Hi Kevin and Rege
I am not pro manual therapy or necessarily anti electrotherapy. I am just
interested in what is truth, and recognise man's propensity to delude
themselves and prefer the comfort of status quo to the disturbance of
change in holding onto entrenched paradigms, and forms of earning an income.
What I am against is embracing the mystical (electricity and invisible
forces like ultrasound) and marketing it under the pretense of something
scientific to a public who expect science. If physiotherapists don't stick
to scientific proofs, then nothing separates us from some of the more
dubious claims of chiropractors, naturopaths, & fortune tellers who use
kirlian photography, crystal therapy, aura reading, tarot cards, palmistry
etc etc. You could go and find a whole lot of people who believe these
things help them, and keep these occupations going.
As for the defence that medicine is only 15% scientifically based, well so
what. How does that justify using something such as ultrasound that has
evidence to say it is of dubious benefit. On the whole, when medicine finds
a consensus of negative evidence, they change their practises, sometimes
slowly.
Electrotherapy has a long history dating back to the early 19th century of
use firstly by well meaning experimental physcians, then perpetuated by
money grubbing quacks, to treat all sorts of things. There are several
references on the net.
I am concerned that in the face of evidence showing ultrasound is of
dubious therapeutic benefit that physiotherapists hold onto it as if their
income depended on it (maybe it does for many of you). It is my view that
it is a convenient cost effective "high tech" thing for private
practitioners to impress patients with, and that it has a high placebo
effect with certain personality types.
For every physiotherapist using ultrasound and claiming great results,
there are just as many physios not using it who get just as good a result.
And we should all remember that a lot of the acute conditions we treat get
better in time with no intervention.
As for manual therapy and the use of heat and ice, there is no consensus of
evidence saying these things are of dubious benefit. When that evidence
comes about, I will change my perspective about such treatment.
Ciao
Bruce
|