MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Recently, the UK Advertising Standards Authority (ASA) together with the UK General Osteopathic Council (GOsC) have sent new guidance to over 4,800 UK osteopaths on the GOsC register.  The guidance covers marketing claims for pregnant women, children and babies. It also provides examples of what kind of claims can, and can’t, be made for these patient groups.

Regulated by statute, osteopaths may offer advice on, diagnosis of and treatment for conditions only if they hold convincing evidence.  Claims for treating conditions specific to pregnant women, children and babies  are not supported by the evidence available to date.

The new ASA guidance is intended to help osteopaths talk about the healthcare they provide in a way that complies with the Advertising Codes and to protect consumers from being misled. It provides some basic principles and many examples of claims that are, and aren’t, acceptable. The ASA hopes it will provide greater clarity to osteopaths on how to advertise osteopathic care for pregnant women, children and babies responsibly.

Specifically, the guidance points out that “osteopaths may make claims to treat general as well as specific patient populations, including pregnant women, children and babies, provided they are qualified to do so.  Osteopaths may not claim to treat conditions or symptoms presented as specific to these groups (e.g. colic, growing pains, morning sickness) unless the ASA or CAP has seen evidence for the efficacy of osteopathy for the particular condition claimed, or for which the advertiser holds suitable substantiation. Osteopaths may refer to the provision of general health advice to specific patient populations, providing they do not make implied and unsubstantiated treatment claims for conditions.”

Examples of claims previously made by UK osteopaths which are “unlikely to be acceptable” include:

  • Osteopaths often work with lactation consultations where babies are having difficulty feeding. 
  • Osteopaths are qualified to advise and treat patients across the full breadth of primary care practice.
  • Osteopaths often work with crying, unsettled babies.
  • Birth is a stressful process for babies.
  • Babies’ skulls are susceptible to strain or moulding, leading to asymmetrical or flattened head shapes. This usually resolves quickly but can sometimes be retained. Osteopathy can help.
  • If your baby suffers from excessive crying, sometimes known as colic, osteopathy might help.
  • Children often complain of growing pains in their muscles and joints; your osteopath can treat these pains.
  • Osteopathy can help your baby recover from the trauma of birth; I will gently massage your baby’s skull.
  • Midwives often recommend an osteopathic check-up for babies after birth.
  • Osteopathy can help with breast soreness or mastitis after birth.
  • If your baby is having difficulty breastfeeding, osteopathy might be able to help.
  • Many pregnant women experience pain in the pelvic girdle area.  Osteopaths offer safe, gentle manipulation and stretches.
  • Many pregnant women find osteopathy relieves common symptoms such as nausea and heartburn.
  • Use of osteopathy can limit perineum or pelvic floor trauma.
  • If your baby suffers from constipation then osteopathy could help.
  • Osteopathy can also play an important preventative role in the care of a baby, child or teenager and bring the body back to a state of balance in health.
  • In assessing a newborn baby, an osteopath checks for asymmetry or tension in the pelvis, spine and head, and ensures that a good breathing pattern has been established.
  • Cranial osteopathy releases stresses and strains in the skull and throughout the body.
  • Osteopaths can feel involuntary motion and mechanisms within the body.
  • Cranial osteopathy aims to reduce restrictions in movement.

Elsewhere in the ASA announcement, we find the statement that “The effectiveness of osteopathy for treating some conditions is underpinned by robust evidence”. The two examples provided are rheumatic pain and joint pain. I have to say I was mystified by this. I am not aware of robust evidence for these two indications. Perhaps someone could help me out here and provide some references?

The only condition for which there is enough encouraging evidence is, as far, as I know low back pain – and even here I would not call the evidence ‘robust’. Am I mistaken? If you think so, please supply the evidence with links to the references.

But, in general, the new guidance is certainly a step in the right direction. Now we have to wait and see whether osteopaths change their advertising and behaviour accordingly and what happens to those who don’t.

