Cupping in Portland

There has been a lot of electrons spilt on the subject of cupping this week, thanks to Michael Phelps. I have written about cupping in the context of use by the Portland Trailblazers and a review of the topic over at Science-Based Medicine. I did not have anything to add over the posts by Orac and Dr. Novella .

Then I saw, Why Portland docs think Michael Phelps's therapy is spot on.

Local reports do get my interest. 11 paragraphs of gullible reporting.

No real 'docs' were quoted in the story.

Dr. Loch Chandler, a naturopath with Providence Integrative Medicine, does cupping on patients five-to–10 times a week to help reduce pain, improve muscle function and enhance recovery from soft tissue injuries.

He is a naturopath who specializes in acupuncture at the Providence Integrative Medicine center, where they offer "therapeutic, acupuncture, naturopathy (including homeopathy) and dietary counseling." In my opinion it appears Providence is at the forefront of offering useless pseudo-science in Portland.

"The majority of my patients say they feel cupping helps," Chandler said. "Less than 10 percent say it didn't make any difference."

Which is always the case. Patients usually have subjective improvement after a pseudo-medical intervention. The fact that cupping, and most of traditional Chinese pseudo-medicine has no reality-based reason to work and does not work in well controlled studies. Pseudo-medical providers often prefer to follow the three most dangerous words in medicine, in my experience, rather than reality-based practice.

Cupping is generally used during acupuncture.

Combining two useless pseudo-medicines.  They have a ways to go before they beat The Onion.

Practitioners place special cups or glass containers on the skin and use heat or an air pump to create suction and pull the skin up and away from the muscles. Chandler said he moves the cups around, as opposed to "static cupping," which Phelps uses.

So both forms of cupping are equally effective? Why?  Wouldn't one be less effective?  Of course not.  Pseudo-medicines are like the citizens of Lake Woebegone, where where all the therapies are strong, all the diagnoses are good looking, and all the results are above average.  Only in pseudo-medicine are all the variations on a theme equivalent, like the infinite varieties of acupuncture.

The technique increases blood circulation and range of motion, said Ken Glowacki, associate dean of clinic education in the College of Classical Chinese Medicine in Portland, part of the National University of Natural Medicine.

Except it doesn't, although pseudo-medical providers like to repeat the same nonsense as if it will make it true. Of course, it is trivially true in that blood supply is increased to areas of trauma, like a bruise. At least they do not mention the pseudo-scientific concepts of qi and meridians.

Some patients even get the treatment for respiratory and digestive ailments to open up breast respiration.

For which there is zero good data for efficacy and even less data for plausibility of cupping in lung and gastrointestinal diseases. And what in the hell is breast respiration? It has to be a typo, but for what? I can't find "breast respiration" on google.

Since it brings blood capillaries to the surface, cupping often leaves welts, just like those dotting Phelps' shoulders and back. But it typically doesn't hurt, said Daryl Ewing, a lead physical therapist at Providence Sports Care Clinic in Portland.

It does not bring blood capillaries to the surface. That is anatomical nonsense. It ruptures capillaries, causing a great, big hickey, which in the right circumstances can have effects. Just not the form used by Traditional Chinese Pseudo-Medicine.  

One knock against the practice is that the science is relatively thin and patients may be feeling a placebo effect.

It is not thin, it is nonexistent and based on a fantastical understanding of disease, anatomy, and physiology totally divorced from reality.  And to deliberately offer placebo is considered unethical outside of clinical trials. So giving people unproven placebos is a good thing? Yep:

Whether the effects are real or a placebo, cupping seems to be working for at least one member of Team USA. Phelps won a record 21st gold medal yesterday.

Seriously? You are purport causality from the cupping to the winning of a gold medal? And how did he win all the prior golds with no pseudo-medical hickeys to help his swimming.

Like much of the reporting on cupping this week, the easy path of the standard narrative is preferred over critical thinking and real investigation.  Same as it ever was.