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Ayurvedic Therapy-  Practiced in India for more than 5000 years, Ayurvedic tradition holds that illness is a state of imbalance among body systems that can be detected through diagnostic procedures such as reading the pulse and observing the tongue. The use of a multitude of therapies are used including enemas, purgation, modified fasting, dietary advice, lifestyle advice, manual treatments, phytotherapy, yoga, meditation, and music/mantra are used as treatments to address nearly all diseases treated by western medicine. Human clinical trials for osteoarthritis show large clinical and statistical effects for the medication Rumalaya compound and to a lesser degree Shunti-Guduchi are useful. (Rheumatol Int 2015 Feb:35(2) 211-32.  There is some evidence Bacopa monnieri has strong antidepressant effects and pain killing effects.  It utilizes the Cox-2 inhibitory mechanism (same as Celebrex) and augments morphine analgesia, opioid induced hyperalgesia, and is a moderately powerful pain medication. (Curr Med Chem 2013;20(8):1028-37).    Other anti-inflammatory and pain killer meds include Adiantum capillus veneris Linn and Mesua ferrea Linn (Cobra’s saffron).   Polyherb therapy for rheumatoid arthritis has been demonstrated with Tinospora cordifolia and Zingiber officinale (Clin Rheumatol 2012 Feb;31(2):259-269).  There is animal model evidence of the analgesic and hypnotic effect of Laghupanchamula in rats (Ayu. 2014 Jan;35(1):79-84).  There are safety concerns with this medication as there have been reports of lead poisoning with Ayurvedic medications given that they are not assayed for safety (J Gen Intern Med 2012 Oct;27(10):1384-6,  J Hematol Oncol 2011 Dec 20;4:51,   Acta Clin Belg 2008 Jan-Feb;63(1):42-45,  N Z Med J 2006 May 5:119(1233):U1958,  Ned Tijdschr Geneeskd 2005 Dec 24:149(52);2893-6,   Med Klin (Munich) 2004 Aug 15;99(8);476-80

Painbytes assessment: neutral: safety concerns of lead poisoning are real however, there are several well constructed studies demonstrate effectiveness.

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Bach flower therapy- this therapy was devised by “Doctor” Edward Bach, a homeopath, who devised a system of treatment of emotions with 38 flower essences.  Flower essences are prepared by a sun method involving floating the flower heads in pure water for three hours in direct sunlight or boiling the woodier plants and those that bloom when the sun is weak.  Once the “energy of the flowers has transferred to the water, the energized water is mixed with an equal quantity of brandy”.  This becomes the “mother tincture” that is further diluted into brandy at a rate of two drops of mother tincture to 30ml of brandy to make the stock bottles seen in shops.  These “flower essences” are paired with a Bach list of remedies- for instance Aspen is used to treat the “fear of unknown things”, Cherry Plum is used to treat the “fear of the mind giving way”, Chicory for “selfish, possessive love”, Clematis for “dreaming of the future without working in the present”, Gorse for “hopelessness and despair”, Holly for “hatred, envy and jealousy” and so on.  The Bach center in Mt Vernon offers courses in the system including becoming a practitioner, becoming a licensed trainer, Level 1-3 courses, and courses on “How to Build Your Business” in Bach therapy.  Since Bach was a homeopath, there is no alpha or beta scientific evidence any of these treatments, consisting mainly of alcohol, actually work.  There are some delta level uncontrolled trials  (eg. I gave then flower therapy and they got better) such as a Spanish publication “Emotional support and Bach Flower Therapy (Rev Enferm 2009 Oct;32(10):16-9) and a non abstracted opinion on the use of the therapy in the treatment of chronic major depressive disorder (Altern Ther Health Med 2003 Nov-Dec;9(6):112, 108-10.)   Recommendation- avoid due to the lack of scientific evidence and the mercenary nature of marketing this alcoholic product.

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Balneotherapy- the treatment of disease by bathing or immersion in mineral water or mineral-containing mud, a traditional medicine technique practiced at spas, and part of several traditional folk medicine treatments.  Balneotherapy may involve hot or cold water, massage through moving water, relaxation, or stimulation.  It is distinct from hydrotherapy, but there are some overlaps.  Balneotherapy has been used to treat many diseases including arthritis, fibromyalgia and for relaxation.  Another type of balneotherapy uses medicinal clays and is known as fangotherpy.  There is one quality RCT showing balneotherapy was superior to paroxetine (Paxil) for generalized anxiety disorder (Adv Ther 2018 Mar 5. Doi: 10.1007/s12325-018-0680-6).    There is some alpha level evidence of effectiveness.

      There are mixed results on cortisol levels with balneotherapy (Int J Biometerol 2018 Feb 18:doi:10.0007/s00484-018-1504-8).  Baleotherapy is clinically effective in relieving pain and stiffness in osteoarthritis of the knee, and improving function in a meta-analysis (Clin Rheumatol 2017 Aug;36(8):1839-47).   There is insufficient evidence to recommend balneotherapy for the treatment of rheumatoid arthritis (Eur J Phys Rehabil Med 2015 Dec;51(6):833-47).  For fibromyalgia syndrome, balneotherapy results in a small reduction in pain and large quantity of improvement of Quality of life) (Arthritis Res Ther, 2014 Jul7;R 141).  Balneotherapy results in an improvement short term for knee osteoarthritis (Clin Rheumatol 2009 May;28(5):501-7)

 

Bee sting therapy- see apitherapy

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Biodanza- a Spanish neologism meaning life-dance.  This is a system of self-development, using music, movement, and positive thoughts to deepen self awareness, and thereby promotes the ability to make a “holistic link to oneself and one’s emotions and express them”.   Biodanza is the Hispanic equivalent to Tai Chi, but with more movement.  There are schools of Biodanza in San Francisco and LA.  Biodanza has 4 “lines” of vivencia (living in the present moment): vitality, sexuality, creativity, and affectivity.  Additionally there is transcendence, which means connecting to something greater in the universe.  There are some studies on biodanza, a delta level study showing biodanza reduces acute pain severity by 16%  in women with fibromyalgia (Pain Manag Nurs 2017 Oct;18(5):319-27).  There is a biodanza beta level RCT demonstrating significant reduction of stress and depression in university students (J Altern Complement Med 2017 Jul;23(7):558-565).  However there was also a gamma level fibromyalgia study that found biodanza inferior to multidisciplinary therapy (Acta Reumatol Port 2012 Jul-Sep;37(3):240-50).  Lastly, there was a RCT for fibromyalgia (beta level) that was invalid due to a high dropout rate using aqua-biodanza for treatment of fibromyalgia. (Aten Primaria 2012 Nov;44(11):641-9)

