Alexander Technique..Validated alternative therapy.

[Justforfun000]

I've HEARD of this, but know nothing about it. Apparently I should if I ever grow into having back pain.

http://www.medicalnewstoday.com/articles/132945.php

Back Pain Solution For NHS - Economic Report Finds Alexander Technique Lessons Are Cost Effective For NHS, UK
Main Category: Rehabilitation / Physical Therapy
Also Included In: Complementary Medicine / Alternative Medicine; Pain / Anesthetics; Bones / Orthopaedics
Article Date: 15 Dec 2008 - 0:00 PST

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An economic evaluation published in the BMJ has concluded that Alexander Technique lessons are an effective and cost-effective option for the NHS[1].

The evaluation found that a series of six Alexander Technique lessons followed by an exercise prescription is more than 85% likely to be a cost effective option for primary care providers treating patients with chronic non-specific low-back pain.

The independent research, carried out at the University of Bristol, evaluated results of a recently published trial that showed Alexander Technique lessons have significant long-term benefits for back pain[2].

The analysis looked at NHS costs for the intervention, primary care contacts, outpatient appointments, in-patient hospital stays and medication, as well as personal and societal costs.

Significantly, researchers found that an prescription alone has only a moderate effect on the number of days a patient is in pain and massage is unlikely to provide a sustained improvement, whereas Alexander Technique lessons are effective in the longer term over a range of outcomes. It was concluded a series of six Alexander Technique lessons followed by an exercise prescription is the most effective and cost-effective option for the treatment of back pain in primary care.

The report's author, Sandra Hollinghurst, says: "The Alexander Technique could have a more lasting effect than either massage therapy or an exercise prescription due to the active teaching method used in the Alexander Technique lessons, which equips patients with life skills they are more likely to be able to use beyond the intervention period".

Back pain is one of the most costly reasons for patients to consult in primary care[3] - the research conservatively estimates annual UK production losses due to back pain are in excess of £3,000m. Non-specific back pain accounts for up to five million lost working days per year[4] and its overall cost on the NHS, business and the economy is £5 billion a year[5]. It is one of the most common conditions managed in primary care, a common cause of disability and affects general well-being and quality of life.

Kamal Thapen, chair of The Society of Teacher of the Alexander Technique (STAT) says: "We are delighted with the results of this report and hope policy makers will recognise the benefits the Alexander Technique can bring to the NHS. Patients with back pain should be offered one-to-one lessons with a STAT teacher, which will improve their body use, natural balance, co-ordination and movement skills, and to recognise and avoid poor movement habits that cause or aggravate their pain."

The evaluation compared the cost and outcomes of courses of six and 24 Alexander Technique lessons, six sessions of massage therapy and a GP prescription for home-based exercise with a nurse follow-up. Costs to the NHS were evaluated against the Roland Disability/Function score, which measures a patient's quality of life, days in pain and Quality Adjusted Life Years (QALYs).

Benefits of Alexander Technique lessons:

The Alexander Technique is a taught self-help method that helps people recognise, understand, and avoid poor habits affecting postural tone and neuromuscular coordination. Lessons involve an individualised approach designed to provide lifelong skills for self care that can lead to a wide variety of benefits.

Testimonials:

"Since beginning AT I have not had one session of physiotherapy. After over 30 years of back problems I no longer think of myself with a back problem!"
Melody Hirst, 58, retired. STAT Pupil Survey 2006

"It has made an enormous difference after 20+ years of constant pain."
Mike Gwillian, 38, part-time worker. STAT Pupil Survey 2006

"For the first time in years I no longer suffer from recurrent bouts of back pain."
James Krafft, 61, retired. STAT Pupil Survey 2006

