MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

You might think that the question asked in the title of this post is a bit impertinent. Let’s see whether you change your mind after reading on.

“Come along for a ten minute taster sessions and experience the Bowen Technique.
It is appropriate for a wide range of acute and chronic conditions, including back pain, sciatica, neck, shoulder and knee problems, arthritis, asthma, migraine, sports injuries and stress. Ten-minute taster sessions will be offered so that you can experience the therapy first hand. Many find their aches and pains melt away!” 

It is with these exact words that the Royal College of Nursing advertises a session on Bowen Technique to be held during their major conference on Saturday 13 – Wednesday 17 May 2017, Liverpool Arena and Convention Centre.

You may not have heard of the Bowen Technique, one of the more exotic types of alternative medicine. So, let me fill you in:

According to proponents, it is “a system of subtle and precise mobilizations called “Bowen moves” over muscles, tendons, nerves and fascia. The moves are performed using the thumbs and fingers applying only gentle, non invasive pressure. A treatment consists of a series of specific sequences of moves called procedures, with frequent pauses to allow time for the body to respond.”

Wikipedia explains: “recipients are generally fully clothed. Each session typically involves gentle rolling motions along the muscles, tendons, and fascia. The therapy’s distinctive features are the minimal nature of the physical intervention and pauses incorporated in the treatment. Proponents claim these pauses allow the body to “reset” itself. In 2015 the Australian Government’s Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; Bowen Technique was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.”

Medline lists just one single trial of Bowen Technique; it is not a clinical trial with patients but a study with healthy volunteers; here is its abstract:

The hamstring muscles are regularly implicated in recurrent injuries, movement dysfunction and low back pain. Links between limited flexibility and development of neuromusculoskeletal symptoms are frequently reported. The Bowen Technique is used to treat many conditions including lack of flexibility. The study set out to investigate the effect of the Bowen Technique on hamstring flexibility over time. An assessor-blind, prospective, randomised controlled trial was performed on 120 asymptomatic volunteers. Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment. A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group. Continuing increases in flexibility levels were observed over one week. No significant change over time was noted for the control group.

So, whichever way we look at it, there is no evidence whatsoever that Bowen Technique is helpful for patients suffering from any condition. This clearly means that therapeutic claims made for it are bogus, and that the way the Royal College of Nursing advertised it is misleading to the point of being unethical. By definition, the promotion of bogus treatments is quackery. Ergo, the Royal College of Nursing is promoting quackery.

If that is so, there is of course another question that needs an answer: Why does the Royal College of Nursing promote quackery?

As I see it, there are several possibilities, for instance:

  • They see nothing wrong with the Bowen session.
  • They don’t know better.
  • They don’t adhere to EBM.
  • They don’t care.
  • They were asked to run the session by someone with influence.
  • They believe that nurses want this sort of thing.
  • They think it’s trendy.

I would be fascinated to hear from someone who knows the correct answer.

19 Responses to Is the Royal College of Nursing promoting quackery?

  • This therapy is one of many events listed under “Fringe” at the convention.

    E.g. Yoga, karate (yes KARATE!), bath-tub…
    https://www.rcn.org.uk/congress/agenda
    (Monday)

    I’ll cut them some slack if they are viewed simply as being stress-busters – and not magical cure-alls.

  • In case anyone isn’t sure what Bowen therapy/technique is and lest anyone should think it’s just a form of relaxing massage, there are many videos on youtube (an attractive model in a bikini seems to be an essential prop) demonstration it such as this one. Note the waiting time after a Bowen move: this is a requirement of Bowen therapy. The practitioner sometimes has to leave the room to let the brain re-learn from what the Bowen move has just taught it…

    • Meh, as massage goes Bowen is just pants…

    • Unbelievable!! The guy in this video claims that a single, gentle rub to the thigh or elsewhere causes muscles to ‘unwind, untwist and elongate’. Lots of the moves are made over major meridian points [qué?!] which release chemicals and electrical currents from the meridian points…also opens up channels so the meridians can flow more freely. Elongation of tissues allows water, blood and lymph to flow more freely…in addition it releases endorphins from meridian points…”it turns out that endorphins is [sic] one of the mechanisms by which the immune system, the central nervous system and the endocrine system internet [qué?!] with each other”. Last but not least the Bowen move balances the autonomic nervous system…