 

Bioenergetic therapy – is a form of body psychotherapy developed by Alexander Lowen and John Pierrakos, students of William Reich.  The idea behind this treatment is that blocks to emotional expression and wellness are expressed in the body as chronic muscle tensions that are often subconscious.  The blocks are treated by combining bioenergetically designed physical exercises, affective expressions, and palpation of the muscular tensions.   The therapist “reads the body of the patient, resonates with its energy, feels the emotions, listens, hears and answers the words. This therapy is supposedly used in sexual healing.   There is no scientific evidence of efficacy.   Painbytes assessment: all energy healing therapies have no basis in science, have no proof of efficacy, and using such systems to diagnose and direct therapies are dangerous since they delay or misdiagnose disease.  Two thumbs down.

http://www.bioenergetic-therapy.com/index.php/en/

 

Biofeedback: A medical technique used especially for stress-related conditions, such as asthma, migraines, insomnia, and high blood pressure, biofeedback is a way of monitoring minute metabolic changes in one's own body (for example, temperature changes, heart rate, and muscle tension) with the aid of sensitive machines. By consciously visualizing, relaxing, or imagining while observing light, sound, or metered feedback, the client learns to make subtle adjustments to move toward a more balanced internal state.

 

Biomagnetic pair- is also called “medical biomagnetism” and is touted as a “natural therapy that purposes diagnosing and treating a large number of illnesses throuth the use of pairs of magnets of medium intensity that seek to equalize the organism’s pH level.”  This is another bizarre concept that has no foundation in science since the pH of an organism is completely independent of magnetic or energy fields.  It is claimed “a large number of illnesses, including cancer and many other complex diseases, are associated with fundamental alterations in the pH level in the internal organs and with the presence of viruses, bacteria, fungus, parasites, toxins, and other harmful factors.  The development of illness cannot happen with a balanced pH level.”  The claims are that unlike magnet therapy, the Biomagnetic Pair uses pairs of magnets of opposite charges to depolarize areas in the body that are unbalanced due to pathogens or other factors that resonate energetically and vibrationally.  They also claim the biomagnetic pair can diagnose the etiology and combat the real causes of the diseases, especially viruses, even before symptoms of disease occurs.  The system, developed by a Mexican doctor, uses 350 different biomagnetic pairs that cover most of the glandular dysfunctions, diseases, emotional issues, syndromes, and illnesses. 

There is no science, no validated studies, and little logic in this therapy.

Painbytes assessment: Two thumbs down.

http://biomagnetism.net/biomagneticpair/

 

Biomagnetic therapy- see biomagnetic pair

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Bioresonance therapy- see biomagnetic pair

 

Bovine cartilage products-  aka Antitumor Angiogenesis Factor (anti-TAF), Bovine Tracheal Cartilage (BTC), Cartilage Trachéal de Bovins, Cartílago Bovino, Catrix, Catrix-S, Collagen Bovine, Collagène Bovin, Glycosaminoglycan Polysulphuric Acid Complex, Processed Bovine Cartilage, Psoriacin, Psoriacin-T, Rumalon.  These are cow derived cartilage used to treat a variety of diseases.  The theory behind their use is that they contain chondroitin and glucosamine- two building blocks of cartilage.  Some of these products (supplements) are very expensive, especially in combination with other components.  There are no significant quality studies linking bovine cartilage to significant improvements in disease.  It is possibly effective in treating poison oak and ivy, treating acne, skin psoriasis, hemorrhoids and anal itching, rheumatoid arthritis, dry socket after tooth extraction.   It may be effective in some cases of osteoarthritis.  But overall, it is very questionable.  Aetna considers it experimental.

http://www.medicinenet.com/bovine_cartilage/supplements-vitamins.htm

 

Cao Gio- also known as "coin rubbing" or "coining", is practiced throughout Southeast Asia (esp. Vietnam and Thailand) and by immigrants from such areas to the US and other countries.  Literally, "Cao Gio" means catch the wind.  In the Southeastern Asia belief, the "wind" is a "body force" or humor that is  imbalanced. An excess of "wind" in the body can be released by pulling the "wind" to the surface of the body, creating a pathway in which it can be released.  Cao Gio uses a coin to create abrasion lines of the skin, extending from the spine outwards along the path of the ribs.  The body is first treated with an oil (eucalyptus, peppermint, cinnamon, winter green, menthol, camphor) or ointment or balm (such as Tiger Balm), then the edge of a coin makes linear red abrasions of the skin over and over again .  The amount of "wind" is measured by the degree of redness appearing on the body after coining, that also measures the severity of the illness.  If the red marks are mild, then the underlying illness is mild.  If the marks are severely red, then there is much "excess wind" and the disease is major. The long red marks on the back (up to 20) fade after a few days.  Cao Gio is used to treat a variety of illnesses such as aches, pains, fevers, colds, cough, nausea, abdominal pain, chills and symptoms related to changes in the weather.  

     Levels of evidence: There is no alpha, beta, gamma, or delta evidence of effectiveness.  

Also see gua sha, a closely related technique used in China and Korea, except a sharpened object is used to create the dermabrasion rather than a coin. 

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Cellular therapy – This is not the same as human stem cell therapy.   It is instead a treatment with animal cells, also called live cell therapy, cellular suspensions, glandular therapy, fresh cell therapy, siccacell therapy, embryonic cell therapy, and organotherapy -- refers to various procedures in which processed tissue from animal embryos, fetuses or organs, is injected or taken orally. Products are obtained from specific organs or tissues said to correspond with the unhealthy organs or tissues of the recipient. Proponents claim that the recipient's body automatically transports the injected cells to the target organs, where they supposedly strengthen them and regenerate their structure. The organs and glands used in cell treatment include brain, pituitary, thyroid, adrenals, thymus, liver, kidney, pancreas, spleen, heart, ovary, testis, and parotid. Several different types of cell or cell extract can be given simultaneously -- some practitioners routinely give up to 20 or more at once.  The treatment is dangerous and has resulted in many deaths and serious immunological reactions.  It is not only experimental but is overtly hazardous and should be avoided. It is sometimes promoted in the US by Naturopaths, a sort of alternative medical system doctor that has not gone to medical school.  The original use of cellular therapy was in 1912 when German physicians attempted to treat hypothyroid children with thyroid cells.  Paul Niehans MD, a Swiss physician was known as the “father of cell therapy”.  The clinic he developed in Clarens-Montreaux Switzerland continues to attract patients at the tune of $10,000 per week.  John Brinkly MD began doing operations implanting men with tissue from goat testicles in 1917 and by 1941 had his license to practice revoked due to quackery.  The technique was used in Tijuana Mexico where clinics continue, since 1970.  Unwitting patients will travel there to “build the immune system” and “help patients” with Down’s syndrome, Alzheimer’s disease, epilepsy, AIDS, and various other diseases.  Of course there are no scientific studies of significance to support the use of this bizarre therapy.

