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Quackery’s scientific double standard

 •  • by Paul Ingraham

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 PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Quacks and cranks love to make advanced-sounding scientific claims … but can they be bothered to do an actual clinical trial? Ohhhhh no, not that kind of science! 🙄 Yet again, xkcd seems made for PainScience.com:

The comic is about supplement snake oil, certainly one of the best examples, but you can see the same pattern in most kinds of quackery. For instance, fascial therapy is one of the worst offenders of this type in rehab medicine.

Sheets and wrappings of connective tissue called fascia are an “exciting frontier” in manual therapy. Supposedly it can get tight and needs to be “released” by massage therapists. But basically none of the research about the tissue fascia actually supports or even tries to test the efficacy of fascial therapy.

Hype about fascia has inspired an astonishing amount of basic research, but virtually no translational research and near-zero clinical trials. Lots fascia research, not a stitch of it clinically relevant. Why? Because fascia is a fad, driven by a craving for mainstream legitimacy and relevance — therapists reaching for a plausible-sounding scientific explanation for what they (unwisely) take on faith they are doing for their patients. See Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties.

Most other pseudo-quackeries in the field have the same problem. Photobiomodulation (laser therapy) is another particularly egregious example: lots of test tube and animal studies of the effects of light on cells, extremely few clinical trials of actual laser therapy on actual patients.

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