      I’m really not sure this is actually better than the guy who told us recently that all disease is caused by “blockages” (without giving any details). At least most people have probably heard of infectious agents, vitamin deficiencies, injuries, etc. and might be in a position to challenge the “blockage” theory of pathology. But the fellow in the video Alan links to knows a lot of medical terminology and mixes it all together freely in a word spaghetti that just might sound convincing to anyone who knows zilch about biology and medicine. The fact that it’s total, utter, unmitigated bollocks, guff and horse manure might well pass over many people’s heads.

      I dread being managed in any way by a nurse who believes this tripe makes any contribution whatsoever to a patient’s health or well being.

      Though I guess it has to be better than the automatic death sentence people receive by visiting a doctor and coming away with a prescription for a synthetic drug. 🙂

      • The effect of a mere mention of ‘meridian points’ or mysterioys ‘energies’ is enough to send my blood pressure up, so the only effect of yet another nutty quack therapy is a negative one!

        • Don’t worry Joanna if your blood pressure goes up because there’s a pill your doctor can give you that will lower it. Then when low blood pressure becomes an issue, don’t worry there’s a pill you can take that will raise it.

          Unfortunately there are negative side effects but who cares. Um and the catch is you’ll have to take these magic pills for the rest of your life.

      • “Though I guess it has to be better than the automatic death sentence people receive by visiting a doctor and coming away with a prescription for a synthetic drug.” 🙂

        Oh finally someone’s actually getting it. Hip, hip, hooray.

  • I know someone who is studying this “therapy”. There’s booklets with funny manipulations, whose effects are measured by trying the same stretch before and after poking or prodding the hapless patient’s body and saying out loud “ah! much more flexible now”. I saw a “patient” feeling much better as if by magic after a gentle poke in the shoulder. Not clear to me that her range of motion changed between the before and after, but I didn’t spoil it for her.

    As far as I could see, nobody is taking photos or measurements of said flexibility or range of motion. If we keep things low on details and slightly ambiguous, it’s easier to carry on.

    Sadly, this looks like a pyramid scheme where trainers and “schools” find more and more levels of accreditation for customers to pay for additional chapters of the little booklets of techniques. It is attractive for massage practitioners who realise that their normal job is hard on their own joints. If poking the patient with a finger does a convincing job, why bother with tiresome manipulations and the endless laundry that goes with massage?

  • From ‘Real Secrets of Alternative Medicine’:

    “Bowen Technique.
    Thomas Bowen (1916-1982) was born in Victoria, Australia, to parents having emigrated from Wolverhampton. He went on to be actively involved in the Salvation Army. For many years, he was a general hand in a cement works, but over time developed a technique for dealing with the musculoskeletal problems of his colleagues.

    Being profoundly deaf, Bowen did not talk much with patients and often saw up to fifteen patients an hour. They were told ‘If I don’t get you right in two sessions, go away and save your money’. His technique involved massage to tendons, ligaments and fascia by ‘rolling moves’. This may only take a short while and the therapist then leaves the patient to have a break and rest, before another ‘move’. Bowen held that the breaks allowed time for the body to heal itself, particularly by re-balancing muscle length. Although he appears to have used some osteopathic thrust methods, he strongly opposed other ‘body work’ techniques being used in conjunction with his own.

    Bowen’s work was reviewed by the Victorian Government Inquiry into Chiropractic, Osteopathy and Naturopathy in 1975. He told the Commission he was seeing 13,000 patients a year with an 80% success rate. This was due to having studied books on osteopathy and having ‘a knack’. He applied to be a registered osteopath in 1982 but was unsuccessful.

    As practised by Bowen, his technique involved ‘seeing’ what was wrong with the patient by using his fingers to ‘sense the vibrations in musculo-skeletal tissue’ and so determining what imbalance needed to be corrected in order that the body would heal itself. Bowen’s method also applies finger touch analysis of a patient’s entire skeleton in order to detect misalignments. These are then corrected by light, fast movements known as ‘toggle-torque-recoil’, which induce minute vibrations and allow the body to readjust itself. Patients hardly feel the force of the ‘toggle’.