Painbytes assessment: Two thumbs down.   Experimental, no data on safety or efficacy, shady practices.

 

Chakra Healing- Chakra healing is an energy field therapy that uses the concept of the 7 major chakras or energy centers, that are located in the midline from above the head to below the pelvis.  They are defined as the “openings for life energy to flow into and out of our aura. Their function is to vitalize the physical body and to bring about the development of our self-consciousness. They are associated with our physical, mental and emotional interactions. “  They are invisible but “can be perceived intuitively by trained energy workers.” The energy workers claim to be able to determine which chakras are functioning properly and which are working overtime.  The theory is that if some of the chakras are performing at a reduced level, the others have to pick up the slack, leading to a “blowout” of a healthy chakra. There is little proof there is any validity to the technique, a paucity of studies that are of low quality, and many “case studies” subject to bias.  Chakra healing for pain has not been demonstrated by scientific standards to be effective.

Painbytes assessment: energy therapies are largely quackery since there is no scientific proof they work.  Should be avoided.  Two thumbs down. 

 

Chelation therapy: Typically administered in an osteopathic or medical doctor's office, chelation therapy is a series of intravenous injections of the synthetic amino acid ethylenediaminetetraacetic acid, designed to detoxify the body of heavy metals. While the treatment often is used to treat arteriosclerosis, or hardening of the arteries with little evidence of effectiveness.  However in recent times, chelation has been used as a treatment for fibromyalgia in a series of 20-30 treatments over several months.  These are expensive treatments, costing thousands of dollars for the series, usually are offered by doctors preying on the desperation of those with fibromyalgia, but with no scientific evidence of effectiveness.  The treatment can also be hazardous due to removal of essential elements of the body.

Painbytes Assessment:  Two thumbs down

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Chinese Pulse Diagnosis-  In Traditional Chinese Medicine (TCM) , before acupuncture, herbs and massage are prescribed, a diagnosis is made from evaluation of the pulse and examination of the tongue.  Pulse diagnosis is not at all similar to evaluation of pulse in modern medicine, instead is a perception of energies flowing through the body and any obstruction to such flow. From the work of Stephen Barrett, MD it can be seen the diagnosis and therapy prescribed varies wildly from one TCM practitioner to the next, even when they have years of training. 

"Researchers who examined 16 TCM acupuncture texts or treatment articles to determine the consistency of diagnosis and recommended treatment for chronic low-back pain. Although 24 diagnostic patterns were described by one or more texts, only 4 patterns were described by at least half of them. Most texts (12/16) described only 3 or 4 patterns. The patterns could be categorized into 3 broad types:

1. Cold, damp, wind, heat channel obstruction patterns

2. Kidney vacuity patterns (sometimes differentiated into yang and yin patterns)

3. blood (or blood and qi) stasis patterns.

Several acupuncture points were recommended by most texts regardless of the diagnosis, whereas other acupoints were recommended for specific diagnostic patterns. There was, however, substantial variation between texts in recommended acupoints, with fewer than 20% of all acupoints recommended by half or more of the texts [1].

In a study published in 2001, a 40-year-old woman with chronic back pain who visited seven acupuncturists during a 2-week period was diagnosed with "Qi stagnation" by 6 of them, "blood stagnation" by 5 , "kidney Qi deficiency" by 2, "yin deficiency" by 1, and "liver Qi deficiency" by 1. The proposed treatments varied even more. Among the six who recorded their recommendations, the practitioners planned to use between 7 and 26 needles inserted into 4 to 16 specific "acupuncture points" in the back, leg, hand, and foot. Of 28 acupuncture points selected, only 4 (14%) were prescribed by two or more acupuncturists. [2]. The study appears to have been designed to make the results as consistent as possible. All of the acupuncturists had been trained at a school of traditional Chinese medicine (TCM). Six other volunteers were excluded because they "used highly atypical practices," and three were excluded because they had been in practice for less than three years. The study's authors stated that the diagnostic findings showed "considerable consistency" because nearly all of the practitioners found Qi or blood stagnation. However, the most likely explanation was that these are diagnosed in nearly everyone.

In another study, six TCM acupuncturists evaluated the same six patients on the same day. Twenty diagnoses and 65 acupoints were used at least once. The diagnosis of "Qi/Blood Stagnation with Kidney Deficiency" and the acupoint UB23 were used for every patient by most acupuncturists. However, consistency across acupuncturists regarding diagnostic details and other acupoints was poor. No diagnoses, and only one acupoint, were used preferentially for a subgroup of patients. Some diagnoses and treatment recommendations were dependent more on the practitioner than on the patient. Fine-grained diagnoses and most acupoints were unrelated to either patient or practitioner. The researchers concluded that TCM diagnoses and treatment recommendations for specific patients with chronic low back pain vary widely from one practitioner to another [3].

Another study examined TCM diagnoses and treatments for patients with chronic low-back pain using two separate sets of treatment records. Information from more than 150 initial visits was available for analysis. A diagnosis of "Qi and Blood Stagnation" or "Qi Stagnation" was made for 85% of patients. A diagnosis of kidney deficiency (or one of its three subtypes) was made for 33%-51% of patients. Other specific diagnoses were made for less than 20% of the patients. An average of 12-13 needles was used in each treatment. Although more than 85 different acupoints were used in each data set, only 5 or 6 acupoints were used in more than 20 of the treatments in each data set. Only two of those acupoints (UB23, UB40) were the same for both sources of data. More than half of the patients received adjunctive treatments, including heat (36%-67%), and cupping (16%-21%). There was substantial variability in treatments among providers [4].