WATCH THIS SPACE

9 Responses to New advertising guidelines for UK osteopaths

  • I agree that most of the listed claims are dubious. However, I don’t see a problem with the claim that osteopathy(i.e. assumed SMT) MIGHT help improve infantile colic. My own management of colicky infants consists primarily of consolation of the parents and of reducing/eliminating milk, eggs, nuts, and some gluten products from the breast-feeding mother’s diet. There is some evidence for these rxs. If colic persists past 3 months, I consider SMT if I palpate any areas of spinal dysfunction. There is some evidence for SMT in colicky infants, albeit not a lot. If the colic hasn’t reduced after 2-3 manipulations, I discontinue the treatment plan. The claim that such treatment MIGHT improve colic is not spurious.

    • L-B; You “claim that such treatment might improve colic is not spurious.” It is spurious and certainly ridiculous!! Please provide a rational explanation of how manipulation of a child’s spine could possibly treat colic. The colic you claim to have cured likely resolved with time as many do, but you apparently took credit for a magical cure. You could “cure” most self limited common colds with the same “technique.” I imagine many of your colleagues do this as well.

      • @Cox

        The primary managment of colic consists of parental consolation and maternal diet changes. Most colic self-limits by 3 months of age. Conceivably an infant could be colicky due to spinal pain, thus evaluation of his spine for dysfunction is reasonable; if dysfunction is present, and its reduction positively affects the colic…Happy Day. If there is no dysfunction, manipulative treatment is not provided.

        Please point out where I referred to “colic I claim to have cured.” Why do you purposely impute claims to me I have not made? Perhaps you have comprehension problems? BTW, I agree that colic usually does self-resolve; but it usually does so within 12 weeks.

        I note that the dullard Geir jumped into this conversation with his typical and intellecutally vacuous detritus, which he considers to be relevant opinion. LMAO! He injected the concept of “pediatric chiropractic”(and all of the bogus practices which it entails) into this thread and disparaged it; I actually agree with his injected canard regarding much of “pediatric chiropractic.” Sadly, the sub-cogent dolt simply finds it difficult to focus on the specific topic of my comment: infantile colic management.

        You should re-read my first post, Cox. Edzard stated that claims that osteopathy(SMT) might help infantile colic would be unlikely to be acceptable. I pointed out that there is some evidence for SMT efficacy when managing the condition. Now read this s l o w l y: because there is some evidence for it, the claim that osteopathy(SMT) for colic is not spurious.

  • Something about eggs, nuts…etc. caught my eye in the comment above before I noticed it was by L-B. I no longer bother reading his/her pathetic garbage, much less responding to it but I had already read this and I respond with deep contempt because I have seen enough of charlatans defrauding parents of crying toddlers by pretending to treat a problem that is almost always harmless and self limiting.

    However well intentioned it may be, such fraud is beyond contempt, not the least the recent, detestable, invention (not discovery) of “pediatric chiropractic”. There are neither evidence nor plausible mechanisms supporting manual therapy, chiropractic or otherwise, massage, diet-restrictions, herbs or anything other than reassurance and supportive measures for the parents, and of course eliminating the rare significant cause like constipation, fissure, reflux, etc. Having a chiropractor or some other idiot fiddle with make-believe magical ceremonies on toddlers and children will only risk delaying proper diagnosis and treatment in rare cases of organic disease.

    • @Geir

      How and why is my proposed and described management of infantile colic fraudulent? Please be intellectually(at least semi-intellectually) honest and acknowledge that my main treatment was noted to include parental consolation and maternal diet rxs.

      “Charlatans defrauding parents of crying toddlers,” stated Geir, clumsily, as usual. Defraud = swindle, rob. Perhaps Geir is now trying to morph this conversation into one about the kidnapping of toddlers? Please do clarify, dear Geir.

      I doubt that even the bogus pediatric chiropractic vitalists inflict a 4.6% one-year fatality rate onto their patients as the bariatric surgeons statistically do. Geir has failed in the past to effectively argue against this truth and my previously provided statistics and has retreated from such conversation; not surprising.

      Be well

  • As expected, the L-B gets all worked up and haughty. Yes, chiropractors pretending to treat children is fraud and swindle. If anyone can prove me wrong then please do.
    The mortality figure it has pulled from some hat and keeps parroting is far from correct.

