MD, PhD, FMedSci, FSB, FRCP, FRCPEd

In my last post, I made a fairly bold statement without any evidence to support it: “[this] demonstrates once again that, in the realm of alternative medicine, organisations and individuals make statements that sound fine and are politically correct, while at the same time disregarding these pompous aims/visions/objectives by promoting outright quackery. This sort of thing is so wide-spread that most of us just take it for granted and very few have the nerve to object. The result of this collective behaviour is obvious: on the one hand, charlatans can claim to be entirely in line with public health, EBM etc.; on the other hand, they are free to exploit the public with their bogus treatments.”

I felt that my statement was supported by so many websites that it was almost self-evident. But, as it happens, I was alerted today to another website that provides impressive first had evidence of what I meant:

“The purpose of this site is to provide the public with information about Craniosacral Therapy

Craniosacral therapists recognise health as an active principle. This health is the expression of life – an inherent ordering force, a natural internal intelligence. Craniosacral Therapy is a subtle and profound healing form which assists this natural bodily intelligence.

It is clear that a living human organism is immensely complex and requires an enormous amount of internal organisation. Craniosacral Therapy helps nurture these internal ordering principles. It helps increase physical vitality and well-being, not only effecting structural change, but also having much wider implications e.g. improving interpersonal relationships, managing life more appropriately etc…

The work can address issues in whatever way the client wishes; physical aches and pains, acute and chronic disease, emotional or psychological disturbances, or simply developing well-being, health and vitality.

Craniosacral Therapy is so gentle that it is suitable for babies, children, and the elderly, as well as adults; and also in fragile or acutely painful conditions. As a whole-body therapy, treatment may aid almost every condition, raising the vitality and enabling the body’s own self-healing process to be utilised.”

I find this text rather typical and very revealing: the authors first make several bland statements which are little more that politically correct platitudes. Eventually, they try to tell us what their therapy is good for: it is suitable for babies adults and the elderly. In other words, it is for everyone!

And what is so truly brilliant, it can be used to treat acute and chronic conditions. In other words, it is effective for every disease afflicting mankind!

Once you have realised it, the strategy of such ‘position statements’ (or whatever they might call it) is all too obvious: behind a smokescreen of empty platitudes, quackery is being promoted for profit. The phraseology used is such that there can be little concrete objections in legal or regulatory terms. All the therapeutic claims are general, cleverly hidden and operate merely by implication.

Quackery? Yes, absolutely!

Craniosacral therapy has not been proven to be effective for anything and, as a therapy, it is therefore not ‘suitable’ for anyone. To me, this is almost the definition of quackery.

17 Responses to Craniosacral therapy: for ‘physical aches and pains, acute and chronic disease, emotional or psychological disturbances’ ?

  • But, Edzard, it treats the whole person. What more do you need to know? 😉

    This reminds me of a homeopath friend’s webpage, where she pretty much covers all bases, while letting her off the hook for any specific shortcomings of the treatment …

    Homeopathic treatment, like all truly natural therapies, seeks to stimulate the innate healing power of the individual so that all physiological systems function at their best. As the person moves toward his or her optimal level of general health, he or she feels better. Secondarily, localized symptoms improve as the strengthened body defenses become active. But the homeopathic remedy does not directly treat a symptom or condition. Instead, it simply helps to initiate the process by which the person heals him or herself.

    The homeopath views a person’s health as a condition of the entire individual rather than in terms of the presence or absence of isolated symptoms. Homeopaths do not diagnose disease or treat diseases. Remedies are selected which best correspond to the person’s total state. Evaluation of the individual’s level of health and choice of the correct remedy does depend in part on a thorough understanding of all symptoms. But in addition, important indicators of general health, like the level of vitality the person experiences and his or her emotional well being, demand close attention. …

    Since homeopathy is used to assist people rather than treat illness, anyone, whatever the diagnosis, can benefit from homeopathic care. Homeopathy helps by increasing the individual’s strength and resistance to disease. Homeopathy does not cure disease, nor is it a substitute for good health habits. Good health provides the individual with the freedom to do what he or she would like to do with their life. Illness is any condition on a physical, emotional or mental level that impedes this freedom. Although homeopathy does not replace conventional medicine, it addresses the root of the imbalance, and in many cases lessens the need for allopathic medicines and treatments. In general, health depends in good measure on eating well and exercising adequately, getting enough rest, dealing effectively with stress, and living creatively.

    It makes my brain hurt.

