You are correct and Freud was probably wrong money is a more important
driving force than sex. :-)
I always tell my students that when you treat a patient and they feel better
*after* they have left the office, they should always question was this
placebo or natural history. But when one sees instantaneous responses I
have less belief it is natural history but it could still be placebo.
So from my personal experience let's look at a low back pain patient where
the literature is much more equivocal. The patient barely walks into my
office. I mean they walk bent over with their hands on their thighs to help
hold up their body. They are obviously in extreme distress They have been
suffering for two weeks with no change in Sx. They saw their M.D. and had
both Rx NSAIDs and muscle relaxers which have had absolutely no effect. A
friend twists their arm and makes them come to see the quack, er I mean, the
chiropractor. I examine the patient and give them one manipulative thrust
and concurrent with the thrust they are instantly pain free. (BTW this is
an example of a relatively common occurrence) If this is a placebo, why
didn't the medication work as a placebo? Why is the placebo a treatment
that they absolutely did not want because they knew it would not work?
Aren't placebo effective because the patient BELIEVES it will work?
_____________________________________________
Stephen M. Perle, D.C.
Associate Professor of Clinical Sciences
University of Bridgeport College of Chiropractic
Bridgeport, CT 06601
www.bridgeport.edu/~perle
______________________________________________
"Be ashamed to die until you have achieved some
victory for humanity."
Horace Mann
----- Original Message -----
From: "preston" <[log in to unmask]>
To: "Stephen M. Perle, D.C." <[log in to unmask]>;
<[log in to unmask]>
Sent: Thursday, May 02, 2002 8:55 AM
Subject: Re: How do various specialities view EBM?
> The evidence for spinal manipulation is that it might be better than
placebo
> or it might not. The financial incentives and rewards will not allow most
if
> not all chiropractors and schools to become evidence-based.
> --
> Preston H. Long
>
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