Hard News by Russell Brown

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Hard News: Another entry in the Public Address Medical Journal

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  • giovanni tiso,

    That's a little hard to verify, and I think we'd know if it was such a scourge in New Zealand, don't you think. Small, closely knit community and that, you don't keep this stuff hidden. I wonder too how it compares to the number of people who die or become paraplegics due to the actions of a neurosurgeon - here for instance the few cases of misshaps involving midwives are heavily publicised, whereas when a woman is cared for by a doctor or an obstetrician, not so much. And yet the outcomes for midwife care are statistically better (much as that derives in part for not dealing with at risk pregnancies that need to be medicalised). Go figure.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • B Jones,

    That's a little hard to verify,

    But so is your magnetic example, Giovanni, from the point of view of everyone who doesn't know you personally.

    Personal anecdotes are a significant way we exchange information, but they are pretty useless in developing an accurate picture of risk. We count the hits and forget the misses (miracle cures), or we focus on the horrible exceptions and forget the subtle improvements (vaccines).

    My own anecdote about chiropraxy is that one hurt a family member so badly he thought he was either going to pass out, or hit the chiropractor. Being a kiwi bloke, he didn't complain, he just never went back.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • giovanni tiso,

    But so is your magnetic example, Giovanni, from the point of view of everyone who doesn't know you personally.

    I don't have any magnetic examples. I have a partner who went to a highly regarded local osteopath after trying several physiotherapists in vain and had a long-standing and debilitating problem solved in the space of a few sessions. It doesn't make jurisprudence, it's what it is, as you rightly point out, an anecdote. But if somebody comes up to me and says that Justine was an idiot for going to a quack, well, that's insulting and reality disproves it, so...

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • steven crawford,

    Every single week with little or no exception, one of those cases is someone who died or became a paraplegic due to the actions of a chiropractor.

    WOW, thats a lot of malpractice. I'm surprised that ACC contracts out to chiropractors, if what that blog says is true.

    Atlantis • Since Nov 2006 • 4442 posts Report Reply

  • Jackie Clark,

    I don't know much about osteopathy. However, I do know several people who have had screaming newborns, taken them to get some cranial manipulation, and Robert's your father's brother. No more screaming babies. Happy babies. So, there's no hard evidence? It just doesn't matter if it helps people is my VHO.

    Mt Eden, Auckland • Since Nov 2006 • 3136 posts Report Reply

  • Ross Mason,

    Russell,
    I apologise for being rude and patronising. Please be assured it was never the intention at all.

    I did not comment on your research. I thought there may not be enough space for the replies to my comments as I suspect I might get blitzed. I have looked at the links and also at the osteopath wiki link (as opposed to "osteopathy in ameirca") as well. I do note from the discussions on the pages that the americans seem to 'absorb' some osteopathy within the conventional medical system but the comments suggest that as they become more trained in conventional medicine the use of osteopathy becomes a sideline rather than mainstream. I suspect that is the reason there is angst and obviously a split between the two(?) philosophies. I note also that there are a number of surveys in progress that are out to test the efficacy of osteopathy methods in reply to the request of the conventional medical fraternity to "supply the numbers". I await the results with interest and they may offer some reasons to change my mind.

    http://en.wikipedia.org/wiki/Talk:Osteopathy

    Was it Michael Shermer? What say you to his change of mind?
    And regarding ACC and magnetic underlays. I make no apologies for ensuring my taxes are not used for sham treatments.

    Finally, I was the shooting coach for the NZ Paralympic Shooting team in Athens. Amongst the athletes shooting I came across a Canadian - an ex lumberjack but someone who now has difficulty in even wiping his own arse- who is now in a wheelchair after a chiropractor snapped his neck 'cos he was suffering some neck pain and was looking to get it fixed. (And yes, I now expect some comment that conventional medicine has produced as good a result as that. Plenty of them.)

    But maybe I have an idea why I remain skeptical.

