Society for Science-Based Medicine

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CAM PR effective in getting parents to use unproven treatments on children

Parents of children with pain are more likely to use "complementary and alternative medicine" ("CAM") to treat their children than parents whose children who do not suffer from pain conditions according to analysis of data from the 2012 National Health Interview Survey. About a quarter of children had pain conditions in a one-year period and, of those, about a fifth used CAM. This is far more than children without pain conditions: Only about 8% of them used CAM.

Because CAM proponents so often rebrand conventional medicine (e.g., exercise and diet) as "CAM," it's hard to tell how much of this CAM use is really CAM, a problem the authors of the article discussing the results of the analysis themselves note. For example, 6.4% of children with pain used "special diets," but we don't know if they were evidence-based (e.g., avoiding certain foods to avoid gastrointestinal pain) or the fanciful fabrications of a naturopath. Also included under the CAM umbrella were yoga and tai chi, which are essentially exercise, and massage and meditation, neither of which are truly "alternative." A category labeled "Other" under the heading "manipulative or body-based therapy" lumps together "craniosacral therapy & exercise therapy." Go figure.

There was some hard-core CAM use by children with pain: chiropractic and osteopathic manipulation (37.5%), herbal or non-vitamin supplements (42.8%), homeopathic "medicine" (15.9%), and another "other" under "alternative medical systems" that lumps together "acupuncture, Ayurveda, naturopathic medicine, traditional healers, energy therapy" (9.2%). None of these has any good evidence of effectiveness for children in pain and many have risks.

Yet, over 60% of parents said that CAM treatments "improved overall health" for their children. Oddly, in reporting perceived benefit of CAM use for their child with pain, actual pain reduction is not recorded. We aren't told whether that's because it wasn't a choice among the responses or the parents truly didn't find that CAM relieved their child's pain. Not surprisingly, all the perceived benefits are consistent with placebo effects: "reduced stress," "feeling better emotionally," "better sleep."

Parents were also asked the reasons for their CAM use for children with pain. The authors made a chart of the reasons for using the top three CAM modalities, although it is not clear whether by "modality" the authors mean a particular treatment (e.g., acupuncture) or the category into which it falls (alternative medical systems).

In any event, what comes through loud and clear is that the false claims made by CAM purveyors like chiropractors, naturopaths, acupuncturists, and homeopathic remedy and supplement sellers are being accepted as truthful by parents. Among the "perceived benefits from CAM use" are:

These are nothing more than marketing slogans created by the CAM industry, not proven benefits of any CAM treatment. (True CAM, that is, not purloined conventional medicine.) And the marketing seems to be working.

The article ends by saying that there is a "growing body of literature supports the use of CAM in pediatric pain management," that physicians should "familiarize themselves with referral options for CAM therapies in their communities," and that "research is urgently needed to better understand which CAM therapies are most efficacious for childhood pain conditions . . . "

No, no, and no. There is not "growing body" of literature and the authors appear to admit this by citing none. Physicians should avoid referring pediatric patients to chiropractors, naturopaths, homeopaths, acupuncturists and "Traditional Chinese medicine" practitioners because there is no good evidence that anything they do will be effective in treating pain and there are risks involved in their treatments. Chiropractors and naturopaths are also anti-vaccination. Finally, we don't need more research of highly implausible treatments and, in any event, CAM practitioners regularly disregard the evidence, so what would be the point?

Points of Interest 03/05/2017
Points of Interest 03/04/2017