Questionable practice techniques

[_FNG_]

As a student I am constantly told the importance of sound physiological reasoning (and evidence) for therapeutic interventions but notice that a lot of "therapies" seem questionable.
I'd like this thread to address some of these techniques by people with some more experience than a first year student. A few techniques that have come up in our classroom discussion include PRRT, craniosacral therapy, strain-counterstrain, and myofascial release.

I'd be interested in hearing some of your experiences with techniques that haven't been heavily researched but may still offer pain relief. Feel free to take this thread in any direction surrounding this topic.

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[Elbrus]

Yes, these are definately fringe areas of practice and are viewed rather poorly by most PTs. Soft tissue mobilization (including myofascia) does have some merit, but not in the 'John Barnes' way. I think the big problem with these types of 'treatments' is that they are worthless if done alone. The common point of all of them is to bring about relaxation.. But once pain/muscle guarding is calmed down, then it's time to address what is causing the dysfunction. Not just chasing and treating symptoms.
As a student, developing good examination, assessment, and patient education skills are the most critical. Treatment techniques will come and go, but being a good sleuth is key.

I would add the following to the list:
Ultrasound has been researched and demonstrated no better than placebo--yet it is still taught (minimally) and used clinically. (Not to be confused with real-time US--which is a fantastic tool.)

Surgery & drugs should also be considered questionable treatment (USA Today, Oregonian, Boston Globe, Newsweek, NPR. Even the media has figured out this one.)

 

[truthseeker]

Nicely put. Always find the "why". The "what" is usually the easiest thing to figure out. Finding the"why" separates the good from the average.

 

[Elbrus]

I was searching for something else--but came across this website which relates to the main topic:
http://www.csp.org.uk/director/physiotherapyexplained/complementaryhealth.cfm

 

[jesspt]

The complimentary health techniques listed on the Chartered Physiotherapy link are "fringe" techniques, with virtually no evidence in reference to their efficacy. Worst of all, the theories that most of these treatments are based on are not scientifcally sound.
Hopefully few, in any, of these techniques will be taught to you in school.
Unfortunately, you will probably be introduced to many, if not all, of these techniques once you start your clinical affiliations. Our profession is in the midst of an evidence-based practice revolution, but we still have a way to go until we've cleaned up our own house, and currently many of these "fringe" interventions are practiced by physical therapists across the country.

FNG - do yourself a favor and once you've graduated avoid any continuing education courses that teach these techniques, at least until some quality evidence surfaces.