    That is my experience. It is obvious you and others have yours. And there is nothing, nothing on this planet that cannot convince you something works than having a nearest and dearest healed by some process that appears to have no logical reason at all. It is a very powerful (and innate?) force. Keep the defences up and be aware of it.

    Question, investigate, use the facts that you know, hypothesise, test and reject or test and accept. If something still does not match the facts (or new facts) then more knowledge is required. I find it difficult to accept that when a reason appears to be unknowable there is an apparent need to invoke what are usually spurious reasons to placate the mind.

    I leave you with this:

    "The combination of phenomena is beyond the grasp of the human intellect. But the impulse to seek causes is innate in the soul of man. And the human intellect, with no inkling of the immense variety and complexity of circumstances conditioning a phenomenon, any one of which may be separately conceived of as the cause of it, snatches at the first and most easily understood approximation, and says here is the cause."

    Count Leo Tolstoy, “War and Peace”

    Upper Hutt • Since Jun 2007 • 1590 posts Report Reply

  • Kyle Matthews,

    Uh, I think you just conflated them ...

    Not me sir, I've never made any commentary on osteopathy that I'm aware of. I was commenting on other people's comments :)

    Can you give me an analogy that would apply to religion. Somebody being cured or something, or winning at Lotto after praying... what are you looking at exactly? How can religion be said to sometimes "work" in the same way as alternative medicine?

    There are umpteen people around the world who will stand up and say "I had illness/disease/disability/was dying etc and I went to see a priest/spiritual healer/tv evangalist/monk/witch doctor and afterwards I was fine [possibly then adding "god cured me"]."

    Which isn't poles apart from your story of your wife's experience where she had an issue, went to see an osteopath, and since then it's been fine. Different intervention, but same result leading to the belief that the intervention was in some way responsible.

    I would say that in the first instance, if the person actually was improved, it wasn't because of some higher being, but some other factor, and in your wife's instance, it might have been partially related to the osteopath and whatever he/she did. As Russell points out, there's obviously some evidence that osteopathy has some effect (I know very little about it).

    I was just entertained by the similarities of proof that you and a couple of other people were using which led them to very different conclusions than people presenting relatively similar 'religious' proof.

    Since Nov 2006 • 6243 posts Report Reply

  • Stewart,

    There is an article on kidney stones in the on-line version of the guardian here

    Te Ika A Maui - Whakatane… • Since Oct 2008 • 577 posts Report Reply

  • giovanni tiso,

    I would say that in the first instance, if the person actually was improved, it wasn't because of some higher being, but some other factor, and in your wife's instance, it might have been partially related to the osteopath and whatever he/she did.

    You're being obtuse. She went in to see this guy, in whom she had no more trust than in any of the other people she had been seeing up to that point. She was if anything more resigned than she had been before seeing her first physio. She *immediately* received significant relief and after a few more sessions the problem became entirely manageable. To suggest that it may only be tangentially or coincidentally related to her being in the same room as the osteopath at the time is downright ridiculous, and to imply that her benefits are due to some fideistic predisposition is a little insulting. If you cared to apply your rational mind, no to mention Occam's razor, it is simply a case in which an actual physical intervention (and not a "going to Lourdes" sort of affair) by a practicioner of an empirical technique happens to have worked. We have recommended the same guy to other people in Justine's situation, and they found it helpful too. I really don't see how you get off suggesting that it's the same as seeing your priest.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • steven crawford,

    I once saw a video documentary about 95% of a tribe of north american indians, that where treated for alcoholism but not by conventional medicine (because there isn't any) and it worked surprisingly well.

    Atlantis • Since Nov 2006 • 4442 posts Report Reply

  • Rich Lock,

    From The Guardian


    'extracorporeal shockwave lithotripsy' sounds rather like a prog track to me....

    back in the mother countr… • Since Feb 2007 • 2728 posts Report Reply

  • Russell Brown,

    No more screaming babies.

