Topic: Homeopathy a viable alternative

[Halleyscomet/Wakefield]

The Woo is strong with this one. I'd LOVE to see the study he cites.  Anyone got a link?

By Dr. Patrick Massey

Homeopathy a viable alternative ... sometimes

Published: 9/22/2008 12:09 AM

A recent German medical study showed the use of a homeopathic remedy to be as effective as a prescription medication for post-surgical foot pain and discomfort.

Homeopathy is one of the most common medical systems worldwide.

It is based on the idea that a person who is sick can be treated with a vanishingly small concentration of a substance (remedy) that at higher concentrations would cause similar symptoms of illness in a healthy person.

In homeopathy, the more dilute the remedy, the stronger the action. This is in stark contrast to traditional medicine where the higher concentration of drug, the stronger the action.

Homeopathy does not lend itself well to the usual research format since remedies are tailor-made for each patient and can change as the patient's condition changes. For example, the initial remedy that a person might take for high blood pressure could change over time as the blood pressure improves. In traditional medicine, the patient may stay on a specific medical regimen, possibly for life.

As a result, few clinical trials comparing homeopathic remedies to commonly used medications have been done. However, the recent German study was a well-designed clinical trial, and the results were published in the peer-reviewed Journal of Alternative in Complementary Medicine.

In this study, 88 patients underwent the same type of foot surgery and were randomized to receive either Arnica montana (homeopathic remedy) or diclofenac sodium (anti-inflammatory medication). Reduction in pain was slightly better with the diclofenac sodium group; however, swelling, redness and range of motion were significantly better in those taking Arnica montana.

The researchers concluded that Arnica montana would be a good option for patients after foot surgery. Like other drugs in its class (non-steroidal anti-inflammatory drugs), diclofenac sodium can cause side effects. It's also more expensive than Arnica montana.

Homeopathic remedies may not work for everyone, and undoubtedly there are some people who will not respond all. However, at least for foot surgery, it certainly seems to be a reasonable option in those people who would like to try it or for those who have problems with anti-inflammatory medications.

Homeopathic remedies are manufactured in FDA-approved laboratories under strict guidelines. And while there is no licensing for homeopathy in Illinois, we are fortunate in the Chicago area to have a number of excellent medical physicians and well-qualified chiropractors who are experts in homeopathy.

• Dr. Patrick B. Massey M.D, Ph.D., is medical director for complementary and alternative medicine for Alexian Brothers Hospital Network.

[diabhal]

Homeopathic remedies are manufactured in FDA-approved laboratories under strict guidelines.

. . . FDA approved water . . .

[Halleyscomet/Wakefield]

I've posted the following comment to the article. I wonder if it will be deleted or edited?

There are critical omissions in Dr. Patrick Massey's "article" advocating Homeopathy.  First, he mentions "FDA approved" laboratories.  The FDA approval in question merely means the laboratories are physically clean and unlikely to suffer from contamination. It says nothing about the quality, effectiveness or reliability of the materials produced.

No details are mentioned about the "German study". In all competently conducted clinical trials to date, homeopathy performs no better than placebo.  Homeopathic remedies have never been shown to out perform a sugar pill. The lack of details about the study lead me to suspect the credibility of the researchers.

Massey fails to mention that the "active" ingredient in a Homeopathic remedy is diluted to the point where you're unlikely to find even a single molecule of the compound in the "remedy."  By the time you actually take a homeopathic remedy you're drinking water.

Massey's reasoning for Homeopathy being hard to test, that the treatments can change for a given patient, is absurd.  The same can be said of conventional, science based medicine, yet scientists have no trouble testing the effectiveness of science based treatments.

[Chris Noble]

The Woo is strong with this one.

This is the article in question

http://www.ncbi.nlm.nih.gov/pubmed/18199022

There was no placebo arm.

It doesn't really deal with the more important question of whether homeopathy is better than placebo.

There is a reason why homeopathy trials focus on these sort of complaints where "mainstream" treatments offer only small benefits.

[Drosophila]

I've posted the following comment to the article. I wonder if it will be deleted or edited?

There are critical omissions in Dr. Patrick Massey's "article" advocating Homeopathy.  First, he mentions "FDA approved" laboratories.  The FDA approval in question merely means the laboratories are physically clean and unlikely to suffer from contamination. It says nothing about the quality, effectiveness or reliability of the materials produced.

