How dangerous is Shiatsu? Science and polemics (Dr. Eduard Tripp)

But Edzard Ernst goes one step further and states that even much more serious consequences are possible, such as a stroke, and refers to the 2002 work by M.A. Elliott and L.P. Taylor (Shiatsu sympathectomy: ICA dissection associated with a shiatsu massager¹).

The work of Elliot and Taylor describes two cases of dissection of carotid² that occurred after the use of a mechanical shiatsu-type massager. Figure 1 of this paper clearly shows the first patient, the massager and the position he had taken on it before the dissection.

Although the title of the work already shows that it is a shiatsu-type massage device and not a shiatsu treatment by a qualified practitioner (or did Edzard Ernst think that a shiatsu massager is a person, but then he might not have really studied the illustration in the original work or perhaps even the whole work), he draws an unfounded and almost polemical conclusion on this basis: „These might be extreme rarities – but who knows? Nobody! Why? Because, as with most alternative therapies, there is no reporting or monitoring system for such events. Therefore the true prevalence is anyone’s guess„.

The entry concludes (logically from Edzard Ernst’s point of view) that there is no real evidence for the effectiveness of Shiatsu, but there is evidence for risks – and that can only mean one thing: The demonstrable benefit does not outweigh the potential harm („the proven benefits do not outweigh the potential harm„).

Conclusion

In summary one could call this account: A tendentious report on Shiatsu, which concludes with a blatant misjudgment based on partially incorrect statements.

It is true that the evidence for the effectiveness of Shiatsu is weak. But it is incorrect to state that there is evidence of a high risk from Shiatsu treatments: One of the cited papers does not refer to Shiatsu treatments at all, while the other deals with the distinction between theory-compliant and undesirable reactions to Shiatsu treatment and concludes that Shiatsu (professionally performed) is a safe form of treatment.

To assume risks that are not present, for which there is no evidence, is not scientific, certainly not in the „responsible“ medicine that Edzard Ernst strives for.

Quote from the comments on the page:³.

Tom on 12/6/17: „Absence of evidence is not evidence of absence. Just because no adequate research has been done on Shiatsu does not mean that it is therefore quackery, it just means that no adequate research has been done yet.“

Edzard as answer, also on 12/6/17: „How clever!!!! But in responsible medicine, we tend to discard treatments that are not evidence-based and focus where possible on those that are – and the latter category does NOT include shiatsu!“

The effectiveness of Shiatsu does lack the necessary evidence. Nevertheless, dangers for Shiatsu recipients are not scientifically proven to be evident. To quote A.F. Long et al.⁴ once more: Shiatsu is a safe form of treatment, at least when performed by a competent, experienced and accredited practitioner.

Anmerkungen/Fußnoten

1
Elliott MA, Taylor LP: „Shiatsu sympathectomy“: ICA dissection associated with a shiatsu massager. Neurology. 2002 Apr 23;58(8):1302-4. https://www.ncbi.nlm.nih.gov/pubmed/?term=shiatsu+sympathecyomy%2C+neurology+2002
2
A dissection is a tear within the wall of a blood vessel, which allows blood to separate the wall layers.
3
https://edzardernst.com/2016/05/shiatsu-do-the-benefits-outweigh-the-risks. Access: 28/6/19
4
Long AF, Esmonde L, Connolly S: A typology of negative responses: a case study of shiatsu. Complement Ther Med. 2009 Jun;17(3):168-75. Doi: 10.1016/j.ctim.2008.09.004. Epub 2008 Nov 17.

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