01 Aug 2007 02:37 pm

Why We Fall For Alternative Medicine

I received a very interesting email from an acupuncturist a while back.

She related the usual anecdotal stories (including the one about major surgery being performed with only one needle in the ear for anesthesia) and then offered the following as the main point she wanted to get across:

“… having practiced acupuncture for 20 years … I know without a shred of doubt that acupuncture most certainly releases endorphins to relieve pain.”

All of which made for interesting reading, but unfortunately, did not even come close to changing my opinion about alternative medicine.

The reason her letter didn’t change my opinion is not because I’m just stubborn… or arrogant… or biased… or ignoring the facts… or (and this is my personal favorite) because I have “an unhealthy hatred for alternative medicine.”

No, all of those little gems are so silly… they’re not even worth addressing.

The simple fact is the reason I did not accept her argument is that it just wasn’t good enough. All she had managed to do was tell me that she’d fallen for the hook.

Every Hit Song Has to Have a Hook

It’s a well-known fact in the music industry that for a song to be popular, it has to have what we musicians refer to as “a hook.”

The hook is that memorable line from the chorus that keeps repeating over and over again in your head. It’s what makes the song instantly recognizable and tugs at your heart when you hear it on the radio.

  • It’s Tammy Wynette singing, “Stand by your man…”
  • It’s Paul McCartney singing, “Yesterday… ”
  • It’s Roy Orbison singing, “Pretty woman…”

Clever songwriters know it’s the hook that makes you remember the song and gets you to buy the CD.

Without a hook, the song will not make a lasting impression on your mind. You will not be impressed and… you’ll not only forget it quickly… you probably won’t even like it in the first place.

How Does This Apply to Alternative Medicine?

I’ve also noticed that the really successful alternative therapies also have a hook. In this case, it’s that one thing they can point to and say, “See… it works!”

The hook is usually a memorable sensation or amazing result that just sticks in your mind and makes you think, “Hey, it did something!”

You’re not really sure what… but it definitely did something… and that something is where the deception gets a hold of you. It’s what gets you to come back and buy the song-and-dance.

If the treatment didn’t do anything, there would be no basis to support the illusion. Without the hook, the therapy would never get off the ground. It would die out before it ever got started.

Some Example Hooks

Snake oil I’m told, was quite often just grain alcohol (Moonshine) or some other form of opiate.

With chiropractic, the hook is usually that satisfying popping sound and the brief pleasant sensation, which I’ve discussed in my articles on that subject.

With acupuncture that “something” is endorphins.

Now there is very little question that science has been able to observe an increase of endorphins in patients being treated with acupuncture. How this is accomplished (whether physically or psychologically) has not been clearly established. [1]

It’s worthwhile to note that the same results are obtainable with electrical stimulation, heat and even just pressure. [2]

This does not mean that acupuncture is a legitimate medical profession. It just means it does something… and that something appears to help relieve pain for some people.

Endorphins Don’t Cure Disease

Just because acupuncture can stimulate endorphins does not mean it can cure disease, heal an injury, or bring about world peace. It just means it does something.

Endorphins are natural chemicals produced in the brain that affect how you feel.

The fact that acupuncture causes an increase in these chemicals does not throw open the doors or grant permission to make wild exaggerated claims of miracle cures.

Endorphins can’t correct an underlying physical problem. There is no evidence that they can cure any known disease or have any effect on things like germs or viral infections.

Treating everything with endorphins would be tantamount to a medical doctor treating every patient with Valium. That would not be proper medical care… that would just be plain irresponsible.

It’s what a sane person would call quackery.

The Danger of Jumping to Conclusions

The problem with virtually all of the so-called alternative medical professions is that they ignore sound scientific principles. They base their conclusions on personal observations and assumptions about what those observations mean. In scientific terms… they rely entirely on anecdotal evidence.

In my vernacular, they’ve simply fallen for the hook.

The problem with acupuncture, chiropractic and any other alternative isn’t that it doesn’t do something. The problems begin when they start to translate that “something” into miracle cures for every known disease from cancer to whooping cough to HIV.

The problems are compounded when they try to build an entire medical profession around just one trick. And the real danger begins when people get so caught up in believing the hook that they turn to it instead of effective medical intervention.

This simply delays the patient from receiving proper medical care… and in some cases… has been known to result in death.

Don’t Let the Hook Trick You into Believing Nonsense

“Hey, I feel great… everything they say must be true!”