"From a discal neck injury in 1990 I developed progressive spinal problems. By 2002 I had suffered mechanical neck and back pain, several episodes of nerve root pain at different levels with loss of power and reflexes in my arms. I saw 4 neurosurgeons who all recommended (different) neck operations. I then developed complex regional pain syndrome and could barely use my right arm. I was in unbearable pain and virtually unable to move my neck. I started taking Alexander Technique lessons and began to experience improvement and lessening of pain after some 12-15 lessons. I did regular Alexander Technique for about 4 years. Progressive improvement since 2003 such that I now have no neck or arm pain. Alexander Technique lessons from a good teacher are an effective technique and were instrumental in my recovery. Based on simple applied principles it can afford sustained relief from pain of spinal origin. It teaches the body to undo neuromuscular tensions and reduce strain in normal motor function; probably cost effective were it taught in primary health care. Welcome positive trial evidence."
Dr. Nick Mann, 45, GP. London

1. Society of Teachers of the Alexander Technique (STAT)

The Society of Teachers of the Alexander Technique (STAT) was founded in the UK in 1958. It is the world's oldest and largest professional body of Alexander Technique teachers. www.stat.org.uk

STAT Teaching members (MSTAT):

• Are certified to teach the Technique after successfully completing a three-year, full-time training course approved by the Society or an affiliated society.
• Adhere to the Society's published Code of Professional Conduct and hold professional indemnity insurance.

2. Economic Evaluation

Economic evaluation of the MRC ATEAM randomised controlled trial of Alexander Technique lessons, Exercise and Massage for chronic or recurrent back pain.

Sandra Hollinghurst, Debbie Sharp, Kathleen Ballard, Jane Barnett, Angela Beattie, Maggie Evans, George Lewith, Karen Middleton, Frances Oxford, Fran Webley, Paul Little

1. Academic Unit of Primary Health Care, University of Bristol, UK
2. Primary Care group, CCS Division, University of Southampton, UK
3. The Society of Teachers of the Alexander Technique, UK

Funded by The Medical Research Council ISRCTN: 26416991 (2000 - 2005)

Abstract: Objective: An economic evaluation of therapeutic massage, exercise, and lessons in the Alexander Technique for back pain.

Design: Cost consequences study and cost-effectiveness analysis at 12-month follow up of a factorial randomised controlled trial.

Participants: 579 patients with chronic or recurrent low back pain recruited from primary care.

Interventions: Normal care (control), massage therapy (MT), 6 Alexander Technique lessons (6AT), and 24 Alexander Technique lessons (24AT). Half of each group were randomised to GP exercise prescription and practice nurse behavioural counseling (EP).

Main outcome measures: Costs to the NHS and to participants. Comparison of costs with Roland-Morris score (number of activities impaired by pain), days in pain, and Quality Adjusted Life Years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. Results: Intervention cost range: £30 (EP) to £596 (24AT+EP). Cost of health services range: £50 (24AT) to £124 (EP). Incremental cost-effectiveness of single therapies: EP offers best value (£61 per point on Roland-Morris, £9 per additional pain-free day, £2,847 per QALY gain). Two-stage therapy, 6AT combined with EP is best value (additional £64 per point on Roland-Morris, £43 per additional pain-free day, £5,332 per QALY gain).

Conclusions: EP and 6AT alone are both more than 85% likely to be cost effective at values above £20,000 per QALY. 6AT performed better than EP on the full range of outcomes. A combination of a short series of Alexander Technique lessons followed by exercise is the most effective and cost-effective option for primary care providers.

[mr friendly guy]

where's the statistical p-value from the randomised control trial?

[Stark]

I love how it's an 'alternative therapy' to strengthen your lower back muscles and maintain better posture. That's EXACTLY what my GP told me to do when I suffered 'non-specific lower back pain'. ZOMG ALTERNATIVE.

[Hillary]

It has to be alternative as it doesn't involve drugs. It's common knowledge that Doctors only want to fill you full of pills and boost the profits of big pharma.

[Broomstick]

I think the "alternative" part comes in, in that it is not traditional physical rehab but rather relearning the proper way to move and it's a specific method. A method developed by an actor, apparently (I had to look up what this was) rather a doctor. Also, the UK health service apparently considers it alternative.

[Mr Bean]

I think the "alternative" part comes in, in that it is not traditional physical rehab but rather relearning the proper way to move and it's a specific method. A method developed by an actor, apparently (I had to look up what this was) rather a doctor. Also, the UK health service apparently considers it alternative.

