Tuesday, September 4, 2012

Placebo Back Treatments

Reminder: If you have not done so, please read the Initial Post and  Blog Information.  At the upper left of this page above my picture click on the button, Initial Post and  Blog Information.

Sorry this is late.  My wife and I went to visit friends in the Florida panhandle over the Labor Day weekend.

A placebo is a device that simulates treatment for a medical problem.  It is an inert substance, procedure, or device that has no known effect on a disease or healing process.  Even though it is given to a patient, the patient has no idea whether it is a placebo, a new active substance, or something already known to help his condition.

The best example I know of was the large study done with polio vaccinations.  In the 1950s, tens of thousands of children were given polio vaccine while thousands of others were given placebos (non-vaccine shots, saline).  After waiting to see which group got more cases of polio, it was statistically obvious that the vaccine protected children from the polio infection and the placebo did not.  The remainder of the children were then given the real vaccine.  I remember this because I got the experimental vaccine; my sister did not and she had to get a second injection.  Boy, was she upset.  Fortunately she did not get the disease.

Sometimes physicians will devise studies in which a sugar pill is given in place of an active substance, a sham surgery is done in place of a real one, or a sham exercise or device is used.  These studies are usually done with the patients' knowledge.  The patients know someone is getting a placebo, but not who until the study is over.  With luck the treatment proves effective and then all the patients can receive the treatment  The best studies have thousands of participants (better statistics), are blinded or double-blinded (limited number of people know who is in each group), and are prospective (planned ahead of time).  The more participants, the more accurate the statistics are at the end of the study.

Anecdotal results are unplanned serendipitous results.  "My cousin broke an egg on his head and his low back pain went away."  Such reports are generally worthless. When 80-90% of back pain goes away on its own, it is tough to attribute a reason for the recovery.

The following treatments for low back pain have not been proven more effective than placebo in large, controlled, medical studies, at least so far.  Don't waste your money paying for these things to treat your low back pain:

1.   Any form of traction, including VAX-D, DRS, DRX, Inversion Therapy, Lordex, etc.
2.   Trigger point injections.
3.   Facet injections.
4.   Sacro-iliac injections.
5.   Acupuncture
6.   Paleo (or any other fad) diet
7.   Magnetic Therapy (of any type)
8.   Prolotherapy
9.   Reflexology
10. Over the counter nutritional supplements
11. Qigong
12. Cupping

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