In a larger study published in 2004, three TCM practitioners examined the same 39 rheumatoid arthritis (RA) patients separately at the University of Maryland General Clinical Research Center. Each patient filled out a questionnaire and underwent a physical examination that included tongue and pulse diagnosis. Then each practitioner provided both a TCM diagnosis and a herbal prescription. Agreement on TCM diagnoses among the 3 pairs of TCM practitioners ranged from 25.6% to 33.3%. The degree to which the herbal prescriptions agreed with textbook recommended practice of each TCM diagnosis ranged from 87.2% to 100%. The study's authors concluded:

The total agreement on TCM diagnosis on RA patients among 3 TCM practitioners was low. When less stringent, but theoretically justifiable, criteria were employed, greater consensus was obtained. . . . The correspondence between the TCM diagnosis and the herbal formula prescribed for that diagnosis was high, although there was little agreement among the 3 practitioners with respect to the herbal formulas prescribed for individual patients [5].

The University of Maryland researchers then repeated the above study using 40 RA patients and three practitioners who had had at least five years of experience. The results were nearly identical to the previous findings [6]."  Therefore pulse diagnosis not only results in significant disagreement, but the applied use of therapies also varies wildly, bringing into question both the diagnostic consistency of pulse diagnosis and the therapies used. 

Ref. 1. Alternative and Complementary Medicine 5:4150425, 1999.  2. Southern Medical Journal 94:486-492, 2001  3. Complementary Therapies in Medicine 9:154-166, 2001.  4. Alternative and Complementary Medicine 7:641-650, 2001.  5. Alternative Therapies in Health and Medicine 10:58-63, 2004  6. Alternative Therapies in Health and Medicine 11:415-421, 2005.

 

 

Chios Energy Healing- is an energy healing method that uses a trademarked term “Chios”, that is actually a type of what is claimed to be a unique approach to using both the aura and chakra’s (see Chakra healing above) for healing…  They claim Reiki and other energy healing forms do not translate to Chios energy healing.  The system can be learned by anyone but is taught by “Chios Master Teachers” and is learned in part by a Chios book sold on Amazon.  The system awards symbols for each level achieved and a secret symbol for master teachers.   The system teaches to reach the hands in front of the patient and feel the auras, diagnosing what is wrong with them, use symbols for treatment, and imagining bringing energy into the hands.  The practitioners are taught to imagine layers of energy and light near the patient, and see the colors of the auras.  The practitioners are taught to charge the chakras with the hands placed on the body with the right palm over the imagined chakra and the left hand on the back of the right, moving the hands away then apart, then sending colors to the chakra by moving the hands in circles.  The psychic senses are emphasized in receiving and transmitting energy.

There is no scientific study demonstrating effectiveness of Chios….it is a belief system rather than scientifically validated system.  Painbytes assessment: Two thumbs down.  www.chioshealing.com

 

Chiropractic- Chiropractic is a alternative medical system based on the premise that the spine is literally the backbone of human health: misalignments of the vertebrae caused by poor posture or trauma result in pressure on the spinal cord, which may lead to diminished function and illness. Chiropractic was started by Daniel David Palmer, involved in several “natural healing philosophies” such as animal magnetism, vitalism, spiritualism, and others, when in 1895 he manipulated the spine of a man who had lost his hearing earlier when he twisted his back, hearing a pop.  Palmer ostensibly restored the hearing by manipulation, and on this basis alone, developed chiropractic. He opened a school in 1897 of chiropractic. There were many similarities of chiropractic and Palmer’s writings to that of Still’s creation of osteopathy a decade earlier. 

The chiropractor seeks to analyze and correct spinal misalignments through spinal manipulation or adjustment.  At best, chiropractors offer counseling, massage, electrotherapy, manipulation of the spine and other joints, and supplements for back and neck pain.  At worst, chiropractors claim to be primary care physicians, neurologists, etc. and fraudulently claim to be able to treat everything the modern medical system can treat.  There is a wide array of practitioners in between.  Chiropractic is not without risk: risk of misdiagnosis of serious medical problems as spine misalignment, delay in diagnosis of the treatment of cancer and other aggressive diseases they may treat with supplements and manipulation, and dangers of manipulation itself with numerous reports of permanent paralysis and injury due to manipulation of the neck.  Adverse events are reported in 38% of chiropractic studies (Spine J 2016 Sep;16(9);1143-51).  Lumbar manipulation may result in cauda equina syndrome (paralysis), disc herniation, fractures, hematomas, and other neurological or vascular compromise, soft tissue trauma, muscle abscesses, disruption of fracture healing and esophageal rupture (J Manipulative Physiol Ther 2015 Nov-Dec;38(9):677-91).

Alpha level evidence:

Lack of evidence to support chiropractic for adolescent idiopathic scoliosis (J Manipulative Physiol Ther 2017 Jul-Aug;40(6):452-458.  In cervical manipulation, there is a large effect size on increasing range of motion of the neck and mouth opening, and in patients with tennis elbow, after cervical manipulation there is a significant increase in pain free handgrip strength (J Altern Complement Med 2017 Sep;23(9):667-675). A review found chiropractic controls in trials are very imperfect, and few trials assess for successful blinding of controls or active, thereby introducing significant bias in chiropractic studies (Spine J 2017 Mar;17(3):445-456).  A review found adding chiropractic to medical therapy offers no additional benefit in the treatment of acute low back pain (Am J Emerg Med 2017 Jan; 35(1):55-61).  European guidelines recommend chiropractic for acute lumbar disc herniation or for acute low back pain (Eur J Pain 2017 Feb;21(2):201-216) however compared to other therapies, chiropractic offers no difference in effectiveness  and is no better than usual medical treatments (Cochrane Database Syst Rev 2012 Sep 12;(9):CD008880).  There is evidence of chiropractic benefit in neck pain, shoulder pain and sport injuries, but there is no conclusive scientific evidence to recommend chiropractic for treatment of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, chronic back pain, and carpal tunnel syndrome (Int J Community Based Nurs Midwifery 2015 Oct;3(4):244-54).

