Tag Archives: Natural fallacy

Natural pain relief

From WDDTY e-news 3 April 2007 No.347

Natural pain relief

A reader is eager for advice on how he can replace prescription pain medication with a natural alternative.  He suffers from multiple herniated discs and degenerative disc disease and without medication the pain is unbearable.  He has chronic pain in his lower back, buttocks and sciatic nerve.  He currently takes oxycodone, fetanyl (skin patch) and methadone in high doses, but doctors say his medication can be reduced if he opts for surgery.  He has had surgery for his condition in the past and is not keen to have any more operations.  Is there a natural remedy out there that may be able to help?

If you seriously believe that a magnetic bracelet can replace high dose methadone, then you have absolutely no business offering health advice.

Let’s be really clear here: as @LennyLaw pointed out on Twitter, this man is in agony due to serious structural problems. He is unlikely to get relief without some form of surgical intervention. The pain killers he is using are among the strongest available, and go way beyond the “ooh my dodgy knee felt a bit better” kinds of effects that the quack treatments proposed could provide, even if they worked as advertised.

But what counts as “natural”? What “works”? Let’s review the responses one by one:

Bioflow wristbands

According to Nick, you should try a Bioflow wristband, which uses a patented magnetic module to treat the blood and assist the body to heal itself, providing natural pain relief.  “My arthritic thumbs and knees no longer give me any pain and I am sleeping better and have more energy,” he reports.  Another reader points out that the wristbands have been proven to reduce pain in a clinical trial of nearly 200 men and women with osteoarthritis of the hip or knee (BMJ, 2004; 329: 1450-4).

Apparently, Bioflow comes with a 90-day money back guarantee, so there is nothing to lose – but the pain!  See www.usefulmagnets.co.uk for more information.

Does it work?

Bioflow have a sciencey-looking study and are apparently classified as a class 1 medical device. So how do they work?

ernst-bioflowEr, apparently they don’t. The website makes no claims for therapeutic effect other than to cite the study. To see the problem with this approach, check this crank website making all kinds of inflated claims for the product – note the weasel words. Intriguingly the study is from Peninsula, and was overseen by Edzard ErnstW. I asked @EdzardErnst whether the result was reliable. His reply was unequivocal (right).

The consensus of systematic reviews is that magnets do not objectively improve symptoms of arthritis or any other condition (Complement Ther Med. 2009 Oct-Dec;17(5-6):249-56, FACT Volume 13, Issue 1, pages 5–6, March 2008).

Is it plausible?

No. There is no reason to suppose that these permanent magnets should have any effect whatsoever. They are, after all, quite small magnets, much stronger fields are used in medical imaging with no evidence of clinical effect (CSI, BBC). Some of the authors of the study Bioflow cite, have since published a rather different view.

 

Is it natural?

No. There is nothing remotely natural about wearing chunks of rare-earth magnets. These are an industrially manufactured product. And a profitable one: the magnet therapy industry was estimated at $1bn by CSI five years ago.

Should WDDTY have known this?

Probably. They promoted Bioflow in vol 16 no. 9 (Dec 2005), vol 17 no. 4 (Jul 2006) and vol 18 no. 3 (Jun 2007), as well as in this article from their e-news. Claims for magnets date back a long way, with sciencey-looking studies in the late 90s being prominently promoted (CSI). They have been busted for at least as long (e.g. Ann Intern Med. 1993;118(5):376-383).

Icewave

Another recommended product for natural pain relief is IceWave.  According to the manufacturer’s website, IceWave is “a non-invasive nanotechnology product that works within minutes to provide a cooling effect and soothing relief to inflamed and injured areas.”  See www.lifewave.com for more information.

Does it work?

You have to be kidding. LifeWave is a vendor of devices to “protect” you from non-ionising (i.e. essentially harmless) radiation, it is a predator on the vulnerable (people with chronic pain).

Our exclusive non-transdermal patch system utilizes new technology to gently stimulate acupuncture points – literally improving the flow of energy in the body for improvement of pain and discomfort – within minutes of use!

