are probably too conservative, however, the essence of the matter is that when an alternative treatment or therapy has gained enough support in studies it will cease to be "alternative" and become "standard". This is to some extent true for acupuncture, which is now used occasionally as a treatment for various conditions even though it has long been controversial. However, importantly, the mechanism that makes acupuncture work seems to be different from what has been claimed by those who have used this procedure in the past. No meridians have ever been demonstrated. Instead it seems that acupuncture stimulate pain sensing nerve endings. These nerve endings in turn exercise a form of lateral inhibition meaning that they block other pain sensing nerve endings around them, thus preventing the patient from experiencing pain in that area.

Complementary and alternative practices can often give the illusion of being effective because we recover spontaneously from diseases. We have an impressive immune system, which deals with seemingly limitless pathogens in an extremely efficient and competent manner. I am making up the numbers here, but say that after taking a certain herb 90% of all people recover from the flue within a week. Wow, surely there must be something to it then? But wait a minute. Almost everyone (say 90%) recovers from the flue within a week if they just stay home in bed. Suddenly these herbs do not seem that fantastic, and they seem even less attractive if you take into account the often excessive price tags.

Back pain is another example that deserves mention, and these figures I am not making up (they come from a lecture I attended recently). Nine out of ten (90% that is) cases of acute back pain will go away after one week. Combine this with the fact that 60-80% of all individuals will experience back pain sometime in their lifetime and what you get is an awful lot of cases of back pain that goes away in one week. Not surprisingly, at least not to a cynic like me, there are a huge number of alternative or complementary therapies for back pain, and they all seem really successful as long as you do not compare them to no treatment at all…



Here is my advice, my alternative therapy if you like. If you experience back pain, and don't have any other serious symptoms such as your vertebrae penetrating your back muscles (in which case I would advice going to a doctor), don't spend your money on all sorts of alternative/complementary therapies, rather relax for one week and see if the pain simple goes away (in most cases it will). Once you have recovered, use the money you would have spent on a therapy on something nice, such taking your girlfriend to a cozy restaurant. If the pain does not go away after one week, go see a doctor and have your back checked up…

Writing about alternative medicines is something that really warms my heart. I have written about homeopathy here, here and here, and here I have written about the role of the placebo effect.

25 comments:

new illuminati said...

Nice post - but the comments on acupuncture re 'nerve endings' as an alternative to acupuncture 'theory' show a lack of knowledge of five element and chi concepts that underlie the practice.
These are the roots or eastern understanding and worth further exploration.
ses also http://newilluminati.blog-city.com

Jan Thurin said...

Read your posts on homeopathy and placebo, as well as your piece on PNI, and realize that your interest is of the same nature that of religion. I can see that you are not medically trained, are you a psychologist by training?

You discussed acupuncture and made a reference to Traditional Chinese Medicine. Do you, as a humanist, categorize TCM as a religion or rather as some kind of pseudo science. Acupuncture does seem to work, even if there isn't any explanation for how. If I understand it correctly, the meridians and the dermatomes doesn't match so it is probably difficult with a theory of lateral inhibition as a general explanation of the observed effects.

I'm interested because a friend of mine spent four years studying TCM and works with clinical acupuncture and a while ago, discussing with her, I had problems relating to TCM as a person with a basic medical training. My feeling was that a common ground with Western medicine will be some time off. What's your feeling?

rasmussenanders said...

Thanks for the comments
Though I do not have a degree in medicine I have taken quite a few courses in medical sciences. A lot of neuroscience, biology, and pharmacology and more recently I have also studied some anatomy and physiology. What do you mean when you say that you can see that I am not medically trained? Is it because I haven't written it in my profile.

I don't know exactly how I would categorize TCM, if you can even categorise such a varied set of treaments. However, I do think that many of the concepts that are used lack evidence and I guess that their rigidity when it comes to changing basic concepts and adapting to new evidence resembles religion.

For instance you still hear people referring to meridians when they want to explain the supposed effectiveness of acupuncture, even though there is nothing to suggest that meridians exist.

I did not quite understand your reasons for saying that the lateral inhibition explanation was insufficient.

Z said...

.....but some chinese claim that our nervous system has its ends on the soles of our feet and the palms of our hands.

