A Skeptic’s Guide to Biofreeze

If you’re of a skeptical mindset (that is, ready to question just about any claim you come across), then you are aware that the Internet is full of woo. Most of the time it’s easy to spot, but sometimes it is cleverly disguised. And quite often, even normal, sane, intelligent people fall for the trickery (hey, some of them are probably your family or friends; I see this quite a lot on Facebook). The most successful claims usually feature at least one true or mostly true element, a handful of plausible ones, and some outright misrepresentations (intentional or not). Unfortunately, when someone points out which is which, some of those who believe the claim respond as if they are personally under attack.

And so it was, one day (today actually), that I was minding my own business, checking the happenings on Facebook, when a comment by one of my Facebook friends caught my attention. She mentioned something about loving “Biofreeze.” I hadn’t heard of it, so I looked it up.

Turns out Biofreeze is a line of pain relieving products made by Performance Health, Inc. There are many topical pain relievers on the market, and they generally do a reasonable job of relieving mild muscle pain (like when you’re sore from exercising). They are usually menthol and/or methyl salicylate based, and they work by creating the illusion of a hot or cold sensation (the body has trouble telling the difference) where they are applied (the actual mechanism at work is by capillary dilation, increasing blood flow to the area). Whether that pain relief effect is physiological or psychological is largely irrelevant here; suffice it to say that, even if the effect is placebo, it’s usually pretty harmless (although you can apparently overdo it, since methyl salicylate is a toxin). [1] I looked around on the Biofreeze web site for clues as to how it worked, and all I could find was an active ingredient list included with the description for the all new Biofreeze Cryospray:

The new Spray is specially formulated with natural menthol, MSM, Ilex and a new blend of botanical ingredients, Arnica, Calendula, Chamomile, Echinacea, Juniper Berry, and White Tea. [2]

OK, so it’s menthol based with some herbal additives. Two things on the ingredient list stand out: MSM and Ilex. I didn’t know what either of those were, but Wikipedia answered both questions. I will talk about each of these shortly, but I also want to point out something else: What the heck is Cryospray? I understand what the root words mean, but I’ve not seen them combined this way before. Digging around on the site yields some clues as to what the company means by it. They call their pain relief method cryotherapy, which is a real term for a treatment that doctors use. But what is it?

Cryotherapy

This was the most interesting claim I found on the site, because the company insists on calling this cryotherapy. I did a search for it, even though I had an idea what it really was, and here’s what I found. It turns out that cryotherapy (also known as cryosurgery) is what a doctor uses to kill warts, cysts, and get rid of lesions.[3] It works by freezing the affected area with something like liquid nitrogen, and yes, it can be applied with a spray. This freezing and thawing of the tissue kills it, and the damaged tissue (cyst, lesion, or wart) necroses and falls off. I have actually had this procedure done before, when I was a kid, so I have firsthand experience with it.

Other search results pointed to a different use of the term as a synonym for ice therapy (you know, putting an ice pack on whatever hurts). I could find no uses equating cryotherapy and ice packs on any general medical web sites (I find WebMD to be reasonably reliable), and indeed the only places where such a correlation occurs is on sites that are very specific to joint and muscle pain.[4] Does that mean there is no medical literature that equates the two? Certainly not, but it does suggest that the two are probably unrelated, or that medical literature that does equate them is uncommon, and that at least a few purveyors of pain relievers have confused the idea of applying cold (frequently used to reduce inflammation and relieve joint and muscle pain) with actually freezing (medically recognized as a good way to destroy badly-behaving skin tissue).

Where does that leave Biofreeze? At best, Biofreeze’s use of the term is simply misleading, either deliberately or by the company’s own confusion. I didn’t see liquid nitrogen in the active ingredient list, and I’m pretty sure a plastic bottle is not up to the challenge of maintaining adequate pressure to maintain that liquid state. At worst, use of the term is fraudulent since it does correlate with a wholly different medical procedure intended to treat a wholly different condition.

MSM and Ilex

The next point of contention comes from two of its specially listed active ingredients, MSM and Ilex. Once again, I knew nothing about either one of these, but found information pretty quickly. Of the two ingredients, only Ilex appears along with the product name, so let’s start with that.