 

Chung Moo Doe therapy- The word chung means true or correct with the abstract meanings of mental or mind.  Moo is Chinese for military with the abstract meanings physical or body.  Doe is Chinese for road, way, path, truth. This therapy is a combination of 8 martial arts and is more a body therapy than mind therapy, but encompasses both.  It emphasizes correct breathing with Qi Gong breathing, Tai Chi movements, Tae Kwon Do, Samurai, Ju Jitsu, Kung Fu, Ship Pal Gae, Bagwa.  Since several of these martial arts have been demonstrated to improve flexibility and improve pain, the Chung Moo Doe therapy would be expected to also improve chronic pain.  There are no specific studies for the combined therapies effect however.   Painbytes assessment: neutral given the lack of any specific studies but given that each component has movement therapies that could be useful.

http://www.oomyungdoe-ne.com/

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Coining- see cao gio

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Colloidal Silver- Colloidal silver is an illegal drug in the US (not a supplement), sold via the internet and in some vitamin stores as primarily a "natural" method of treating infections as a substitute for antibiotics.  Although it has been used for 120 years, there is nearly no medical or scientific evidence of effectiveness or safety, yet it is widely used.  It has a nasty side effect of turning the skin, whites of the eyes, and fingernail beds a grey to bluish color (called argyria) due to deposits of silver in these areas, making the person appear to be near death.  Whacko internet doctors and naturopaths, who do not value human safety or believe it is necessary to prove effectiveness, tout this misbranded drug as a panacea for bacterial, viral, fungal infections and as an anti-inflammatory agent.  

     Evidence of safety and effectiveness:  In 1999 the FDA issued a ruling colloidal silver or silver salts for human consumption is a misbranded drug, and is neither safe nor effective.  This means it is not a supplement, but is an illegally produced drug in the US, and cannot be sold legally via the internet or in stores (Fed Regist. 1999 Aug 17;64(158):44653-8).  There are no alpha or beta level studies to support its use. There is a beta level study showing that colloidal silver applied topically was completely ineffective in treatment of rhinosinusitis (J Otolaryngol Head Neck Surg. 2017 Nov 25;46(1):64).  A delta (low) level report showed healing of superficial ulcers with a colloidal silver spray (Panminerva Med. 2011 Sep;53(3):185-91).  There is a epsilon level (very low) single case report of treatment of a child with cystic fibrosis with colloidal silver (J R Soc Med. 2008 Jul;101 Suppl 1:S51-2.).  There is a case report of kidney damage from colloidal silver treatment for lymphoma (BMC Nephrol. 2016 May 17;17(1):49) and another with nephrotic syndrome associated with colloidal silver (Med Monatsschr Pharm. 2008 Feb;31(2):67-9).  Also there is a case report of a woman admitted to the hospital for acute psychosis after long term colloidal silver ingestion (Ann Clin Biochem. 2012 May;49(Pt 3):300-1).  A case report exists of a man presenting with seizures and brain degeneration after long term use of ingested colloidal silver (Ann Clin Biochem. 2009 Nov;46(Pt 6):520-2.) and another associated with seizures (Neurology. 2004 Apr 27;62(8):1408-10).  In a review of colloidal silver effects it was stated: "Consumption of large doses of colloidal silver can result in coma, pleural edema, and hemolysis. Colloidal silver is also toxic to the bone marrow and may be associated with agranulocytosis. The toxic effects of inorganic silver ingested orally in large doses are very similar to any corrosive solution. Such ingestion can result in burning of the throat and epigastrium, leading to abdominal pain, vomiting, and diarrhea. The patient often suffers convulsions and goes into shock." (Dermatol Online J. 2005 Mar 1;11(1):12) 

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Colonic irrigation (colonic cleansing, colonic lavage)- This treatment has been used to treat back pain based on the unsubstantiated supposition that “weakness in the intestine causes weakness of the back and makes it prone to injury” and that “the muscles of the back have nerve pathway connections to the large intestines”.   This is simply nonsense spouted by those trying to make a fast buck off of colon cleansing.  Colonic irrigation is approved by the FDA to clear the colon before surgery or for radiology exams, but not for the purposes touted for “detoxifying”.  In fact,  Dr. Ranit Mishiori published an excellent paper in the Journal of Family Practice that colon cleanses don’t do much except cause uncomfortable side effects such as severe cramping, and in some cases dangerous side effects due to perforation of the colon and introduction of bacteria.  Colonic irrigation was shown as far back as 1919 to be a scam but was reintroduced by spas seeking clients for money in the 1990s.  The reduction in bacteria due to colonic irrigation can be hazardous to the body since we need bacteria in the gut to ease digestion and voiding of waste.  Now nurses, believing having stool residing in the bowel is bad for the body (completely nonsensical) offer colonic therapy as a voodoo for those with anal fixations.

Painbytes Assessment: Two Thumbs down.  Insufficient proven benefit and certainly no scientifically validated studies for pain reduction. Has significant potential for harm.

 

 

Color therapy or Chromotherapy-  This alternative medicine therapy is classified by its practitioners as a “vibrational therapy” because color is produced by electromagnetic waves.  Typically the therapy conflates feelings about color with the ability to employ color as therapy.   Color therapy may use gemstones, candles, lamps, crystal wands, crystal and glass prisms, colored fabrics, color bath treatments, colored eye lenses, and lasers.  These are used to balance the aura fields and the physical, emotional, spiritual, or mental energies. 

Painbytes Assessment: Two thumbs down.  No scientific basis- this is a belief system rather than a medical treatment.

 

Conceptual mind-body techniques- These are a series of techniques that involve the use of the physical plus mental techniques that are touted to help with chronic pain.   These include Emotional Freedom Techniques (EFT), being a form of psychological acupressure.  Tapping specific meridians on the head and chest with the fingertips is used to “transfer kinetic energy” while you think about your problems and vocalize positive affirmations.  Theoretically this works to clear the “short circuit” or emotional block, from the body’s bioenergy system, thus restoring body’s balance that essential for optimal health and physical disease healing.  

Painbytes Assessment: Neutral- no scientific evidence of effectiveness for pain, use of unproven meridians, but the meditation aspect could have positive benefits.