No details are mentioned about the "German study". In all competently conducted clinical trials to date, homeopathy performs no better than placebo.  Homeopathic remedies have never been shown to out perform a sugar pill. The lack of details about the study lead me to suspect the credibility of the researchers.

Massey fails to mention that the "active" ingredient in a Homeopathic remedy is diluted to the point where you're unlikely to find even a single molecule of the compound in the "remedy."  By the time you actually take a homeopathic remedy you're drinking water.

Massey's reasoning for Homeopathy being hard to test, that the treatments can change for a given patient, is absurd.  The same can be said of conventional, science based medicine, yet scientists have no trouble testing the effectiveness of science based treatments.

Awesome. That's pretty much everything I would have thought to say on the article, as well.

[Chris Noble]

The Woo is strong with this one. I'd LOVE to see the study he cites.  Anyone got a link?

From the study:
Diclofenac is standard for the therapy of postoperative
pain. A Cochrane review revealed a clear superiority to
placebo (relative benefit 3.2 CI 2.6–4.0).3 With respect to
postoperative swelling, which is especially relevant to chiropody
because of the possible complications of wound
dehiscence and aberrations in the healing of wounds, diclofenac,
3 times 50 mg per day, orally, is generally recommended,
15 and was significantly superior to placebo in
placebo-controlled studies for both postoperative use21 and
for post-traumatic swelling, which is subject to a similar
mechanism as postoperative swelling.2,22 A control to placebo
was therefore refused by the Ethics Commission for our study.

What sort of Ethics Commision is that?

You can't do a trial comparing homeopathy with placebo because that would be unethical. But doing a trial comparing homeopathy with diclofenac is ethical?

[astrostu]

I've posted the following comment to the article. I wonder if it will be deleted or edited?

There are critical omissions in Dr. Patrick Massey's "article" advocating Homeopathy.  First, he mentions "FDA approved" laboratories.  The FDA approval in question merely means the laboratories are physically clean and unlikely to suffer from contamination. It says nothing about the quality, effectiveness or reliability of the materials produced.

No details are mentioned about the "German study". In all competently conducted clinical trials to date, homeopathy performs no better than placebo.  Homeopathic remedies have never been shown to out perform a sugar pill. The lack of details about the study lead me to suspect the credibility of the researchers.

Massey fails to mention that the "active" ingredient in a Homeopathic remedy is diluted to the point where you're unlikely to find even a single molecule of the compound in the "remedy."  By the time you actually take a homeopathic remedy you're drinking water.

Massey's reasoning for Homeopathy being hard to test, that the treatments can change for a given patient, is absurd.  The same can be said of conventional, science based medicine, yet scientists have no trouble testing the effectiveness of science based treatments.

That's pretty much what I thought of, too, though there was one more thing:

Homeopathic remedies may not work for everyone, and undoubtedly there are some people who will not respond all. However, at least for foot surgery, it certainly seems to be a reasonable option in those people who would like to try it or for those who have problems with anti-inflammatory medications.

Translation:  It should work because I think it should, but if it doesn't, then that's just because you're different.  It doesn't mean that the homeopathic water doesn't really do what I say it does, it just means that you're unique.

[Chris Noble]

[quote ]
A recent German medical study showed the use of a homeopathic remedy to be as effective as a prescription medication for post-surgical foot pain and discomfort.[/quote]

No it didn't.

In this study, 88 patients underwent the same type of foot surgery and were randomized to receive either Arnica montana (homeopathic remedy) or diclofenac sodium (anti-inflammatory medication). Reduction in pain was slightly better with the diclofenac sodium group; however, swelling, redness and range of motion were significantly better in those taking Arnica montana.

This is just wrong.

Diclofenac is given to relieve postoperative pain. On this measure the homeopathic treatment was inferior to diclofenac.

With respect to intensity of pain there were significant
differences in the groups on the evening of the first postoperative
day (p  0.012) as well as in the morning and
evening of the second postoperative day (both p  0.03;
Table 4, Fig. 2). The difference of the medians at these three
points in time was 25 (i.e., at any one time the median for
the patients in the Arnica group was 25 VAS points higher
pain score). Furthermore, in relation to the total of all VAS
pain, the patients in the Arnica group had more pain than
the patients in the Diclofenac group (p  0.027; Table 3)

The study also looked at other measures.