They say that pressing those (zone therapy) on different points, may liberatde some "salts", or "grains" that are stuck, and will "massage these back to the system" which is good for the organ in question, which is linked to that particular spot.

What do the doctors say about that theory?

rasmussenanders said...

I think most doctors would consider that proposal quite ignorant. We know quite well how the anatomy of the nervous system looks like, and there are certainly no prominent nerves going from say your big toe to the kidney.

In a sense everything is connected to everything else via the brain, but I don't think their claim is that modest.

Massaging of the feet and hands is nice and relaxing and such relaxing make you feel better in general, at least for a while, but other than that I don't think zone therapy and the like has any effect whatsoever...

Jan Thurin said...

Anders,

I did not think you seemed ignorant in any way with my comments it was just a feeling I got having been around medical student for many years. Perhaps a medical doctor, I myself has only a Läkarexamen, wouldn't have written four long posts about homeopathy. They don't believe in it for sure but they would not try to take it away from people who like it either. As you yourself pointed out, there is nothing dangerous to it. The biology behind the placebo effect must be interesting though. As is the innate immune system.

My comment on the lateral inhibition was anatomical i nature as you yourself pointed out to Zs comment.

Z,
I have heard more strange things than your theory. Like the mysterious force Qi. My bottom line with TCM is that they are serious about it. It is probably possible to find, for Western Medicine, interesting matters. Acupuncture therapy can be referred to by normal physicians in the US. So it has made an entrance.

rasmussenanders said...

So what you are saying is that because I write four posts on homeopathy, I cannot be medically trained? I don't know if that type of reasoning will hold in general. I think that there are many doctors who are actively trying to get rid of homeopathy, and I know that many doctors are also in favour of it and believe in it, though they are probably a minority.

Furthermore, it is not entirely true to say that it is not dangerous. Indeed there is nothing dangerous to the substance itself, but if people stop using standard practices because they believe homeopathy can help them, then there is a danger in that. Not treating a disease can have consequences.

I am actually very interested in the biological nature of the placebo effect. Most likely it is a form of classical conditioning, so I am actually in the field, not directly but anyway...

Angel HR said...

There are many alternative medicines like Herbal, Ayurveda, so on.....
Which helps you to cure your decease safely and permanently.
Better you think of alternative medicines before you go for doctor.
I know these kind if medicines will take long time to cure, but all of these are permanent solutions.
There is now a safe, clinically proven and effective solution to control your health problems! Just log on to herbal medicines and learn how the brand new herbal preparation can help you

rasmussenanders said...

Thank you for the comment Angel.
I remanin very sceptical of what you say in your comment. You say that herbal medicines cure you permanently and that they are safe however, if you google for herbal medicines you will find the following on: http://www.nlm.nih.gov/medlineplus/herbalmedicine.html


An herb is a plant or plant part used for its scent, flavor or therapeutic properties. Herbal medicine products are dietary supplements that people take to improve their health. Many herbs have been used for a long time for claimed health benefits. They are sold as tablets, capsules, powders, teas, extracts and fresh or dried plants. However, some can cause health problems, some are not effective and some may interact with other drugs you are taking.

To use an herbal product as safely as possible

Consult your doctor first
Do not take a bigger dose than the label recommends
Take it under the guidance of a trained medical professional
Be especially cautious if you are pregnant or nursing

It seems that the medical establishment at least does not share your beliefs, and I don't either. Futhermore, the link you provided did not work.

As I implied in my post I do not think that all herbal medicines are ineffective. Some of them probably works without having serious side effects. The problem is just that we cannot tell which ones are the good ones since there are no studies...

Felicia Gilljam said...

Tag!

Bayman said...

Re back pain, which is indeed a major problem for a huge number of people. The major problem here is not the type of pain that goes away in a week, but chronic back pain that can incessantly persist for years. A huge number of people suffer from pains, back and otherwise, that just doesn't go away, no matter what options they pursue. Exploring homeopathic therapies which may or may not work for them is one path someone might pursue. Anyone who suffers from chronic pain has a right to experiment with whichever means they like to alleviate their suffering and should not be forced to rely solely on Western medical science, which in the case of this particular ailment, currently has very little help to offer other than mind-altering narcotics.

rasmussenanders said...