The UK heath services also pays for magic water, the UK heath services is not by any means a good gold standard to go by.
More to the point this is a grey area to begin with. Like "non-specific back pain" or even back pain in general it's relieving symptoms not curing the condition.

I could make you stand ankle deep in ice cold water while poring sand over you and spraying you with jets of hot water while the sound of a busy street is played over speakers and cure some people's back pain. I made just that treatment on the spot, I'll call it, the Doctor Von Wolfgang procedure and charge you a thousand dollars per application and still I'd cure some people's back pain.

Of course I'd need to jazz it up a bit, the Sand of course would be from a local beach but I'd tell them it was from some far off place in Asia, the water would not be ordinary tap water but rather taken from Japanese mineral springs and the water would of course not just be the hot water that had gotten cold but rather the ice melt chipped directly from the Andes Mountains.

If you make shit up, put in a nice wrapper you can cure lots of stuff.

[Broomstick]

I think the "alternative" part comes in, in that it is not traditional physical rehab but rather relearning the proper way to move and it's a specific method. A method developed by an actor, apparently (I had to look up what this was) rather a doctor. Also, the UK health service apparently considers it alternative.

The UK heath services also pays for magic water, the UK heath services is not by any means a good gold standard to go by.

I never said it was - I merely stated that the UK NHS categorizes Alexander Technique as alternative. Whether or not it's considered that somewhere else is not touched upon in my statement.

More to the point this is a grey area to begin with. Like "non-specific back pain" or even back pain in general it's relieving symptoms not curing the condition.

For many people with back pain we don't have a cure - and if you can't cure a condition then treating the symptoms is an entirely reasonable course of action.

I could make you stand ankle deep in ice cold water while poring sand over you and spraying you with jets of hot water while the sound of a busy street is played over speakers and cure some people's back pain. I made just that treatment on the spot, I'll call it, the Doctor Von Wolfgang procedure and charge you a thousand dollars per application and still I'd cure some people's back pain.

Of course I'd need to jazz it up a bit, the Sand of course would be from a local beach but I'd tell them it was from some far off place in Asia, the water would not be ordinary tap water but rather taken from Japanese mineral springs and the water would of course not just be the hot water that had gotten cold but rather the ice melt chipped directly from the Andes Mountains.

If you make shit up, put in a nice wrapper you can cure lots of stuff.

All of which is irrelevant to a study that seems to show some effectiveness for this particular treatment. I would have to ask about the structure of the study, the size of the experimental and control group, and so forth to make any sort of evaluation.

Nonetheless, where weak muscles are a factor in back pain exercises promoting increased strength and flexibility ARE useful in treating said back pain. For that matter, alternating applications of hot and cold are also useful in treating joint and muscle pains. In other words, non-pharmaceutical and non-surgical treatments for back pain ARE proven to be useful in at least a sub-set of cases. In other words, this particular alternative therapy may have some use, and if these results are replicated it may well move from "alternative" to "conventional". Maybe.

[Mr Bean]

I never said it was - I merely stated that the UK NHS categorizes Alexander Technique as alternative. Whether or not it's considered that somewhere else is not touched upon in my statement.

Let me say it a bit clearer then, the fact that the UK NHS counts it as alternative is not a positive in it's favor considering the UK's rather shall we say science free stance towards "alternative" therapies

For many people with back pain we don't have a cure - and if you can't cure a condition then treating the symptoms is an entirely reasonable course of action.

The problem is the fact that such treatments normally exploit the pure placebo effect. There are not science based but as in my example, pseudoscience or out and out money-making fraud based. I know back pain is a serious issue and varies widely from individual to individual and considering how complicated the human spinal cord is, by default treating such pains required customization of treatment to the individual patient

All of which is irrelevant to a study that seems to show some effectiveness for this particular treatment. I would have to ask about the structure of the study, the size of the experimental and control group, and so forth to make any sort of evaluation.

It in fact shows no such thing

Let me quote a few bits at you.