Needless to say, there is no good evidence that acupuncture points are of any physiological significance (J Intern Med. 2006 Feb;259(2):125-37). There’s no uniform definition of where they are or what they do; the apparent uniformity within parts of TCM is largely an artifact of the Maoist refactoring f TCM in the 1950s – Japanese analogues exist but are different, and needling does not seem to have any different effect whether the “correct” points are used or not.

The sales pitch relies on the usual anecdotes. Oh, and the packaging says they are homeopathic, hence the nanobollocks, presumably. And note the quack Miranda warningW.

Is it plausible?

Not remotely. And to be fair they don’t even try to make it look plausible, other than using sciencey-sounding language.

Is it natural?

No. It’s an entirely synthetic product with completely made up claims.

Should WDDTY have known this?

Almost certainly. The community that promotes LifeWave’s numerous bogus products is well aware of the fact that skeptics know it to be bogus. Oh, and it seems to be sold via multi-level marketingW, which is another red flag.

Homeopathy

If these suggestions don’t appeal to you, why not try readers’ favourite, homeopathy. According to Sue, the homeopathic remedy Mag Phos in a 200C potency (available from homepathic pharmacies such as Helios and Ainsworth’s) is known to be very effective for pain relief, especially if dissolved in a little warm water and sipped at regular intervals.  Norene also swears by homeopathy for the treatment of pain – although she uses arnica:  “Start with a very high dose of arnica (for myself I used 10M).  After a couple of days, reduce the dose and continue taking the remedy for a while, according to personal needs.  To maximise effectiveness, take homeopathic Symphytum (comfrey) in addition to arnica.”

Does it work?

No. There is not one case where homeopathy has been unambiguously and objectively proven to have cured anything, ever. All observations are consistent with the null hypothesis (see homeopathyW at Wikipedia, which goes into great detail).

Is it plausible?

No remotely plausible mechanism has ever been advanced, and the doctrines of homeopathy conflict at a fundamental level with basic principles of physics such as the Heisenberg uncertainty principle and the laws of thermodynamics and conservation of energy. Unless you believe in “future-information medicine“, in which case you may be interested in buying this rather fine bridge I have for sale.

Is it natural?

No. Not only is the entire system of preparation by dilution and twerking entirely man-made, most over the counter remedies are manufactured by industrial scale pharmaceutical companies.

Should WDDTY have known this?

Yes. Homeopathy has been known to be wrong since at least 1840, and the doctrines were refuted by the early years of the 20th Century.

Bowen therapy

Other suggestions for this problem are Bowen therapy and osteopathy.  Says Lorraine of osteopathy, “I cannot sing its praises enough…I suffered terrible back problems but have not felt a twinge in the past six years since my treatment.”  As for Bowen, Angela reckons it can bring amazing relief to many pain sufferers.

Does it work?

It depends who you believe. SCAM believers claim it is “useful” (source),  but when challenged, practitioners were unable to provide any credible evidence.

So that’s a no.

Is it plausible?

Bowen was an unregistered osteopath. There’s no reason to suppose that Bowen technique  has any effect beyond that of massage, which is basically what it is, when the bullshit is stripped away. Claims to allow the body to “reset” itself are fanciful. You’re probably better off with a warm bath.

Is it natural?

Massage is sort of natural, Bowen technique is completely made up.

Should WDDTY have known this?

If you look for any credible evidence, you find none. If on the other hand you routinely believe the claims of commercial providers of services at face value without looking for evidence or applying any critical judgment then you’ll probably not spot that it’s quackery.

So, if WDDTY pretends to be in any way scientific or evidence based, it absolutely should have spotted this.

Osteopathy 

Finally, we have an encouraging story from Diane:

“I have suffered from bulging discs, sciatica, oedema and a host of related problems for the past three years.  But recently I have started several therapies which have helped me immensely.  First of all I started going to acupuncture once a week, then I began drinking Green’s Plus – adding powdered calcium, magnesium, and powdered MSM (Methyl-sulfonyl-methane) to the drink – everyday for nutrition.  MSM is a great natural pain reliever, along with magnesium.  I also use magnesium oil – either in the bath or applied directly to the site of pain.  It works wonders!

