Archive for Acupuncture

NPR and the False Choice of Alternative Medicine

NPR National Public Radio logo

A recent segment on NPR is an excellent representation of some of the mischief that promotion of unscientific medical treatments can create. The title is a good summary of the problem: “To Curb Pain Without Opioids, Oregon Looks To Alternative Treatments.

The entire segment is premised around a false dichotomy, between excess use of opioids and unproven alternative treatments. It is clear that the reporters didn’t even speak to a pain specialist who relies upon science-based treatments, or if they did the specialist was completely ignored because a SBM approach did not fit into the narrative of the report.

Non-opioid options for pain control

The problem addressed by the segment is real – the current technology of pain control is limited. I don’t want to sell pain management short, we have an array of powerful and effective treatments. There are limitations, however, and many patients are inadequately treated.


Posted in: Acupuncture, Science and the Media

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Massage Therapy rubs me the wrong way

Massage therapy? Pranic healing? Polarity therapy? Zero balancing?

Massage therapy? Pranic healing? Polarity therapy? Zero balancing?

Back in my days of practicing law, one of my escapes from reality was a good massage. It was a great treat, exchanging the high-octane atmosphere of the law office for the soothing music, subdued voices and pastel tones of the treatment room. I could have stayed on that table for hours.

Little did I know just how much an escape from reality massage therapy would soon become.

About 15 years ago, when I called to book an appointment with my favorite therapist, a recorded message offered something called “ray-kee” – at least, that is how it was pronounced. I assumed it was just a form of massage and didn’t think anything about it. Then, at one session, while my feet were being rubbed, my massage therapist – an RN, no less – suggested I would be surprised at how often a sore spot actually correlated with a medical problem. She was talking about reflexology, of course.

Fast forward a few years. A new massage therapist and a new location, this time a “health center” (actually, a gym) owned by a local hospital. The massage therapist inquired whether I’d like to try “cranial sacral therapy“. “What’s that?” I asked. “Oh,” she said, “it would be hard to explain.” (She got that right.) She then proceeded to inform me that she had actually used it in one of our sessions. This alerted me to the possibility that informed consent was not part of the massage therapy protocol.

A few more years went by. Another therapist (also an RN), another location. I was pleased with her because I thought she did a good job and she also taught me some simple stretching exercises. To my surprise, in one session, she started pressing on the space between my toes because, she said, it corresponded with the (something, something – I didn’t get this part) of my neck. Reflexology again. (Are they now teaching reflexology in nursing school? I am beginning to wonder.) (more…)

Posted in: Acupuncture, Energy Medicine, Health Fraud, Politics and Regulation

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An Industry of Worthless Acupuncture Studies

Electro-AcupunctureEven more interesting to me than the question of whether or not acupuncture is effective for any particular symptom is the meta-question of how acupuncture proponents have managed to promote a treatment with systematically terrible scientific data. A new study provides a fresh example of this, which I will discuss below.

I think the behavior of acupuncturists reflects the fact that there are subcultures within science, where each community has its own standards, culture, and typical practices. You see this reflected in how they conduct their research and support their claims. Chiropractors, for example, have what is in my opinion a very unscientific culture. Their treatments are not science-based; science is an afterthought cherry-picked to support what is ultimately their philosophy.

The culture of acupuncture

The world of acupuncture has its own culture as well. Within this world there are special, very permissive rules of science that allow acupuncture to work for almost anything. One trend is to look for anything that happens locally in the skin when you stick a needle into it and then declare that a “mechanism for acupuncture.” The rules of the acupuncture culture also allow for a shifting definition of what acupuncture actually is, allowing the definition to conform to whatever the evidence shows. It’s a neat and subtle trick that allows acupuncture proponents to completely subvert the purpose of science.


Posted in: Acupuncture

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Learning quackery for Continuing Medical Education credit



The Integrative Addiction Conference 2015 (“A New Era in Natural Treatment”) starts tomorrow in Myrtle Beach, SC. Medical doctors, doctors of osteopathy, naturopaths and other health care providers will hear lectures on such subjects as “IV Therapies and Addiction Solutions,” given by Kenneth Proefrock, a naturopath whose Arizona Stem Cell Center specializes in autologous stem cell transplants derived from adipose tissue. Proefrock, who was disciplined for using prolotherapy in the cervical spine without proper credentialing in 2008, claims that stem cells treatments are an “incredibly versatile therapy” and uses them for variety of conditions, such as MS and viral diseases. At the same time, he admits that they are not FDA approved and he is not claiming they are effective for anything (and he’s right), which leads one to wonder why he employs them.

