The $100B per year back pain industry is mostly a hoax • Hacker News Board

Re: The $100B per year back pain industry is mostly a hoax

#321

Post by mcbobbington » Wed, Jul 05, 2017, 5:48 PM UTC

scient wrote: post #289

mcbobbington wrote: post #49

I think a medical license is a total joke. Now instead of quacks peddling snake oil, we get extremely expensive quacks with diplomas peddling snake oil. My wife has back pain and we paid for a $1000 injection the doctor recommended that did nothing.

And I think people who make these kinds of ridiculous blanket statements are a joke.

The government doesn't have any business telling anyone they can't smoke weed, and they don't have any business telling skmeone they can't get medical advice from someone they trust.

The licensure is a government run monopoly, which always leads to higher prices and lower quality care.

The fact is good doctors will be good doctors regardless of licensure because they will put in the effort to learn what's needed to treat the patient. Bad doctors will be bad doctors, becaude their motive is money, and they won't care about patients welfare either way. In some ways a license gives a false sense of security.

Re: The $100B per year back pain industry is mostly a hoax

#322

Post by capsule_toy » Wed, Jul 05, 2017, 6:29 PM UTC

seanwilson wrote: post #45

I thought this community would be more scientific...instead of anecdotes I'd rather see links to rigorous studies e.g. showing acupuncture or chiropractors work especially since these two forms of intervention have been subjected to decades of research already, have no plausible scientific basis and claim to treat many more things besides back pain. They should be held to the same standards as other medicine.

Why? No one is telling anyone to stop chemotherapy and use acupuncture to treat their cancer. In the context of back pain, so what if acupuncture isn't better than a placebo? We know placebo works for making people feel better. That's the whole reason why we need to control for them.

Re: The $100B per year back pain industry is mostly a hoax

#323

Post by capsule_toy » Wed, Jul 05, 2017, 6:35 PM UTC

seanwilson wrote: post #89

CodeWriter23 wrote: post #82

Earlier quoted context omitted.

Maybe that's another signal (along with the linked article) that the "science" in this arena hasn't advanced to the point of being repeatable and predictable.

> Maybe that's another signal (along with the linked article) that the "science" in this arena hasn't advanced to the point of being repeatable and predictable. Why would there be a treatment right now that works well but can't be shown to work in a controlled study? There's nothing special about back pain that makes it impossible to scientifically study. Personally, I think the signal you mention is more because bac…

It's easy to see if someone has a broken leg or test them for cancer. For most back pain, you can't even prove that person is actually suffering from it.

Re: The $100B per year back pain industry is mostly a hoax

#324

Post by notadoc » Wed, Jul 05, 2017, 7:14 PM UTC

Most people I've known with back pain related to weak or strained muscles were best helped with physical therapy. Often it means strengthening the abdominal muscles and loosening the chest/shoulders. Most of modern life is terrible for posture and is very sedentary, so this is not too surprising.

Pain is wildly complex though, and the causes are not always understood or easily helped. Some people require pills and other treatments. The amount of media animosity towards pain medication and related vitriol spewed at doctors is shocking and totally unwarranted in most cases.

Re: The $100B per year back pain industry is mostly a hoax

#325

Post by notadoc » Wed, Jul 05, 2017, 7:16 PM UTC

randlet wrote: post #283

CogitoCogito wrote: post #185

Earlier quoted context omitted.

> I don't mean to be smug, as back pain really is an individual thing. There's an element of searching for what works, and I was lucky in that I was pointed directly towards an effective treatment. I think this is extremely important for everyone to remember. People tend to (correctly) scoff at anecdotal experience, but often that's all you can work with. When studying health problems, most studies will tend to find…

"I should point out that for myself the most effective way to lose weight is basically just starvation. I exercise a lot and track calories and only consume between 1500 and 2000 a day (I probably need at least 2500 a day and maybe closer to 3000)" Maybe I'm misunderstanding your point but this is the only effective way to lose weight. If your body needs 2500 calories a day and you eat 2000 you'll lose ~1lb a week.

> If your body needs 2500 calories a day and you eat 2000

Very few people require 2500 calories a day, particularly with modern sedentary lifestyles.

Plus, aside from the thermodynamics component, from a nutrition standpoint not all calories are the same.

Re: The $100B per year back pain industry is mostly a hoax

#326

Post by astrostl » Wed, Jul 05, 2017, 7:31 PM UTC

nradov wrote: post #199

pif wrote: post #171

Earlier quoted context omitted.