Does it work?

Osteopathy is a grey area. There is evidence of effects for musculoskeletal pain, as for any manipulative therapy, but the claims of the fringes of osteopathy (and especially cranial osteopathy aka cranio-sacral therapy) are unambiguously bogus. The writer also adds acupuncture (bogus), magnesium (plausible to a degree) and MSM (bogus) to the mix.

Is it plausible?

As invented by Andrew Taylor Still the practice is completely speculative – he surmised that the bone (osteon) was the root of all disease, and this is unambiguously nonsense, but subsequent changes have resulted in a variety of manipulative therapy which is plausible for some conditions, but wildly implausible for others. Note that this varies around the world, the Wikipedia article on osteopathyW is essential reading.

Is it natural?

The practice was invented from whole cloth in 1874. It’s a manual therapy so you could defend it as natural, but the practice is largely a set of man-made rituals.

Should WDDTY have known this?

Yes. The consensus around osteopathy has been settled for a long time.

Chiropractic

In addition to this, last year I started seeing a chiropractor, who uses a ‘Pro Adjuster’ on me.  I have now been free of pain for the last month.  I was told that I was going to have to have back surgery, but now I am feeling so wonderful that I am considering not having the surgery at all.  I can go all day without my pain medication and can sit and stand longer than I ever thought I would again!”

Does it work?

No. OK, technically, it is as effective as other forms of manipulation therapy for musculo-skeletal pain, but so many chiropractors exceed the bounds of evidential supportability that it is safer t avoid them altogether, especially given their history of antivaccinationism and the fact that one of their signature moves is potentially deadly.

The chiropractic profession includes some of the most cynical charlatans on the planet. Their training is big on “practice building” (i.e. maximising revenue) and chiropractors’ aim is to get you in, and keep you coming back, not to discharge a healthy patient. They use all manner of superstitious nonsense about “maintenance adjustments” and maintaining optimum wellness, but basically they are the canonical manipulative quacks.

Is it plausible?

As Wikipedia says:

A critical evaluation found that collectively, spinal manipulation failed to show it is effective for any condition. The scientific consensus is that chiropractic may be on a par with other manual therapies for some musculoskeletal conditions such as lower back pain, but that there is no credible evidence or mechanism for effects on other conditions, and some evidence of severe adverse effects from cervical vertebral manipulation. The ideas of innate intelligence and the chiropractic subluxation are regarded as pseudoscience.

So as with osteopathy, it’s plausible up to a point, but the profession as a whole is deeply untrustworthy due to widespread belief in completely bogus ideas, and a tendency to duplicate the action of hanging.

Is it natural?

No. It was invented from whole cloth by D. D. Palmer in 1895

Should WDDTY have known this?

The facts about chiropractic have been known for a long time. Yes, WDDTY should know that this is a dangerous woo-riddled field that no responsible person could possibly recommend without serious caveats around the likely harms and the costs of endless unnecessary treatments.

Summary

WDDTY’s ideas of what constitutes a “natural” remedy are absurd and seem to be founded more on the absence of credible evidence (i.e. being “alternative”) than on any actual natural origin. They try to have their cake and eat it, simultaneously claiming that something is “natural” and that it’s “nanotechnology”.

Their approach to the therapies is entirely credulous. Homeopathy was refuted over a century ago, they still promote it. There is no evidence that their enthusiasm for a product or treatment is conditional on plausibility or evidence of effect.

The article acts primarily as a propaganda piece for disproven or unproven therapies, often at significant potential cost.

Supplements. Because natural

Natural vitamins being crushed from fresh fruit by Fairtrade villagers. Or... not.
Natural vitamins being crushed from fresh organically grown fruit by Fairtrade villagers. Or… not.

WDDTY want us to believe that supplements are better than drugs because they are natural.

Is that true?

First up, rejecting “big pharma” puts you in the grips of “big herba” – and if you dig beneath the skin, you find that they are not only similar, they are often one and the same.