    • @LinnieMay

      When I saw the text you give as an example I thought I recognised it. I tried taking a some 10-15 word samples from it and ask uncle Google if he could find them. It turns out this is a standard text used by scores of different homeopaths.
      What I really wanted to see was if I would find the exact same text used for other versions of make-believe medicine. I found not exactly the same lines but many examples of the same collection of buzzword in very similar concatenations.
       
      You can take this text and simply substitute “homeopathy” with other quackery names like craniosacral therapy, Bowen technique, Reiki, acupuncture, etc. etc.
      No one will suspect you are simply recycling a “Lorem ipsum dolor sit amet…” type filler text 😀

      • @ Björn: Yeah, maybe part of the education for a career in alt-med comes with an interactive meme generator that allows them to randomly drop in buzzwords for what they do. At least that’s how it strikes me. When you look closely, you see no details to explain phrases like: “the innate healing power of the individual,” “the person’s total state,” or “the root of the imbalance.” They’re just filler in between the grand, vague promises (gives a person the freedom to do what he or she would like to do with their life) and the disclaimers (“Homeopaths do not diagnose disease or treat diseases”).

      • I had the same déjà vu, so I translated that text to german (as a cross check also to french) and did a google search.
        Same result – lots of homeopathy websites in DE/FR/CH use texts with similar sentences and the same buzzwords.

        I already noticed that some time ago, when I checked the “According to the World Health Organisation…homeopathy is the second largest system of medicine in the world” statement that sometimes comes up by homeopaths in discussions.
        While I didn’t find an independent source for that statement, it’s quoted on a lot of websites in different languages (usually without reference, but if they give one, it’s another homeopathy website or homeopath).

  • I begin to think we must find a different word. I quite like ducks, and it seems unkind to make an oblique reference to their cheery sounds in describing such utter bullsh.. – oh, dear, now I have to apologise to cattle.

  • I’m sure this website (energymedphysio.org.uk ) is already familiar to you but just in case it isn’t then you might find it illuminating. Conditions suitable for treatment with Craniosacral Therapy include ‘..acute or chronic conditions and babies, children or older people’. And .. ‘Therapy can be the treatment of choice in longstanding and complex pain situations and where there has been a poor response to conventional techniques’. So essentially anything and everybody is ‘suitable’. No doubt while you are being ‘treated’ by the these providers of Craniosacral Therapy you can be topped up with a little Reiki and acupuncture. The bull manure seems to be thriving in conventional healthcare.

  • Excellent sceptical article by Steve Hartman here about cranial osteopathy;

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1564028/

  • Prof Ernst, the concerning problem to which you allude, if I understand you correctly, is indeed recognised within some osteopathic circles. It has been the subject of a recent publication:
    http://www.journalofosteopathicmedicine.com/article/S1746-0689%2815%2900005-X/abstract
    It is a profoundly regrettable problem and perhaps it may be demonstrable of a state of institutionalised cognitive dissonance, where an assertion of evidence-based or informed practice may appear beside the claims to which you make reference? Such practice appears to have flourished in a climate of political correctness, where it may often be considered unfashionable to disagree and where ‘street cred’ value is accorded irrespective of scientific merit. It is also and obviously raises the equally thorny issue of ethics.
    Perhaps one way around this to refer to such treatments as ‘experimental’ and require them to undergo ethical approval? Another may be to engage with the wider public in an educational campaign designed to enhance awareness of these issues? In any event, these issues need to be usefully addressed sooner rather than later.

    • Forgive the typos. The eyesight is not what it used to be. To quote part of the above linked abstract:

      “The [questionable and unverifiable] data within the Osteopathic International Alliance [unpublished] report identified the most frequently utilised form of osteopathic manipulative treatment (OMT) as ‘osteopathy in the cranial field’ (OCF). These issues are explored further by comparing the bibliographies of a systematic review of cranial osteopathy conducted 12 years ago with a current snap-shot summary (2013) published by the UK National Council for Osteopathic Research. OCF appears to be an unfalsifiable practice that has become professionally institutionalised. Far from being marginalised this practice now holds a central position, one inconsistent with a claim of ethical, evidence-based best practice, and one seemingly endorsed by statutory regulators.”

      Words included within [ ] are added here for clarity. They are not a part of the published abstract.

    • A recent article published by The Journal of the American Osteopathic Association May 2015 | Vol 115 | No. 5 | entitled:
      Variations in the Diagnosis and Treatment of Somatic Dysfunction Between 4 Osteopathic Residency Programs;
      Hon GA et al.
      …highlights the usage of OCF when compared with other techniques between differing US residency programmes. The dominant techiques of choice appear to be ‘myofascial release’ and ‘muscle energy’. OCF appears well down the list.