Ilex is a another name for the genus of plant we call holly.[5] The Biofreeze web site doesn’t say what part of the plant is used, nor which species (there are over 600), only that it contains Ilex. Most of us know that holly berries are mildly toxic if ingested, but I doubt anyone has ever looked at topical applications. Holly leaves on the other hand, are sometimes used in teas, since some species’ leaves contain high amounts of caffeiene. I found no documented uses of holly (leaves or berries) as a pain reliever (although I would be happy to look at any double-blind, peer-reviewed studies published in known and respected medical journals if you have them). So it’s unclear what purpose it serves in Biofreeze; my instinct tells me that, topically applied, Ilex is a harmless enough substance and had a sufficiently science-y name that its addition to the ingredient list lends it that extra air of plausibility.

MSM, on the other hand, is a shortened form of Methylsulfonylmethane (unless they mean something else, which is not clear).[6] This is another one of those wonder chemicals that has many claims attached to it, including the relief of osteoarthritis symptoms. The studies that indicate any success in combating the effects of arthritis only looked at oral application (that is, ingested) and did not consider topical application. In the case of Biofreeze, the inclusion of MSM appears to be attributable to these studies, but it’s far from clear whether MSM actually works as a topical remedy. Chalk another one to the plausibility category.

Conclusion

Does Biofreeze actually do what it claims? I haven’t tested it myself, but anecdotal evidence is highly suspect in the first place. Obviously people believe in its effects, or they wouldn’t buy it. That said, we can point out one obvious way in which it expressly DOES NOT do what it says. Because Biofreeze is marketed as a cryotherapy treatment, and we’ve established that doctors use cryotherapy to freeze tissue (which destroys it), we can say for a fact that Biofreeze doesn’t actually freeze your skin. It is difficult to imagine a scenario in which skin necrosis through freezing and thawing would be an effective pain relief (cryotherapy hurts, which is why a topical anesthetic is also recommended), especially in muscles and joints. The ingredients are suspect, aren’t specifically tested as topical agents, and their claims have not been evaluated by the FDA (they are herbal remedies, which the FDA doesn’t regulate but should), but they probably pose no health threats that we know of.

The remaining question is should you buy it? The company that sells it makes you jump through some significant hoops to get your hands on it, making you go through a licensed dealer. It is expensive, moreso than other topical pain relievers. And finally, it appears to have no special ingredients in it that are any more effective for muscle and joint pain relief than other products available on the market with fewer hurdles to obtain them. My recommendation? If you are already buying it and like it, don’t stop on my account. But it seems like you could save yourself time and money by buying the cheaper and more readily available products at your local store.

References

[1] http://en.wikipedia.org/wiki/Methyl_Salicylate
[2] http://biofreeze.com
[3] http://emedicine.medscape.com/article/1125851-overview
[4] http://www.jointhealing.com/pages/productpages/cryotherapy.html
[5] http://en.wikipedia.org/wiki/Holly
[6] http://en.wikipedia.org/wiki/Methylsulfonylmethane

Disclaimers and Addenda

I am not a medical professional. I also am not a chemist. I also also am not a professional researcher. The statements above reflect my opinion based on some admittedly basic research. As always, I am interested in any real studies that contradict my opinion, in which case I can be persuaded with the right evidence to modify my position. My guidelines for accepting such a study as evidence: it was published in a peer-reviewed journal that is known and recognized (AMA, NEJM, etc). Additionally, the study should have no questions surrounding its methodology. These typically arise when the data is not available, the study was not double-blind, the study was paid for by someone with a direct financial stake in a particular result, or the research team is inexperienced (not a disqualifier, just a red flag).

Also, I use Wikipedia as a starting point for most research. No, it’s not always perfectly accurate, but I don’t expect it to be, and for most purposes it doesn’t have to be (although for most purposes it is reasonably so). What it does give me is access to its sources, which you can easily follow if you are so inclined.

What I’m Reading

I normally just paste individual links on Facebook, and I will probably continue to do that to some degree, but it’s not exactly a public way of sharing what I am reading, unless you happen to be one of my Facebook friends. So instead of doing that, I am going to try the same concept out on my blog, but instead of trickling links in one at a time, I will collect them for a daily (or near-daily) blog post, complete with my own commentary. I welcome comments on any of the items posted; after all, that’s what the blog is all about. Enjoy!