    • @Geir

      I have previously supported the quoted mortality figure regarding bariatric surgery as well as its source. Unfortunately Geir was unable to refute it. Apparently the truth is still sticking in his craw.

      Would Geir care to intelligently explain why my stated treatment protocol is fraudulent? He has made the bogus claim twice now yet has provided zero substantiation for his specious notions. In what country specifically would my described treatment be considered fraudulent? I await Geir’s hopefully credible response.

      I wonder if Geir would also consider the Paxil situation and GlaxoSmithKline’s involvement in same to be fraudulent. Earth to Geir: more infants died from that single “modern medicine” quackery-scam than have died throughout the 121- year history of chiropractice. I have posted information regarding this medical debacle to Geir in the AIH/comedy gold thread. Since the example failed to reconcile with Gier’s biased notions(medicine good/paramedical bogus), he failed to respond. All is good for Geir when he can trash with impunity non-medical procedures and studies; he clams up big time when he is confronted with the exposure of blatant medical quackery.

      Be well

  • Unfortunately Geir was unable to refute it

    Well, unable is not the same as not finding it worthwhile. L-B seems to need help with fact finding. Let’s try the tube-feeding approach.

    For those in the astonished audience who are wondering about that off-topic factoid that L-B seems so preoccupied with trying to belittle me with…
    It might well be a correctly quoted, published figure from a study that is not representative of the subject at hand. Here is one of the many strong, perhaps even strongest evidence that it is incorrect in the general context of bariatric surgery :
    https://www.ncbi.nlm.nih.gov/pubmed/17715408?dopt=Abstract
    This paper is one of many publications produced by one of the largest and most thorough studies of its kind, the “SOS-study” from Sweden. Another, somewhat different study from Utah with similarly strong evidence of the positive effects on mortality was published in the same issue of NEJM back in 2007. Since the era that these studies published in 2007 looked at, safety and results have improved even further.

    Evidence for the positive effects of bariatric surgery on health and life expectancy is nothing less than massive. Of course you can find odd studies or opinions that differ but the facts are not found by picking the cherries you like the looks of. As the professor so often reminds us here in his blog – if you wish to approach the truth you will have to look at the totality of evidence.
    Ignorantly, L-B chooses to pick a single result that seems to fit the puerile purposes of an inflated purveyor of 121 year-old parlour tricks digging fiercely into the bottom of the proverbial hole. If L-B has posted a reference to this odd result somewhere, I probably missed it as I am trying to make a habit of skipping commentators known for tediously irrelevant ramblings.

    • @Geir

      Glad to have Gier back! I did in fact post a reference supporting my statement regarding bariatric surgery and Geir deflected from directly addressing it. I also cited studies which countenanced the safety of SMT in response to his unfounded attack on its safety.

      “Evidence for the positive effects of bariatric surgery on health and life expectancy is nothing less than massive. Of course you can find odd studies or opinions that differ but the facts are not found by picking the cherries you like the looks of. As the professor so often reminds us here in his blog – if you wish to approach the truth you will have to look at the totality of evidence,” stated Geir. I agree(regarding the need to study the totality of evidence statement), but apparently Geir does not follow his own prescriptions. He should by now have realized that mainstream chiropractice in the US includes much more than SMT; why does he not accept the totality of the evidence which supports my claim, instead continuing to proffer prattle suggesting that chiropractic physicians’ only tool is spinal manipulation?

      Why has Geir again deflected from answering my questions regarding his chimerical claim that my proposed treatment of infantile colic is fraudulent? Was he merely blathering his typical rubbish as per usual, or did he have a legitimate foundation for his allegation? Who knows? Geir has been unwilling(unable) to support his claim.

      Of course Geir retreated from commenting on my ancillary statements regarding drug-company quackery and Paxil for children. Quackery and fraud in his own (“modern medicine”)backyard must be too much for him to assimilate, especially since the fraud has cost many young lives. Yes, it is so true that this scam within medicine has cost more lives than have been lost resultant to chiropractic SMT since 1895.

      Be well

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