MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Some osteopaths – similar to their chiropractic, naturopathic, homeopathic, etc. colleagues – claim they can treat almost any condition under the sun. Even gynaecological ones? Sure! But is the claim true? Let’s find out.

The aim of this recent review was to evaluate the effects of the osteopathic manipulative treatment (OMT) on women with gynaecological and obstetric disorders. An extensive search from inception to April 2014 was conducted on MEDLINE, Embase, the Cochrane library using MeSH and free terms. Clinical studies investigating the effect of OMT in gynaecologic and obstetric conditions were included as well as unpublished works. Reviews and personal contributions were excluded. Studies were screened for population, outcome, results and adverse effects by two independent reviewers using an ad-hoc data extraction form. The high heterogeneity of the studies led to a narrative review.

In total, 24 studies were included. They addressed the following conditions: back pain and low back functioning in pregnancy, pain and drug use during labor and delivery, infertility and subfertility, dysmenorrhea, symptoms of (peri)menopause and pelvic pain. Overall, OMT was considered to be effective for pregnancy related back pain. For all other gynaecological and obstetrical conditions the evidence was considered to be uncertain. Only three studies mentioned adverse events after OMT.

The authors concluded that, although positive effects were found, the heterogeneity of study designs, the low number of studies and the high risk of bias of included trials prevented any indication on the effect of osteopathic care. Further investigation with more pragmatic methodology, better and detailed description of interventions and systematic reporting of adverse events are recommended in order to obtain solid and generalizable results.

Given the fact that the lead authors of this review come from the “Accademia Italiana Osteopatia Tradizionale, Pescara, Italy, we can probably answer the question in the title of this blog with a straight NO. I see no reason why OMT should work for gynaecological conditions, and I am not in the least surprised to read that there is no clinical evidence for this notion. Sadly, this is unlikely to stop osteopaths to claim otherwise and continue to prey on the desperate and the gullible.

One might thus say that this review is totally unremarkable – but I would beg to differ: it highlights yet again one very important finding, namely the fact that trials of alternative therapies far too often fail to report adverse effects. I have stated this often already, but I will say it again: THIS OMISSION IS A VIOLATION OF RESEARCH ETHICS WHICH GIVES US A FALSE POSITIVE OVERALL PICTURE OF THE RISKS ASSOCIATED WITH ALTERNATIVE MEDICINE.

3 Responses to Osteopathy for gynaecological and obstetric disorders?

  • “that trials of alternative therapies far too often fail to report adverse effects. I have stated this often already, but I will say it again: THIS OMISSION IS A VIOLATION OF RESEARCH ETHICS WHICH GIVES US A FALSE POSITIVE OVERALL PICTURE OF THE RISKS ASSOCIATED WITH ALTERNATIVE MEDICINE,” states Edzard emphatically, as though he sincerely is concerned about false positive overall pictures by the public at large of inverventions by various non-medical health professionals. Yet Edzard and his fellow forum cynics have had zero substantive comments regarding the quacky medical ruse foisted upon young girls and their parents in the name of reduced health risk and for the purpose of selling HPV vaccines. I discussed some concerns regarding HPV vaccines in the Swiss Homeopathy thread and none of the cynics was able to effectively diss the concerns. Unfortunately the risks of this vaccine to girls’ health is “spun” efficiently enough by the medical profession that they are interpreted by patients as nominal.

    Edzard’s (faux) outrage regarding disclosure of risks to patients(and to readers of research) is blatantly bogus. His aganda is oriented more toward cynical criticism of paramedical professions than it is toward the betterment of public health. I will await his snarky, one-sentence response that cynicism of CAM is in the pubilic health interest, but such a response will not obfuscate the fact neither he nor his comrades in this forum have demonstrated the willingness or capability to intellectually engage in criticisms of medicine. Are they oblivious to medical quackery or do they simply choose to ignore it?

    • “Edzard’s (faux) outrage regarding disclosure of risks to patients(and to readers of research) is blatantly bogus.”

      No, it isn’t and I note you offer no reason for saying that it is. That’s a gratuitously unpleasant comment, which reflects poorly on you.

      “His aganda is oriented more toward cynical criticism of paramedical professions than it is toward the betterment of public health.”

      His agenda is to expose the nonsense promoted by quacks and to highlight how the principles of medical ethics are routinely ignored and violated within various brands of quackery. The above piece is a fairly typical example and I note you fail to engage with the content beyond using it as a launchpad to cast aspersions. Your oft-repeated allegation of cynicism against others is somewhat ironic given your mean-spirited assumptions about Edzard’s motives.

      “neither he nor his comrades in this forum have demonstrated the willingness or capability to intellectually engage in criticisms of medicine”

      Well maybe they’re not clever enough to intellectually engage with your astoundingly original arguments. (Just kidding.) Actually, the content of this blog and of many of the comments would suggest to most reasonable people that those you rail against are perfectly capable of intellectually engaging in criticisms of medicine. But that is not what people come to this particular blog – by a prof of complementary therapies – to do and certainly not with someone who comes across as petulant and snarky and whose arguments are fallacious and unsupported.

      • Yawn…..another Ad Hominem attack(to borrow this phrase from another poster). I note that you also have failed to address my comments, quite clearly written and understandable, regarding the HPV vaccine; how typical of the many folks who participate in this forum, yourself included, of course!

        If you would care to point out the errors in my HPV comments, please do so. I would appreciate your hopefully cogent thoughts. Petulant and snarky? Have you read some of the titles of Edzard’s recent “articles”? I have observed incessant snark, jokes, insults, etc by virtually all of this site’s posters regarding almost anything outside of medicine. Yet when criticism of various medical procedures and practices is criticized, such posters have NOT rebutted my stated concerns with anything intelligible; rather, they wax apoplectic or else perform a pitifully poor imitation of an angry Don Trump who’s unable to mount educated, contradictory arguments to my posts.

        If you want to play the role of Edzard’s Padawan, go for it. If instead you’d like to engage in reasoned dialogue regarding my criticism of some of medicine’s dubious practices, such would be welcome. Be well.

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