Friday, November 16, 2007

Man versus Machine

I have been asked a few times : "How come your treatment can be effective if you don't use any machines ?".

How fantastic are these machines ! They make some noises, vibrate, send some electric shocks, alter your magnetic field and boost your cellular regeneration ! They are widely use by physiotherapists and other physical therapists.

You may know these machines by the name of TENS, Ultrasound, Sonic wave..

The US and TENS are not really effective

Human kind loves these types of gadgets and tends to rely blindly on it, while their effectiveness is in fact relatively approximative.

TENS (Transcutaneous Electric Nerve Stimulation) does not seem to do much better than a placebo (

UltraSound does not do any better, it has been used for more than 35 years in the treatment of musculo-skeletal pain and studies clearly shows that it is not more effective than a placebo treatment (

The machine : a good excuse

These machines are an answer to the inhability of the conventionnal medical field to deal with the dysfunctions of the body classified as musculo-skeletal problems.

The therapist uses the machine as an "excuse" for not being able to help the patient :

"I use the best machine for your pain and yet you do not get better... You really suffer from a chronic problem !"

It sounds much better than saying :

"I can't help you, I don't know what is going on, and my therapeutic competency is really questionable as you are not getting any better".

The machine is used symptomatically

If these machines really help to relax a muscle or an organ, their lack of effectiveness on treatment could rely on the fact that their are not used at the right place ! As we have seen in the previous posts treating the symptom is rarely effective compared to treating the cause. If the patient complains of a chronic knee pain caused by an old ankle injury it might be more interesting and effective to use the US on the ankle rather than on the knee for example.

The machine will always be obsolete, the hand will never be

In 10 years time the most modern machine will look like a prehistoric equipment, and 10 years later it will be the same for the latest model.

The human hand has been used for thousands of years and is still not obsolete ! Far from it ! More and more people seek massages, and other manual therapies.

The Human Hand has fantastic abilities

The hand is able to massage, to drain, to push, to pull, to vibrate, to twist, to be firm, to be soft, to warm up, to cool down, to feel and to adapt to the patient' s body response.

The hand is the part of the body which is the most represented in the cortex (in the brain) this means that it is one of the most sensitive and precise part of your body. It can detect variation of temperature as little as 0.1 Cdeg.

J.P. Barral (One of the most talented Osteopath) says : "The hand is at the Osteopath what the nose is at the Oenologue". It is recognised that wine testers can differenciate and recognise different vignards and different years of production. The Osteopath with a bit of experience can easily pick up old injuries and with more experience can even date them.

The Hand cares the Machine does not

Physical contact is very important. I do believe that during the treatment an Osteopathic hand talks to the patient's body. A treatment is a real physical communication between the patient and the practitioner.

Does the hand of a serial killer around your neck will feel the same than the hand of your lover ? Certainly not ! The "ruffness", stiffness, heavyness, "speedness", clumsyness (actually if it is a real serial killer he may not be that clumsy), coldness(...) will clearly give you a different feeling.

The hand of the practitioner cares about you but the machine does not.

The human hand is definitely winning this contest, no appeal !

No comments: