Proving the Point?

The current Coronavirus pandemic has demonstrated a huge deficit in what we consider to be an appropriate medical approach around the developed world.  There is currently no branch of medicine within a western approach that deals with the provision of touch or the ability of touch to provide, if not intervention, then certainly huge support to over stretched and under funded health services.  There can be little doubt that the application of touch, even in acute settings is going to have a beneficial effect.  It needs to be studied, quantified and understood and managed carefully so that patients are able to receive the right touch at the right time for the greatest effect.  Quackery, magic, assumption and story telling have no place here, but we know touch to be a powerful medicine at all stages of life and in all stages of disease.

Touch has more recently become a word shrouded in suspicion and fear.  Sexualised by years of abuse of power, the very word has become synonymous with inappropriate behaviour.  We fear touch and yet without it a baby would fail to thrive and would potential die.  A condition known as privation dwarfism.  Touch however has everything going for it.  It is, by comparison to medication, very cheap.  It has no side effects, is readily available and if directed properly could conceivably play an important role in infection control, immune system function, tissue repair and many others.  The Nobel Prize for Medicine or Physiology for 2021 was shared by two laureates, whose work into researching touch over the last ten years has seen evidence emerge of specific ion channels, previously undiscovered, that respond to touch.  Named Piezo1 and Piezo2, these channels are understood to be involved in the regulation of blood pressure, respiration and urinary control amongst others.  Whist it is predictable that the discovery of the channels are being touted as routes to market for analgesics, they should also be seen as the start of discovering what kinds of touch are required for these channels to be activated, how long they remain open for and what factors might block their response.  It puts the call for touch to be at the forefront of medical treatment beyond the realm of alternative and instead demonstrates the importance, not just sociologically, but clinically of human to human touch.

The Covid crisis has revealed the vulnerability of health systems to cope and the strain on resources when faced with increased demands from a compromised population.  Touch as a preventative approach or as treatment, if embraced by governments and health care providers, could see the burden on conventional medicine reduced significantly.  Of course there is the potential for a reduction in profits from this approach and where health care provision is based on user pay systems, the resistance from those charged with delivering a profit could be understandable.  However in systems such as the UK, where free at the point of delivery is king, making use of touch in a controlled environment is a no brainer.

In spite of there being a wealth of evidence available, it still requires people to go and look for it and to know where to look.  In an attempt to ease the burden of literature review, I am establishing this page which will provide a simple click to at least an abstract, from which further reading can be carried out.

There is a worrying disconnect in the world today with polar ends of the scale being equally to blame.  At one end are the anti medicine, anti ‘big pharma’ anti-vaxxers and those that hold nothing but contempt for ‘modern medicine.’  At the other end are the scientists and sceptics, convinced that evidence holds the key and that anything that hasn’t been proven in a double blind RCT isn’t worth considering.  Tim Minchin says, “There is a word for alternative medicine that works. It’s called medicine.”  This is a naive and recidivist understanding of medicine if ever there was one.  Science is a blunt tool with which to dissect reality and lack of evidence is not the same as evidence of lack.  Somewhere in the middle between these two extremes is a wealth of potential that is being missed out on. See my blog post here for further discussion on this topic.

Therapists have not helped themselves and have spent years telling unlikely and biologically implausible stories to increase their standing.  It is the therapists who, even if they don’t like the current model, are unwittingly preventing the person in the street from accessing the treatment that they need, by failing to engage with a scientific approach.  We need evidence! The better the better, but also the more the better.  At the same time, the task of building evidence in the form of research papers or detailed case studies is an onerous one.  The majority of those practicing touch therapy would have neither the time or the skill to write a paper and get it published and wouldn’t know how to go about it.  What is needed is a change in the will of those who write and define health policy to undertake a fact finding mission on exactly what is going on in the treatment rooms of therapists around the world.  

In the meantime by building a reference resource in one place, perhaps we can shine a light on some of the evidence that does exist and create a basis for a better discussion in the future. As this resource grows, the therapies will migrate to their own section. Please send any submissions to me [email protected]

Accupuncture

The British Acupuncture Council hosts an extensive section of reviews relating to specific conditions treated by acupuncture

Osteopathy

The role of gentle touch in perinatal osteopathic manual therapy

Touch Therapy

The effect of healing touch on the pain and mobility of persons with osteoarthritis: A feasibility study 

Human Touch Effectively and Safely Reduces Pain in the Newborn Intensive Care Unit

Non Specific Complementary Medicine

Using Complementary and Alternative Medicine to Treat Pain and Agitation in Dementia: A Review of Randomized Controlled Trials from Long-Term Care with Potential Use in Critical Care

Integrative Medicine for the Treatment of Persistent Pain

YOGA

NICE Guidelines

BMJ article relating to above