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I am awed by the alien beauty of Mars, and a recent Big Picture publication showcases the rich geological diversity that Mars has to offer. It’s easy to forget that Mars is a planet and comes complete with its own weather, its own geological events, and even its own climates (which differ markedly from our own, of course, but which are probably pretty similar to each other). All this on a planet where life either never evolved or hasn’t yet been detected.  [Big Picture]

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Texas kills the most, but Florida throws away the most keys, apparently. Possibly one of the lamest quotes I’ve seen from an article came from this one, from victim rights advocate Shannon Goessling: “They are recidivists. They’ve had every opportunity to avoid being in prison for the rest of their lives. They knew the consequences of their conduct.” Study after study has indicated that juveniles can know the consequences of an action without fully understanding their implications. Why do you think the military targets their recruitment at 17-24 year olds? Hint: it’s only partly because they are (on average) in better physical condition than other age groups. Life imprisonment for a legally-established adult is one thing, but locking up bad kids for the rest of their lives? Let’s hope that the Supreme Court’s decision remedies this miscarriage of justice.  [NPR]

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I haven’t watched the video yet, but it doesn’t matter: others are already saying it’s pretty good, and what it represents lets us peer into the future just a bit. What’s funny about this is that I am reading Accelerando by Charlie Stross, and the protagonist pretty much embodies the ideal by which this video was made. It’s going to take a long time before something like this becomes an acceptable way to do business, but it has merit. One need only look at the vast amount of content that people freely provide on the Web (this blog included) to get a glimpse of how it could come to be.  [Mashable]

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E-book retailers have a long way to go before I would willingly give up my dead trees. The very idea of licensing a book instead of owning it is ludicrous to me. If I can’t sell it back, borrow it or lend it out, it is no good to me. I know some libraries are experimenting with “checking out” e-books, but I’m not sure I like their approach either. What’s the solution? Is there one?  [The Guardian]

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Let’s turn to microfinance.  It turns out microfinance poster child Kiva.org doesn’t operate quite the way they advertised. Instead of connecting lenders to specific entrepreneurs, it is more likely that lenders are connected to other microfinance lenders. This is actually something I had looked at as recently as this year, since I did a graduate capstone project that involved creating a business plan that was similar. Instead of micro-lending, however, it was micro-donation, and instead of supporting foreign projects, it was intended for domestic recipients, preferably in the same neighborhood or town. The business plan pointed out to me some major hurdles, but one thing I had considered was the idea that organizations could solicit donations as well, only it would be obvious that they were not individuals since they were classified differently. The question remains though: is it even possible to do real p2p lending or donation online? I suspect the answer, at least right now, is a less-than-reassuring “maybe.”  [New York Times]

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And now some fuel for the anti-science crowd. If you believe that humans did better at fending off infectious diseases 50,000 years ago, you might want to take a closer look at some actual data. 300 years ago, a Londoner by the name of John Graunt did some very rigorous statistical analysis of life expectancy that showed a life expectancy averaging just 27 years. A staggering 65% of the population died before age 16, mostly from infectious disease. Mind you, this was before mass industrialization. If your argument hinges on the idea that cities are part of the problem, we need only turn to fossil evidence to show that infant mortality rates were high, and a person was unlikely, 50,000 years ago, to reach age 35. Diseases leave their marks on our bones, and the evidence is all there. If you’re so enamored by the idea of hunting and gathering and think that’s all you need to be healthy, be my guest. Also, I realize that this article will fall on deaf ears if you do believe humans were better off pre-civilization.   [Respectful Insolence]

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Finally, on a very similar subject, I am enjoying Orac’s thorough smackdown of a new book by Suzanne Somers (I would link to the book, but I’m not in the habit of promoting woo). The book is supposed to be about how cancer can be fought and prevented without resorting to that dangerous modern medicine. What’s quite apparent is that neither Somers nor those who buy into her argument have any idea how cancer actually works. Once again, though, presenting rational arguments to people who believe this stuff is useless. Here’s a hint: if the advice you’re following for your health comes from a “brave maverick doctor” who’s going against established medical knowledge (especially if the advice has you tossing it out like it explains nothing), then that advice is wrong. I can say that with 99% certainty, which makes it true. I welcome anyone who can provide the text (and links) to medical case studies and papers published in recognized peer-reviewed journals that support your point of view (just to make that clear: I want links to the articles themselves, as they appeared in a respected peer-reviewed journal; the “doctor’s” web site doesn’t count). And if your “doctor” isn’t willing to play by those rules (sometimes they claim that their methods can’t be evaluated clinically; homeopaths are good at this), then it’s not science. End of story.  [Respectful Insolence]

