Read Trick or Treatment Online
Authors: Simon Singh,Edzard Ernst M.D.
Alexander Technique
A process of relearning correct postural balance and coordination of body movements.
Background
Fredrick M. Alexander was an Australian actor whose career was threatened by a recurring loss of voice. Doctors were unable to diagnose any problem with his throat, but Alexander noticed that his silence was linked to his poor posture. In the early twentieth century he developed a cure for his problem which focused on relearning correct posture.
Alexander teachers encourage their patients to move with the head leading and the spine following. These patterns of movement and posture are rehearsed repeatedly with a view to creating new motor pathways and improving posture, coordination and balance. Essentially, the mind is taught to modulate the autonomic nervous system through regular, supervised exercises.
The Alexander technique quickly became popular with performing artists. It was then noted that, apparently, it was also useful for a wider range of medical conditions. Today Alexander teachers claim that it is effective for treating asthma, chronic pain, anxiety and other illnesses.
Alexander teachers instruct their clients in a series of one-hour exercise sessions. They guide the process of relearning simple postures and body movements through a gentle, hands-on approach. As plenty of repetition is needed, 30–100 such sessions are usually required to master the technique. This obviously demands a considerable level of commitment from the client, in terms of both time and money.
What is the evidence?
Very little research has so far been conducted on the Alexander technique. Some promising findings have emerged in terms of improvement of respiratory function, reduction of anxiety, reduction of disability in Parkinson’s disease, and improvement of chronic back pain. However, for none of these conditions is the evidence sufficient to claim that the Alexander technique is of proven effectiveness. There are no serious risks associated with this method.
Conclusion
Alexander technique is not well researched, so the evidence is not conclusive. It might generate benefit for some health problems, provided patients are sufficiently committed and wealthy.
Alternative Diagnostic Techniques
Diagnostic methods not used in conventional medicine but employed by practitioners of alternative medicine.
Background
Before administering a treatment, alternative therapists will often assess the patient’s condition using a variety of diagnostic techniques. Some of these are entirely conventional, but others are not. Some of the more unusual diagnostic techniques are specific to a particular therapy. These are therefore discussed in the relevant sections of this book. The following list includes many of those diagnostic methods that are used in several disciplines:
What is the evidence?
In nearly every case, these methods and the concepts behind them are not plausible, so their ability to diagnose accurately must be treated with great scepticism. Moreover, when these methods have been rigorously tested, the most reliable results of such investigations show that they are not valid. Finally, they typically fail the test of reproducibility, which means that ten practitioners generate ten different results.
Conclusion
Alternative diagnostic techniques are dangerous as they are likely to generate false diagnoses. They can be misused by fraudulent practitioners to cause unwarranted fears in patients and to convince them to pay for ineffective or harmful treatments of conditions they did not have in the first place.
Alternative Diets
Regimented plans of eating and drinking with health claims that are not in line with accepted knowledge.
Background
In alternative medicine, unsubstantiated health claims are being made for dozens of special diets. Many of these are ‘flavour of the month’ approaches. To name but a few: Ama-reducing diet (Ayurvedic diet to burn off accumulated ama, which are supposed toxins); anthroposophic diet (lactovegetarian food with sour-milk products); Budwig’s diet (fruit, juices, flaxseed oil and curd cheese); Gerson diet (fresh fruit juices, vegetables, supplements, liver extracts and coffee enemas to cure cancer); Kelly diet (anti-cancer diet including supplements and enzymes); Kousmine diet (anti-cancer diet with ‘vital energy’ foods, raw vegetables and wheat); macrobiotic diet (aimed at balancing yin and yang); McDougall diet (vegetarian diet, low fat, whole foods); Moerman diet (anti-cancer lactovegetarian diet with added iodine, sulphur, iron, citric acid and vitamins A, B, C, E); Pritikin diet (vegetarian diet combined with aerobic exercise); Swank diet (low amounts of saturated fat to combat multiple sclerosis).
Each of these diets has its own unique concept and is promoted for specific circumstances. Some must be followed long-term, others only until the condition in question is cured. Alternative diets are promoted by a range of alternative practitioners and health writers, and via the internet.
What is the evidence?
Clearly one would need to assess each diet on its own merits, yet little data has been gathered on any of those mentioned above or in general. Where evidence does exist, it is usually seriously flawed. For instance, the Gerson diet is relentlessly promoted as a cancer cure, but the only positive evidence comes from an analysis which is now widely accepted to be fatally flawed and which should therefore be ignored.
Several alternative diets can lead to malnutrition, particularly in seriously ill patients for whom it is important to consume a balanced diet with sufficient calorie intake. Feeding a highly restricted diet to a cancer patient, for instance, hastens death and reduces quality of life. Some proponents of these diets make patients feel guilty if they cannot follow their often tedious regimens. This can further reduce quality of life.
Conclusion
Alternative diets are burdened with the risk of malnutrition and have not been shown to be effective for any condition. Our advice is to stay well clear of them.
