The Democratization of Information: Filtering Through the Rubbish

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wikipedia logoSeveral years ago, I injured my knee while exercising and then re-injured my knee two years later.  I recently received the results of my MRI, and found out I had a joint effusion, which is basically a small bubble of fluid that has accumulated in the knee as a result of the injuries.  The doctor suggested I begin physio therapy to strengthen the knee (since I now favour the other knee), and that I exercise regularly.  If the issue persists 6 months from now, then I can take the next steps – but I basically got the all-clear for regular exercise, and that there is no major damage like a torn MCL or ACL.

When I got home, I decided to research “treating joint effusion”.  The top result came up on eHow.com, with a “moderately easy” 9 steps for treatment.  Some of these steps make sense, but several of them caused me to wave my skeptical flags.  I will present the steps below, along with my comments in blue.

Step 1
Lose 20 lbs. Excess body fat adds extra pressure on all of the body’s joints. So losing weight will reduce fluid and pressure everywhere.

While losing weight certainly is good for the joints, suggesting 20 lbs is rather arbitrary because it depends entirely on the weight of the individual.  If I took this advice, my Body Mass Index (BMI) would drop to an unhealthy level.  Consult your physician before deciding to lose weight, especially if you are on the low end of the scale.

Step 2
Walk on a regular basis. By moving your joints, you will remain flexible. Also, it will thwart any arthritis trying to set in to your joints.

Fair enough, and makes common sense.

Step 3
Take a pill. Aspirin, acetaminophen and ibuprofen help with pain. They will help you manage on days when your joint effusion is flared up.

Again, consult your physician before taking any medication.  Taking aspirin or ibuprofen is dangerous if you are already take blood thinners for another condition.

Step 4
Drink 8 glasses of water daily. Water helps the body flush itself of toxins. As a result, it will function better and be less likely to build up fluid.

“There is no medical evidence to suggest that you need that much water,” said Dr. Rachel Vreeman, a pediatrics research fellow at the university and co-author of the journal article. Vreeman thinks this myth can be traced back to a 1945 recommendation from the Nutrition Council that a person consume the equivalent of 8 glasses (64 ounces) of fluid a day. Over the years, “fluid” turned to water. But fruits and vegetables, plus coffee and other liquids, count.   (Source:  http://www.livescience.com/health/071220-medical-myths.html)

Step 5
Lift weights. Make sure you focus on your legs. By building up the muscle in that area, you will strengthen your knees and fight the affects of arthritis and joint effusion.

Make sense – regular exercise is always a good thing.

Step 6
Eat your vitamins. Consume a diet high in leafy greens that contain B6. B6 reduces tissue swelling and will bring you relief from joint effusion.

B6 reduces tissue swelling?  In my research, I found no concrete proof.  On WebMD, I did find a feature article on arthritis and joint pain, and B6 was not listed as one of the recommended supplements.  A well balanced diet will certainly help, but as to whether or not “B6 reduces tissue swelling and will bring you relief” – I remain highly skeptical.   (Source:  http://www.webmd.com/vitamins-lifestyle-guide/alternatives-and-supplements-for-arthritis-joint-pain)

Step 7
Adjust your chair. Proper posture will help reduce pressure on your joints. So make sure the chair you sit in at work is adjusted to the right height and has a strong back.

Ok, makes sense.

Step 8
Visit an acupuncturist. Holistic healing has been proven to help a lot of medical conditions dealing with the joints. Regular treatment will help reduce pain and swelling in your knee.

Hold the phone!  Two huge red flags:  “acupuncture” and “holistic healing has been proven to help a lot of medical conditions dealing with the joints.”.  Really?

According to Dr. Steven Novella, from his article discussing Acupunture:

“Once again we see that the best acupuncture clinical trials show that it does not matter where or if you place the needles. Since these are the two interventions specific to acpuncture, we can conclude (confidently, at this point) that acupuncture does not work and that any perceived benefit from acupucture is due to placebo or nonspecific effects.”  (Source:  http://www.sciencebasedmedicine.org/?p=492)

According to Dr. Harriet Hall, in her article, Puncturing the Acupuncture Myth:

“Considering the inconsistent research results, the implausibility of qi and meridians, and the many questions that remain, it’s reasonable to conclude that acupuncture is nothing more than a recipe for an elaborate placebo seasoned with a soupçon of counter-irritant.”  (Source:  http://www.skeptic.com/eskeptic/08-10-08/

Take a few minutes and read the articles – you will see there has been no conclusive evidence for the efficacy of acupuncture.

Step 9
Get surgery. A doctor can drain the fluid in your knee by making an incision near the large joint of the knee. It will also allow him to do two other things:he can make sure an infection is not contributing to your joint effusion, or he can give you a cortisone shot to prevent future fluid build up.

Wow – I am surprised that surgery falls under the category “moderately easy“.  Enough said. 

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There is a valuable lesson to be learned – do not immediately trust the first thing you read on the Internet, unless if you know it if from a reliable source.  This may seem obvious to some, but not everyone knows and realizes that “steps” like the ones above, are not necessarily written by professionals.  Do some research, and look for both sides of the argument.  When doing your research, make sure you look for sites where a product is not being sold, or someone is out to promote their product or service.  Their information will almost certainly be biased.

I suggest reading the article “Twenty-Five Ways to Spot Quacks and Vitamin Pushers“, by Stephen Barrett, M.D., and Victor Herbert, M.D., J.D..  Also, the article “Be Wary of “Alternative” Health Methods“, by Stephen Barrett, M.D. 

The eHow “steps” are a clear example of why we need to be cautious when presented with information.  We need to filter through the rubbish using our skeptical toolkits, and make educated decisions.  Of course, we should also check with our licensed professionals – they are the real experts.