Wrong. The one does not equal the other. Just because they’ve discovered a clever trick that seems to do something… does not mean that everything they say is true.

For example, it has been observed that acupuncturists generally tend to diagnose everyone with the same unscientific maladies. These typically include such things as energy stagnation, qi stagnation… and my personal favorite… blood stagnation. [2]

Now I don’t have any formal medical training (and you doctors can correct me if I’m wrong) but I believe if you had blood stagnation… you would be dead.

So be wary when these practitioners start using nice sounding but obscure concepts for which no clear medical definition really exists.

When they start talking about such things as yin and yang, harmony, balance and energy fields that only they can detect… you can sit and listen if you like… but I’m gonna be late for the door.

Learn to Spot the Hooks

Hooks can be very seductive.

There’s no question that the right hook can turn a mediocre song into a hit single.

The same can be said for the hooks in alternative medicine.

Hooks make wonderful placebos. So wonderful, in fact, that even the practitioners are fooled by the results.

*****

References:

1. A Different Way To Heal – Scientific American Frontiers w/ Allan Alda

2. Be Wary of Acupuncture, Qigong, and “Chinese Medicine” – Stephen Barrett, M.D.

3. Why Bogus Therapies Often Seem to Work – Barry L. Beyerstein, Ph.D.

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27 Responses to “Why We Fall For Alternative Medicine”

  1. on 01 Aug 2007 at 3:32 pm 1.#1 Dinosaur said …

    Well said.

  2. on 01 Aug 2007 at 8:29 pm 2.Ileana said …

    A good friend of my husband is a homeopath and naturopath. He’s a really nice guy and he honestly believes inwhat he is doing.

    He lost me when he told me by phone from a couple thousand miles away that my back pain comes from an infection in my left kidney that he can feel. Needless to say the pack pain went away a few days later after my husband gave me a back massage.

    What’s scary is that they really believe in these things.

  3. on 01 Aug 2007 at 11:03 pm 3.Dean said …

    Thanks Dr. Dino.

    Ileana: Yes, it is scary to think that nice, honest, otherwise intelligent people can get caught up in the craziest things.

  4. on 02 Aug 2007 at 5:30 am 4.randolph said …

    Tremendous article. Should be part of the article selection on the home page.

    Another great medical idea to connect with placebo treatments like acupuncture and chiropractic is what doctors call the “natural progression of disease”… which is embodied in the observation that typically a cold will last, say, one week if you don’t do anything for it, and will last one week if you do any number of things like take echinacea, or think good thoughts, rub vick’s vaporub on your chest, or megadose on vitamin C, etc.

    The personal challenge, as usual, is to be objective about our cherished (but-obviously-wrong-to-everyone-but-ourselves) mis-beliefs.

    Randolph

  5. on 02 Aug 2007 at 5:20 pm 5.Terry at Counting Sheep said …

    Great article, Dean.

    As an anesthetist, I am trained in “Western” thought, and I practice Western principles. But I have always been fascinated by acupuncture.

    I personally saw an MD, who by the way was not a kook, get instant relief from chronic bilateral knee pain after a couple of needles were placed strategically in her forearm by an acupuncturist. She went from hobbling and limping to kicking her heels and walking without pain. She needed total knee replacements, and still does, but the acupuncture has bought her some time.

    I have also heard good news from people who have gone the traditional route (eg – back surgery, hip surgery) but are left with some chronic pain situations. Acupuncture has helped these people too, to avoid taking chronic pain meds and chronic physical therapy.

    I agree with your assessment that for some people acupuncture can just be a hook, a release of endorphins. But I do believe there is a time and a place for it. I’ve recently read about its use for hot flashes – there’s plenty of middle-aged women who may be interested in a hook like that (myself included!)

    Like I said, I’ve never used it, but it does fascinate me.

  6. on 03 Aug 2007 at 12:28 am 6.Dean said …

    Hey Randolph:

    Yes, this one is slated to go in the sidebar as part of the “Treatment Options” literature.

    Hey Terry:

    I’m glad you liked the article. I’m also gathering data for an article that will cover the positive studies that have been done on acupuncture… including treating back pain… since so many of my readers are interested in that subject.

    Like I said in the article, the hooks wouldn’t be very good hooks if they didn’t do something. We, as consumers, just need to be careful we don’t allow someone with a clever hook to convince us they’re a medical doctor.

