An On-Air mixture of Whiplash, Acupuncture and Anecdote

By Mal Vickers

An interesting discussion took place on radio whilst James Randi was in Australia. It happened on Friday the 30th of November during The Conversation Hour, a kind of group interview session with popular radio host Jon Faine, (ABC Local Melbourne Radio 774). The particular exchange I’d like to highlight took place at the very end of the program.

James Randi

James Randi

Being a skeptic, of course I’m an admirer of the work of James Randi however, being a Melburnian I also regularly listen to ABC 774 and think highly of Jon Faine.

Many times I’ve heard Jon Faine ask some excellent, insightful questions of politicians. He’s sharp, knowledgeable and in my humble opinion, Melbourne’s best talkback radio host.

Jon Faine

Jon Faine

Jon Faine was, I think, the only media commentator willing to strongly criticise self proclaimed US psychic John Edwards when he came to Australia. The stoush between the two made the national media at the time.

Getting back to the 30th  November Conversation Hour broadcast, with James Randi, comedian Stella Young and psychiatrist Iain McGilchrist; whilst discussing the topic of psychics, Faine said the following:

They [psychics] take away the fundamental and unavoidable importance of us being responsible for our own destiny. And that’s a fraud on every individual, that’s a fraud on all of us.

I think most skeptics would heartily agree with these sentiments. However, at the very end of the program, this is what happened when the subject of alternative medicine was raised by Jon Faine:

(Click the play button or  see the transcript below.)

Could it be that Jon Faine is repeating the well known correlation does not imply causation fallacy? Initially, I thought he was. However, I could be wrong and the truth more interesting.

Acupuncture has been associated with some strange and biologically implausible theories. Practitioners describe a mysterious life-force known as ‘qi’ (pronounced “chee”) and that this ‘qi’ flows along specific lines along the body known as ‘meridians’. Needless to say, there is absolutely no evidence for this.

This kind of talk raises huge red flags for skeptics. It’s hard to understand how Jon Faine might have felt better after a treatment based on these magical ideas. However, at this point, I thought it might be worthwhile consulting an expert, just in case there is something more to it.

The Victorian Skeptics has among its membership Dr Mick Vagg, an expert on pain management. Based only on the brief description Jon Faine gave on-air, this is Mick’s comment.

It’s exactly the sort of thing I encounter a lot with acupuncture. Clearly Faine has had some myofascial pain which the acupuncturist has unwittingly dry needled. It’s a classic case of ‘Right for the Wrong Reason’. It’s not widely known about outside of sports medicine and pain medicine, but dry needling has an established, though fairly limited place in mainstream care. I might send an email to Faine and point this out to him so he can get the story straight in future.

Also, I wouldn’t mind betting he’s misremembering how quickly his pain got better. If he did have myofascial neck pain it would be predictable for it to get worse with chiropractic treatment then slowly improve. But dry needling works best when the pain is at its worst, so we’ll never really know. Anyway, thanks for bringing this to my attention…

So there you go, that’s interesting. I actually knew nothing of  ‘dry needling’ and had to look it up. Putting solid needles (not the hollow types used for injections) into the skin can be effective in reducing myofascial pain. Dry needling has none of the acupuncture, pseudoscientific talk of ‘qi’ and ‘meridians’ associated with it.

It’s also worth reiterating Mick’s point:

…dry needling has an established, though fairly limited place in mainstream care.

This contrasts strongly with alternative medicine’s claims for acupuncture; that it is effective in treating, well…. almost everything. If you do a search on Dr Google within Australia, you’ll find acupuncture practitioners claiming to treat a huge range of conditions:

Bedwetting, colic, period pain, fertility, stress, bloat, etc… etc…

Of course, I don’t specifically know (and Mick doesn’t either) what happened with Jon’s whiplash injury. In a way, that’s the whole problem with single case anecdotes; they’re not scientifically controlled. Even a single controlled experiment is weak evidence. For example, imagine if Jon Faine had an identical twin brother who suffered exactly the same whiplash injury. The real Jon Faine gets acupuncture, the identical Jon Faine gets sham acupuncture – what’s the outcome? That’s a much better trial; however, with just two participants, it’s still very difficult to draw any significant conclusions. One would think, based on Mick’s advice, that both the twin Jon Faine and the real Jon Faine would feel better.