    Oh god. I'm going to have to tell the story I told in my speech to the Skeptics conference. Later ...

    Auckland • Since Nov 2006 • 22843 posts Report Reply

  • Russell Brown,

    I apologise for being rude and patronising. Please be assured it was never the intention at all.

    Apology accepted.

    Finally, I was the shooting coach for the NZ Paralympic Shooting team in Athens.

    Yikes. Ghastly story. I've never even thought of going to a chiropractor actually.

    But I was osteopathically treated by Kristy Milliken, of the NZ (able-bodied) cycling team. She's very strong ...

    Auckland • Since Nov 2006 • 22843 posts Report Reply

  • Russell Brown,

    Which isn't poles apart from your story of your wife's experience where she had an issue, went to see an osteopath, and since then it's been fine.

    But your underlying assumption is that she got some form of magical faith healing. Gio's wife was treated and given exercises to practice at home, and her previously immutable symptoms eased.

    Different intervention, but same result leading to the belief that the intervention was in some way responsible.

    By the sound of it, I don't think it's entirely irrational to suppose it wasn't mere coincidence.

    I just don't think it's all that irrational to think that a practice that began with a kooky theory evolved over a century of clinical experience into a hands-on physical therapy that seems to do some good, when there's both anecdote and medical research to support the idea.

    Auckland • Since Nov 2006 • 22843 posts Report Reply

  • David Slack,

    I might as well ask.
    Karren has been on a heavy diet of assorted pain relief up to and including Tramadol for the past few months. Her problem is Frozen Shoulder. Both of them. She's getting regular physio, doctor and specialist treatment, including two rounds of cortisone injections. She's less than thrilled at the prospect of the recovery taking months at least and perhaps a year or more. Does anyone have any useful advice to offer?

    Devonport • Since Nov 2006 • 599 posts Report Reply

  • Heather W.,

    Found this via Arbroath

    Apparently some UK Doctors would like the legal option to pray alongside patients as part of meeting the patient's needs.

    North Shore • Since Nov 2008 • 189 posts Report Reply

  • B Jones,

    Medical research yes, anecdotes, not so much.

    Homeopathy began with a kookyish theory (like cures like) and while it hasn't exactly developed over a century of clinical experience (I think it's gotten kookier), there are many adherents and practitioners today and there are bound to be plentiful anecdotes of its efficacy. Most pregnancy books have at least some of their text dedicated to homeopathy, for example.

    The only way you can tell the difference, objectively, between a thoughtful skeptical anecdote and an entirely credulous one, is by collating lots of them and turning them into data. If 55 of a sample of 100 people report feeling better after treatment x, then that's useful. Two out of two is less so.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • giovanni tiso,

    I think part of the reason why alternative medicines can work in areas where allopathic medicine doesn't, it's that the latter doesn't seem to have quite learned to look at the body as a complex system of interrelated parts, and insists on treating the local symptoms rather than the causes. But sometimes you've got to look at the whole body, which actually now that I think about it is what Justine's osteopath did. The physio had been working on her forearms, where the pain was. The osteopath claimed it was a postural imbalance in the upper body and neck and worked on that.

    Since we're into anecdotes, I once met a hospital dentist (I wasn't his patient) who told me that he didn't believe that it's the bacteria that cause most cavities, but rather bad alignment of the jaw or even incorrect chewing. I'm sure he was probably wrong, but he did make the point that dentists can't see the mouth for the teeth, as it were, that they are not trained to take a step back, and maybe there's something in that. And he wasn't an alternative healer of any kind, just another dentist.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Russell Brown,

    She's less than thrilled at the prospect of the recovery taking months at least and perhaps a year or more. Does anyone have any useful advice to offer?

    Sadly, everything I hear about frozen shoulder is that it's a waiting game.

    But ... at the risk of being shouted at again, a clinical trial last year at a British hospital (published in the British Journal of Rheumatology) seemed to indicate symptom relief in 80% of patients from one particular OMT technique.