    After all, I’m not against Moonshine… I just don’t think it should be sold as medicine. :-)

  7. on 03 Aug 2007 at 7:29 am 7.Ben USN (Ret) said …

    I don’t know, Dean, I tried moonshine for a sore throat and after the initial “my throat’s gonna melt!” moment, it was numb for awhile.
    I find that beer works better though, and is easier on the stomach.

    Plus, and this is a good safety tip, beer is not flammable. :^)

    Excellent post, Dean!
    Another way to counter pain is Tai Chi or Yoga, with the added benefit of calming the mind, working out the muscles and added flexibility, and it’s free.

    You probably have somethin’ in your archives about that, I bet.

  8. on 03 Aug 2007 at 9:22 am 8.Rob said …

    It all seems to depend on what you are treating. If you are finding a non-invasive way of treating arthritis of the knee, it is not all bad to try something like acupuncture. Why? Because it is not in itself dangerous and surgical intervention has risk.

    “Traditional” therapies have hooks as well. Nyquil’s hook is the alcohol in it. B-12 shots “give people energy.” Then there is the whole subject of anti-oxidants, which people feel is clearly scientifically shown to help people (Vitamin E, in fact, raised all-cause mortality in women). I have a hard time talking people out of taking their vitamin E.

    I am sometimes willing to give people B-12 shots, mainly because it does not cross my oath of “first do no harm.” I explain to them, however, that this is unscientific and may just be a placebo effect. They smile and accept that from me and still get the shot and swear it gives them energy. As long as they aren’t hurting themselves, I am OK with that.

  9. on 05 Aug 2007 at 11:37 am 9.fitline said …

    Now allthough I didn’t drill too much in to your post, i feel you got a genuine point. The problem is people donot want to waste time to look for the same medicine and come in the trap

  10. on 05 Aug 2007 at 4:28 pm 10.Sophie said …

    I really, really wish that more people would take this kind of approach to alternative medicine – I genuinely despair sometimes when I hear some of the “arguments” which are out forward to “prove” this or that treatment.

    I also despair because I suffer from IBS and therefore I hear from a lot of very vulnerable IBS sufferers who are desperate for a cure, so desperate that they throw their logic out the window. Anecdotal evidence rules, placebos don’t exist, and if it worked for your hairdresser’s mother then that’s proof it’s a proper therapy. What nonsense.

  11. on 07 Aug 2007 at 2:39 am 11.Grand Rounds at the Beach said …

    [...] Dean Moyer at Rebuild Your Back takes down alternative medicine and says that practitioners use endorphins as the “hook.” [...]

  12. on 07 Aug 2007 at 1:32 pm 12.MLO said …

    I suggest you do a Medline search that is not exclusive to the English language. You will find that there are several well-thought out studies that have shown benefits to acupuncture in some very specific circumstances. There are even preliminary studies showing that acupuncture – not herbs – can help relieve the symptoms of menopause. Just go to medpubs and plug in “acupuncture”. The rigor of the studies is just fine.

    Again, chiropractic is known to be beneficial in treating sports injuries. There is a reason athletes see them. I have never had a need to delve into the research surrounding chiropractic.

    No practitioner with his or her salt is going to tell you that acupuncture can cure everything.

    The problem with a lot of skeptics is that they have bought into the notion that drugging or cutting are the only solutions. They aren’t. Sometimes exercise and diet are better met to manage a disease. But, that is too much work for the average American.

    Pax,

    MLO

  13. on 07 Aug 2007 at 2:41 pm 13.David Bradley said …

    I had a seriously bad back, sciatica, pin prick pains in my foot, a leg permanently in spasm. A massage therapist, a sports physio, an osteopath, an acupuncturist and my own GP, all told me I was overdoing it at the gym and should ease off the heavy stuff and that I was causing repeated connective tissue damage getting referred pain, myofascial trigger points blah, blah, blah.

    An MRI revealed it was a prolapsed disc.

    A chiropractor treated accordingly.

    I walk straight and don’t feel five times my actual age any more.

    Not sure what I can conclude from this except that I know for a fact it wasn’t the release of endorphins that fixed it.

    db

  14. on 08 Aug 2007 at 12:48 pm 14.David Harmon said …

    A lot of alternative and “magical” therapies have similar hooks. Endorphins can be triggered not only by non-lethal pain (acupuncture, spicy food, SM), but by pressure or touch (massage, aquatherapy), foods (chocolate!), breath control (chanting, singing), exercise or even cognitive methods (meditation etc.). Note that disciplines such as some yogas or martial arts can combine methods, those last three especially!

