Trick or Treatment (45 page)

The therapy is carried out in two steps: during the ‘functional integration’ phase, the practitioner uses touch to demonstrate to the patient techniques that improve breathing and body movement. During the subsequent ‘awareness through movement’ phase, the practitioner teaches the patient to correct so-called false movements.

The aim is to improve everyday functions. According to Feldenkrais, behaviour is not innate, but is merely acquired. False behaviour, he thought, was ‘a groove into which a person sinks never to leave unless some physical force makes him do so’. His treatment, he was convinced, provides that force.

The therapy consists of a series of sessions usually carried out in small groups. Once the lessons are learned, the patient has to practise continuously at home. The conditions treated include musculoskeletal problems, multiple sclerosis and psychosomatic problems.

What is the evidence?

Only about half a dozen rigorous clinical trials are currently available. Their results are far from uniform. Some, but not all, results suggest that the Feldenkrais method is useful for multiple sclerosis patients. For other conditions, the evidence is even less convincing. There are no conceivable serious risks.

Conclusion

The Feldenkrais method is not well researched, and there is currently no compelling evidence that it is effective for any condition.

Feng Shui

The Chinese art of placing objects in accordance with the theory of yin and yang in order to optimize the flow of life energy, which, in turn, is thought to influence health and wellbeing.

Background

Chinese medicine assumes that all health is governed by the flow of energy (Ch’i) and the balance of yin and yang within the body, but these concepts can also be applied to the things that surround us. Feng shui consultants give advice on the position of objects in an office or home. They may, for instance, place a screen in a certain position to make sure that the energy is travelling in the right direction, or they might advise their clients to reposition their beds so that they can benefit from the right energy flow while sleeping.

Feng shui is not biologically plausible, because its basic tenets make no sense in the context of modern science. The benefit some people experience after following the advice of feng shui consultants could be due to expectation and has no physiological basis, nor is it likely to last.

Feng shui consultants do not normally claim to cure diseases, but they say that their work can improve wellbeing and prevent ill-health. Increasingly, feng shui consultants are giving advice on how to deal with the health effects of electromagnetic fields in the home, even though there is no evidence that such fields are harmful. These consultants generally charge considerable amounts of money for their services.

What is the evidence?

It would not be difficult to test some of these claims, but as yet there have been no serious studies. However, informal tests comparing the judgements of feng shui consultants demonstrate significant conflicts over their interpretation of the energy flow in any given space, which implies that their advice is based on subjective imaginings.

Therefore all we can say is that there is no evidence to show that feng shui does anything but enrich those who promote it.

Conclusion

Feng shui is based on biologically implausible concepts and there is no evidence to show that it works. A competent interior designer can probably offer equally good, if not better, advice.

Food Supplements

Substances usually taken by mouth to increase the intake of vitamins, minerals, fats, amino-acids or other natural substances in order to maintain or improve health, fitness or wellbeing.

Background

Food supplements are a relatively new invention. At present, sales are booming. Regulation of food supplements varies nationally but, generally speaking, it is very lax. Manufacturers can sell supplements without providing proof that they do any good at all, and often without sufficient data on safety.

Medical claims are not normally allowed for food supplements. This does not, however, stop the industry from cleverly conveying the message that this or that supplement is effective for treating this or that condition. Health writers, books and the internet relentlessly target the consumer with exactly that aim.

What is the evidence?

It is obvious that not all food supplements are the same, as is the case with herbal supplements, which were discussed in detail in Chapter 5. Some are likely to be useful and are supported by evidence; others are either unproven or disproven, and many supplements carry risks of adverse effects. The dangers can be due to a supplement’s inherent properties, contamination (e.g. heavy metals), or adulteration (e.g. synthetic drugs). Also, it is likely that there are many adverse effects that are not known due to lack of research and under-reporting.

Fish-oil capsules, as discussed in Chapter 6, are an excellent example of an effective supplement, because they have been proved to reduce the risk of heart disease. They may also reduce inflammation, which might make them beneficial for rheumatoid arthritis and many other conditions.

Shark cartilage, also discussed in Chapter 6, is an example of a popular supplement which has been shown to be ineffective. Although it is probably harmless, it can distract patients from seeking more appropriate treatment and it is certainly damaging for the sharks who are victims of the supplement industry.

Vitamin B
₆
is an example of a supplement that can be harmful in large doses. It can result in nerve damage to the arms and legs. There are several reports of people reporting such complications having taken 500mg of B
₆
per day.

Conclusion

Food supplements are a very broad category – too broad to generalize. Some are undoubtedly helpful in certain situations. For many others, the effectiveness is uncertain or even disproven. Adverse effects can occur.

Hypnotherapy

The use of hypnosis, a trance-like state, for therapeutic purposes.

Background

Hypnotherapy has a long history – it can be traced back to ancient Egypt – but its modern development started in the eighteenth century with the work of the charismatic Viennese scientist Anton Mesmer. He was followed in the nineteenth century by the Scottish physician James Braid.