Proefrock also offers a typical naturopathic mish-mash of services, from oncology to urology to “naturopathic endocrinology,” and claims he specializes in treating influenza, high blood pressure and kidney stones, as well as addiction. In other words, he doesn’t seem to be the sort of expert you’d find speaking at a science-based conference on addiction medicine.

You’ll find similarly troubling bios of some of the other speakers, as well as dubious treatments for addiction, on the conference website. Here, for example, are speaker Giordano’s and Eidelman’s websites.

Dalal Akoury, MD, is the “Title Sponsor” of the conference and appears to be running the show. Although she is listed by the S.C. Board of Medicine as board certified in pediatrics, she is the founder of the “Integrative Addiction Institute” and runs the “AwareMed Health and Wellness Resource Center” in Myrtle Beach. Like the Arizona Stem Cell Center, it offers a range of treatments that defy categorization as any particular specialty: addiction recovery, “adrenal fatigue” treatment, stem cells, “anti-aging,” weight loss, “functional medicine” and “integrative cancer care“. Yet, only Akoury and one licensed practical nurse are on the staff of the Center. Again, it is questionable whether she is has sufficient qualifications in addiction medicine to run a conference on the subject. (more…)

Posted in: Acupuncture, Cancer, Chiropractic, Dentistry, Diagnostic tests & procedures, Energy Medicine, Homeopathy, Medical Academia, Medical Ethics, Naturopathy

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Do You Believe in Magic? Oregon Does.

Pictured: OHP and HERB picking "evidence-based treatment options"

Pictured: OHP and HERB picking “evidence-based treatment options”

Do You Believe in Magic?

Do you believe in magic for a back pains fix

How the needles can free her, where ever it pricks

And it’s magic, if the chi is groovy

It makes you feel happy like an old-time movie

I’ll tell you about the magic, and it’ll free your soul

But it’s like trying to tell a CAM ’bout randomized control

If you believe in magic don’t bother to choose

Although subluxation is simply a ruse

Just go and get adjusted on the table

It won’t wipe off the pain no matter how hard you try

Your wallet is empty and you can’t seem to find

How you got there, so just blow your mind

If you believe in magic, come along with me

We’ll CAM until morning paid for by the OHP

And maybe, if the CAM is right

I’ll meet you tomorrow, sort of late at night

And we’ll go dancing, baby, then you’ll see

How the magic’s in the CAM and the CAM’s in me

Yeah, do you believe in magic

Yeah, believe in the magic of a back pains fix

Believe in the magic of CAM

Believe in the magic that can set you free

Oh, talking ’bout magic

Do you believe like I believe… Do you believe in magic

Do you believe like I believe… Do you believe, believer

Do you believe like I believe… Do you believe in magic

The Lovin’ Spoonful. Sort-of.

Maybe not my best lyrics.

More Oregon magic

It continues.

Oregon has a problem with prescription pain pills. Oregon leads the nation in the abuse of such drugs, federal statistics show, with Oregon’s rate of prescription drug abuse 39 percent higher than the national average. Go us.

Why that is, I do not know. As an Infectious Disease doctor I prescribe a narcotic about once a year. There are real problems with the treatment of chronic pain and while I am aware of the issues and the changes over the last 25 years, it does not impact my practice, so my knowledge of the issues is basic.

I am also well aware of the Oregon Health Plan (OHP). The OHP was intended to make health care more available to the working poor, while rationing benefits. They were fairly transparent that resources were fixed and not everything would be covered.

Given limited resources, part of the plan has always included a prioritization of treatments and diagnostics, paying for care that give the most bang for the buck. Not a perfect way to ration care and as is always the case, no good deed goes unpunished. (more…)

Posted in: Acupuncture, Chiropractic, Legal, Medical Academia, Naturopathy

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Bastions of quackademic medicine: Georgetown University

The cover of Georgetown Medicine Spring/Summer 2015 issue. This image will drive Mark Crislip crazy, as it features yet another acupuncturist not using gloves while sticking needles into people. Dr. Gorski loves watching Dr. Crislip's reactions to such photos.

The cover of Georgetown Medicine Spring/Summer 2015 issue. This image will drive Mark Crislip crazy, as it features yet another acupuncturist not using gloves while sticking needles into people. Dr. Gorski loves watching Dr. Crislip’s reactions to such photos.