Alternative Exercise Therapies
Approaches that employ regular movements for improving health and wellbeing, and which are not normally used in conventional healthcare.
Background
The health benefits of regular exercise cannot be valued highly enough. Knowledge about exercise developed in all cultures, so unique exercise regimens emerged in different parts of the world and are often embedded in the specific concepts about health and disease of that region. Examples are t’ai chi (China) and yoga (India). Both include meditative aspects, need to be practised regularly and place a strong emphasis on disease prevention and wellbeing.
In addition to these traditional forms of exercise, there are modern variations on the theme. An example is pilates, developed relatively recently by Joseph Pilates (1880–1967). This approach integrates breathing, proper body mechanics and strengthening exercises, as well as stabilization of the pelvis and the trunk. It is estimated that there are now over 10 million people who practise pilates worldwide.
Exercises are best learned in small groups and then have to be practised regularly – once or twice a week, or even daily.
What is the evidence?
Although there is far less research into alternative exercises than into common sports or physiotherapy exercise, some encouraging conclusions have started to emerge. For example, yoga, which encompasses a whole lifestyle including diet and meditation, has been shown to be effective in reducing cardiovascular risks.
T’ai chi has also been studied quite thoroughly. It improves balance, prevents falls in the elderly, enhances cardiovascular fitness, increases joint flexibility, prevents osteoporosis in post-menopausal women and improves quality of life in patients suffering from chronic heart failure. There is, however, no significant evidence that alternative exercise therapies convey any additional benefits compared to many forms of conventional exercise.
Conclusion
Regular exercise, whether exotic or conventional, is undoubtedly good for our health and wellbeing. A well-trained, experienced tutor is important, as alternative exercise therapies can carry the sort of risks associated with any exercise that puts the body under strain.
Alternative Gadgets
An increasing number of alternative gadgets are being promoted with promises of health benefits for those who buy them. These gadgets have little in common except that the theories behind them conflict with mainstream science.
Background
For some entrepreneurs, alternative medicine is a highly profitable business, and there seems to be no limit to their inventiveness. They develop gadgets and claim that, if we buy and use them, our health will improve, certain illnesses will be cured or diseases will be prevented. The ideal medium for promoting these gadgets is, of course, the internet – there is no control over what claims can be made.
Examples of alternative gadgets are copper bracelets, devices that are said to shield us from electromagnetic radiation, jewellery with healing crystals, foot-baths that supposedly extract toxins from our body, etc. In many cases, the only evidence provided by the manufacturer is statements by satisfied customers and ‘experts’, providing a thin veneer of credibility. Currently there are, for instance, dozens of websites where Professor Kim Jobst promotes the ‘Q link’ as a ‘safe and effective tool that helps guard the cells of the body against electromagnetic field effects’. He also claims, ‘Emerging evidence from early clinical cellular and molecular studies of the effects of Q link on cardiovascular, immune and central nervous systems are startling,’ but this is simply not true.
What is the evidence?
The medicinal claims for these gadgets are often couched in apparently scientific language. This is to convince the consumer that the product is serious. On closer inspection, those with a scientific background can easily see their pseudo-scientific nature (i.e. the jargon is gobbledygook). The assumed mode of action of alternative gadgets is biologically implausible and no data exist to show that they have any positive health effects at all. Indeed, when devices have been tested, then the conclusion has invariably been disappointing.
The financial loss for patients is obvious, but there is also a health risk, as some people might employ these gadgets as alternatives to effective treatments. Seemingly harmless gadgets can then even hasten death.
Conclusion
A plethora of alternative gadgets exists, allegedly curing this or preventing that condition. They are not supported by science or evidence and are a waste of money at best and a danger to health at worst.
Anthroposophic Medicine
A school of medicine developed by Rudolf Steiner based on imagination, inspiration and intuition. Anthroposophic medicine is influenced by mystical, alchemistic and homeopathic concepts and claims to relate to the spiritual nature of man.
Background
Rudolf Steiner (1861–1925) created, among other things, the Waldorf schools, biodynamic farming and his own philosophy, known as anthroposophy. Applying his philosophical concepts to health, he founded, together with Dr Ita Wegman, an entirely new school of medicine. It assumes metaphysical relations between planets, metals and human organs, which provide the basis for therapeutic strategies. Diseases are believed to be related to actions in previous lives; in order to redeem oneself, it may be best to live through them without conventional therapy. Instead a range of other therapeutic modalities is employed in anthroposophic medicine: herbal extracts, art therapy, massage, exercise therapy and other unconventional approaches.
The best-known anthroposophic remedy is a fermented mistletoe extract which is used to treat cancer. Steiner argued that mistletoe is a parasitic plant which eventually kills its host – a striking resemblance to a malignant tumour which also lives off its host and finally kills him/her. His conclusion, therefore, was that mistletoe can be used to treat cancer. The concepts of anthroposophic medicine are biologically implausible.