The evaluation compared the cost and outcomes of courses of six and 24 Alexander Technique lessons, six sessions of massage therapy and a GP prescription for home-based exercise with a nurse follow-up. Costs to the NHS were evaluated against the Roland Disability/Function score, which measures a patient's quality of life, days in pain and Quality Adjusted Life Years (QALYs).

Participants: 579 patients with chronic or recurrent low back pain recruited from primary care.

Interventions: Normal care (control), massage therapy (MT), 6 Alexander Technique lessons (6AT), and 24 Alexander Technique lessons (24AT). Half of each group were randomised to GP exercise prescription and practice nurse behavioural counseling (EP).

costs with Roland-Morris score (number of activities impaired by pain), days in pain, and Quality Adjusted Life Years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. Results: Intervention cost range: £30 (EP) to £596 (24AT+EP). Cost of health services range: £50 (24AT) to £124 (EP). Incremental cost-effectiveness of single therapies: EP offers best value (£61 per point on Roland-Morris, £9 per additional pain-free day, £2,847 per QALY gain). Two-stage therapy, 6AT combined with EP is best value (additional £64 per point on Roland-Morris, £43 per additional pain-free day, £5,332 per QALY gain).

What did the study show? It's more cost effective to combine Alexander Technique lessons with standard medical methods than Massage therapy or more often but constant medical care. However it should be noted that per the data all three alternative treatments (MT, 6AT and 24 AT) were more effective than standard care.

Which is to say when they combined with standard medical care the Alexander Technique proved more cost effective than EP which is GP exercise prescription and practice nurse behavioural counseling. Or in other words it's cheaper and close to as effective to provide them with medical and a few classes on this Technique than it is to send them in to have a nurse check them over every week.

It was a heart an economic viability study, not a pure effectiveness study since there was no Alexander Technique only group all groups received some form of standard medical care(Including medication)

[Mr Bean]

So let me sum up, just shy of six hundred people, about a year in length and everyone stayed on standard medical care they were not testing Alexander VS modern treatments, but instead modern treatments plus Alexander VS just modern treatments VS modern w/massage treatment.

And it should be noted that sending them them all year to Alexander Technique classes provided only about 30% above just sending them for three months.

[Broomstick]

I never said it was - I merely stated that the UK NHS categorizes Alexander Technique as alternative. Whether or not it's considered that somewhere else is not touched upon in my statement.

Let me say it a bit clearer then, the fact that the UK NHS counts it as alternative is not a positive in it's favor considering the UK's rather shall we say science free stance towards "alternative" therapies

AGAIN - I was making a statement of FACT: The UK NHS counts Alexander Technique as an alternative therapy. Period. That statement contains NO JUDGMENT POSITIVE OR NEGATIVE. That is YOU reading something into my statement THAT IS NOT THERE.

In other words, read what I fucking wrote instead of what you want to hear.

For many people with back pain we don't have a cure - and if you can't cure a condition then treating the symptoms is an entirely reasonable course of action.

The problem is the fact that such treatments normally exploit the pure placebo effect.

If there is nothing else to offer - and conventional medicine is very unreliable in regards to treating back pain - please tell me why relief achieved through placebo somehow "doesn't count"? Of course actual therapeutic relief is preferred, but if someone derives relief from reciting a recipe for cupcakes every morning at 7 am I'm not going to take it away from them. Especially for anything involving chronic pain which standard medicine does NOT treat well at all over the long term.

There are not science based but as in my example, pseudoscience or out and out money-making fraud based. I know back pain is a serious issue and varies widely from individual to individual and considering how complicated the human spinal cord is, by default treating such pains required customization of treatment to the individual patient

All of which is irrelevant to a study that seems to show some effectiveness for this particular treatment. I would have to ask about the structure of the study, the size of the experimental and control group, and so forth to make any sort of evaluation.

It in fact shows no such thing

Let me quote a few bits at you.

The evaluation compared the cost and outcomes of courses of six and 24 Alexander Technique lessons, six sessions of massage therapy and a GP prescription for home-based exercise with a nurse follow-up. Costs to the NHS were evaluated against the Roland Disability/Function score, which measures a patient's quality of life, days in pain and Quality Adjusted Life Years (QALYs).