UN NCRE Interview

On October 16, 2009, I sat for the United Nations National Competitive Recruiting Exam (UN NCRE) P2 Interview in New York City, USA.  Since I am in Washington, DC, now, it was a 2 hour, 45 minute train ride up the east coast.  I had to get up pretty early to get there with enough time to find the UN building, which turned out to be about 2 miles from NY Penn Station.

Anyway, before the interview, the Office of Human Resources Management (OHRM) provided some basic preparation instructions, which I attempted to follow on the train ride in.  Among the materials provided was a document containing the UN competencies, qualities they are testing for with the interview process.  Other tips included reading periodicals, newspapers, and the UN’s web sites and those of its agencies.

I arrived in New York armed with what I could glean from the United Nations Wikipedia page (which, frankly, is easier to read than trying to navigate the UN system) and answers to a few particular questions I could think of (namely what the difference between peace keeping and peace building is).  Upon arriving at the UN building, I had to go to the information desk and call the contact number I was given.  Escort is required in the building, which makes sense.  Once my escort arrived, he presented me with a badge and took me up to one of the offices.  I have to say, the inside of the UN building, at least in NY, is about as gray and featureless as it could possibly get.  Even if I had wanted to take mental snapshots of distinctive features, there wouldn’t have been much.

Presently my escort ushered me into a similarly featureless room, where a lone chair was situated facing a blank wall outside an empty cubicle.  I was early, and so I sat and waited.  The room I was in was adjacent to a conference room that had frosted windows.  Beyond I could see daylight and shadowy forms moving about as if in conversation.  The inner room was the interview room.

After waiting about ten minutes, one of the panelists opened the door and showed me in.  The room was arranged with two tables butted together in the center of the room, four chairs on one side and one chair on the other.  An extra chair in the corner provided a resting spot for my coat and briefcase.  Some blank sheets of paper rested on the table in front of me, and the panelists advised me that, while I could take notes, the papers would have to stay with them.  The interview style is one I have experience with, as I have been through many interviews in the last 6 years.

The panelists briefly introduced themselves.  There were three women and one man on the interview panel.  After introductions, they explained that the interview consisted of two parts: competency questions and the international affairs questions.  It was all very formulaic, and the panelists remained largely neutral throughout.  Each took a turn either asking a question or asking a follow-up question, trying to gauge from my responses the level of exposure to the various competency areas.  The only competency they didn’t specifically ask about is communication, since this was evaluated holistically with the interview.

I was not nervous to begin with, and I never felt uneasy while they probed for very specific circumstantial details.  My examination subject is Information Technology, so a number of the questions had at least a component of this, and one panelist continually sought out the specific technologies I mentioned (like what operating systems, programming languages, database systems I had worked with).  The competency portion took a while, and I am pretty sure I was very thorough with my answers.  I was satisfied with the answers I gave anyway.

Once the competency portion was done, the panelists explained the rules for the international affairs portion.  This portion consisted of one question in each of four subjects.  If I did not know the answer to one of the questions, they said, I could ask to skip that question and go to another question in the list for that subject.  I was allowed to use this only once during  the interview.  The four sections and the accompanying questions were as follows (keep in mind that these are the best I can recall; actual mileage may vary, so use with caution):

• (General UN) Recently, UN aid workers have suffered attacks.  In your opinion, what is the cause of these attacks and what can be done to keep them from happening?

• (Environment, Science, and Technology) What are the drawbacks of solar power?

• (Economics and Social Affairs) What is the global poverty threshold, and what is the UN doing to fight global poverty?

• (Security) What is the United Nations Peacebuilding Commission?  Why was it created, and what does it do?

I had to skip one of the questions, presumably in the economics section, because I had never heard of the subject.  The original question was something like, “What is the Doha Development Round and why has it failed?”