 

Craniosacral therapy (CST)- this alternative body-mind therapy originated with cranial osteopathy, developed by an osteopath William Sutherland, who noted the cranial sutures looked like gills of a fish and proposed they move with respiration.  John Upledger conducted the purported pulse of the cranial bone movement and developed the concept of a cranial rhythm.  Their research findings were later concluded to not meet scientific standards of proof of effectiveness of the CST and cranial bone movement.  Current practitioners believe small rhythmic motions of the cranial bones occur due to the cerebral spinal fluid or arterial pulsations and they can detect these movements by palpating the cranium and the sacrum, focusing intently on the patient’s body, becoming “in tune” with the patient’s body, calling this process “Entrainment”.  Patients do report relaxation during the process.  The sacrum, that has been shown scientifically to have such small movements that are not reliably determinable, is palpated in a similar fashion to attempt to detect small movements.  CST is effective for relaxation, but has not been demonstrated to be of any other value in scientific studies.  The studies that were conducted was so poorly designed that they could not be used to draw any conclusions.  The science behind CST is extremely questionable with very little evidence suggesting cranial sutures move at all and the sacroiliac joint motions so subtle that different practitioners do not agree on such movement.   Painbytes assessment:  one thumb down due to erroneous dianostics leading to misdiagnosis or delay in diagnosis.  It is useful for relaxation but nothing else.  The science is bad and buying into this therapy is a belief system rather than proven medical science.  The placebo effect is probably strong, both for patient and practitioner.

 

Crystal healing- is an “energy healing” alternative therapy that believes crystals (especially quartz) and stones have healing powers.  The crystals are either aligned with the chakras of the body (see description above) in an attempt to construct an “energy grid” that surrounds the client with healing energy.  There is no available scientific evidence that shows the presence of chakras, energy fields, or healing from crystals.  The crystals are therefore a shtick or prop employed by alternative healers to induce an air mysticism about the technique for the unknowing clients.  Painbytes recommendation:  avoid.  Two thumbs down.

 

Cupping- This alternative therapy has been practiced for over 3,000 years and is performed frequently in Muslim countries as a treatment for anemia, hemophilia, rheumatic diseases, back pain, fertility disorders, and skin disorders.  It has almost no scientific study backing its use, but is a traditional medicine method that uses closed cups or bowls with a vacuum inside, placed on the skin to suck part of the soft tissues inward, breaking the capillaries at the point of contact with the skin. 

   Dry cupping involves the use of cups 1-3 inches wide made of plastic or glass in modern times.  There are two types of dry cupping: fire cupping and vacuum cupping.  Fire cupping involves suction created by heating the cup or air inside with an open flame or a bath in hot scented oils or an using alcohol soaked cotton ball that is set on fire in the cup heating the interior.  In fire cupping, the fires is extinguished, then then the cup is placed against the skin.  As the air inside cools, a suction is created, holding the cups onto the skin.  Vacuum cupping is the other type of dry cupping that uses rubber cups used to squeeze out the air inside or vacuum cups that have a one way evacuation valve or evacuation tube connected to a suction device.  The skin may be lubricated and the cups may slowly move across the skin on their own.         Wet cupping (also called Hijama) is used primarily in Muslim countries.  It involves making several small incisions in the skin, then placing the fire cupping over the incised area.  This sucks blood from the wounds and partially fills the cups with blood.  This is neither safe or effective, and strongly resembles the bleeding procedures used in the 1600s and 1700s in Europe that weakens and kills.  There have been reports of hospitalizations after wet cupping, so it should be completely avoided.  Wet cupping results in scarification of the skin or may use suction followed by use of a scalpel to make small cuts in the skin to let blood, followed by a second suction cupping treatment.  This is thought to eliminate scar tissue.  Because cupping was described as having been used by Mohammed, many Muslim countries still use cupping and wet cupping (fire cupping) with its bloodletting is used in China frequently..  The American Cancer Society and most guidelines for use of alternative therapies have concluded cupping has no health benefits at all.   

Alpha levels of evidence- No recommendation for or against due to widely varying outcomes (J Altern Complement Med. 2017 Nov 29);  for low back pain, cupping in a meta-analysis demonstrated mild reduction in VAS pain scores and significant reduction in disability (J Back Musculoskelet Rehabil. 2017 Nov 6;30(6):1187-1195).  Cupping therapy only minimally improves knee arthritis (Complement Ther Clin Pract. 2017 Aug;28:152-160)  The latter two studies are Chinese studies, and therefore highly suspect.  With regard to wet cupping 9 RCTs favored wet cupping while 5 did not. ( Altern Complement Med. 2016 Oct;22(10):768-777. Epub 2016 Aug 24. Review.)  A Chinese study demonstrated wet cupping reduces pain due to Shingles (Altern Ther Health Med. 2010 Nov-Dec;16(6):48-54).  Wet cupping was not found to be recommended in a Cochrane database for acne vulgaris (Cochrane Database Syst Rev. 2015 Jan 19;1:CD009436)  A study of miniscalpel-needle use of relief of myofascial pain in a Chinese study showed improvement but because of randomization problems in the study, there was concern over the outcomes  PLoS One. 2015 Feb 24;10(2):e0117146. doi: 10.1371  Other studies: 

• J Back Musculoskelet Rehabil. 2017 Nov 6;30(6):1187-1195 A meta-analysis of randomized trials demonstrated significant effectiveness for the treatment of low back pain

• J Pain. 2009 Jun;10(6):601-8. Cupping of the trapezius for carpal tunnel syndrome led to significant reduction in pain (RCT)

• A systematic review of studies in 2011 (Evid Based Complement Alternat Med. 2011;2011:467014) it was found there were two randomized controlled trials showing some benefit in pain treatment and one that found no benefit. Overall, the quality of the available studies being conducted by those using cupping are so poor that no conclusions may be drawn about efficacy. 

Injuries from cupping, while rare, may be serious.