The lower margins of the 95% CI for the individual criteria
swelling ( 0.3674), calor ( 0.4106), and rubor (
0.4729) were over the critical threshold for therapeutic
equivalence of 0.36. Arnica D4 and diclofenac were thus
therapeutically equivalent (Fig. 1; Table 1).

Massey is therefore completely wrong to claim that the homeopathic treatment was better than diclofenac on this measure.

To determine convalescence, patient mobility was evaluated,
as this is dependent on the stage of wound healing.
On the fourth day, the lower margin of the 95% CI for
convalescence was 0.4726 and thus over the confidence limit
of 0.36. Arnica is not therapeutically inferior to diclofenac.
The descriptive test for group differences indicated the
superiority of Arnica D4: On the 4th postoperative day patients
in the Arnic a group were out of bed, on average, twice
as long as the patients in the diclofenac group (p  0.045;
Table 2). The comparison on the first 3 postoperative days
showed no significant differences in the groups (p for day
1  0.78, p for day 2  0.67, p for day 3  0.41).

The only measure in which the homeopathic treatment was significantly better than diclofenac was the amount of time the patients spent out of bed on the fourth day (but not the first,second or third days).

If you look at a large number of different measures then you are bound to find one that goes in your favour.

For pain relief, the main indication for diclofenac and the measure used in the placebo controlled trials the homeopathic treatment did worse than diclofenac.   
 

[gone]

yeah so homeopathy sometime works on to help a totally subjective outcome in a test that is impossible to control for every variable, on a condition that is not even a real medical problem ( shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?)

[Chris Noble]

shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?

You mean treat the underlying cause rather than the symptoms?

[gone]

shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?

You mean treat the underlying cause rather than the symptoms?

There were not even any symptoms in this example.  the "treatment" was just controlling pain associated with a real treatment.

[Halleyscomet/Wakefield]

shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?

You mean treat the underlying cause rather than the symptoms?

There were not even any symptoms in this example.  the "treatment" was just controlling pain associated with a real treatment.

Now now, pain form having knives jammed into your body, even by a doctor, is still pain and a symptom of injury. (Warning, I'm not a doctor, I don't even play on on TV.)

[gone]

shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?

You mean treat the underlying cause rather than the symptoms?

There were not even any symptoms in this example.  the "treatment" was just controlling pain associated with a real treatment.

Now now, pain form having knives jammed into your body, even by a doctor, is still pain and a symptom of injury. (Warning, I'm not a doctor, I don't even play on on TV.)

Yeah, you're right, but still, i think it's a pitiful example.  The cause of the pain is well known, and it is probably the kind of pain that woudl resolve itself assuming the surgery went well.

[Chris Noble]

shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?

You mean treat the underlying cause rather than the symptoms?

There were not even any symptoms in this example.  the "treatment" was just controlling pain associated with a real treatment.

Now now, pain form having knives jammed into your body, even by a doctor, is still pain and a symptom of injury. (Warning, I'm not a doctor, I don't even play on on TV.)

I think doctors prefer the term "postoperative pain".

It seems clear from the paper that if you want something to deal with post operative  pain then take diclofenac.  Arnica Montana D4 doesn't appear to do anything (more than placebo).

That makes me wonder. What is the correct homeopathic preparation for postoperative pain? Highly diluted scalpels?

[Halleyscomet/Wakefield]

shouldn't homeopathy be able to fix what ever neccesitated the foot surgery in the first place?

You mean treat the underlying cause rather than the symptoms?

There were not even any symptoms in this example.  the "treatment" was just controlling pain associated with a real treatment.

Now now, pain form having knives jammed into your body, even by a doctor, is still pain and a symptom of injury. (Warning, I'm not a doctor, I don't even play on on TV.)

I think doctors prefer the term "postoperative pain".

It seems clear from the paper that if you want something to deal with post operative  pain then take diclofenac.  Arnica Montana D4 doesn't appear to do anything (more than placebo).

That makes me wonder. What is the correct homeopathic preparation for postoperative pain? Highly diluted scalpels?

What about Capsaicin? They could even argue that science based medicine backs up its use as a pain killer because of its presence in topical liniments and chemically activated heating pads.