A scientific quote?

[bernard]

"There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is 'Eastern' or 'Western,' is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues-namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy." - Fontanarosa P.B., and Lundberg G.D. "Alternative medicine meets science" JAMA. 1998; 280: 1618-1619.

This quote is on a site of Paul LEE, a member of Somasimple.

I bolded a surprizing piece. Actually the body mind connection is not denied at all. Actually, education acts on mind and body for sure?
Actually, I cannot try to care a patient without acting at the same time on body and mind!

Does that means I'm doing alternative pseudoscientific medicine?

[emad]

hi bernard;

could you make the issue more clear ?

cheers
emad

[bernard]

A statement is clear?
If a therapeutic involves a brain/body connection then it may be not scientific?

It excludes clearly, in my view, all education, chronic pain management, all placebo...

It is a cartesian definition but Descartes was wrong!

This definition is out to date!

[nari]

Except, Bernard, placebo is a scientific reality - they have proved it acts on opiod receptors......


Nari

[bernard]

Sorry Nari,

But I couldn't agree there.

1/I accept of course the existence of placebo and of its counterpart nocebo but show me only one study that quantifies it?
2/ It is rejected from the quote, as pseudo-scientific?

The quote is wrong because it rejects all the actual knowledge about brain/body connections???

[nari]

Bernard
I was talking about the study with my students and could not find the paper - my catalogue system needs defragging!!

Will find it on Monday.

it is for real - as real as an opioid and better than some!

Nari

[bernard]

Nari,

As Ian, I'm a perfect believer to Placebo but all I wanted to say, is that because it involves mind-body techniques... is largely irrelevant.

That's the quote! It is a pity to have said it!!!
Lundberg said it ,not me, and I do not agree with him, definetely.

[Diane]

Paul has apparently not read the 2002, volume 4 issue of Topical Issues in Pain, with an introductory chapter by Patrick Wall. The whole book is about placebo and the ethical consideration and use of it. How to avoid nocebo.

This chapter examines some of the misconceptions of placebos that have led to a denigration of their effectiveness - a self--fulfilling assesssment (a nocebo, in fact.) from chapter 2, p. 41, by Nigel Lawes, "The reality of the placeo response."

Topical Issues in Pain books available online from www.achesandpainsonline.com
Diane

[bernard]

I believe most of medicine relies on placebo . The diseases of our culture are essentially novel stressors which we are not well equipped to deal with ......
I don't personally believe in any of the theories of manual therapy that exclude the cns processing of information and the human interaction ......I don't believe in most of the medical intervention of pain and depression which looks at the problems biomedically as they all seem to me to be inherently dualistic ......The trouble is there is a morass of bulshit .....
Alternative therapies have some nice people who are caring and often make very little (some friends of mine!) Chiropracters are business minded rip off merchants --should stick to selling windows of package holidays.....
Placebo is the science of inherent healing that is thwarted by misinformation,iatrogenisis, uncaring health professioinals, militaristic protocols , greed and frenetic lifestyles of patients, poverty of emotion and spiritual direction, poverty of environment , lack of bonding and nurturing , lack of family ties with an area that one lives in, work that is deadening to the spirit, and lastly some medical problems that in fact defective and it the organisms best interests to maintain adaptive chronic pain ( end stage OA) some neuropathic disorders and cancer as an example..........

the above essay covers things well-- i think i have sent it to you before?

[emad]

Hi Bernard :

Hold horses :arrow: English experssion means be slowly. :D

Okay , at least for me was not clear , but now it is . :D :D


cheers
emad

[BB]

Emad,
Once again, I am impressed by yours and others skills in communication! You are all very dedicated clinicians.
Cory

[emad]

Hi Bernard &Cory:

Thank you for your encourge to my english .

i will put a link /topic to english experssions

cheers
emad

[nari]

emad,

Such a link could be quite useful.

Sometimes I need a translation to the expressions and abbreviations the good citizens of the USA use!!

Bernard
I really think placebo is not a faith - it is subconscious healing.
If you use U/S with the intensity on zero, the patient believes the sound waves are doing good, and feels better. That patient thinks: 'Ah, that cold metal head and magic cream (gel) is wonderful...' just as a pasive mobilisation on C3C4 might get the same response: "Ah, massage feels so good'......
I will find that article on the genuine science of placebo!!

Nari

[bernard]

it is subconscious healing... the patient believes the sound waves are...

There is a contradiction! :wink:

[bernard]

http://brain.hastypastry.net/forums/showthread.php?t=26261

[emad]

Hi

okay nari , but it is a link to some experssions and their meanings .

Regarding placebo
yes , lot of patients i do work with the apparatus off , and they say ah iot is hot ,or some experssions like these.

cheers
emad

[nari]

I disagree, Bernard.

Patient feels the steel head and the gel texture and thinks 'oh that's nice'.
NO conscious thought of "this will make me better"..but 'oh that's nice'..

The healing takes place in the same way as swallowing an aspirin -same pathways, but the patient consciously thinks: this is a drug, it will help.
If it were a sugar pill it wouldn't, if the pt was aware of the sugar pill.
If the pt was aware that the PT had not turned on the intensity - it would not work.
Positive thinking(a placebo) is the most powerful analgesic of all.
Still trying to locate the paper on placebo.


nari

[ian s]

nari ,

the best paper I have read ever on the placebo and the evolutionary approach to why it evolved is by nicholas humphrey ....its called great expectation and its on his website .......I will send it to you as a pdf if you email me !

[nari]

Thanks, ian, I have that paper and it is a good one. Still cannot locate the really interesting one re the 'proof' of placebo effects - still hunting.
Also I have a few others, and when (?) I collate them all intp a placebo folder, will post off the refs or the article..

Nari

[nari]

APOEL,

I agree that we need to know when to hand over to another professional for emotional issues that is a primary concern for them.
But where there are emotional issues that directly impact on their function and mobility, every physio should be able to deal with them as well as the physical issues. Unless we do that, our physically based efforts will not be as effective; so we treat the brain - by managing the issues in the tissues and delivering strategies to help with their emotional aspects.

I think it is our role, amd we deal with emotional issues far more than we realise as part of our caring role.

Placebo plays its part, and is the one thing that is more scientifically based than almost anything else. It is one of the most powerful analgesics known. For over thirty years it has been investigated and researched; now its role is established and we must make the most of it.


Nari

[bernard]

For me, Placebo is yet a neural complex process?

[bernard]

http://www.the-scientist.com/yr2004/aug/research2_040802.html