    Of course, there’s still plenty of research to do on just what uses an endorphin rush actually has for medicine!

  15. on 16 Aug 2007 at 7:37 am 15.PalMD said …

    Wow…so well said. I never thought of the “hook” thing.
    What’s interesting is that some hooks actually hurt, smell bad, or have some other aspect that is more unpleasant than the real treatment.
    I always tell my residents to prescribe guaifenasin syrup for coughs…because it tastes bad. If it tastes bad, it’s gotta work, right?

  16. on 16 Aug 2007 at 4:30 pm 16.Dean said …

    Thanks for the comment PalMD. I hadn’t thought of the negative hook.

  17. on 17 Aug 2007 at 8:17 am 17.daedalus2u said …

    There is the danger of rejecting data because the explanation given by the person providing the data is completely bogus.

    People “fell” for alternative medicine before there were any explanations. Any explanation necessarily came after any observed therapeutic benefit. The “explanation” may be completely bogus, and have no basis in reality, and have no predictive power. But that doesn’t mean that the data (the observation) is bogus too.

    I go into quite some detail explaining the placebo effect.

    http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html

    We know that placebos do “something”, that puts constraints on what physiology must be like for placebos to do the “something” that they do. Placebos can only have an effect by affecting the actual physiological processes involved in disease and health.

    If those physiological processes are so easy to “hook into” that it can be done by purely psychological means, perhaps there are other means that would be more effective (such as raising basal NO).

  18. on 18 Aug 2007 at 7:03 pm 18.Dean said …

    Thanks for the comment and the link Daedalus2u.

    Very interesting article on the placebo effect. (Notice how I’m pretending I understood even half of it.) :-)

    Dean

  19. on 27 Aug 2007 at 9:59 pm 19.william said …

    I have lyme disease, and now a slipped back. I couldn’t help but take notice on this article. I followed traditional medicine for years, as I continually deterioratted and spiralled downward. It wasn’t until I changed diet, added mild hyperbaric, heat and certain supplements that I was able to start living a “normal” life again. Unfortunately, none of those are “cures”, so whenever leave one of them out, my symptoms return fast and furiously. All my “Western” docs thought I was nuts (even though all their treatments failed)! Alternative medicine has saved me from being homebound and destitute. Luckily, I found Alternative medicine, and I wouldn’t change it for the world. (This site isn’t exactly towing the Western medicine line either)!Just my opinion.

    William

  20. on 05 Jan 2008 at 6:35 pm 20.maryanne said …

    There is a time and place for everything.

    20 years ago I had debilitating RSI symptoms, and eventually I had a ganglion in my left wrist (like a hard pea under the surface). They are usually removed with surgery.

    3 sessions at an acupuncturist got rid of it.

    3 months ago, I got a ganglion in my right wrist. It was very hard and the local acupuncturist was hesitant to treat it as he says it can be quite painful, and he asked if I have ever had one before. I said yes, 20 years ago. I also let him know that how I handled childbirth labout and a few other life experiences has taught me I have a pretty good pain threshold, so I am willing for him to have a go. He said it was a very hard one. After 2 sessions it was gone.

    A book on homeopathy once put it all in a good perspective – start with alternative, non intervention methods and know when to get allopathic (standard western medical) help. And gave more information on that. I have used this strategy for 15 years now, including raising 2 children, and I have found where they help and where they don’t. And when unsure I check with my family physician. He still tries to persuade me to vaccinate my 2nd son – but I won’t. And my 2nd son has been sick heaps less than my first son and have only ever had anti-biotics once – he is 9.

    So – time and place for everything.

    Like your style Dean.

    Maryanne

  21. on 15 Jan 2008 at 4:23 pm 21.Faith said …

    I am very disappointed to see that many people immediately disrespect the effects and need for alternative medication. Sadly, those who “despise” the practice have never had the willingness to experience it.

    I have been treated by countless doctors for depression & anxiety, as well as ongoing sinus infections. My city is known for its wonderful doctors, yet I have been prescribed over 20 medications in the last 4 years… 3 of which have almost killed me.

    Instead of spending the rest of my life in a doctors office or a hospital, and taking medications that are damaging to my body – I am given an alternative to experience a BETTER way of life. So far, my acupuncturist, as well as my kinesiologist have been able to stabilize my anxiety and cure me of a sinus infection that I have battled for 10 years. Also, I cracked my tailbone and was projected to take 8 weeks to heal – instead, I healed in 3 weeks.