• Interv Neuroradiol. 2016 Dec;22(6):728-731 Cupping was associated with a vertebral artery rupture and large hematoma on the back of the neck

• Wounds. 2014 Jul;26(7):214-20.  Burn injuries from cupping in China are not uncommon, more often seen with wet vs. dry cupping

• J Dtsch Dermatol Ges. 2015 Apr;13(4):337-8  Cupping may cause permanent dermal scarring

• J Cutan Med Surg. 2015 May-Jun;19(3):320-2  Cupping may induce psoriasis in areas under the cups

• J Burn Care Res. 2011 Mar-Apr;32(2):e31  Burn injuries due to cupping

• J Altern Complement Med. 2009 Nov;15(11):1243-5.  Cupping may create severe blistering as well as bruising

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Dance/Movement therapy (DMT)- represents the fusion of movement in the form of dance to combat fatigue, balance issues, and chronic pain.  Although considered experimental by insurance companies.  The journal Arts in Psychotherapy (Vol 41(1), pp 46-64) published a meta-analysis of studies on DMT in 2014 and found moderate effects for quality of life and clinical outcomes (depression, anxiety) and small effects for improvement of well-being, mood, affect and body image.  There was no specific analysis for pain reduction but frequently improvement in depression and anxiety leads to reduction in pain.   Painbytes recommendation: one thumb up.  Some research indirectly involving pain

 

Digital myography-  

 

Ear Candling – is also called “auricular candling”, coning or “thermo-auricular therapy”, and refers to procedures that place a cone shaped device in the ear canal extracting earwax and other impurities with the aid of a burning wick or smoke.  It is used to improve general health and well-being, to purify the blood, and cure cancer.  Medical research has shown it is both dangerous and ineffective, and fails to remove either earwax or toxins, and has no effect on cancer.   The potential for burns to the face or of hot wax dripping into the ear poses real safety concerns.   Painbytes assessment: two thumbs down.  This is a potentially dangerous procedure, does nothing useful, and should be avoided.

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Ear Seeds- these are small seeds of a plant such as the vaccaria plant (small black seeds) that serve the place of pellets in providing autoauricular therapy.  The seeds are attached to the ear with adhesive tape and then stimulated once an hour with the fingertips to support the production of a healing of one of many maladies thought by those believing in auricular therapy .  There is virtually no significant scientific research to support the use of ear seeds. 

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Eclectic medicine- This is mentioned only for historical purposes as this was a medical system in the US existing from 1820-1939 when the last eclectic medical school closed.  Eclectic medicine had its roots in early American herbal medicine and was an extension of Thomsonian medicine and Native American medicine.  At the time of its initiation in the 1820s, standard medical practices at the time extensively used cathartic purges using calomel and other mercury based remedies as well as extensive bloodletting- practices common in Europe.  Eclectic medicine was a reaction to those practices that they considered barbaric and also Eclectic medicine was an attempt to restrict Thomsonian medical innovations (herbal medicine) to medical professionals.  Eclectic medicine had numerous medical schools with one of the earliest being the Reformed Medical College of New York in 1837.  In 1833, the Eclectic Medical Institute in Worthington, Ohio graduated its first class in 1833, then the school moved to Cincinnati in 1842. Training in these institutions were in physiology and conventional medicine along with herbal and botanical medicine. By the 1850s, the influence of the dozen medical schools of eclectic medicine was becoming widespread and standard medical doctors began using herbal salves of Eclectic medicine.  Eclectic medicine was in competition with other forms of medicine that were on equal footing in the 1800s and early 1900s including homeopathy (there were many homeopathic hospitals at one time), native American medicine, chiropractic, osteopathy, and standard medicine.

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Egoscue method- Is a physical therapy postural correction designed to “Stop Chronic Pain”.    This system is taught through “Egoscue University” that offers proprietary method courses that are online in several different levels.  Generally 6 months is required for the level of certification required to open a clinic.  It does not seem according to the website that any prerequistes are required.  The patients are taught “E-cises” that are designed for postural correction that is stated on the egoscue website to reduce pain.  Egoscue’s method is based on many older methods including chiropractic, osteopathic, feldenkrais, rolfing, yoga, etc and is in no means revolutionary, but is an excellent synthesis of other ideas.   Peter Egoscue appears to believe his method can cure pain but there is little evidence in the literature for this.  Painbytes assessment:  movement and posture methods are generally favorable for pain therefore even in the absence of specific proof for this, a mildly positive recommendation is given to the Egoscue method.

 

Electrodermal stress analysis- Also known as electrodynamic screening (EDS), electrodermal testing (EDT), bioelectric functions diagnosis (BFD), bioresonance therapy (BRT), bio-energy regulatory technique (BER), biocybernectic medicine (BM), computerized electrodermal screening (CEDS), computerized electrodermal stress analysis (CEDSA), limbic stress analysis (LSA), meridian energy analysis (MEA), point testing, etc.  It is a simple galvanometer measuring electrical conductance of the skin with the operator applying a probe over acupuncture points on the other hand.  Readings higher than 50 indicate inflammation and lower readings mean organ stagnation and degeneration.  The operator can control the readings by varying the amount of pressure, the angle of the probe, or the amount of moisture on the skin.  The operator asks the patient a series of questions that have yes or no answers.  The patient’s subconscious is touted to know the intention of the machine or operator, and the operator must be a believer due to the “quantum link” between the operator and patient’s mind will interfere with the patient’s response.  The hands have points for diagnostics including the adrenal, circulation, jaw, hypothalamus, ileocecal valve, heart, allergies, protein metabolism, fiber, uric acid, carbs, etc.   The science behind this technology is very unproven and is simply speculative and there is no underlying scientific basis to suggest there is anything to this technology.  It appears to be more of a belief system rather than any meaningful medical diagnostic technique.  Painbytes rates this two thumbs down.

 

Electrodiagnosis according to Voll (EAV)- see above entry

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Electrohomeopathy- also called Mattei cancer cure, is a 19th century invention of Count Cesare Mattei (1809-1896)  based on homeopathy developed by Hahnemann in the 18th century with the addition of the concept of "bio-energy content extracted from plants".  To contrast,  homeopathy uses extracts of plants, animals, and minerals.  It was popular in the late 19th century.  Mattei believed there was "electricity" in botanical extracts and made bold, unsupported claims for the efficacy of his treatments including treatment of cancer.  Mattei believed different biological extracts contained red, yellow, blue, green, and white electricity.  There were three journals of electrohomeopathy at the beginning of the 20th century but interest in this system has waned. According to electrohomeopathy, all diseases were due to changes of the blood or lymphatic system, and therefore remedies were broadly divided into two categories to be used in response to either blood or lymphatic disease.  Electrohomeopaths believe diseased organisms are far more sensitive than healthy organisms and changing the condition of the bodily fluids will work on the cause of the disease.  Mattei would select the plant extract that was extremely diluted, that contained the kind of "vegetable electricity" needed to cure.  Now electrohomeopathy is practiced predominately in Pakistan and India, but some immigrants bring it with them to the US. Interestingly, the electrohomeopaths believe a complex mixture is needed to cure disease contrasted to Hahnemann (the originator of homeopathy) who believed only one agent should be employed.   LEVEL OF EVIDENCE: There are no scientific articles in the National Library of Medicine regarding electrohomeopathy therefore its use is purely speculative, based on hope rather than on any proof of safety or efficacy.

