Found a new prolotherapist WOW

Discussion in 'Injuries and Prevention' started by yannick35, Aug 19, 2010.

  1. Late for dinner

    Late for dinner Valued Member

    I do agree with you on this. As I mentioned it is not the needling but the stimulation of the nervous system that appears to be more important.

    I agree with you wholly. I have not made any suggestion that specialised training is necessary. Dr. Michael Smith was able to produce better clinical results than any psychological or pharmacological method when dealing with alcoholic recidivists when his research was presented more than 20 years ago. I know that the work of Dr Bruce Pomeranz on the physiological mechanisms in acupuncture and the relationship to the production of endogenous opiates has been show to produce chemical changes in rats that show reduced sensitivity to pain following acupuncture. Now these examples are not done using classical meridian theories but rather using chemical markers to see what mechanisms in the body might be present for controlling the body's response to injury.

    No one suggested that randomly applying toothpicks to the body produced the same effects as much as stimulating a de facto sensitive area with a stimulus would produce and effect. Different than the situation you have described. I like to think that the argument should be that you need to find out what produces the desired effect rather than dismissing it because it has not been explained yet. For example. My brother in law is a firm sceptic but under duress submitted to having some acupuncture because of suffering from a dental abscess. He reported complete cessation of any pain within 30 seconds of my applying the needles and was completely shocked at the effect. I am not a classical acupuncturist but it is hard to deny anecdotal accounts but I have seen this in a number of circumstances where the outcome was not what the patient or I expected. I am curious enough to try to find out more rather than rely on pure logic. I remember that at one time engineers were theorising that bees could not fly because their flight did not conform to classical aerodynamic theories.

    I find much of chinese medicine to be speculative and hard to justify. There are differences in the practices of acupuncturists from each of the major countries that use acupuncture. In spite of this the World Health Organisation recommends acupuncture as a treatment because of the relative low costs and complication rates. You may be failing to consider that if there is a chemical/physiological basis for acupuncture then you must consider that not all organisms will react similarly when testing medications and not all humans will react the same either. If you have a lower number of receptors in your body then you won't have a good response to a medication that requires that receptor. There have been studies that have shown that Naloxone , an opiate inhibitor used for drug over doses , suppresses the effects of acupuncture as it sits in the receptor site normally taken up by endogenous or other opiates.

    I commend you on your studies but have you equally looked at the medical acupuncture research?

    ''Biochemical theories

    Most of the scientific studies of acupuncture have been centered on the analgesic aspects of pain relief. Acupuncture is definitely effective in treating pain; it works 70% to 80% of the time, far greater than the placebo, which only has about 30% efficiency. (2) The problem with attributing all of acupuncture's effects to the placebo effect, which is based on a "suggestive way" or the fact that one just wants to believe that it works, was the fact that veterinarians in China have used acupuncture successfully to treat animals. (3)

    Dr. Bruce Promeranz, working at the University of Toronto, was very involved in research done on acupuncture analgesia. By activating small myelinated nerve fibers, acupuncture applications send impulses to the spinal chord, midbrain and pituitary-hypothalamus in the diencephelon. (4) Neurological research done in the late 70's discovered the naturally occurring chemicals in the body known as endorphins. (5) By binding to the opiate receptors that are found throughout the nervous system, endorphins are able to stop pain. The hypothalamus-pituitary releases Beta-endorphins into the blood and cerebral spinal fluid to create an analgesic effect by causing incoming pain signals from reaching the brain. Pomeranz discovered that pre-treating rats with a drug called Naloxone, a drug known to block the healing endorphins, could not achieve acupuncture pain relief. This finding suggested that endorphin release caused by acupuncture stimulus was an important mechanism behind acupuncture's pain relieving effects.

    Pomeranz was then interested in the effects of electrical stimulation and manipulation of acupuncture needles. What he also discovered was the difference between high frequency, low intensity vs. low frequency, high intensity application.

    The low frequency, high intensity produced an analgesic effect which was slower at the onset but longer in duration and also having cumulative effects. Therefore, repeated treatments produce more and more benefits for the patient.

    The high frequency, low intensity produced a very rapid analgesic effect, which is great for acute pain but shorter in duration with no cumulative effects. (6)

    There are presently 100 different neurotransmitters and neuroendocrine substances in the body, of which the endorphins constitute only one class. (7) Hence, there is much work to be done in testing and researching these chemicals and their possible effects with acupuncture.