Participants: 579 patients with chronic or recurrent low back pain recruited from primary care.

Interventions: Normal care (control), massage therapy (MT), 6 Alexander Technique lessons (6AT), and 24 Alexander Technique lessons (24AT). Half of each group were randomised to GP exercise prescription and practice nurse behavioural counseling (EP).

costs with Roland-Morris score (number of activities impaired by pain), days in pain, and Quality Adjusted Life Years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. Results: Intervention cost range: £30 (EP) to £596 (24AT+EP). Cost of health services range: £50 (24AT) to £124 (EP). Incremental cost-effectiveness of single therapies: EP offers best value (£61 per point on Roland-Morris, £9 per additional pain-free day, £2,847 per QALY gain). Two-stage therapy, 6AT combined with EP is best value (additional £64 per point on Roland-Morris, £43 per additional pain-free day, £5,332 per QALY gain).

What did the study show? It's more cost effective to combine Alexander Technique lessons with standard medical methods than Massage therapy or more often but constant medical care. However it should be noted that per the data all three alternative treatments (MT, 6AT and 24 AT) were more effective than standard care.

If the "alternative" treatments were more effective than standard care why do you attribute that to a placebo effect? Seriously, if standard care can't stand up in comparison why the fuck is it standard? If combining standard care with an alternative therapy is more effective standard therapy alone then logically that is what we should do.

And why the fuck do you have a problem with cost-effectiveness? The same results for less money is usually considered a good thing.

Which is to say when they combined with standard medical care the Alexander Technique proved more cost effective than EP which is GP exercise prescription and practice nurse behavioural counseling. Or in other words it's cheaper and close to as effective to provide them with medical and a few classes on this Technique than it is to send them in to have a nurse check them over every week.

Then you should give them medical care and AT classes instead of using a nurse! How is that fraudulent or "money-making"?

It was a heart an economic viability study, not a pure effectiveness study since there was no Alexander Technique only group all groups received some form of standard medical care(Including medication)

That does NOT invalidate the study. If the purpose was to test which alternative therapies worked best with standard care then of course all groups must also receive standard care. And there is nothing wrong with economic viability or cost-effectiveness studies. The NHS tries to give the most care possible on a limited budget of course cost-effectiveness studies are needed to determine how to do this. It's no different than my choice of generic diphenhydramine rather than brand-name Benadryl to treat allergies - the former does the same job as the latter at half the cost.

In any case, just one study is NOT enough. Results must be duplicated in order to have scientific validity. That, in fact, is the biggest weakness of studies purporting to show effectiveness for alternative therapies - lack of reproducible results after a positive result.

I have often spoken out against alternative therapies on SD.net, but I am willing to examine evidence provided from legitimate studies and keep an open mind about some of it because some alternative therapies/theories do, in fact, have effectiveness or are true - at which point they become standard and no longer alternative. (Heliobacter pylori as a cause of stomach ulcers being a prominent example that comes to mind - originally heresy, now standard medicine). You, clearly, have a prejudicial bias against anything outside of current practice. Skepticism is a valid position, but not close-mindedness.

[Broomstick]

So let me sum up, just shy of six hundred people, about a year in length and everyone stayed on standard medical care they were not testing Alexander VS modern treatments, but instead modern treatments plus Alexander VS just modern treatments VS modern w/massage treatment.

Right - and it showed that adding the additional therapy to standard care was beneficial Why the fuck do you have an issue with that? We combine different medicines to treat cancer or HIV because the "cocktail" is more effective than any one drug alone. We prescribe diet changes AND exercise for weight loss. Why the FUCK do you have a problem with the concept that multiple therapies for back pain might be more effective than any ONE therapy alone?

If AT alone is not as effective as standard care, but standard care AND AT combined is more effective than either one then doctors should prescribe both.

And it should be noted that sending them them all year to Alexander Technique classes provided only about 30% above just sending them for three months.

So?

For an additional 30% improvement it may well be worth it to at least some patients to continue for a year. It may even be cost effective to do so.

I would conclude, based upon this study, that combining standard care with AT (or some of those other treatments) is well worth additional study so it may be either confirmed or refuted.

