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Alternative therapy for back pain smacks of desperation
Dr Christian Jessen27 May 2009
Guidelines published yesterday tell GPs they should now offer acupuncture to patients suffering from chronic back pain.
This is the first time an alternative therapy has been backed in this way and, to me, it smacks of desperation.
The guidance says anyone whose pain persists for more than six weeks should be given a choice of treatments because no one treatment has been proved to cure back problems.
Roughly translated this means: "We have no idea what to do so we might as well try every treatment in the hope that one works."
And this advice comes from the drugs and therapies watchdog, NICE (National Institute for Health and Clinical Excellence). Makes you think.
There is no scientific evidence to support the efficacy of so-called alternative remedies and I think this is why NICE refers to acupuncture as a "complementary" treatment, ie, one supposed to be used alongside conventional medicine. If that doesn't sound like an admission of their uselessness I don't know what is.
If I appear closed to other ways of treating illness then forgive me. I am not.
What I am utterly opposed to is the dressing-up of unsubstantiated mumbo-jumbo as science, together with an all too selective reading of the word "evidence".
The truth is that back pain is notoriously difficult to treat and rarely has an easily identifiable cause.
It is high on the list of complaints that GPs dread hearing, such as "I'm tired all the time, doctor" or "I don't feel right in myself".
For many GPs, the NICE guidance will be manna from heaven - finally something to help get the patients out of the consulting room on time while feeling like we have actually been helpful. Doctor happy, patient happy.
But common sense, logic and 200 years of medical science have just been undone because, while acupuncture brings some pain relief, so does sham acupuncture (sticking needles anywhere) and jabbing the skin with toothpicks.
And, come to think of it, so does a cup of green tea, a good chat with a friendly-looking therapist and a back rub.
And perhaps that is the key: time and a sympathetic ear, certainly missing from most GP consultations, go a long way to make patients feel better.
If more money were spent on changing this situation, I am certain that many chronic conditions would improve - without the need to humour patients with sham quackery.
Reader views (8)
'Scientific Evidence' is there but to have absolute proof as some Doctor's scientific minds require in the region of US $50 Million to gain full FDA approval. You think an un-patentable method will get that funding required?! Wake up.
- David, London, 29/05/2009 11:10
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"There is no scientific evidence to support the efficacy
of so-called alternative remedies".
And you're a doctor?
Yes he is. So am I. There isn't. In fact there is a lot of evidence (RCTs, meta-analyses) to show that at best they are no better than placebo, at worst, they are dangerous, a tax on the gullible, and prevent people seeking evidence based medical intervention that may save their life (see man who treated his gangrene with honey then died)
The plural of anecdote is not data.
"fluid from her heart was leaking into her lungs "
What fluid might this be? Do you mean blood? Or oedema? How does osteopathy (a manipulation of _bones_ have any effect on fluid leaking from her heart?
"lack of circulation in the lower body"
So how did her bowel, uterus, legs, bladder not become ischaemic & kill her? How did shiatsu restore the circulation to her lower body?
You are of course free to pursue whatever nonsensical treatment you feel makes you better administered by whichever quack sees fit to pray on your gullibility. You are not entitled to do this with other people's money. Unless it is proven to work. Which it isn't.
- Alex, Birmingham, 28/05/2009 21:01
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The phrase "blinded by science" has never rang so true .... it's sad and this is why patients are treated as a number and not as individuals ... if the pill doesn't work...errr sorry can't help you, next !
- Jb, london, 27/05/2009 16:48
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Here are some facts:
My sister had chronic back pain and walked with two sticks. She went to two doctors - including a specialist - who gave her pain killers and said the only option was surgery. A friend had had that operation and spent the rest of her life in pain as it hadn't worked. After several years of this, my sister went to a Shaitsu practitioner who had trained for 12 yrs with Shiatsu masters in Japan. She said my sister's problem was lack of circulation in the lower body. A few weeks later, my sister could walk properly and has been doing ever since. That was 25 years ago.
My mother had constant coughing and chest infections. The doctor gave her 6 seperate courses of antibiotics one after the other which did nothing. She went to an osteopath who told her that fluid from her heart was leaking into her lungs which was causing the problem. After 3 sessions, the problem ceased.
I myself have cured myself of many things, including endotriosis using essential oils, while a new acquaintance has told me she has had 2 operations and constantly taking drugs for the last 20 years. Which is best for the NHS and the taxpayer?
I am sick and tired of these put downs of Alternative Medicine that actually work.
- Jane, London, 27/05/2009 15:53
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I am amused and surprised that Dr. Jessen refers to complementary therapies, including the regulated professions of Osteopathy and Chiropractic? as "sham quackery"! Does this apply to their organisations as well? If so, then he will be interested to learn that another medical doctor has recently been found guilty of libel in the High Court for using similar terminology.
I must praise him though for his as yet unrealised insight to his own profession in the paragraph that reads "But common sense, logic and 200 years of medical science have just been undone...". He is quite right in that statement. Traditional medicine is not only highly overrated, dangerous as well as ineffective for treating chronic backpain and related musculo-skeletal disorders.
- Per Hansson, Newton Abbot, Devon, 27/05/2009 12:23
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Well, it's a point of view.
The real key to what you are addressing is that there is a difference between medicine and science. Medics know the problems with back pain becoming chronic. In some cases, or at some point in time, they might prefer unproven, "sham" acupuncture to risky surgery.
Cost-savers then get involved, and want to remove "unscientific" treatments. The unwanted results are attempts to address the red herring and be more scientific, which can funnel money from treating that patient into less directly useful studies.
- Britt Johnston, Basel Switzerland, 27/05/2009 10:44
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What worries me is that if NICE has backed Chiropractic manipulation for lower back pain treatment, does this extend to manipulation for neck pain also?
I have been campaigning for 8 years to have neck manipulation properly trialed and independently reviewed or even banned. It still exists as therapy today and is promoted despited a worldwide escalating level of safety and proven benefit to the patient over other treatments.
- Mrs Frances Denoon, Bristol UK, 27/05/2009 10:11
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Chiropractic.
"There is no scientific evidence to support the efficacy
of so-called alternative remedies".
And you're a doctor?
- Paul Ainsworth, Northern England, 27/05/2009 10:07
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