My local rag, the Stroud news and journal, printed this in its edition of 27 april as a news item:
A PENSIONER who suffers from a rare condition has thanked a therapist who helped her regain confidence.
Joy Alexander, 74, was diagnosed with Ramsay Hunt Syndrome in 2014, making it difficult for her to eat and drink, affecting her speech and appearance in the left side of her face.
After taking advice and trying exercises, she could not find treatment for the condition. “I couldn’t see that it was ever going to get better,” said Joy…
“When I was on the bus, children would look at my face intrigued because I looked different. I would try to smile but because of the condition it would look like a grimace and something grotesque. My face would not send out the message I was trying to give out. I looked angry when I was trying to smile.”
The symptoms are similar to having a stroke,” she said.
“I found it difficult to meet up and socialise with people. “It makes you become quite depressed about yourself.”
Joy started acupuncture and massage treatment at Stonehouse Holistic Centre in December… Since then she attended 15 sessions with therapist Christopher Handbury.
“It has helped me so much,” she said. “I am 99 per cent of the way there and have regained a lot of confidence. There is no price you can put on it. If I won the lottery I would give him £4 million. I feel so much better.”
During her last class, Joy presented a card and £40 cash to Mr Handbury as a gesture of thanks.
I wrote to the editor suggesting that presenting this as a news item when it is nothing of the sort was disingenuous; it is just an “advertisement feature”.
Five minutes on a reputable website [*1] will tell you that Ramsay Hunt Syndrome (RHS) is caused by a virus—the same one that causes chickenpox and shingles—infecting and damaging a facial nerve near the inner ear.
I learn that, “The more severe the damage, the longer it will take to recover… If damage is more severe, you may not fully recover, even after several months. … when the treatment is delayed for more than 3 days, the chances of a complete recovery drop to about 50%. Children are more likely to have a complete recovery than adults.” [*1]
And that, “Strong anti-inflammatory drugs called steroids (such as prednisone) are usually prescribed for 5-7 days. Antiviral medications, such as acyclovir or valacyclovir, can be given for 7-10 days, although the benefit of antiviral medications is uncertain. Sometimes strong painkillers are also needed if the pain continues even with steroids.” [*1]
So, I assume that these treatments, which could have been obtained from Miss Alexander’s GP at no cost, didn’t work (but see point 1 below).
The “therapist” is described as using acupuncture and massage to “99 per cent” cure Miss Alexander’s condition.
1 Given that Ms Alexander has apparently almost fully recovered, we can assume that the infection wasn’t severe. (Of course, what a clinician describes as “not severe” may still be distressing and handicapping for the sufferer.) A cheaper and quicker course of action would appear to have been via her GP and the article is remiss in not explaining why either this route was not sought, or, if it was, why it didn’t work.
2 She is lucky to have recovered given her age and, I assume, a wait of more than three days before starting treatment.
3 The virus damages the nerve; how does massage “un-damage” the nerve? How can massage have any effect on a viral infection? Do people have massages for influenza? I am sure Miss Alexander enjoyed being massaged by Mr Handbury; whether it had any effect on her RHS would seem to be unlikely.
4 Unbiased websites are very cautious about whether acupuncture is curative. It is one thing to assert it relieves pain, quite another to assert that it cures viral infections and restores functionality to damaged nerves. NICE “only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraine”, ie, it restricts its pain relief.
5 The article fails to mention the placebo effect and fails to give any evidence that this effect was absent in Ms Alexander’s case.
All in all, it seems highly likely that Miss Alexander’s condition cleared up of its own accord (albeit with some residual nerve damage—99% being probably a rather enthusiastic estimate of the degree of recovery), probably with the help of the placebo effect. As Ben Jonson wrote in the sixteenth century:
The art of medicine consists of amusing the patient while nature cures the disease
Note added, it may be that the journalist, Saul Cooke-Black, being rather more circumspect than I initially gave him credit for, got it right when he wrote that the therapist “helped her regain confidence”. It was the reinstatement of her confidence for which Miss Alexander paid and, if she felt that was good value for money (fifteen sessions plus £40 bonus), then everyone should be pleased. Let’s just not have any of this silliness about needles being able to cure viral infections.
[*1] Ramsay Hunt syndrome (Medline website)
[*2] NHS Choices: Acupuncture
© 2016 Jeremy Marchant, extended 31 may 2016 . correction 13 october 2017 . image: Free images