    • @”Dr” Christopher McGrath,
      “Dr” Chris is an osteopath, not a medical doctor.
      Argument from (False) Authority?
      ~
      It is a trait of alt-med, which includes osteopathy, that these “profoundly regrettable” problems constantly and frequently arise. Science is secondary to the religious belief that constitutes the forms of alt-med.

      • @Frank Collins
        Argument from (False) Authority?

        Throwing stones in the glass house? Never the best approach. Your implication Frank Collins – that holding one or two undergraduate degrees confer authority, much like Dr Andrew Wakefield or perhaps Dr Harold Shipman, or perhaps the recent BMJ superstar, Dr Ranjit Kumar Chandra and his colleagues at Newfoundland’s Memorial University?
        Come now, your ‘straw man’ is so weak it borders on an even weaker ‘ad hom’.

        I refer you to Dawes et al. BMC Medical Education 2005, 5:1 doi:10.1186/1472-6920-5-1
        Sicily statement on evidence-based practice

        “This emphasises the fact that evidence-based practitioners may share more attitudes in common with other evidence-based practitioners than with non evidence-based colleagues from their own profession who do not embrace an evidence-based paradigm.”

        • @Chris McGrath, osteopath,

          “Throwing stones in the glass house? Never the best approach. Your implication Frank Collins – that holding one or two undergraduate degrees confer authority, much like Dr Andrew Wakefield or perhaps Dr Harold Shipman, or perhaps the recent BMJ superstar, Dr Ranjit Kumar Chandra and his colleagues at Newfoundland’s Memorial University?
          Come now, your ‘straw man’ is so weak it borders on an even weaker ‘ad hom’.”

          I have no idea how you drifted into this stream of thinking. Maybe you can explain it?

          “I refer you to Dawes et al. BMC Medical Education 2005, 5:1 doi:10.1186/1472-6920-5-1
          Sicily statement on evidence-based practice

          “This emphasises the fact that evidence-based practitioners may share more attitudes in common with other evidence-based practitioners than with non evidence-based colleagues from their own profession who do not embrace an evidence-based paradigm.””

          Ah, evidence-based medicine? I also wonder how you reconcile the osteopathy with evidence? Has Still been banished from the religion of osteopathy?

          Your website hypes you up:
          http://www.drchrismcgrath.co.nz/about.php
          “With more than 30 years of clinical practice, research and academic engagement, Dr Chris brings an exceptional range of value-added skill that is so vital and rarely seen in manual care, where practice is often fraught with institutionalised belief and fashionable opinion, the vagaries of uncertain, unscientific fads and the ethically questionable ‘over-servicing’. With evidence-informed practice Christopher is able to cut through this intellectual and clinical fog.”

          It seems you treat many things;
          http://www.drchrismcgrath.co.nz/services.php
          “Dr McGrath applies evidence informed diagnosis, treatment and management to a wide range of musculoskeletal pain presentations. For example, acute and chronic back pain, neck – shoulder – arm pain, tension (neck) headache, jaw and face pain, shoulder problems, rib and chest pain, hip, thigh and buttock pain, knee pain, leg – ankle – foot pain, are all seen. With a special interest in pregnancy related pelvic pain, ‘sacroiliac joint pain’, period pain (dysmenorrhoea), ‘trochanteric’ lateral hip pain, jaw and facial pain, age related joint pain (degenerative or arthritic), adhesive capsulitis (frozen shoulder), and whiplash injuries, Dr McGrath is well placed to make a meaningful and lasting contribution to the relief of your pain, to your functional abilities and to your on-going well being. Dr McGrath will also refer you for relevant investigations or to another health professional as required.”

          Period pain?

  • I did some digging on Craniosacral Therapy earlier in the year. The website cited in this blog post seems to have been written so that practitioners could like to it from their own websites, so as to avoid making the direct claims for efficacy on their own sites (which would land them in trouble). To quote the linked page (see near the end):


    This site exists to provide independent information about Craniosacral Therapy. Therapists, practitioners, alternative health clinics, and other interested parties are invited to link to any page on the site (the more the better) and may do so in order to provide information about how Craniosacral Therapy can help with medical conditions, without putting this information directly onto their own websites, which is now against ASA rules
    According to the Advertising Standards Authority, text relating to the link Is OK as long as it doesn’t refer to medical conditions. They gave the example that a permissible link would be ‘For more information about Craniosacral Therapy click here’, but not, ‘for information about how Craniosacral Therapy can help alleviate arthritis click here’.

    • I think this post gives at least one of the reasons why alternative therapy blurb tends towards the same generalities: a legal one. Therapies can’t use words like ‘treat’ or cure in their claims so they are all reduced to using ideas like self-healing, a concept no doctor would dream of using.

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