To sum up:

- I don't understand why you have an issue with cost-effectiveness studies.

- I don't know why you are opposed to combination therapies that are proven effective over single therapies alone.

- I don't know why you have a problem with symptom relief for disorders we for which have no definitive cure.

[Admiral Valdemar]

The UK heath services also pays for magic water, the UK heath services is not by any means a good gold standard to go by.
More to the point this is a grey area to begin with. Like "non-specific back pain" or even back pain in general it's relieving symptoms not curing the condition.

It has been demonstrated to be effective and is quite scientific. Anyone who has ever heard of sugar pills and good bedside manner will know it to be so. The fact that the water itself carries no active ingredient is totally irrelevant to the efficacy of the actual programme which is, as I say, quite good. Few could argue that playing with the psyche of a patient in order to garner a positive result is an unscientific or ignoble thing should it cure someone of their malady.

[Kanastrous]

My father had me start doing calisthenics and back exercises with him, when I was about ten.

Now that I'm older, I'm very grateful that he got me into that habit.

How there can be any room for argument over the basic idea that exercising a part of your body can help prevent or alleviate trouble there, is kind of perplexing.

[Broomstick]

It's the meme "RAR! ALL ALTERNATIVE MEDICINE IS BUNK!" running away with our friend, I think. Yes, a lot of it is garbage - but not all of it. Just because you have to wade through a lot of oysters to get a pearl doesn't make the pearl worth less.

[Mr Bean]

It has been demonstrated to be effective and is quite scientific. Anyone who has ever heard of sugar pills and good bedside manner will know it to be so. The fact that the water itself carries no active ingredient is totally irrelevant to the efficacy of the actual programme which is, as I say, quite good. Few could argue that playing with the psyche of a patient in order to garner a positive result is an unscientific or ignoble thing should it cure someone of their malady.

The problem is Vlademar is that the UK citizens are being taxed for fifteen dollars a pill sugar pills. Something that costs much less than that

It's quite one thing to take advantage of the placebo effect. It's quite another to spend sixty dollars a week to take advantage of that effect. It's being taken. Heck a quick check online finds that you can get a bottle of 50 sugar pills for about 2.50$. Or you can get some homeopathic painkillers for seven hundred and fifty dollars for the same sized bottle and send the bill on to the tax payers.

The problem with alternative therapies is not that they are alternative, but that they are science free. Look here we see a study in which they did not test the method on it's own. They tested it with standard medical treatments. Fine, did it validate the therapy? No, all this study shows that the Alexander Technique may.... MAY I stress improve the quality of life for back pain sufferers.

It in no way "validates" this "alternative" therapy, it's not alternative at all, if accepted it would become standard out patent style therapy.

[Broomstick]

It has been demonstrated to be effective and is quite scientific. Anyone who has ever heard of sugar pills and good bedside manner will know it to be so. The fact that the water itself carries no active ingredient is totally irrelevant to the efficacy of the actual programme which is, as I say, quite good. Few could argue that playing with the psyche of a patient in order to garner a positive result is an unscientific or ignoble thing should it cure someone of their malady.

The problem is Vlademar is that the UK citizens are being taxed for fifteen dollars a pill sugar pills. Something that costs much less than that

What does the cost of sugar pills have to do with Alexander Technique, which does not (as near as I can tell) involve pills at all?

The problem with alternative therapies is not that they are alternative, but that they are science free. Look here we see a study in which they did not test the method on it's own. They tested it with standard medical treatments. Fine, did it validate the therapy?

Yes, yes it did. You do NOT have to study AT all by itself to determine if combining it with standard therapy improves overall response. Standard therapy + AT is the experimental group, standard therapy alone the control group, and the variable is the addition or not of AT.

No, all this study shows that the Alexander Technique may.... MAY I stress improve the quality of life for back pain sufferers.

You obviously know jackshit about back pain and suffering to be so dismissive of improved quality of life

It in no way "validates" this "alternative" therapy, it's not alternative at all, if accepted it would become standard out patent style therapy.