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Electromagnetic therapy- the application of low gauss electromagnets have been used by alternative medicine practitioners for over a hundred years for a variety of purposes, including cell growth promotion, pain reduction, improved blood circulation, bone repair, increased wound healing, sedative effects, enhanced sleep, and arthritic relief.  Most of the claims have been disproven, however there is low level alpha evidence in 2 out of three trials for venous leg ulcers healed faster with EMT. (Cochrane Database Syst Rev 2015 Jul 2(7):CD002933)   There is alpha evidence of reduction of pain by 1.5 points on the VAS scale but no significant improvement in function for those receiving electromagnetic therapy for arthritis (Cochrane Database Syst Rev 2013 Dec 14(12): CD003523)  There is marginal beta evidence in a small trial using EMT for treatment of healing of pressure ulcers (Cochrane Database Syst Rev 2015 Sep 3(9):CD002930)  There is beta evidence pulsed electromagnetic field therapy may be useful to treat adhesive capsulitis of the shoulder with 30% pain relief vs 0% for placebo (Cochrane Databse Syst Rev 2014 Oct 1;(10):CD011324).

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Emotional Freedom Technique (EFT)- This is a therapy developed by Gary Craig largely based on Thought Field Therapy (TFT) developed by Roger Callahan for the treatment of anxiety disorders and emotional distress.  EFT incorporates a combination of neuro-linguistic programming, energy medicine, and acupressure into a hodgepodge of concepts.  Alpha level evidence from 2009 showed flaws in the studies but that there were reported “small successes” for EFT.  A 2016 systematic review found “EFT was effective in reducing anxiety compared to controls” (The Journal of Nervous and Mental Disease. 204 (5): 388–395. )  Similar to the recommendation for TFT, there is a limited positive support for this therapy that had previously been dismissed as quack therapy by the medical and scientific community.

 

Essential Metabolics Analysis (EMA) or Essential Metabolic and Fatty Acid Analysis (EMFA)- is a laboratory analysis of the blood for fatty acid ratios (omega 6/omega 3 ratio) that is purported without significant scientific backing, to be indicative of the general state of inflammation of the body.   The inflammatory state of the body is thought by physicians that buy into this to be a purveyor of disease.  There are some doctors that take the animal research or molecular research and apply it directly to human disease, effectively believing they can cure or curtail the ravages of many disease with dietary changes and supplements.   While there is little evidence this works, it does provide some doctors with a very healthy supplement business.   Labs are profiting greatly from these analysis with some analyzing up to 24 fatty acids in the blood and calculating a host of ratios, the significance of most are speculative.  Insurers such as Aetna consider this to be experimental and will not pay, therefore the cost of such analysis comes out of the patient’s pocket.  Especially homeopathic doctors and naturopathic doctors strongly subscribe to these notions of fatty acid significance and attempt to sell the patient even more uncovered treatments, the supplements.    That being said, there is evidence that treatment with omega 3 fatty acids improves chronic headaches (Pain. 2013 Nov;154(11):2441-51), alpha linoleic acid plus superoxide dismutase improves low back pain (Eur J Phys Rehabil Med. 2013 Oct;49(5):659-64), N-palmitoylethanolamine plus transpolydatin improved endometriosis pain (Eur J Obstet Gynecol Reprod Biol. 2013 Jun;168(2):209-13), and Palmitoylethanolamide 600mg twice a day reduced multiple source chronic pain (Pain Med. 2012 Sep;13(9):1121-30).  However, the use of these substances as a treatment does not require measurement of these substances in the blood.

 

Essential Oils- see aromatherapy

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Essiac tea- touted as an anticancer tea, an anti-inflammatory drug, and immune boosting drug, this tea is a mixture of four different herbal medicines: burdock root, sheep sorrel herb, slippery elm bark, and Turkey or Indian rhubarb root.  The name Essiac is the name of the nurse spelled backwards (Caisse) who was given the formula in the 1920s by a patient and claimed it was an ancient Indian (American) tea.  She used it to treat cancer in Canada, then the drug was submitted to the FDA in the US for approval and was rejected.  Canada rejected the drug, and the nurse continued to make the tea anyway and give it away.  There are almost no scientific studies proving efficacy of the tea.

 

Faith healing- Randomized trials have shown faith healing has no effect on health outcome.  Intercessory prayer did show a very small improvement in pain.  The primary finding was that unless the person believed in prayer initially, there was no detectable insurance (2004 Jun;10(3):438-48 Journal Altern Complement Med) was there any improvement.  There are no published randomized or series trials on faith healers effect on pain or any malady.  That being said, prayer is frequently used in chronic disease in the US and around the world, and certain ethnicities employ prayer more than others (Pain Manag. 2014 Nov;4(6):389-406).  On the contrary, high degrees of religiousness are directly related to the presence of headaches. (Cephalalgia 2015 Mar;35(3):240-7).  Faith healing is distinct and separate to spiritualism or religious beliefs of the patient since in the latter two issues, these are integrated into several healing systems including yoga, etc.

 

Fangotherapy- Fangotherapy is the name of a spa body treatment in which mineral-rich thermal mud, clay or peat is spread over the body for the purpose of purification, revitalization, deep cleansing and to help reduce bodily toxins.   It is similar to balneotherapy and dissimilar to hydrotherapy.

Some fangotherapy sessions include bathing in the mud (mud baths), others include mud massages, while others involve the simple application of the mud to the skin.  

Analgesic and detoxifying mud baths have been used since ancient times to minimize muscle aches and pains, is will purportedly “draw out toxins” from the skin and body and help ease conditions such as osteoarthritis, rheumatoid arthritis, immune disorders, cardiac disorders, fibromyalgia, tuberculosis, acne, psoriasis gout and chronic dry skin. Fangotherapy techniques also increase blood circulation, which opens follicles, aids in nutrient/waste exchange and increases skin elasticity. 

 

Fangotherapy gets its name from the Italian word “fango,” which means mud. The most popular place to receive therapeutic fangotherapy is at one of the many spas located in either Abano or Montegrotto Terme, two towns located in the volcanic Euganean Hills of Italy.   The results are the same scientifically as balneotherapy

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