We frequently discuss a disturbing phenomenon known as quackademic medicine. Basically, quackademic medicine is a phenomenon that has taken hold over the last two decades in medical academia in which once ostensibly science-based medical schools and academic medical centers embrace quackery. This embrace was once called “complementary and alternative medicine” (CAM) but among quackademics the preferred term is now “integrative medicine.” Of course, when looked at objectively, integrative medicine is far more a brand than a specialty. Specifically, it’s a combination of rebranding some science-based modalities, such as nutrition and exercise, as somehow being “alternative” or “integrative” with the integration of outright quackery, such as reiki and “energy healing,” acupuncture, and naturopathy, into conventional medicine. As my good bud and fellow Science-Based Medicine (SBM) blogger Mark Crislip put it, mixing cow pie with apple pie does not make the cow pie better, but we seem to be “integrating” the cow pie of quackery with the apple pie of science-based medicine thinking that somehow it will improve the smell, taste, and texture of the cow pie.

I remember how, when I first discovered how prevalent outright pseudoscience and quackery had become in medical academia (which was before I became one of the founding SBM bloggers), I was in denial. I couldn’t believe it. Then I tracked this phenomenon with something I called the Academic Woo Aggregator. It turned out to be a hopeless endeavor because, as I soon discovered, the phenomenon was so pervasive that it was really hard to keep the Aggregator up to date. Since then, I’ve generally only focused on particularly egregious examples, naming names when institutions like my alma mater embrace anthroposophic medicine; “respectable” journals publish “integrative medicine” guidelines for breast cancer patients; cancer organizations include “integrative oncology” in their professional meetings; NCI-designated comprehensive cancer centers promote reiki to pediatric cancer patients or offer high dose unproven vitamin C treatment to patients; or respected academic institutions embrace traditional Chinese medicine (TCM) and the quackery that is function medicine. You get the idea. It’s depressing just how far medical academia has fallen in terms of being “open-minded” to the point of brains falling out when it comes to medical pseudoscience.

Posted in: Acupuncture, Basic Science, Energy Medicine, Homeopathy, Medical Academia

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NCCIH and the true evolution of integrative medicine

NCCIH and the true evolution of integrative medicine

There can be no doubt that, when it comes to medicine, The Atlantic has an enormous blind spot. Under the guise of being seemingly “skeptical,” the magazine has, over the last few years, published some truly atrocious articles about medicine. I first noticed this during the H1N1 pandemic, when The Atlantic published an article lionizing flu vaccine “skeptic” Tom Jefferson, who, unfortunately, happens to be head of the Vaccines Field at the Cochrane Collaboration, entitled “Does the Vaccine Matter?” It was so bad that Mark Crislip did a paragraph-by-paragraph fisking of the article, while Revere also explained just where the article went so very, very wrong. Over at a blog known to many here, the question was asked whether The Atlantic (among other things) matters. It didn’t take The Atlantic long to cement its lack of judgment over medical stories by publishing, for example, a misguided defense of chelation therapy, a rather poor article by Megan McArdle on the relationship between health insurance status and mortality, and an article in which John Ioannidis’ work was represented as meaning we can’t believe anything in science-based medicine. Topping it all off was the most notorious article of all, the most blatant apologetics for alternative medicine in general and quackademic medicine in particular that Steve Novella or I have seen in a long time. The article was even entitled “The Triumph of New Age Medicine.”

Now The Atlantic has published an article that is, in essence, The Triumph of New Age Medicine, Part Deux. In this case, the article is by Jennie Rothenberg Gritz, a senior editor at The Atlantic, and entitled “The Evolution of Alternative Medicine.” It is, in essence, pure propaganda for the paired phenomena of “integrative” medicine and quackademic medicine, without which integrative medicine would likely not exist. The central message? It’s the same central (and false) message that advocates of quackademic medicine have been promoting for at least 25 years: “Hey, this stuff isn’t quackery any more! We’re scientific, ma-an!” You can even tell that’s going to be the central message from the tag line under the title:

When it comes to treating pain and chronic disease, many doctors are turning to treatments like acupuncture and meditation—but using them as part of a larger, integrative approach to health.


Posted in: Acupuncture, History, Medical Academia, Naturopathy, Science and the Media

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Dr. David Villarreal’s “Holistic Dentistry:” Full of Holes?

Screenshot of the "BioDental Healing" website showing the "Meridian Tooth Chart".

Screenshot of the “BioDental Healing” website showing the “Meridian Tooth Chart”.