Standard dismissiveness - all alternatives therapies are bad, and any that turn out to be beneficial aren't alternative so they don't count.

Yes, it actually DOES validate combining standard therapy and AT. Are you incapable of reading?

[Justforfun000]

You know, I generally think to myself whenever I post anything involving alternative therapies whether herbal, mechanistic or homeopathic that someone will be at the very least incredibly negative in their viewpoint towards the study no matter how good it is. I seem to be prophetically correct every time. I just might qualify for a "psychic" shingle.

[PainRack]

The problem is Vlademar is that the UK citizens are being taxed for fifteen dollars a pill sugar pills. Something that costs much less than that

Wasn't there a study that shows that the COST of the pills itself had some effects on the placebo effect?

http://jama.ama-assn.org/cgi/content/full/299/9/1016

Granted, too small a sample group but it is an avenue for further research.

[Vendetta]

It's quite one thing to take advantage of the placebo effect. It's quite another to spend sixty dollars a week to take advantage of that effect. It's being taken. Heck a quick check online finds that you can get a bottle of 50 sugar pills for about 2.50$. Or you can get some homeopathic painkillers for seven hundred and fifty dollars for the same sized bottle and send the bill on to the tax payers.

It's actually worth noting at this point that, contrary to what common sense might indicate, not all placebos are equal.

A meta-analysis by Daniel Moerman* of studies into medicines for gastric ulcers (handily measurable, you can tell whether an ulcer is there or not) which compared the effects of placebo in trials where the placebo dose was two pills versus four pills showed a statistically significant advantage in recovery rate to the four pill dose.

There's more even that that in play though, a study in 1972** measuring alertness levels in students after recieving a medication supposedly to promote alertness (all pills given were placebos) showed that there was a stronger response from a placebo pill with a pink sugar coating than an identical placebo with a blue sugar coating (and again showed that a higher "dose" provoked a stronger reaction and this was corroborated by at least two other studies into the effectiveness of anxiety medicine with different colours.

Another study*** showed that brand name painkillers actually are more effective than no-name versions of the exact same drug in the exact same dose precisely because people expect them to be, and that something as simple as the means of administration (capsule vs. pill, at the time capsules were "new" and more Science! than pills) can have a positive statistically significant effect.

So, it's not as simple as writing off the £40 sugar pill as being "the same" as the 1p sugar pill. It actually probably isn't, because the placebo effect comes from percieved effectiveness, not chemical content. The ceremony and ritual involved in a homeopathic sugar pill (the process of going to someone for a consultation, etc) might well make it more effective than one simply handed over with no expectation of effect. This is especially useful, as Broomstick has already mentioned, for chronic pain wherein there really is no effective long term chemical treatment which won't do more harm than it does good.

Percieved effectiveness even affects drugs with active chemical ingredients. Another study by Moerman**** examined results of 117 trials on ulcer drugs from 1975 to 1994, and found that over time the effectiveness of cimetidine dropped from 80% to 50% when given at the same dosage level. The only difference was that a new drug, ranitidine, had become available and was percieved as "better". The percieved inferiority of cimetidine to ranitidine as a treatment for ulcers actually made it worse at treating them. (The pattern repeated when ranitidine was itself surpassed by a newer drug)

* Med Anth Quarterly (August 1983) 14; 4: 3-16
** Lancet (10 June 1972); 1 (7763): 1279-82
*** BMJ (Clin Res ed) 1981; 282: 1576-8
**** Sem in Pain Med (March 2005); 3 (1 Spec issue): 2-6

[Justforfun000]

Percieved effectiveness even affects drugs with active chemical ingredients. Another study by Moerman**** examined results of 117 trials on ulcer drugs from 1975 to 1994, and found that over time the effectiveness of cimetidine dropped from 80% to 50% when given at the same dosage level. The only difference was that a new drug, ranitidine, had become available and was percieved as "better". The percieved inferiority of cimetidine to ranitidine as a treatment for ulcers actually made it worse at treating them. (The pattern repeated when ranitidine was itself surpassed by a newer drug)

That's really fascinating you know...It truly IS amazing how powerful the mind is on our body.