    Many of Bowen’s students were osteopaths and chiropractors who wanted to diversify their techniques. Bowen’s ‘knack’ comprised 90% of his own method, based on A. T. Still’s concept that ‘structure governs function’ and that disease requires structure to be corrected. Osteopath Oswald (Ossie) Rentsch controversially claimed that he had been commissioned by Bowen to document his technique. Certainly it has been Rentsch who has promoted the Bowen Technique worldwide. Together with his wife, Elaine, a Bach Flower Therapist, they introduced Bowen Technique to the US in 1990.

    The Bowen Therapy Academy of Australia has trademarked the name ‘Bowenwork’ as a ‘manipulative/body-based practice in the same category as osteopathy and massage.’ It is postulated that gentle hand movements stimulate nerve pathways and cause a transitional state of realignment of microfibers within the nervous system to stimulate healing pathways. ‘Conditions that are seen to respond well include: Crohn’s disease, bed-wetting, scoliosis, haemorrhoids, infertility, uterine fibroids, asthma and anxiety.’ There is no plausible scientific evidence offered in support of these prepostulations, and no indication of any better outcome than from regular physiotherapy. In the UK physiotherapists are regulated by the Health & Care Professions Council, Bowen practitioners are not.”

    Quite what Bowen’s methods of massage have to do with nursing I cannot see.
    Are nurses being encouraged to stray from the limits of their professional competence?
    Is such encouragement unethical?

  • and, of course, what’s sauce for the human is sauce for the horse: http://www.equinebowentherapy.com/…….they “set the standard” for Bowen therapy for horses. What could that possibly mean?

    • Thank you for this! I particularly enjoyed: “[Bowen Therapy] can be anything you need it to be; a sports therapy; a functional muscula-skeletal therapy; a hormone/blood pressure balancer; an aid to comfortable respiration; a stress reliever; and energy booster; the possibilities are infinite!” This can probably be applied to any branch of the Big Snakeoil industry. Of course, evidence to support these extravagant claims is non-existent.

  • I particularly liked the fact that the Bowen Technique is also a sheep shearing technique. https://en.wikipedia.org/wiki/Sheep_shearing but not invented by the same Bown.

    It could be touchy though: Go for a gentle massage and get scalped

  • Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment.

    A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group.

    Continuing increases in flexibility levels were observed over one week.

    No significant change over time was noted for the control group.

    That’s the study you quoted. Did I miss something?

  • My back regularly goes in spasm. Doctors offer pain killer and antiflamitory tablets and I am still struggling for a month. Since using Bowen treatments within a week I am back to yoga. Even if it only works 80% of the time the potential saving to the NHS is massive. Thank goodness we have some progressive thinking nurses and I for one am very sorry to see the way the under minded and attacked from reading previous posts.

    • Does anyone else get the impreßion that this strange comment- “under minded and attacked”…”offer..and I am still struggling”..has been generated by some sort of software?

    • Funny, in Chiropractic and most quack circles everything always “works” 80% of the time. That’s the universal figure for all scams.
      Backs don’t spasm, and even if they did how would you differentiate it from a deeper tissue manifesting as pain “in the muscle” (disc, facet, ligament). Spasm has no objective standard. Rubbing the body in “any” way activates receptors which deactivates nociceptors….rubbing with menthol does even better. Proposing there are “specific ways and specific points” is always on the buisness card of frauds.

  • Laura Burke said:

    Even if it only works 80% of the time

    There’s no good reason to believe it works even 0.00001% of the time.

  • Great to see we’re still in the Middle Ages where accepting Alternative medicine is concerned!! I suggest you speak to those who have had their lives changed by what you term as ‘quackery’. Allopathic medicine does not work for all and in the current trend of shoving pills on to a patient in the ten mins they get surely if an alternative works that can only be a good thing, Don’t be so closed minded!!

    • “if an alternative works that can only be a good thing…” Hear! Hear! We have a name for alternative medicine that works: “medicine”.

      But you have to define what you mean by “works”. For what diseases, under what circumstances, with what level of improvement or cure? “It worked for me!” may sound terrific as a testimonial, but real medicines need to provide cooler, objective proof of their efficacy.

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