Alternative medicine Unconventional
medicine
Acupuncture Aromatherapy Chiropractic Herbal medicine Homeopathy
Hypnosis Massage Nutritional therapy Osteopathy
Relaxation and visualisation Yoga
Osteopaths and chiropractors
have one
Many alternative therapies
are potentially dangerous
Serious pathology may be
undiagnosed
Potentially effective
treatments always have a potential for harm
Poorly researched compared
to conventional medicine
Picture is confused by
publication bias towards positive results; this will distort meta
analysis studies
Factors include touching,
time spend, quality of communication
Patient control reduces
stress and so promotes healing
Hope can be offered Touch
is a strong placebo
Whole person treatment Allows
for individual expression
Taking the patient seriously Believing the patient
Promotion of denial False hope
Scope for financial,
emotional and sexual abuse Guru status can lead to cults
Rejection of conventional
treatments which sometimes work
Needles are left in
acupuncture points for 10 – 30 minutes over 6 – 12 sessions
Used for many disorders
Qi, yin, yang and meridians
probably do not exist
Needles may stimulate A delta fibres which initiate segmental C fibre inhibition
Via midbrain connections
there may be inhibition of descending endorphin mediated pathways
Other claims have no
physiological explanation
Some evidence suggests effectiveness
in pain, nausea and substance abuse
Until 100 years ago most
medicine was herbal
Herbalists use the whole
plant to gain synergistic effects. This also promotes `buffering` where one
alkaloid reduced the toxic effects of another.
Herb combining is also used
for synergy and buffering
These effects account for
variations in dose of active ingredients
History taking and diagnosis
is different
Many ethnic groups have
their own systems, e.g. Ayurvedic medicine in
Some evidence exists, e.g.
ginger for nausea and vomiting, feverfew for migraine prophylaxis, ginkgo for
cerebral insufficiency and dementia,
A combination of 10 Chinese
herbs has been shown to be highly significant in refractory eczema using a
randomised crossover study.
Many plants are highly
toxic.
Like cures like as opposed
to alagopathic medicine
Preparations are usually
from plant or animal products which are diluted
Claim to treat a wide range
of disorders
Some trials show an effect
greater than placebo, others do not
No evidence exists for water
memory
Only failing to use
conventional medicine, the preparations are safe
Hypnosis
Hypnosis is a state of
increased suggestibility
Addictions, psychosomatic
illness, evidence levels are low
False memories,
psychological problems, bring on latent psychosis
Meditation
Probably not a good idea
Some exercises used may promote
subtlety, but also carry risks in some groups
Manipulation
of bones, joints and connective tissues using manual manipulative techniques.
`High velocity thrust` is
often used and produces cracking sounds in a joint
`Functional techniques`
include traction with rotation
Some use craniosacral
techniques which are probably useless, they are used to manipulate `subtle
rhythmic pulsations in the CSF` which probably do not exist
25 – 50% of patients have
some pain at the manipulation sites for up to 24 hours
Practitioner must be aware
of contraindications to particular manipulations
Clearly there are risks in
such a physical treatment, cervical spine in particular
Several published trials do
show benefit over conventional treatments in back and neck pain
Studies cannot be blind
Similar to osteopathy but
focuses on spinal manipulation
Most cultures seem to have
developed massage techniques, e.g.
Promote relaxation, treat
anxiety, treat painful muscular conditions
May generate ascending
inhibition as explained by gate theory
Some claim to improve
circulation and lymphatic drainage
Muscle knots probably do not
exist
Very good for babies and
young children who can not talk, good for bonding
Some evidence that massage
can reduce anxiety scores with a possible cumulative effect
Injury to internal organs Avoid DVTs and skin injuries
Avoid direct pressure over
tumours Close physical contact
is often associated with sex
`Essential oils` may be
toxic in high doses and are probably useless
Smells may be used as aids
to association
Massage of particular areas
of the foot
Can feel relaxing but has no
scientific basis at all as far as is known
Much dietary manipulation is
conventional, e.g. high fibre diet, plenty of fruit and veg, fish oils for
arthritis, gluten free in coeliac disease etc.
Fat and water soluble vitamins
Vit C and zinc offer some prophylaxis for the common
cold
B6 for premenstrual features
and autism Vit E for angina
Inflammatory bowel disease
Hyperactivity Migraine Rheumatoid arthritis
Do you think all people who
call themselves scientists can be trusted to be correct?
Do we know of any
physiological mechanisms which would explain why like should cure like?
Dose homeopathies sometimes
seem confused between the concepts of symptomatic management as opposed to
treatment of the underlying cause?
At a 12C dilution the concentration
is equivalent to one drop in what?
At a 30C solution are there
any of the original molecules left in a homeopathic dilution?
Can the personality of a
leader or guru figure influence the thinking of otherwise dispassionate
people?
Is the concept of blindness
important in research?
Can detailed interviews and
lots of personal attention have a therapeutic effect?
What factors could influence
the effect of homeopathic preparations in humans?
What factors could influence
the effect of homeopathic preparations in humans?
Is it important to remove
human subjectivity from research?
Can you think of anyone or
any claim which could win a million dollars if their claims were correct?
Is homeopathy safe, does in
have any side effects
Are our conventional
treatments always safe?