Detailed guides to painful problems, treatments & more

Hacking the signs

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Dr. Steven Novella made a great point in Skeptics Guide to the Universe Ep. 790. Paraphrasing:

A common theme in alternative and pseudoscientic medicine is trying to control biology by “hacking” the signs associated with (theoretically) desirable states. For instance, if EEG or heart-rate variability looks a certain way when we are relaxed, then can inducing that EEG or HRV artificially make us relaxed? For whatever it’s worth?

This is the underlying logic of dozens of untested therapies and remedies. Some of them might make sense, but, hoo boy, citation badly needed! You have to test these things, and in most cases that test is not going to end well for the hypothesis. In general, it makes about as much sense as trying to make a car go faster by hacking the speedometer.

Dr. David Gorski has often mentioned how much he hates the word “hack” when applied to medicine. This is a great example of why. Medical “hacks” = medicine with a conceptually dull machete, trying to make something clinically meaningful happen with a laughably shallow grasp of mechanism: “These 2 things are related… GOOD ENOUGH FOR ME, CHANGE ONE OF THEM, VICTORY/PROFIT!” Gross.