Second, you cannot be confident that your supplement contains what it says on the label. A random sample of 44 supplements found one in three contained none of the claimed ingredient, and many of the others contained fillers and adulterants.

Third, you never know what else is included free!pesticides, for example, and heavy metals. Granted these are usually within accepted safe levels – but the same applies for the non-organic produce that we’re told is full of “toxins” such as, you know, pesticides and heavy metals.

Fourth, the more you seek to escape “big whoever”, the worse the problem seems to get. Unlicensed products have virtually no safeguards. Continue reading Supplements. Because natural

Home birth is “safer option”

WDDTY is, of course, deeply in the grip of the naturalistic fallacy. So it’s not a surprise that it promotes home birth.

In truth, home birth is tolerably safe in the West these days, but research has consistently shown that it is somewhat less safe than hospital birth, albeit with much uncertainty. If you are a first time mother, have a higher risk pregnancy, live more than about half an hour from a hospital, or your area lacks excellent midwifery services with good escalation to secondary care in case of problems, then you are unquestionably better off in hospital. For your second or subsequent pregnancy you should be no worse off at home, provided you live close to a hospital and have a good doctor or a well-trained midwife with good backup services.

The problem in assessing relative risk has always been unpicking the chooser from the choice: mothers with more complicated pregnancies are more likely to opt for a hospital birth, mothers who opt for home birth are normally expecting a routine delivery.

This newborn has apparently correctly identified that his mother's claim that home birth is safer, is a crock.
This newborn has apparently correctly identified that his mother’s claim that home birth is safer, is a crock.

How much Wrong can you pack in a small callout box?

Home births are safer. Women who give birth at home suffer far fewer complications who decide to have their baby in In fact, women who opt for hospital delivery are more than twice as likely complications compared with a and nearly two times more likely postbirth haemorrhage—unless it’s the first baby.

Really?

Before we go too far down the line, it must be pointed out: home birth is tolerably safe, and de Jonge’s study is underpowered for robust conclusions. There are many more and larger studies, and NHS Choices provides an excellent overview of one large one specific to England. It’s also important to realise that it is very hard to unpick the effects of chooser and choice. If you live in easy reach of a hospital you might very well opt for a home birth secure in the knowledge that a rapid transfer is possible, whereas if you live in the country you might well opt for a hospital birth, and this would be irrespective of the actual risk when a preference is originally expressed.

In fact, home birth is probably not significantly riskier than hospital birth for uncomplicated pregnancies in areas with good midwifery and referral services and transport links – but only with those caveats. The message that home birth is safer is wrong on two levels: it’s wrong because actually it’s at best no riskier than hospital birth for low risk pregnancies, and it’s wrong because that only applies to low risk pregnancies in a low risk system.

Absent both of these, it is significantly more dangerous, especially for first pregnancies.

Crucially, much of the literature proposing that home birth is safer originates form the same source: Ank de Jonge, a home birth advocate in the Netherlands.

The following is reblogged from Amy Tuteur, MD (The Skeptical OB), who has two posts which are combined here (firstsecond).

Here is Dr. Tuteur’s take on the study under discussion, reblogged with permission:

Surprise! There were home birth deaths in the Dutch study that claimed to show that home birth has lower risks.

Surprised girlOn June 14, I wrote about Ank de Jonge’s latest attempt to show that home birth is safe (No, new Dutch study does NOT show that home birth is safe). As I mentioned at the time, de Jonge continues to slice and dice the Dutch home birth data is an effort to somehow prove that home birth is safe, when the data suggests that it is not.

In the latest paper discussed in that post, Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study,  de Jonge concluded:

Low risk women in primary care at the onset of labour with planned home birth had lower rates of severe acute maternal morbidity, postpartum haemorrhage, and manual removal of placenta than those with planned hospital birth. For parous women these differences were statistically significant…

In other words, there was no difference in severe acute maternal morbidity (SAMM) between home and hospital among nulliparous women and a slightly lower rate of SAMM for parous women at home-birth.