    Story upon story can be told by any of those that are open to the practice of alternative medication. After all, you cannot possibly think that your doctor cares enough about you to tell you that the medications he/she prescribes will damage your body… at the end of the day it’s the $ that they care about.

  22. on 16 Jan 2008 at 6:05 pm 22.Dean said …

    Hi Faith,

    I’m glad you’ve found something that you’re happy with.

    In my case, it was 10 years experience with worthless chiropractic treatment that started me down the road to critically examining alternative medicine. So far I have only heard (as you put it) “stories.” I have found no real evidence that any of it is anything but placebo.

    If it works for you, that’s fine. After all, at the end of the day, that’s what really matters. But I doubt that your acupuncturist cares so much for you that s/he is treating you for free.

  23. on 09 Feb 2008 at 9:46 pm 23.Teri said …

    Wow! I thought I was the only one left who wasn’t a big alternative medicine advocate. I have tried homeopathic, acupuncture, supplements, and most recently chiropractic. I believe the chiro injured my back further as I did not have the leg pain until my 3rd or 4th visit. My MRIs show degenerative disk disease, bulging disks in cervical and lumbar regions, bone spurs, and stenosis as well as major bulging disk at L4-L5. I sit all day at work plus have a 4 hour daily commute. I haven’t delved into your website much but I plan to. My plan is for physical therapy and exercise. I notice a huge amount of pain relief on days when I am more active, vs work days when I’m sitting.

  24. on 10 Feb 2008 at 12:10 am 24.Dean said …

    Hi Teri,

    Thanks for sharing your thoughts. I hope you will continue to keep us posted on your rebuilding efforts.

    I’ve posted a partial response to Maryanne’s comments here:

    Acupunture Cures a Ganglion Cyst

    I hope to have more on this subject in future blog posts.

  25. on 28 Nov 2008 at 11:48 pm 25.Heather Tavitian said …

    Ok, so we’re talking alternative medicine here, not just acapunture right?
    Well, why does it work?
    In my many years I’ve visited Chiropracs, herbalists and those Iridologists, massuese and GPs etc. One thing that the “Alternatives ” had that the average GP has long since forgotten about, is that they give you a little attention. You know, It’s a bit like the days of the hairdresser where you would go and tell all to a person that you would normally not be connected with in any other way whilst they are gently taking care of your appearance.
    Yup, I think “Alternatives” work because you can be attended to for all your idiosyncratic complaints and they feign to care! and isn’t that what good medicine is all about?

  26. on 06 Jan 2009 at 6:13 pm 26.Colleen P. said …

    I “fell” for alternative medicine when traditional western medicine could not help me, as I know many share this experience. After 14 years of suffering, I still am not getting the help I need – back pain and other issues. Acupuncture helps control my pain though I need it once per week. I don’t care how it works, it gives me relief for a while.

  27. on 03 Feb 2009 at 2:12 am 27.Marie E. said …

    Comment from a skeptical acupuncturist: What’s funny to me is that chiropractic school sounds similar or worse than acupuncture school as far as gaining experience, but it takes just as long – yet we don’t get to call ourselves “doctors of acupuncture” nor do we pretend we are doctors (at least I don’t). I’ve been personally injured by chiropractic and have seen patients who have been also. I don’t like talking about qi and energy and curing anything, (although I do have respect for a system that has been used for so long), and I just appreciate the benefits I see for a variety of disorders – while always relying on the “real” medical knowledge we were taught to make sure we do not harm.
    I do wish however that medical doctors exercised the same skepticism in their profession, especially when it comes to drugs. No matter how crazy some chinese theories sound to us after they’ve been translated, we cannot simply ignore huge masses of information that have been accumulated after centuries of using chinese herbs and formulas, and go and instantly accept a newly synthesized ultra-powerful drug which we’ve tested for maximum 10 years. Many modern drugs are “invented” after some of these Chinese herbs are researched and found to be helpful. Boiling them down to their “active compounds” changes their properties considerably, and we end up with many side effects the scientists never expected (vioxx, avandia, etc). I’ve also done “real” medical research and have seen how easy it is for all the research data which medicine relies on to be either skewed or misinterpreted for ulterior motives.
    My message: let’s be careful, and truly do the homework on EVERYTHING – there is no sense in accepting wild claims from alternative docs and rejecting all conventional medicine, but there is also no sense in rejecting all alternatives in the same bag and accepting all that western medicine tells you today. We do not know everything about the body yet. New things are still discovered everyday.

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