    2. Scientific Basis of Acupuncture – B. Pomeranz Acupuncture
    textbook and Atlas, NY, NY 1987
    3. Vibrational Medicine for the 21 Century- Richard Gerber M.D.
    Eagle Brook, NY, NY 2000 – "Acupuncture and Chinese Medicine"
    4. "Can Western Science Provide A Foundation For Acupuncture"-
    Beverly Rubik, PhD. Alternative Therapies Magazine September 1995,
    Vol. 1 Number 4
    5. Vibrational Medicine for the 21 Century- Richard Gerber M.D.
    Eagle Brook, NY, NY 2000 – "Acupuncture and Chinese Medicine"
    6. Scientific Basis of Acupuncture – B. Pomeranz Acupuncture
    textbook and Atlas, NY, NY 1987
    7. "Can Western Science Provide A Foundation For Acupuncture"-
    Beverly Rubik, PhD. Alternative Therapies Magazine September 1995, ''
    Andrew Pacholyk MS, L.Ac

    There are a number of types of research: quantitative, qualitative etc.. of course that the double blind study is the gold standard but there are different types and levels of evidence. I think that I am also a skeptic but as I said before if we only used things that had passed this level of testing there would be very little done to help patients . Medicine is part art, part science .

    I am sorry but I think that this was my confusing your comments with another poster.

    I was going to ask this question to the other poster. What do you see as more effective? The National Institute on Clinical Excellence primarily recommends acupuncture, manipulation and exercise as the best treatments to offer patients with low back pain. I include all three in my practice. http://guidance.nice.org.uk/CG88/NICEGuidance/pdf/English What do you think offers a better treatment and has greater validity? Reviews in Spine are available that list the research, strength of evidence and recommendations for clinical use and needs for further research. http://www.shareclevelandla.com/files/Research/Literature_reviews/The_Spine_Journal_Jan-Feb_2008.pdf

    I think that you are jumping to a conclusion here. I don't know that a placebo would work just as well as prolotherapy, The articles in Spine suggest that 3 of the studies showed promising results but further research is needed. As far as controlled studies go there is the problem of sufficient funding, adequate patient numbers and the time and personnel to carry out such research, In physical medicine there is not the interest from large corporations as there is little money to made from the treatments applied. I agree with you that the best efforts must be made to see what is best practice but it is not clear that what has been done in the past is best practice, Would you decide that all medicine should be stopped ? Until we have reasonable studies then the conventional methods are in many ways just as suspect as the ones that still have not been adequately evaluated.

    I agree. In the circumstances we are looking at a person feels he has exhausted the methods that are non-invasive and decided to try something different out. All the discussion has done has achieved has been to isolate him further when he might have benefited from the knowledge and experiences of the persons on this forum. Personally I do not advocate any invasive treatment as a first choice.

    I am pointing out how easy it is to write something off because of poor design leading to a non-conclusive result. I also think that good research is needed. I just think that it is a practicality of practice that clinicians have to try to find methods that could be helpful and then these need to be evaluated on a larger scale. Otherwise where are the hypotheses going to come from as to what works? Only do what the researches say work? Might work in some fields but I am not sure that it would work in medicine.

    Agreed

    I am saying that you need to balance out what is available in an imperfect world and do your best with what is available at the moment. Research should guide treatment but until research is carried out thoroughly and in many circumstances the conclusions are often not very strong and clinicians have to use their judgement to find out what works. I think that you have over estimated what is available that has a strong evidence of efficacy.

    I think that if we want to discuss this any further then you should pm me as I will not be responding further on this thread. Thanks your your point of view.

    powchoy
     
    Last edited by a moderator: Aug 24, 2010
  2. CKava

    CKava Just one more thing... Supporter

    Glad we agree. I'm not convinced by the work of Pomeranz but I do agree that acupuncture is likely invoking some kind of physiological effect- it is sticking needles in people after all!

    Well the study I linked to showed that applying a tooth pick to the same point on a persons back produced the same amount of relief as a needle piercing the skin. This would seem to suggest that as long as the patient believes that the treatment is real acupuncture you can reproduce the clinical benefits supporting the case that acupuncture is a placebo. I would stand by 'random points' too as I believe there are a number of other studies which have shown that where you place the needles is irrelevant which you seem to have already acknowledged.

    But it's not being dismissed, it's the placebo effect.

    It's unlikely that your brother or the patients that came to visit you are immune from the placebo effect. The placebo effect can be dramatic in some people but we can't rely on anecdotes to confirm that something is producing an effect beyond the placebo since every single therapy in the history of medicine has produced a robust amount of anecdotal evidence that it works even when it is harmful i.e. blood letting.