What's funny is that this idea what dismissed as alternative bunk back in the early part of the century. The subconscious mind was a crackpot theory. lol. Now the scientists argue the other way and tell you how strong the mind is on the body and you can't trust your own experiences.

[Graeme Dice]

Yes, it actually DOES validate combining standard therapy and AT. Are you incapable of reading?

The article makes no mention of whether the study was properly constructed, so you can hardly claim that it was validated.

[Sriad]

I took a semester of Alexander Technique lessons at my music school, and it would absolutely help reduce some kinds of back pain. The article's description

The Alexander Technique is a taught self-help method that helps people recognise, understand, and avoid poor habits affecting postural tone and neuromuscular coordination. Lessons involve an individualised approach designed to provide lifelong skills for self care that can lead to a wide variety of benefits.

makes it sound kind of bullshit, but the key is that it teaches people how to move and relax in physiologically efficient ways that place the least needless stress on tissues that didn't evolve for it. The skeleton is a load-bearing structure; AT lessons help correct habits that undermine its function. Someone who walks around hunched over with their skull thrust forward is using their body much less well than someone who walks upright, skull resting on spinal column, weight delivered to the ground directly through skeletal support structures with a minimum of needlessly tensed muscles.

It is simply the medically valid application of "Doctor, it hurts when I do this!" "So don't do that."

[Broomstick]

Yes, it actually DOES validate combining standard therapy and AT. Are you incapable of reading?

The article makes no mention of whether the study was properly constructed, so you can hardly claim that it was validated.

I mention several times that not only must the study be properly constructed but the results must also be replicated in order to be truly valid. However, assuming that is true, then this study validates standard therapy plus AT.

Although the mere fact there was actual control and study groups put it ahead of a lot of so-called studies of alternative therapies.

[FOG3]

It's the meme "RAR! ALL ALTERNATIVE MEDICINE IS BUNK!" running away with our friend, I think. Yes, a lot of it is garbage - but not all of it. Just because you have to wade through a lot of oysters to get a pearl doesn't make the pearl worth less.

Considering the organized Allopaths only stopped trying to "debunk" Chiropractors a few decades ago I'd file it under a misplaced stop order, personally.

Homeopathic thoery is the exact same principle vaccines use. The body isn't a dead thing. It can respond to threats within limits, but occassionally it can use a little help knowing what it's dealing with. Of course, Homeopathy is not designed to be used in the same way Allopathy is. It's designed for case-by-case system tweaks because everyones bodies respond to things differently.

The Homeopath would argue that the Allopath is the nutty one because they're slamming the system around actually encourages the system to fight the drugs effects to move back towards normalacy. They would point at the ever increasing dosage of Allopathic approach drugs as evidence of that. There's a good amount of validity to that, and there is always the issue of putting unnecessary load on the Liver and Kidneys will get you in the long run. There's something to be said for not using the sledgehammer for every little nail.

Plus it's not like the Allopaths have actually had something to show for themselves that actually helped you get better until very, very recently in terms of the overall history of medicine. The Homeopaths and traditional herbal remedies have been around a long time. Part of why I'm not calling the Allopaths "conventional."

Seems as how this technique would fall under Naturopath jurisdiction, criticizing the Homeopaths is kind of pointless. Homeopathy and Naturopathy are rather different approaches to handling a medical problem. As this isn't the out there type of Naturopathy criticizing as far as I can see largely just reveals people with something to prove feeling a need to run the mouth.

[Graeme Dice]

Homeopathic thoery is the exact same principle vaccines use.

They are the same, except, of course, that homeopathic medicines are nothing but water and rely entirely on the placebo effect, while vaccines rely on the ability of the immune system to react to antigens and remember previous threats.

Plus it's not like the Allopaths have actually had something to show for themselves that actually helped you get better until very, very recently in terms of the overall history of medicine. The Homeopaths and traditional herbal remedies have been around a long time. Part of why I'm not calling the Allopaths "conventional."

So what? Nobody but an ignorant fool would care how long something has been around for when determining whether it is effective. Scientific medicine works. Homeopathy is nothing but magic dressed up in fancier language.