> Weight loss isn't "known intractable". Indeed, weight loss is "simple", as you said. The problem arises when you have managed to get to your target and you realize that, short of amphetamines or similarly dangerous drugs, there is no known way to keep your weight stable with an acceptable life quality . Obese people are not stupid when they choose to keep eating; they've just learnt by experience that, unless you s…

Why do people consider mild hunger to be something that seriously impacts their quality of life? Hunger is the natural state of all animals.

If my house were not a constant 73F, it would seriously impact my quality of life - at least for a while - because it's my long-standing definition of normal. That is what people do: seek comfort, then take it for granted.

Re: The $100B per year back pain industry is mostly a hoax

#327

Post by CodeWriter23 » Wed, Jul 05, 2017, 7:32 PM UTC

seanwilson wrote: post #91

CodeWriter23 wrote: post #88

Earlier quoted context omitted.

"Anecdotal" is not the correct term. "Testimonial" is. People are relaying the truth they observed, which is testimony. Anecdote means more along the lines of hearsay, or repeating something from a third party as if it were testimonial.

Anecdotal sounds accurate to me: https://en.wikipedia.org/wiki/Anecdotal_evidence > Anecdotal evidence is evidence from anecdotes, i.e., evidence collected in a casual or informal manner and relying heavily or entirely on personal testimony. When compared to other types of evidence, anecdotal evidence is generally regarded as limited in value due to a number of potential weaknesses, but may be considered within the s…

Wikipedia != dictionary

Re: The $100B per year back pain industry is mostly a hoax

#328

Post by CogitoCogito » Wed, Jul 05, 2017, 7:37 PM UTC

randlet wrote: post #283

CogitoCogito wrote: post #185

Earlier quoted context omitted.

> I don't mean to be smug, as back pain really is an individual thing. There's an element of searching for what works, and I was lucky in that I was pointed directly towards an effective treatment. I think this is extremely important for everyone to remember. People tend to (correctly) scoff at anecdotal experience, but often that's all you can work with. When studying health problems, most studies will tend to find…

"I should point out that for myself the most effective way to lose weight is basically just starvation. I exercise a lot and track calories and only consume between 1500 and 2000 a day (I probably need at least 2500 a day and maybe closer to 3000)" Maybe I'm misunderstanding your point but this is the only effective way to lose weight. If your body needs 2500 calories a day and you eat 2000 you'll lose ~1lb a week.

Sorry my point was more that I'm okay going at a 1000 calorie daily deficit and that I just accept the inevitable hunger. This differs from many approaches which seem to chase the holy grail of finding food that's very filling, but also very low in calories and usually not going for that extreme a calorie deficit.

Put another way, mine is the stubborn bull-headed weightloss plan. Basically I just try to climb the mountain the fastest and most painful way and then be done with it.

Re: The $100B per year back pain industry is mostly a hoax

#329

Post by astrostl » Wed, Jul 05, 2017, 7:55 PM UTC

briantakita wrote: post #39

> Ramin reports that they are impossible to point at on an x-ray, because they don’t exist; a dislocated joint in your spine would be the result of a horrendous injury that sends you to the hospital, she explains, not to a massage table. The Chiropractor I visit utilizes x-rays & a thermographic scanner to identify the subluxations. From consistently seeing my x-rays, it's obvious where my subluxations lie. The therm…

Without making any observations for or against chiropractors in general, or yours in particular, reading, "consistently seeing my x-rays" (of your spine) prompts me to share

"In this investigation, cervical spine films gave rise to radiation doses that are similar to those of chest x-rays. However, lumbar spine radiographs generated effective radiation doses that were approximately an order of magnitude greater than these other studies. In both the cervical and lumbar regions, AP views resulted in significantly greater radiation exposure than corresponding lateral images."

via https://www.ncbi.nlm.nih.gov/pubmed/18679095 . Remotely regular exposure to high levels of radiation is bad, and not good.

Re: The $100B per year back pain industry is mostly a hoax

#330

Post by _acme » Wed, Jul 05, 2017, 8:18 PM UTC

Cthulhu_ wrote: post #285

blister wrote: post #273

Anecdote of one: I was diagnosed with Stage 4 Hodgkins Lymphoma two years ago. My _only_ symptom at the time was pretty severe back pain, which is unusual for lymphoma. After treatment and remission a year later, I still had the severe back pain. The cancer pain management doctor I was seeing was perfectly happy to keep prescribing godlike levels of opiods. (50+ mg of oxycodone on top of 30+ mg of slow-release morphi…

> As a humorous aside, I had to pay for several weeks of PT out of pocket because my insurance did not consider it important. They would prefer to shell out $500+ dollars every month to see a pain management doctor and continue taking pills. The insurance provider (or management / shareholders) probably get a kickback from the pharmaceutical industry.

Do you have any evidence that this ever happens?