Thanks for the comment Bayblab,
My post here was mainly about accute back pain which normally disappears rather quickly after it appeared. I suspect that is the reason why there are so many cures for acute back pain - no matter what you do it will go away.

Chronic back pain is another matter indeed, and from what I have read it seems quite horrible.
I also agree with you that people should have the right experiment with different treatments, at least to some extent. Hypothetically, it is possible that some alternative procedurs are actually dangerous - after all they have often not been tested properly. A perhaps extreme example is the "have sex wth an infant and get cured from AIDS treatment" myth which some people in Africa believe in.

As long as the treatment is safe, as homeopathy is, then I think it is okay that people use this sort of treatment, perhaps they will be helped by the placebo effect.

JJ said...

I suffer from a lot of back pain due to a car accident when I was a child. When it happened I was in pain for a while but after I healed I had very little trouble until I was 15 and my muscles started to develop, I started getting a lot of lower back pain and have suffered with it ever since. That is until recently when I stumbled across memory foam mattresses. They adjust to the shape and weight of my body to support my back perfectly and let me sleep soundly. I can’t even imagine being able to sleep without my memory foam mattress anymore!

Charles said...

Hi Anders, you bring up good points such as it is important to confront actual scientific evidence and scientific trials when making broad claims for or against the efficacy of certain alternative / holistic / integrative therapies. rVita is a new site that brings this scientific information (from Natural Standard) directly to the general consumer in addition to aggregating real user reviews. Check it out at

http://www.rvita.com

sarah said...

I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.

Sarah

http://www.thetreadmillguide.com

ZZZZsleeper said...

For a guy there can be be no greater pain than back pain. I now sleep on a memory foam mattress and wake up pain free every morning. It took my a couple of weeks to get used to, but it was well worth it.

Linda said...

Getting a good nights sleep is paramount to our day to day performance. Sleeping on a memory foam mattress or topper is a great help for anyone who suffers from back pain.

Amay said...

Last week when I was searching for P24 Antigen test I found a nice guide on HIV treatment detailing how to cure the deadly disease through herbal means. Good and nice guide downloadable from following URL http://www.helpcure.com/hiv/ .
 Well this is an amazing subject. This blog is really one of the apt one I have found on this subject. I appreciate the blog master and hope will add more informative posts to this Blog.
I have linked this blog from my blogs already hope this will be helpful to drive my visitors to this blog

shoo said...

If you are looking for tour&travels related information, you can scan the resource page of herbsncures.com and get travel related links on the resource section of the website.

123 123 said...

Great blog as for me. I'd like to read something more about this topic. Thanks for sharing this data.
Sexy Lady
Asian escorts London

mbarnes said...

most alternative therapies end up as such because they are not patentable. Anything that is not patentable will rarely ever get tested in proper placebo controlled trials because no one will spend the sort of money that these trials cost on something they cannot turn into a profit. take a look at vitamin D, (see www.vitaminD3world.com for existing summaries on the data) although its potential effects in cancer have been known for thirty years few proper studies have been conducted to date and we are left to decide whether to use vitamin D or not on mainly epidemiological data. So even when an alternative therapy shows great promise, even govenment funded agencies still dont do the necessary work, and their links with profit making pharma rules the day.

Chad said...

Costa Rica is a country of beautiful landscapes, beaches and lush variety of plant and animal species. Visit


In Costa Rica will always find a variety of animals and plants that beautify our landscape. Come and see the beauty of our land
costa rica real estate

Chad said...

The people of Costa Rica is warm in his dealings, kind and hardworking. Visit our country and will enjoy the natural beauty of the find


When you want to know a country full of beautiful natural landscapes come to Costa Rica, a place of beauty in every way, come and visit our land, you'll easily fall in love with Costa Rica
costa rica investment

Memory Foam Mattresszleeps said...

Nice post!!! i m suffering from back pain..Thanks for sharing such a useful information...

Memory Foam Mattress

Thomas said...

Many alternative medicine practices are effective such as acupuncture. There are also many more but problem is they are not really documented to set a standard. Some former alternative medicine have maid it to the mainstream (western medicine) after proven effective by researchers.


xlpharmacy