Without a twin with the exact same injury and no intervention, to compare with, we don't know from this whether it was just the six extra weeks of healing that made the difference.
I do wonder if the first 6 weeks did the work, and the results appears in parallel with the alternate therapy. Of course, this sort of conversation is a prelude to "let's try alternate therapy first, for science!" with volunteers, so there is benefit.
Indeed, the takeaway I get from this is how we tend to underestimate how long healing takes. People expect major injuries to be healed in 6 weeks, but it often takes that long to simply turn the corner toward full healing.
Yes but some anecdotes are closer to evidence than others. And people seem to be treating the above anecdote like it is evidence. Which we both agree it isn't.
It isn't convincing given the time frame / lack of comparison.
People are adults and can be willing to take chances on anecdotes instead of waiting 30 years for science to maybe fund some studies that end up just as murky
My friend had a kid with a bad eczema. She tried everything. Desperate, she took her to one of these charlatans. He asked the girl to stand on a copper plate. After a few days the eczema disappeared. Now my friend totally believes in all this stuff.
It's probably the stopping of other treatments that fixed it. I had bad eczema and psoriasis. It stopped (after weeks) after I stopped treating it with random creams and taking cool showers. I later found out that the culprit was lidocaine.
Also copper is biocidal, so maybe there's something there.
I have small amounts of eczema on unfortunate spots. It comes and goes usually based on stress and inflammation. Been dealing with it for decades. It stinks.
I’m half tempted to buy myself a copper plate to stand on.
I mean, if I didn’t have anything else I was trying that could plausibly explain it, that’d be really hard to resist accepting as the cause. Totally understand it.
It’s hard to internalize we see permanent and seemingly arbitrary changes from things like hormone levels. The last teen pimple for example isn’t noticeable in the moment as the last teen pimple because you don’t know the future etc etc.
We still don't understand the placebo effect. But definitely better to accept it's a thing and move on than believe grifters actually know what they're talking about.
The placebo effect is unlikely to be important here.
Hormonal changes mean people have permanent differences in their skin at specific points in time. Eczema is known to respond more cyclically with menstrual cycles, which is a lot easier to correlate.
The GP told a good story and was very personable and relatable.
But you can treat their data as garbage, pseudoscience, backed by nothing. Because it is. Any effects are likely to be placebo. Wait for real research. Science isn’t a popularity contest.
My point is that it's tone-deaf to complain about lack of rigor when the first thing the comment says is that it's not meant to be evidence. It's like reading a fictional novel and giving it a negative review for not containing sufficient citations for the events being related.
Even with a twin, you still wouldn’t “know”, because there might have been a difference in either their injury, their ability to heal (people can heal at different rates for many non-genetic reasons), or other, even ‘random’ factors.
There is a well-known case study where a man ‘cracked’ each joint in one hand every day, and never ‘cracked’ any joint in the other hand for many years, to see whether it caused arthritis. He didn’t get arthritis in either hand. The only thing you can take away from that is that cracking the joints doesn’t necessarily cause arthritis for him.
The person posted an anecdote; you don’t have to rely on in, but your dismissal is shallow and unhelpful.
I don't think the dismissal is that shallow. The original anecdote came with a conclusion, the person you replied to seemed to be trying to warn against such conclusions.
So the reason the plural of anecdote is not, in fact, evidence is because science doesn't actually work by piling up data in favor of a hypothesis.
It works by disproving other hypotheses until only one (or more excitingly, zero) is left.
An anecdote like this doesn't disprove the null hypothesis of "the patient just got better after awhile, because people frequently just get better after awhile". It doesn't matter how many similar anecdotes you stack up, because the null hypothesis still hasn't been disproved. You could have millions of perfectly true, identical anecdotes, and it still wouldn't change the situation, so why should anyone listen to one?
(Now, anecdotes are useful for identifying avenues of search, but that means the only thing you should be doing after reading an anecdote like this is running off to do a lit search for any actual studies, not trying it yourself or yes-anding with your own anecdotes.)
On the other hand, there are situations where an anecdote provides ample evidence. If a reiki practitioner walked up to a patient with a complete dissection of the lower spine, verified on X-ray, waves his hands over the patient, and a week later the patient is up and walking, holy shit, reiki works! There is no "people sometimes get better"[0], so the null hypothesis of "the patient will still be paralyzed" would have been disproven adequately by a single anecdote, assuming fraud was ruled out.
[0]I don't actually know for sure that people don't spontaneously get better from such a injury, but it was the clearest example I could think of.
So if you say something is an anecdote, then that anecdote is immune to any discussion or analysis?
How about the idea that some anecdotes are better than others.
E.g. "Anecdotal, but I took paracetamol and found it wasn't helpful for my pain. So I don't think it works."
There's an anecdote for you, maybe you should stop taking paracetamol now. By your logic no one can discuss, analyse, or point out it any potential issues with it.
And btw my stance is that the electrotherapy is interesting and plausibly could help. But tendonitis issues can heal with 6 weeks of basically rest, and that should be acknowledged in the discussion. (12 weeks in total, including the 6 weeks with a PT.)
> tendonitis issues can heal with 6 weeks of basically rest
Not disagreeing with your larger point, but at least for triceps tendinopathy (still often called tendonitis of the elbow), based on getting this myself and doing some research online, the consensus is that it generally doesn't heal from just rest, and that although techniques like massage and foam rolling can offer substantial pain relief, this is only short term. My conclusion was that the only effective therapy is doing slow eccentrics -- allowing your initially extended elbow ( = straight arm) to slowly "lose the fight" against a force trying to flex it (trying to move your hand close to your shoulder), and gradually increasing the force (weights, bands, etc.) over 3-4 months as you become able to do so without pain.
I hope this random tidbit helps someone with a sore elbow.
For Achilles tendonitis, I was told the following:
1. It's going to come and go for the rest of your life.
2. Just try to stay off it while it hurts; here's a couple of simple things to try when it's flaring up (eg, wear shoes or lifts with a > 1 inch difference between the heel and to) to reduce the pain. Don't worry about it when it's not hurting, feel free to keep running etc.
3. At some point it may stop going away; at that point there's some surgical interventions, but they all have mediocre outcomes so you don't want to try that unless you're out of options.
So far it's been five years of minor flare ups once or twice a year lasting a week or two at a time. Goes away without intervention, doesn't seem to be getting progressively worse or more frequent at this point.
There's another universe I'm living in where I tried some treatment for it, and now I swear by it, running off to get it every time I feel a twinge -- after all, that first round of tendonitis was terrible, I could barely walk, it took several weeks to recover, and all those subsequent flare ups only lasted a week or two, and I can usually hobble through them without too much trouble.
I’m not a doctor. I have been through the runner with a different injury (slipped disc), and I’ve seen the medical advice change in my lifetime. my conclusion is pretty loosely “it’s going to come back, the cure may be worse than the disease, the better you take care of it when it’s good the easier it’ll be when it flares up”.
Look at elite athletes - golfers, tennis players, etc. they put their bodies under the stresses we do, pick up “career ending” injuries and manage to recover from them in many cases.
The person you are replying to isn't saying you should give anecdotes more weight. They are just saying that dismissing something outright because someone used an anecdote is similar in nature to blindly believing in an anecdote.
I don't necessarily think there was a problem with the comment they replied to.
This is easier to test than arthritis. A doctor can make incisions on both arms of the same person at the exact same depth and length, then apply electricity to one of the wounds and monitor healing time.
To misquote the amazing James Randi: if you throw a thousand reindeer off a cliff and none of them fly, you haven't proven that reindeer can't fly. You've proven that those specific one thousand reindeer either can't fly or chose not to fly.