    It's an urban myth: http://www.theness.com/scientists-report-bumblebees-cant-fly/

    Does the WHO recommend it? Can you link me?

    This seems to be a ready made excuse with which to dismiss negative findings. Also worth considering is that many of those who take part in acupuncture studies are individuals who have used it in the past and found it to be effective yet when blinded they seem to get the same benefit from sham treatments. It's not unheard of in medicine for treatments to only work on specific sub populations but there are ways to test this.

    This is Pomeranz again isn't it? If so it is the effects of electro-acupuncture on mice that he worked with which is important to distinguish from normal acupuncture. Also, Naloxone has been shown in studies to block the pain reducing effects of placebo treatments.

    Yes that is what I was referring to. I follow the research literature for acupuncture.

    There is an art to treating a patient but not to finding out what treatments are producing real effects. That part should be science based. Using things that have been reliably proven to produce real benefits is not a ridiculously high barrier, it is the minimum standard that we should employ in modern medicine. Again, I don't think you would be recommending drug treatments be recommended before they have been tested and proven effective so why the double standard for alternative therapies?

    I presume you are aware of the controversy surrounding the NICE guidelines and the composition of the board who decided on them?
    http://www.theness.com/neurologicablog/?p=546
    http://www.dcscience.net/?p=1542

    Physio, exercise, massage... not great but no better/worse than acupuncture/chiropractic and they avoid the pseudoscientific baggage that usually accompanies such therapies.

    I'm not saying abandon all prolotherapy- I am saying do more studies before promoting it. I highly suspect that the amount of money made annually by clinics from offering prolotherapy treatments would cover the costs of running small clinical trials. Also, I think it's ludicrous to suggest that there is no real financial interest in back pain treatments- back pain is one of the most common ailments and one of the most nebulous and recurrent so it is also one of the most potentially lucrative treatment areas. Look at chiropractors! You seem to be arguing that proving/investigating the efficacy prolotherapy should be down to the government or large corporations but I think the responsibility falls squarely on those promoting it as an effective treatment and making money from it.

    This is a commonly raised objection but it's simply not true. We do have good evidence for the effectiveness of a whole range of treatments and yes, the ideal should be that we change the treatments offered on the basis of the evidence (or lack thereof). If you look at the effect on mortality rates that modern medicine has had wherever it is introduced you see quite clearly that basing treatments on evidence is a good idea.

    Yannick has displayed the same pattern for years i.e. he comes on the forum promotes whatever therapy he is receiving and gets angry when anyone questions the evidence for efficacy or his reliance on anecdotes. He blows up, gets banned, then returns a few months later saying the people were right those guys were frauds and he has found a new chiropractor/physio/sports doctor offering a new miracle treatment. Cue the cycle starting again. This has happened about four times since I've been here and yannick reports that he has had back pains for nearly a decade. The conclusions I draw are that he yannick does not learn from his mistakes, doesn't appreciate advice that he doesn't agree with and he will eventually throw a tantrum if he hears enough things he doesn't like. The fact that people are still offering him advice despite this pattern after years is I think evidence that it is not the forum that isolates yannick but his personality.

    If you rely on anecdotal evidence then you end up with pre-modern medicine. Anecdotes should be the start not the end of the investigation into a treatment. I can think of few other fields where the need to rely on evidence is greater than in medicine.
     
    Last edited: Aug 28, 2010
  3. Late for dinner

    Late for dinner Valued Member

    As per the WHO etc there are always controversies when any organisation promotes a treatment and there will always be detractors. The evidence is still being collected but that is the nature of research and we will have to wait to find out the final conclusion.

    Statements by medical organizations

    Citing research that had accumulated since 1993, in 1997 the American Medical Association (AMA) produced a report that stated there was insufficient evidence to support acupuncture's effectiveness in treating disease, and highlighted the need for further research. The report also included a policy statement that cited the lack of evidence, and sometimes evidence against, the safety and efficacy of alternative medicne interventions, including acupuncture and called for "Well-designed, stringently controlled research...to evaluate the efficacy of alternative therapies."[101]