    And BBC Health's review doctor endorsed osteopathy as a treatment.

    Auckland • Since Nov 2006 • 22843 posts Report Reply

  • David Slack,

    at the risk of being shouted at again

    Heh. Thanks for that. Hell: at this point, what's to lose?

    Devonport • Since Nov 2006 • 599 posts Report Reply

  • Kyle Matthews,

    To suggest that it may only be tangentially or coincidentally related to her being in the same room as the osteopath at the time is downright ridiculous, and to imply that her benefits are due to some fideistic predisposition is a little insulting.

    Perhaps I was unclear or you misunderstood. I was saying that it probably was due, at least in part, to the osteopath (you said that it might also have been helped by something else that she'd already been doing all along). In summary: No I wouldn't believe that a person would be cured by prayer, but I can believe that an osteopath helped.

    That wasn't my point at all, my point was about the similarities of the story that you told and which might be told by another person about why you thought the intervention had worked. The difference between the two stories would be the different interventions.

    But your underlying assumption is that she got some form of magical faith healing. Gio's wife was treated and given exercises to practice at home, and her previously immutable symptoms eased.

    Ugh, no such assumption please. I presume there are some practical things in osteopathy that actually do something real which can help. See above for why I posted.

    Since Nov 2006 • 6243 posts Report Reply

  • B Jones,

    it's that the latter doesn't seem to have quite learned to look at the body as a complex system of interrelated parts, and insists on treating the local symptoms rather than the causes

    Really? Every medical professional I saw recognised my leg pain and numbness in my feet as being a symptom of an injury to my back, which hardly hurt at all on the site of the injury. I think that example (sorry I got confused with that and magnetic underlays before) sounds like a case a clever osteopath that understands more about physiology than a bad physio, rather than the benefits of osteo over physio as specialties.

    There are plenty of examples where a problem at one site manifests as a symptom at another, and to which conventional medicine responds appropriately. Pain radiating down one arm being a sign of heart attack, say.

    Wellington • Since Nov 2006 • 976 posts Report Reply

  • giovanni tiso,

    Perhaps I was unclear or you misunderstood. I was saying that it probably was due, at least in part, to the osteopath (you said that it might also have been helped by something else that she'd already been doing all along).

    She did quit the job that brought about the OOS, but over a year later the symptoms hadn't abated. What I meant by mentioning it is that if she had continued with that job - in the same way that Russell hasn't quit sitting at the computer I imagine - she'd probably have to see her osteopath periodically.

    No I wouldn't believe that a person would be cured by prayer, but I can believe that an osteopath helped.

    It's really all the we are saying here, which is why your initial equation of the two was a bit puzzling.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Ross Mason,

    In a VERY quiet voice......

    This link is from the UKPubMed that links to a Canadian article.

    http://ukpmc.ac.uk/picrender.cgi?artid=1522754&blobtype=pdf

    BSD rating? I would give it 7/10. Seems to be a "regarded collection of the conventional medical fraternity" and a good list of apparent (needs checking though) references

    Whereas this a wiki article here (whcih has a link to Russells reference BTW:

    http://en.wikipedia.org/wiki/Frozen_shoulder

    gives a more positive prognosis...until one reads the discussion and notes the use of TENS - a controversial pain management system. Also in the discussion that the article has " very few references of no relevance whatsoever and totally ignoring national health associations guidelines."

    BSD rating: I would reluctantly give 1/10.

    Both articles do say that in most cases "time heals". An important piece of information IMHO.

    And that concludes my first steps in discovering new facts about "frozen shoulder".

    Upper Hutt • Since Jun 2007 • 1590 posts Report Reply

  • steven crawford,

    So can anyone say what the most not quacky way to deal with back pain is? I'm getting confused, especially when I here stories about chiropractors maiming and killing people.

    Atlantis • Since Nov 2006 • 4442 posts Report Reply

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