Pleasant does not equate to Effective

Some very pertinent meanderings of Paul Ingraham of

“Essentially every pleasant sensation and experience has therapeutic qualities. These therapeutic qualities are not unimportant, but they’re not the same thing as an effective therapy. There’s a good reason why your physical therapist never prescribes ice cream. Here’s the last big stretching mystery I’d like to cover: how can stretching be so pleasant without (apparently) doing much measurable good? Look at this pattern:

  • Stretching feels great … but it’s over-rated and nowhere near as medically or athletically useful as most people think.
  • Massage feels even better … but its effects on pain are notoriously mild and fleeting.
  • Chiropractic “adjustments” can feel scrumptious, even addictive, especially in that cinder-block-rigid area between the shoulder blades … but in most cases you’ll be craving a re-do before long (which makes for a lovely business model for chiropractors).

The pattern is that of being “relieved” instead of “fixed.” Over many years of thinking about pain and therapy, it has been a stubborn mystery to me why these things can feel so good — really, really good — without making any large or lasting difference to most painful problems, most of the time.

Feeling good without working all that well causes no end of confusion and trouble. The wonderful sensations are largely responsible for an endless epidemic of excessive optimismabout their healing powers. It’s completely understandable that we would expect something that feels that good to work well, but a lot of testing has shown over and over again that stretching, massage and chiropractic are not exactly saving the world from its aches and pains.”