    Also in 1997, the United States National Institutes of Health (NIH) issued a consensus statement on acupuncture that concluded that despite research on acupuncture being difficult to conduct, there was sufficient evidence to encourage further study and expand its use.[5] The consensus statement and conference that produced it were criticized by Wallace Sampson, writing for an affiliated publication of Quackwatch who stated the meeting was chaired by a strong proponent of acupuncture and failed to include speakers who had obtained negative results on studies of acupuncture. Sampson also stated he believed the report showed evidence of pseudoscientific reasoning.[102] In 2006 the NIH's National Center for Complementary and Alternative Medicine stated that it continued to abide by the recommendations of the NIH consensus statement, even if research is still unable to explain its mechanism.[17]

    In 2003 the World Health Organization's Department of Essential Drugs and Medicine Policy produced a report on acupuncture. The report was drafted, revised and updated by Zhu-Fan Xie, the Director for the Institute of Integrated Medicines of Beijing Medical University, and contained, based on research results available in early 1999, a list of diseases, symptoms or conditions for which it was believed acupuncture had been demonstrated as an effective treatment, as well as a second list of conditions that were possibly able to be treated with acupuncture. Noting the difficulties of conducting controlled research and the debate on how to best conduct research on acupuncture, the report was described as "...intended to facilitate research on and the evaluation and application of acupuncture. It is hoped that it will provide a useful resource for researchers, health care providers, national health authorities and the general public."[14] The coordinator for the team that produced the report, Xiaorui Zhang, stated that the report was designed to facilitate research on acupuncture, not recommend treatment for specific diseases.[16] The report was controversial; critics assailed it as being problematic since, in spite of the disclaimer, supporters used it to claim that the WHO endorsed acupuncture and other alternative medicine practices that were either pseudoscientific or lacking sufficient evidence-basis. Medical scientists expressed concern that the evidence supporting acupuncture outlined in the report was weak, and that the report was evidence "[the] WHO has been infiltrated by missionaries for alternative medicine".[16] The report was also criticized in the 2008 book Trick or Treatment for, in addition to being produced by a panel that included no critics of acupuncture at all, containing two major errors - including too many results from low-quality clinical trials, and including a large number of trials originating in China where, probably due to publication bias, no negative trials have ever been produced. In contrast, studies originating in the West include a mixture of positive, negative and neutral results. Ernst and Singh, the authors of the book, described the report as "highly misleading", a "shoddy piece of work that was never rigorously scrutinized" and stated that the results of high-quality clinical trials do not support the use of acupuncture to treat anything but pain and nausea.[103]

    The National Health Service of the United Kingdom states that there is "reasonably good evidence that acupuncture is an effective treatment" for nausea, vomiting, osteoarthritis of the knee and several types of pain but "because of disagreements over the way acupuncture trials should be carried out and over what their results mean, this evidence does not allow us to draw definite conclusions". The NHS states there is evidence against acupuncture being useful for rheumatoid arthritis, smoking cessation and weight loss, and inadequate evidence for most other conditions that acupuncture is used for.[64]

    http://en.wikipedia.org/wiki/Acupuncture

    Lots of good points.... as I mentioned I am happy to discuss this topic further but I think we have used enough bandwidth on the forum for the moment so please direct further comments/critiques to me personally.

    Cheers,

    powchoy
     
  4. CKava

    CKava Just one more thing... Supporter

    I agree that there will always be controversies but I also think that there can be a problem with therapies being shown to produce very little effect yet continuing to be promoted with never ending calls made for further research i.e. homeopathy.

    Anyway, I agree I think we've covered quite a bit. If anyone else has points/comments I'm happy to respond but I'll leave it there for now. Cheers for the discussion!
     
  5. vandamme2011

    vandamme2011 Valued Member

    Typical post about people searching the internet and having no clue about what they are talking about.

    I disagree with all the flaming but i do have to make my stand on this.

    Back in 2005 i was in huge pain, my elbow and shoulder where suffering a lot. I played a lot of tennis when i was younger, badminton and softball. I was an avid weight lifter too and some times pushed myself a lot harder then i should.

    After going to various therapies and finding only temp relief a friend of mine introduced me to prolotherapy, i had doubt and was afraid of the needle injection. Note that cortisone shots where given to me in the past and they provided some relief but at some point the pain always came back.

    I had nothing to lose, so i gave it a try. The injection hurt, i had to call my wife to come pick me up because i could not drive. I was in so much pain for the first week.

    It took 4 treatments and very high dosage and about 5 months later i was pain free.

    I got treated in 2007 and it as been 3 years now, the pain as not come back and i feel great.

    Before surfing the internet and trying to make a point about something you people know nothing about, try to talk to someone who got the treatment done.

    From what i can see you people know nothing about prolotherapy, yet only the junk you have read on the internet.

