Monday, 11 October 2010

The European Shiatsu School of Boredom

While at last week's Mind-Body-Bullshit expo, and while trying to spy on an unrelated exhibitor, I fell into conversation with the world's most proficient bore.

Luckily, he eventually accepted my excuse that I was a noted psychic surgeon on call, but not before shoving some flyers into my hands.

Shiatsu is a massage therapy that originated in 1940s Japan.

Unlike some oriental innovations of that era - and unlike, say, chiropractic - it's not actually dangerous. In fact, it's no more or less effective than a good old-fashioned backrub.

The European Shiatsu School - conveniently located in that great hub of pan-European intellectual exchange, Brentford - are trying to tempt students to enrol on their Certificate of Basic Shiatsu course (cost: £1600) or their Diploma in Shiatsu Therapy course (cost: £5200).

According to their flyer (available here and here), Shiatsu can:

" in the treatment of...migraines, tinnitus, insomnia...IBS, constipation, acid reflux...gynaecological disorders...asthma, bronchitis...

Edzard Ernst, whose only claim to fame seems to be that he's some kind of Professor of Complementary Medicine, begs to differ:

"What is the evidence? - There are virtually no clinical trials of shiatsu, but there is no reason to think that it is any more effective than a conventional massage...Conclusion - Shiatsu is based on the biologically implausible theory of yin and yang. There is no evidence that is is effective for any specific conditions." - Simon Singh, Edzard Ernst, "Trick or Treatment? Alternative Medicine on Trial"

Who is right? The respected academic with countless peer-reviewed clinical studies under his belt, or the walking miracle insomnia cure?

Let's find out! ASA complaint follows.

"I write to complain about a flyer I picked up at the "Mind - Body - Soul" exhibition in London on 2nd October this year.

The flyer, for the "European Shiatsu School", promotes a 1-year "certificate" and a 3-year "diploma" to prospective students.

I suspect that the flyer may be in breach of two sections of the British Code of Advertising, Sales Promotion and Direct Marketing (CAP) code (2010). I can provide the original flyer by post, if necessary.

1. Shiatsu is a complementary massage therapy that originated in 1940s Japan.

2. Edzard Ernst, Professor of Complementary Medicine at the Peninsula Medical School, has recently described the state of the clinical evidence for Shiatsu thus: [1]

"What is the evidence? - There are virtually no clinical trials of shiatsu, but there is no reason to think that it is any more effective than a conventional massage...Conclusion - Shiatsu is based on the biologically implausible theory of yin and yang. There is no evidence that is is effective for any specific conditions."

3. The flyer makes a number of claims that Shiatsu is effective for specific conditions.

4. Under Section 3.7 of the CAP Code, I challenge whether the advertisers can substantiate their claims that "Shiatsu can help in the treatment of the following conditions":

(i) "Stress-related complaints such as head-aches, migraines, eyestrain, tinnitus and insomnia"

(ii) "Digestive ailments - such as IBS, constipation and acid reflux"

(iii) "Gynaecological disorders such as painful, heavy or absent menses and infertility"

(iv) "Respiratory diseases such as asthma, bronchitis and COAD"

5. (i) On the same side, the flyer seems to insinuate that Shiatsu is regarded by Western medicine as a plausible therapy with a "sound theoretical base in both Western and Oriental knowledge".

(ii) Considering Professor Ernst's comments, under Section 3.1 I challenge whether the claim that Shiatsu has a "sound theoretical base in...Western...knowledge" is misleading.

6. I confirm that I have no connections with the advertiser. I confirm that I am not involved in legal proceedings with the advertiser.

[1] Simon Singh, Edzard Ernst, "Trick or Treatment? Alternative Medicine on Trial", First American Edition 2008, p326


  1. "What is a cynic? A man who knows the price of everything and the value of nothing". Oscar Wilde

  2. Curious that you should mention this book which doesn't even give one single reference or source for its claims on shiatsu, and has one very big historical error.
    1) Namikoshi never talked or wrote about yin/yang. He based his studies on the effects of shiatsu on the nervous system.
    2) I have written twice to the authors AND to their editors about their claim of shiatsu being dangerous for osteoporosis. Is this claim from scientific studies, or have they made it up? I had no reply.(which is their way of presenting "scientific" evidence apparently)
    3) I then sent the authors pictures of me and colleagues giving shiatsu to Osteogenesis Imperfecta sufferers and the email of the association we (voluntarily) work for so that they could contact them. Since the bones of those with OI are more brittle than those with osteoporosiss, we should have produced fractures - according to them -. Since we haven't produced one single fracture since 2004 when we started, I asked about their claim again.
    Their "scientific" "evidence-based" reply was to refuse to reply.
    4) I invited them to the next OI congress to talk about the dangers of shiatsu to OI sufferers while we give them shiatsu.
    Their reply: no points for guessing. No reply
    5) If you are a fair person,then you should be complaining to the ASA about THEIR claim that it is a scientific evdence-based book, whic it obviously isn't.
    6) Respected academic? Who doesn't even mention where he got his information from? Who - unless he proves otherwise - makes up claims? Who refuses to reply when challenged about presenting HIS opinion as fact?

    1. Hi Shiatsushi,

      Although, for context, I sometimes provide a summary of the evidence background for a particular therapy at the beginning of a complaint, it isn't used by the ASA in their investigations.

      The only evidence considered is the evidence submitted by the advertiser in support of the claims they make. If the evidence is rigorous enough, the complaint will be rejected (and similar future complaints will be rejected without an investigation).

      Only if the evidence is weak (or if it doesn't exist) will a complaint be upheld. If you think the Ernst-Singh quotation is unfair, you can rest assured that it won't have had any baring on this complaint.

      P.S. Were you aware that Ernst has now retired? If you haven't received a reply, it maybe because he's having a nice relaxing massage on a beach in the Bahamas or somewhere. You might try asking your questions on Twitter, where he makes frequent appearances. (His account is @EdzardErnst)

      P.P.S. There's no reason why you should listen to my opinion, but I don't think that your points 3, 4 and 5 are worth answering. Point 2 certainly is, and I hope you persist with your enquiries until you get an answer.

  3. P.P.P.S. Although it's usually not obvious from the complaints themselves, I routinely do quite a bit of background checking before I challenge a health claim.

    I have never needed to rely on Trick or Treatment alone because, as you point out, it is not in itself a piece of clinical evidence.

    1. That's very good. You are the first person I write to who admits that 'Trick or Treatment' is not a piece of clinical evidence.
      After my eighth attempt I got a reply from Dr Singh about their claim that shiatsu can produce cerebral embolism. It was strange to see that their source states "There is proof that shiatsu has physical healing effects" and "we were unable to find any medical reports of cerebral or retinal artery embolisms directly caused by shiatsu."
      I have written back asking for an explanation of why they present the facts wrong - in the book they talk about shiatsu producing embolism - and they choose to ignore the word proof and contradict it. So, like the archaeologist Richard Nicklin Hall, they choose what evidence is convenient for their thesis.

  4. Hi shiatsushi,

    Can you tell me what the source is? Is it perhaps this one?

  5. Yes, that's the one. Purely anecdotal evidence at best. Distortion of the evidence done on purpose is what I think happened.


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