I get a lot of e-mails from publicists offering suggestions for articles and interviews with their clients. I quickly delete most of them, but one recently caught my eye. It said that patients travel from as far as Europe and Africa to have California “holistic dentist” Dr. David Villarreal remove the old silver fillings that are damaging their health. He has removed 20,000 of them in his 30-year career; removing fillings accounts for 75% of his practice. It said your dental fillings could be killing you – and not just the mercury in your “silver” fillings. Dr. Villarreal says that filling materials that are not compatible with your particular body chemistry can suppress immune responses, leading to a host of illnesses from frequent colds to autoimmune diseases to far worse conditions. He performs a blood compatibility evaluation to pick the right material for your body. He picks the right composite to maintain optimum health and help heal the immune system. (more…)

Posted in: Acupuncture, Dentistry

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Traditional Chinese Pseudo-Medicine Hodgepodge

Qing Dynasty (1662-1722) painting, traditional Chinese medical view of the human viscera from the back.  Image L0039962 from the Wellcome Trust image library, via the Wikimedia Commons.

Qing Dynasty (1662-1722) painting, traditional Chinese medical view of the human viscera from the back. Image L0039962 from the Wellcome Trust image library, via the Wikimedia Commons.

As I have noted before, more is published on acupuncture and traditional Chinese pseudo-medicine than the other SCAM. Here are some of the articles that drew my attention.

Captain Hook and acupuncture

Here is one of the more curious articles on acupuncture I have yet to find, “Psychophysical and neurophysiological responses to acupuncture stimulation to incorporated rubber hand.”

I did not know this, but you can fool a person into thinking that a rubber hand is their own.

The synchronous tactile stimulation of the real hand of an individual and rubber hand leads to the feeling that the rubber hand is incorporated with the body of that individual. This is referred to as the rubber hand illusion (RHI), and it occurs because the brain is attempting to interpret the interaction of the visual, tactile, and proprioceptive systems of the body, which in turn, leads to a re-calibration of the touch and the felt position of the hand. The multimodal visuotactile stimulation inherent in the RHI induces the brain to temporarily incorporate external objects into its body image. In addition, when the experimenter threatens the rubber hand with a needle during this illusion, it generally elicits an enhanced sympathetic response and a measurable cortical anxiety response, which indicates that the bodily ownership of the rubber hand causes changes in the interoceptive system of the brain.

Cool. Check out this video to see how it is done. So what happens when you do acupuncture on a rubber hand that the brain thinks is its own?

The findings of the present study clearly demonstrate that acupuncture stimulation to a rubber hand resulted in the experience of the DeQi sensation when the rubber hand was fully incorporated into the body.

As judged by fMRI findings (always taken with a grain of salt substitute) and patient reports. DeQi is what dey feel when de needle is twirled in de skin. (more…)

Posted in: Acupuncture, Science and Medicine, Traditional Chinese Medicine

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2015 NHIS Report on Complementary Health Approaches (whatever that means)

Formerly known as "relaxing," now known as a "complementary health approach." Gustav Courbet, "Young ladies on the banks of the Seine," 1857.

Formerly known as “relaxing,” now known as a “complementary health approach.” Gustav Courbet, “Young ladies on the banks of the Seine,” 1857. Public domain, via Wikimedia Commons.

Back in 2004, data from the 2002 National Health Interview Survey (NHIS) appeared in a report titled “Complementary and Alternative Medicine Use Among Adults: United States, 2002.” It showed a whopping 62% of adults had used CAM in the past 12 months, but only if prayer for health reasons was included. With prayer excluded, the percentage was substantially lower, at 35%.

“CAM” was defined as:

a group of diverse medical and health care systems, therapies, and products that are not presently considered to be part of conventional medicine.

The authors noted that, in earlier surveys of CAM use, “CAM has been operationally defined in a variety of ways” and the lists of CAM interventions/therapies included “varied considerably among the surveys.”

The most commonly used CAM therapies (excluding prayer) were non-vitamin, non-mineral natural products (18.9%), deep breathing exercises (11.6%), chiropractic care (7.5%), yoga (5.1%), massage (5.0%) and diet-based therapies (3.5%). CAM was most often used to treat back pain or problems, head or chest colds, neck pain or problems, joint pain or stiffness, and anxiety or depression. Most CAM use was self-prescribed. Rebranding things like exercise (yoga) as “CAM” was in the mix from the get-go.


Posted in: Acupuncture, Chiropractic, Clinical Trials, Energy Medicine, Herbs & Supplements, Homeopathy, Naturopathy, Traditional Chinese Medicine

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