This week in my local community paper I had cause to once again raise my brow in surprise at the low bar for inclusion in this publication. I refer to a story written by a journalism student promoting a therapy known as FSM or Frequency Specific Microcurrent (not Flying Spaghetti Monster). I say promoting rather than reporting on as it seemed that the student merely parroted what she had been told of the treatment with nary a skeptical thought. I was unsure when I read this article whether I was looking at a news report or an advertisement for yet another brand of alternative health device. Though I should temper this by pointing out that it seems to be becoming endemic to the field of journalism as a whole rather than be unique to this student of it.
As I could find little in the way of information about this therapy at my usual sources on these sorts of claims (Quackwatch and Skepdic, both excellent resources) I thought I would do some investigation of my own and share the results here. A brief search of PubMed found a decided lack of peer review studies either published by the technology’s alleged inventor Carolyn McMakin, nor on the effectiveness of the therapy itself. So I decided to start with the website of the inventor herself.
The “therapy” consists of applying microamp current to selected areas of the patient’s body, the current is tuned to two different frequencies that historically were supposed to correspond to the resonant frequency of the disease and the tissue of interest. It is unclear whether the current version makes this claim but two frequencies are still employed, apparently providing a unique synergy that is useful for treating only specific ailments. Practically the current is produced by a battery operated device that allows the practitioner to set both the frequency and the current on two independent channels. This current is then transferred to the patient via conductive graphite gloves worn by the practitioner as they lay hands on the patient. The claims for the device itself are modest apparently due to FDA restrictions that apply to the classification of devices it falls under. This classification is that of TENS devices which stands for Transcutaneous Electric Nerve Stimulation, this class of machine can provide relief from certain types of pain simply by virtue of electrical stimulation, no frequencies are explicitly invoked.
However, the frequencies used have much wider claims associated with them, one I found amusing was “There is one frequency combination that so far is 100% effective in a small number of cases to take away kidney stone pain.”, I perhaps naively think that a treatment is either 100% effective or is useful in a small number of cases, combining these two seems to be trying to get the best of both worlds. To clarify I don’t think there are necessarily treatments that are always 100% effective but I do have the opinion that a more useful statement would have been how effective the treatment is for the majority of patients. Other claims include the ability to treat asthma, liver dysfunction and irritable bowel syndrome as well as scar removal.
On the website’s FAQ a simplistic history of the use electromagnetic therapy devices from the early 20th century is given and spoken of in glowing terms stating that “There were thousands of physicians using this technology at this time. They had journals and associations and were treating patients and doing research and sharing the effects of frequencies in articles and books.” This may or may not be true but has no relevance as to the effectiveness of the treatment, I have no doubt there are thousands of practitioners prescribing Homeopathic preparations right now. Dr. Albert Abrams is also referenced as a pioneer of these techniques despite his unusual practices having been exposed as fraud in the 1920s. In 1994 Dr. McMakin started using these frequencies on her chiropractic patients and reports that they “appeared to do exactly what they were alleged to do”.
In 1995 Dr. McMakin developed the therapy using a device and a list of reputedly medically useful frequencies that she apparently inherited from a Canadian osteopath. Two years later Dr. McMakin began teaching FSM according to her website “to see if the effects of FSM were reproducible.” (curious, I thought that’s what studies and controlled trials were for). Despite the order in which the story is related this appears to be before papers were presented to either the American Back Society or Topics in Clinical Chiropractic, both chiropractic based. The teaching of the technique consists of a three day course in “the use of frequency protocols, the differential diagnosis of pain generators and neurologic conditions.”. Were this technique developed by the medical mainstream I hope it would have undergone slightly more rigorous investigation before being tested on patients or taught to other practitioners.
Moving on, there are several papers listed on the website in support of this therapy of mixed quality. The most convincing papers deal with the use of the therapy for Fibromyalgia, in particular this study on “Cytokine changes with microcurrent treatment of fibromyalgia associated with cervical spine trauma“. Now I am not medically trained and readily admit that I am not qualified to accurately interpret the results of this study, however there are several points that I as a layman found concerning. First was the inclusion of only a single control subject who also received treatment. Second there seemed to have been quite a high drop-out rate for the trial (approximately 30%) leaving only 32 subjects to acquire meaningful data from. Thirdly, the use of specific frequencies in the treatment is probably the most controversial part and yet those that were chosen for the study are simply asserted to be the most effective with no reference to how this was done or what data lead to this conclusion. Fourthly, and this is less a criticism of the study itself, is the topic under study. I am given to understand that Fibromyalgia is characterised by periods of flares and remission which may complicate the data. I realise however that this trial may be considered a pilot study and so can not be held to the same standards as a large rigorous placebo/non-treated group controlled trial.
In addition the almost ubiquitous claim in pseudo-scientific medicine and quackery is made that there are no dangers or side effects from the treatment itself. As has been pointed out in other places a modality that affects biological systems is unlikely to be all benefit. If there is an effect then it is almost guaranteed there is a side-effect. The consideration undertaken in the use of valid medical interventions is whether the benefits are worth the accompanying risks.
Due to the nature of the therapy it is unclear exactly what is being tested/providing relief, a shaky theory of dubious plausibility based on the unscientific premise that tissues and diseases have “Frequencies” that if applied externally can enhance or inhibit functioning and so cure medical conditions or transcutaneous electric nerve stimulation that at least one doctor considers to be an uncontroversial treatment for pain. What does seem to be clear is that there seems to be more emphasis on promotion of this therapy than on testing it’s efficacy and introducing to the wider medical community a truly useful technique.
Finally, it seems to me that the evidence is not convincing that there is an effect here that can only be explained by appeals to the recovery of lost knowledge from a golden age of medical treatments that was squashed by a jealous Medical Establishment.