In recent years, hypnotherapy has become recognized in several areas of healthcare. Hypnotherapists treat a range of chronic conditions, including pain, anxiety, addictions and phobias. Hypnotherapy is practised by several healthcare professionals, including psychologists, counsellors and doctors. One session lasts 30–90 minutes and, depending on the condition and the responsiveness of the patient, 6–12 sessions are normally recommended. Autogenic training is a self-hypnotic technique, which, after some instruction, can be practised without the help of a therapist.

What is the evidence?

People who are suggestible generally respond best. Dozens of clinical trials show that hypnotherapy is effective in reducing pain, anxiety and the symptoms of irritable bowel syndrome. However, according to reliable reviews by the Cochrane Collaboration, it is not effective for smoking cessation, even though it is frequently promoted in this context. There is much less research for autogenic training, but the existing evidence is encouraging for anxiety, stress, hypertension, insomnia and some pain syndromes.

Hypnotherapy and autogenic training are relatively safe, but they should not be used by people with psychoses or other severe mental problems. With hypnotherapy, the recovery of repressed or false memories can create problems, and cases of false-memory syndrome (i.e. remembering distressing events which, in reality, have never occurred) have been reported.

Conclusion

The prudent use of hypnotherapy can be helpful for some patients. Whether this is a specific effect of the treatment or a non-specific (placebo) effect is difficult to say. Autogenic training has the added advantage of being an economical self-help approach that maximizes each patient’s own involvement. Neither treatment is associated with serious risks when applied correctly.

Leech Therapy

The application of live leeches to the skin in order to treat a range of illnesses.

Background

Hirudo medicinalis
is a small, black, worm-like animal. It is capable of attaching itself to humans or animals, sucking substantial amounts of blood from the skin. During this process, it increases considerably in size and finally, when it is saturated with blood, it drops off.

Leeches were used for medicinal purposes in ancient Babylon, and in more recent centuries in Europe as a mode of bloodletting, as discussed in Chapter 1. Today their only use in conventional medicine is in plastic surgery: clinical trials show that applying leeches post-operatively improves the cosmetic results of some operations.

In alternative medicine, leeches are employed for a range of conditions. Some therapists believe that they eliminate toxins from the body; others use them to treat painful local conditions such as osteoarthritis.

While sucking blood, leeches inject pharmacologically active substances into the body. Initially they inject an anaesthetic substance which enables them to bite through the skin without causing pain. Subsequently they excrete a substance that prevents blood from clotting so that they can suck blood easily. This substance is called hirudoine and is a well-researched anticoagulant. It can now be synthesized and is used widely in mainstream medicine for its anticoagulation properties.

What is the evidence?

A German group recently published a series of clinical trials which suggested that the application of several leeches over the knee eases the pain of osteoarthritis. These studies still await independent replication.

All other claims of the alternative use of leech therapy are unsupported by evidence.

If done properly, there are few risks. Many patients, however, might feel uncomfortable about leech therapy, either because of the aesthetic aspects of the treatment or the fact that, after one session, the animals are usually destroyed.

Conclusion

Leeches have a long history of medical use. There is some evidence that their use is effective in reducing the pain of osteoarthritis of the knee. There is no evidence to support their use for any other treatment performed by an alternative therapist.

Magnet Therapy

The use of magnetic fields from static magnets, which are usually worn on the body, to treat various conditions, most frequently pain.

Background

Nowadays, rapidly fluctuating magnetic fields are employed in conventional medicine in hi-tech imaging instruments and for promoting the healing of bone fractures. However, alternative medicine tends to focus on the use of static magnets, which give rise to a permanent magnetic field.

Such static magnets have always attracted the interest of physicians, but the boom in magnet therapy began in Europe in the eighteenth century. Although static magnets fell out of favour as medicine progressed, a plethora of static magnets are today again popular within alternative medicine. Their use is promoted for many conditions, most frequently to alleviate chronic pain. These static magnets are worn as wrist bands, belts, leg wraps, shoe inlays, patches, etc. Magnetic mattresses or seat covers are also available. The magnetic strength of these devices varies between 10 and 1,000 Gauss. Static magnets can be purchased through numerous outlets and, more often than not, the consumer/patient would not have had any contact with a healthcare practitioner.

Subtle effects of magnetic fields are observable, for instance, on cell cultures. The question is whether these translate into any therapeutic benefit.

What is the evidence?

Most of the clinical research on static – meaning constant field strength rather than fluctuating strength – magnets relates to pain control. Researchers at Exeter University recently included nine placebo-controlled, randomized trials in a meta-analysis. The results do not support the use of static magnets for pain relief. For other problems, such as menstrual symptoms or varicose veins, the evidence is equally unconvincing.

Static magnets are unlikely to cause direct adverse effects. As they are usually self-administered, there is a danger of missing serious diagnoses and losing valuable time for early treatment of serious diseases.

Conclusion

Static magnets are popular, and the market is booming, but it is important to realize that there is no evidence that they offer any medical benefit, and indeed there is no reason why they ought to. There is more information about magnet therapy in Chapter 5.

Massage Therapy

The manipulation of the tissues close to the body surface (e.g. muscles and tendons) using pressure, traction and vibration.

Background

Massage is as old as medicine itself; indeed, it seems to be a human reflex to rub ourselves where we feel pain. Today many variations exist; for example, classical ‘Swedish’ massage focuses on muscular structures and is popular throughout Europe. Other forms of massage treatment include: