Turning that Frown Upside-down

A patient of mine told me yesterday that she thought too many of my posts were negative:  this supplement doesn't help, that medication doesn't work, this intervention doesn't make a difference.  She's right.  A lot of my posts are negative.  There are two reasons for that.  One is that we're constantly bombarded by advertisement and bogus information in the mass media about the latest and greatest medical wonder, usually long before any evidence exists about its effectiveness.  So I partially s...
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Neither Spinal Manipulation nor NSAIDs Help in Acute Low Back Pain

Acute low back pain is a very common problem, so one would think that we would already know how to treat it optimally.  Sadly, we don't. A study in this week's Lancet raised serious doubts about two of the most common therapies sought out by patients with low back pain: non-steroidal anti-inflammatory drugs (NSAIDs) and spinal manipulation.  The study received much coverage in t...
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Steroids Help for Bell’s Palsy, Antivirals Don’t

Bell's palsy is a fairly common condition that causes the sudden paralysis of half of the face.  Effected people can't fully close the effected eye and have an asymmetric smile, since only one side of the mouth moves well.  The cause is unknown and has always assumed to be viral.  The symptoms slowly resolve over a few months. The accepted treatment has always been steroids and acyclovir (an anti-viral medication), each for about 10 days.  More

Chronic Lyme Disease Still on the Fiction Bookshelf

At any given time thousands of people feel unwell and are dissatisfied with the diagnoses offered them by their doctors.  They struggle to understand their illness and frequently form patient groups for mutual support.  Every few years a new diagnosis captures their attention and becomes the latest vogue illness, usually without any scientific evidence.  Even worse, unscrupulous doctors latch on to these fad diagnoses to promise cures to patients who are desperate for relief.  A few years ago th...
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Vitamin C Can Prevent the Common Cold in Extreme Conditions

The Cochrane Reviews are systematic rigorous reviews of the medical literature on medical therapies.  Because of the objective and comprehensive methods they use for finding all relevant studies and categorizing them by quality, they are regarded as one of the gospels of evidence based medicine. Recently the Cochrane Reviews published this review of the medical literature on vitamin C for the prevention and treatment of ...
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Acute Bronchitis

"I think I have bronchitis.  I probably need some antibiotics." All primary care doctors hear that phrase very frequently.  A patient develops a productive cough that lasts for several days, malaise, and slightly elevated temperature.  Then the patient sees her physician with a clear and predetermined expectation of the correct treatment -- antibiotics.  Knowing that antibiotics are not indicated for acute bronchitis, the physician is then forced to balance practicing appropriate evidence-based...
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