I have to admit, my answers to the international affairs section were rather anemic compared to the competency answers.  I happen to know a bit about solar power, so I had a good enough answer for that, and my attempts to find the difference between peacekeeping and peace building paid off for me (have to say thanks to NCE_Candidate, one of the readers who commented on an earlier thread, for that bit of advice).  I knew just enough about the global poverty threshold that I could answer that (I said it was $2 a day, which turned out to be right according to Wikipedia).  The rest of the questions, meh.

After that, the interview was done.  I was escorted back out past the office security, and that was that.  The next step is that the examiners will reconvene and determine who will be recommended for placement on the roster.  Once on the roster, there is of course no guarantee of a job, but agencies will be able to select pre-screened candidates from the list for further interview.  I was told that a candidate may only turn down two offers before being removed  from the roster, but there is no cap on the time one may remain on the roster.

Does anyone know when this year’s results will be finalized?  Share your thoughts below.

The Triumph of Plan B

When I moved to the Washington, DC, area a few months ago, I had a grand master plan on how I was going to get around: I would ride a bicycle as much as possible.  This was a good plan, though for reasons that will probably become obvious soon, not well executed.  I had a bike that I got while I was still in Texas, so that wasn’t the problem.

La Jolla Cruiser by NEXT

You see, my original plan called for leaving the bike pictured here locked up at the commuter train station in DC overnight and all weekend.  The train station has bike racks nearby, so that shouldn’t *necessarily* have posed a problem, except that someone eventually decided that they needed my bike more than I did.  I arrived one morning less than four weeks after starting my new job to find my bicycle gone.  Of course, being the meticulous planner I am, I set off on foot (in retrospect, I should have had a backup plan).  That left me scrambling to figure out what buses ran where (I already knew that I’d have a minimum 7-8 block walk if I took the Metro) and found a more-or-less suitable one.  It was going to cost me just enough extra per month in transit costs, however, that I soon developed Plan B.

Plan B

This is a Dahon Boardwalk folding bike.  It’s 27 pounds of maximum portability.  Now, instead of leaving a bike locked up overnight, I can take this one with me.  It folds up nicely for train transport, and it’s not TOO incredibly heavy (although there are lighter models around, they just cost more) to maneuver around the train platforms.

I’ve been riding this one for about six weeks now, and so far I am extremely pleased with it.

What Have You Done?

Today is Blog Action Day, an annual event in which bloggers all write on the same topic.  This year’s topic is Global Climate Change.

I know there were a number of approaches I could take with something like this, but instead of warning of the impending doom of our planet (a fate I am not wholly convinced will even occur), I decided instead to focus on some ways I have reduced my own carbon footprint.  I would be interested to hear from anyone else how you’ve managed to reduce your footprint as well, so leave me a comment if you’re interested in sharing.

Before I go over some of the things I have changed about my own life, let me briefly talk about why I decided it was important.  You see, I have not always bought into the global calamity that some people are predicting, but neither do I deny that such catastrophe is possible.  Global climate change is a reality, although it remains to be seen just how prevalent it is and whether we can act in time to stop it.  So I am not acting from a perspective of being able to help avert some crisis, and I am not even certain my contribution would make a difference anyway.  Instead, I have integrated ways of reducing my carbon footprint out of respect for everyone and everything else that lives on this planet, since many of these practices serve more than one purpose.  I will show below some of the specific things I have done and some of the ancillary benefits I am seeing from doing them.  Hopefully you’ll be able to see ways of “being green” that make a lot of sense to you, and maybe, just maybe, if we all find a few behaviors we can each change, we can all look back on this whole climate change issue and wonder what all the fuss was about, Y2K style.

What have I done?  I have…

Ridden a Bike

I ride a bike 3-5 days per week, depending on how my schedule works out.  It, along with the next option, forms my primary commute transport here in the Washington, DC, area.  Not only do I save money by not having to pay for buses or subway transfers from the commuter train, I also save time and get exercise in the process.  The bicycle portion of my trip is about 5 miles a day all said and done.