    I was lucky to find a good prolotherapist, got a lot of injections and got a very high dosage, i am sure that like there are others that perform the therapy with smaller dosage and the patient will get nothing out of the treatment.
     
    Last edited: Jan 12, 2011
  6. holyheadjch

    holyheadjch Valued Member

    Until the results of more controlled studies have been released, scepticism is a perfectly reasonable stance to take.

    It's awesome that you're doing better, but until there is some evidence to the contrary, there is no way to say if your recovery had anything to do with the Prolotherapy treatment you were undergoing.

    Why exactly do you care so much if people don't think there is enough evidence to consider Prolotherapy a miracle cure?

    Edit: and that's 7k
     
  7. CosmicFish

    CosmicFish Aleprechaunist

    I'm glad it worked for you. My position on anything like this is not to disbelieve for no reason, but to remain open-minded but sceptical until scientific proof beyond a reasonable doubt can be presented to show that it works. Whereas your personal example is great news for you and I'm glad you're better now, a single anecdotal example does not provide adequate evidence that the procedure is what caused the improvement. There are two reasons for this. The first is that we only have a sample size of one. The second is is known as the post hoc ergo propter hoc fallacy (Link). In order for it to be proven it would need to be tested on many patients and be demonstrated to work more effectively than a placebo.

    I don't agree with the flamings either, but the majority of the arguments against it weren't so much "it's not true" but "it's not been proven yet". Unfortunately, Yannick didn't appear able to understand this distinction and got needlessly worked up at what he erroneously perceived to be an attack upon himself.

    For the record, I'm not against people claiming that something worked for them, so long as they are clear that the information is anecdotal. If I were in serious pain and conventional approaches had failed, I'd consider something like prolotherapy. If I got better afterwards I'd also be likely to post up about my experiences on the internet for the possible benefit of others. However, unlike Yannick, I'd be careful to stress that my experience is just anecdotal and I'd make sure to remain open minded to the possibility that it might have been a coincidence. I'd also like to think that that I'd have taken such criticism a lot less personally too.
     
  8. Suhosthe

    Suhosthe A dwarf! A dwarf!

  9. Gary

    Gary Vs The Irresistible Farce Supporter

    What do you call alternative medicines with evidence that they work?

    Medicine.
     
  10. vandamme2011

    vandamme2011 Valued Member

    Well to each is own i guess, this conversation is over, i cannot try to convince people like you and you cannot convince me either.

    But my point is by saying things like this, and someone is reading them, will not try prolotherapy as an alternate treatment, a treatment that as been working for many, but from people who know nothing about it just pasting junk off the internet that they found here and there might discourage a person in real pain.

    Prolotherapy as help a few of my friends as well, some with knee problems, lower back pains and upper back pain, foot pain and so much more, i even spoke to a women in her 60 due to have neck surgery and fusion that was saved by prolotherapy, and avoided surgery in the process. I took her around 12 treatments but today she as welll as many are pain free. Her neck posture was a mess, she had her chin between her boobs, sort to say. Prolotherapy was able to fix the posture issue, she was also given strength exercises after the treatment to rebuild the lost muscle strength.

    Before posting utter crap and thinking you are intelligent, and wanting to sound like it, experiment the real thing on yourself then come back and give your personal feedback.

    You people talk like God gave you is hand in blessing. Its a sin
     
    Last edited: Jan 12, 2011
  11. holyheadjch

    holyheadjch Valued Member

    Who's trying to convince you of anything? You want to spend vast sums of money on a treatment that may or may not be a scam, fine, go for it, it's your money.
    The type of people willing to spend hundreds or thousands of dollars on an untested medical treatment aren't going to be dissuaded by...well, anything. Acupuncture has been shown to be ineffective multiple times, but people still hand over the dough.
    I had some pretty gnarly hip issues (or what VZ might call a paper cut) last year and no matter what I tried, it didn't go away. Then, after months and months. It did. Had I been undergoing prolotherapy at the time, perhaps I would have credited it with my recovery. My point is that just because an injury/sickness gets better whilst you are undergoing some form of treatment, doesn't mean that it was due to the treatment. People spent hundreds of years balancing their humours because it appeared to help people. It was complete hogwash, of course, but there was no double blind studies to help point this out back then.
    That's not how science works. I'll review the results of the double blind studies when they are released and then we'll see. But you're right, I do think I'm intelligent.
    Say what?

    You know, we've had two people in this thread receive prolotherapy and both of them have acted like petulant children. Maybe we should start examining the potential side-effects of this treatment.
     

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