There was just one teensy, weensy problem. de Jonge left out the mortality rates. Severe maternal morbidity is an appropriate measure of safely ONLY when death rate is zero or nearly zero. If the death rate is not zero, that MUST be taken into account in assessing safety. My Letter to the Editor of the BMJ regarding this inexplicable oversight was published the same day. de Jonge and colleagues have finally responded, and what do you know, the maternal mortality was NOT zero.

The reply appears to continue the trend of apparent obfuscation of the results.

The authors claim:

We did not mention maternal deaths in our study, but they were included among the women with severe acute maternal morbidity (SAMM). There were two maternal deaths in the planned home birth group (2 per 100,000) and three in the planned hospital birth group (6 per 100,000). The differences between these rates were not statistically significant (Fisher’s exact test, P=0.367).

They described 1 home birth death due to cerebral hemorrhage possibly secondary to pre-eclampsia. The authors try to blame the doctors who evaluated the woman at 37 weeks, at which time she was felt to fine. A lot can and does happen in the last week of pregnancy. To blame the doctors who saw the woman a week before her collapse and absolve the midwife who cared for her at the time of birth is bizarre.

What about the other home birth death? Funny you should mention that. The authors did not say. They lumped the second home birth death in with the hospital deaths and reported:

The other four women were referred during labour from primary to secondary care because of meconium-stained liquor. One woman suffered from sudden collapse during labour, when she was already in secondary care, and died. Although no definite diagnosis was made at postmortem examination, a cardiac cause appeared to be most likely.

A woman who gave birth spontaneously was discharged after one day. On the fourth day postpartum she was readmitted because of profuse vaginal bleeding and shortness of breath. She had a sudden collapse and died. Postmortem examination showed sinus sagittalis superior thrombosis.

Two women died a few weeks after they gave birth from causes not related to the delivery; one from a severe asthma attack, the other one fell down the stairs, had a skull fracture and died of a subarachnoid haemorrhage.

Since the authors did not specify that either of the woman who died of causes unrelated to delivery was in the home birth group, it seems safe to assume that they were both in the hospital group.

Therefore, as far as I can determine, there were 3 maternal deaths attributable to pregnancy in the entire study, 2 in the home birth group and one in the hospital group, for a death rate of 2/100,000 in each group. The only one that appears to have been potentially preventable was the one that occurred in the home birth group. Therefore, the home birth group had one death that was potentially preventable in the hospital, while the hospital group had none.

The study is underpowered to determine whether there is a statistically significant difference in the death rate between the two groups, but the fact that even one woman in the home birth group died of a potentially preventable cause means that there is no basis for concluding that home birth is as safer or safer than hospital birth among the women in this study.

Simply put, the death rate was not zero and until the difference (if any) between maternal deaths at home and in the hospital is determined, we cannot draw any conclusions about the safety of home birth for Dutch mothers.

A more appropriate conclusions for the study would be:

Low risk women in primary care at the onset of labor with planned home birth had lower rates of severe acute maternal morbidity, but this difference was statistically significant only for parous women. However, there was a potentially preventable death in the home birth group, while there were no potentially preventable deaths in the hospital group. The study is underpowered to detect a difference in maternal mortality between home and hospital, therefore, no conclusion can be drawn about the safety of home birth.

Yes, fewer women in the home birth group experienced severe acute maternal morbidity, but that’s nothing to crow about if one of them died and might have been saved in the hospital.

What Doctors Don't Tell You
Why don’t doctors tell you that home birth is safer?

Because it’s not true.

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Treating ear infections naturally

Treating ear infections naturally
Treating ear infections naturally is an article from the November 2013 issue of WDDTY.

It offers a number of folk remedies for ear infections of varying advisability, misrepresents the only source cited, sows fear, uncertainty and doubt against antibiotics and includes nonsensical concepts drawn from pre-scientific superstitious medical systems. The author recommends allowing the eardrum to rupture rather than taking antibiotics.

Otitis mediaW is a very common childhood ailment. 80% of cases resolve spontaneously. Complications can include perforated eardrum, acute pain and occasionally permanent hearing loss. The advice in this article is a little worse than useless.

Continue reading Treating ear infections naturally