Taken Public Transportation

I had been looking to take public transportation for several years, but it’s not always feasible to work public transport into your lifestyle.  That changed when I briefly worked for the University of Texas earlier this year, where I was able to take my bike for a ride on an express bus that dropped me off within a mile of work.  That experience ultimately prepared me for what I do now that I am in DC: I ride a commuter train every weekday, and my folding bike goes along for the ride most days.  The train I ride on has a mid-week ridership of about 1000, so we are all helping out just a little bit.  What benefit do I get?  First, I have none of the stress and danger of driving on busy roadways with rude and impatient drivers.  Second, I save money by not having to own a second car (so I am not tempted to drive in, ever) or worrying about where to park and how much that costs.  I do sacrifice a bit in terms of schedule flexibility, and it can take a while both to get to the train station (even on my bike) and to get home once the train does depart.  Also, if I miss a train, that’s pretty frustrating too.  Overall, though, I have been pleased with the experience despite occasional service hiccups.

Recycled

My household has not always practiced recycling, but over the past 5 years, we have increased the number of things we do recycle.  As a consequence, our trash can is rarely full, and when it is, it is full of actual trash, things that can’t be recycled for whatever reason.  If you routinely cart a large trash can to the curb for pickup, I’m sure you can appreciate the idea of not having to pick up all the overflow after you put it out there.  What we don’t do (yet) is compost our food scraps and yard waste, but that’s largely because we don’t have anything useful to do with the compost we would generate (I guess we could sell it or give it away, but that seems like a lot of effort).

Reduced My Meat Consumption

Back in February of this year, I decided to experiment with vegetarianism.  Since I was unemployed at the time, this was (sort of) easy to do.  Once I started working again, however, it became difficult to maintain, largely because I wasn’t the one doing the cooking at that point.  What I did manage to do is reduce my meat consumption, not just by limiting myself to so many servings per week (I don’t officially do this, but I do keep an eye on it), but more by limiting what kinds of meat I take in.  Namely, I eliminated beef from my diet (I already ate pork and lamb so rarely that removing these hardly counted for anything).  The majority of all grain crops grown in the U.S. goes to beef production as food for cows.  It became clear to me that commercial beef production in this country, including the grain agriculture that supports it, is responsible for huge carbon emissions.  What have I gained from removing beef?  It’s not money, that’s for sure, but one thing beef has more of than, say, chicken, is cholesterol.  Fat content in beef is also generally higher than in poultry and fish, so by eliminating beef from my diet, I am taking an active role in keeping myself protected against heart disease and obesity-related illnesses.

Used CFL Bulbs

This is an easy one, even though there is currently a higher cash outlay.  By replacing all of my incandescent bulbs with compact fluorescent bulbs, I not only got light bulbs that lasted longer, but they cost less to operate.  When LED bulbs drop in price and become more widely available, I plan to move to those.  I’ll admit, though, that getting used to CFL was not easy at first.  They don’t look the same as incandescents, so it will definitely take getting used to if you are contemplating it.

Bought Less and Considered Packaging

As part of a minimalist kick my family went on starting sometime last year, I started seriously considering the kinds of things I bought, not just in terms of quality and quantity, but also in terms of how it was packaged.  As a result, I have reduced the number of things I buy, focusing on making quality purchases instead of simply buying cheap things that would break or wear out quickly, only to need replacement soon.  My other consideration is packaging.  I detest clamshell packaging, since it usually uses far more material than the item it contains should need.  On the other hand, it’s usually recyclable.  I do look at how things are packaged in the store, and that extends to how I get them home, so part of this is either refusing to bag small numbers of items or using reusable bags when I can (and, to be honest, when I even remember to).  After all, what in the world am I going to do with a cabinet full of grocery store plastic bags?

Sold Some Stuff on Craigslist

This is part of the reduce, reuse, recycle mantra we’ve seen on TV for years.  Turns out, selling your old crap can make you some money.  Not a lot, mind you, but it beats tossing it in the garbage.  If it’s too small to sell, we donate it to Goodwill or some other charity.  Just because I can’t use it anymore doesn’t mean nobody can use it, and I would much rather it be reused than end up in a landfill.

Bought a Hybrid Car

Driving a more fuel efficient car than the old minivan is saving me gas money.  Sure, prices are way down NOW, but they will go back up eventually.  This was the biggest selling point on the hybrid, so much so that we barely pay attention to gas prices, since we don’t fill up but about once every week and a half.  In conjunction with my other choices (namely the bike and the train), I am saving a great deal of money by driving only one very efficient car.

So these are all changes I have made in my life, and almost all of them are extremely pragmatic.  If I can do it, so can you, so I encourage you to get started.  For those of you who have already, I refer you to the title of this post and would appreciate your feedback.