Digging a little deeper into this, Mick suggests that dry needling might work to reduce myofascial pain. Would Cochrane Reviews, which are based on clinical trials, actually suggest acupuncture as an effective treatment for whiplash injury?

Cochrane Reviews are the best place to look on the internet for science-based treatment recommendations. I searched specifically for information about acupuncture as a treatment for whiplash. Note, more generally, there have been many, many studies done trialling acupuncture as a treatment for other health conditions. My search was narrowly focussed on whiplash.

Acupuncture is not recommended as a treatment for whiplash. Interestingly, Cochrane Reviews currently states that the research into whiplash is so inconsistent and poorly done that the data can’t be pooled.

The only way to test whether acupuncture is truly effective in the treatment of whiplash is by conducting a scientific trial with all the appropriate controls: placebo control, blinding, or better still, double blinding, randomising etc, etc.

In a way it’s a shame that the discussion about acupuncture came about at Jon Faine’s last time slot on radio for 2012. Perhaps, if Jon had mentioned his acupuncture treatment earlier, Randi might have had a chance to discuss the issue in more detail and perhaps mention the lack of supporting science behind acupuncture. This short, on-air exchange might not be such a big deal, perhaps simply a discussion cut short, The Conversation Hour was up.

Let’s try to be aware that one can’t judge acupuncture or other similar unproven treatments, as being effective treatment based on just one anecdote.

Transcript

[Context: wide-ranging discussion about science, and sceptical thinking]

Jon Faine: And then there are people who say…. well in fact they disregard medicine and people who say well placebo effects, homeopathy all these sorts of things, there are people who don’t believe in acupuncture. I’ve had acupuncture it helped me with my neck.

Iain McGilchrist: Yeah

Jon Faine: And so on, there are all sorts of things that…..

Stella Young: Is that because you….

Iain McGilchrist: It pays to keep an open, but sceptical mind-that would be my position.

Stella Young: Is that because you believed that you were open to that…. kind of assisting you?

Jon Faine: No. I had a whiplash injury and my neck was killing me and someone had treated it and made it worse and the acupuncturist made it better.

James Randi: Oh wait a minute, did the acupuncturist make it better or did you feel better after you had the acupuncture?

Jon Faine: Then why didn’t I feel better after the chiropractor? Because I went to the chiropractor to get it made better but it was actually worse. So I went to the acupuncturist it could have been worse but in fact it got better.

James Randi: No…. It got better… but did it get better because of the acupuncturist?

Jon Faine: Oh yeah it was whiplash, it….I was having terrible headaches…daily.

James Randi: OK, but did it get better because of the acupuncturist?

Jon Faine: Well, why else would daily headaches for a month suddenly stop?

James Randi: I don’t know, it could have been other causes.

Jon Faine: Well, I’m quite happy with the acupuncturist.

James Randi: Oh very well.

(Indistinct, all talking at the same time)

Stella Young: I don’t think that’s called scientific evidence?

Iain McGilchrist: I think you’re right to be happy with it.

Jon Faine: It provided me with the evidence… cause and effect.

James Randi: Oh yes… absolutely.

Iain McGilchrist: But…nothing is more amusing than somebody who’s life is one party with drugs, followed by another and they come to you and you say “I think you need medication” and they go “Oh no, I wouldn’t put anything like that in my body”.

(Laughter)

Jon Faine: Iain, wonderful to have you here…. [John Faine thanks all the guests and wraps up the show saying it was the last ‘conversation hour’ for this year, 2012.]

One Response to An On-Air mixture of Whiplash, Acupuncture and Anecdote

  1. terrykelly3 says:

    Great work, Mal.

    Terry.

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