The TIMES HIGHER EDUCATION (THE) reported yesterday that the British School of Osteopathy (BSO) has won university college title, meaning that it could be on the road towards full university status. University college title, awarded by the Privy Council on the advice of the Department for Education (DfE) and the Higher Education Funding Council for England, is usually seen as a step towards full university status. The London-based BSO already secured degree-awarding powers and access to Hefce public teaching and research funding in 2015. The BSO will be known, from September, as the University College of Osteopathy.

The THE quoted me saying “Osteopathy is based on implausible assumptions, and there is no good evidence for its effectiveness. Yet osteopaths regularly make all sorts of therapeutic claims. These facts make the BSO not a candidate for becoming a university; on the contrary, such a move would significantly downgrade the credibility of UK universities and make a mockery of academia and evidence-based healthcare.”

Charles Hunt, the BSO principal, responded: “We recognise that for some of the things that some osteopaths are doing, there is very limited evidence [to demonstrate their effectiveness], and we need to gain more for that. But within medicine, there’s a lot of things that also do not have evidence for them, but some medical practitioners are doing [them anyway].”


The BSO principal should offer a course on logical fallacies and enlist as the first student in it, I thought when reading his response.

Anyway, having stated that “osteopaths regularly make all sorts of therapeutic claims”, I better provide some evidence. Perhaps another occasion for a slide-show?

Here are a few images I found on Twitter that are relevant in this context.

[please click to see them full size]

50 Responses to Osteopathy making a mockery of academia and evidence-based healthcare

  • The mind boggles as to what students actually get taught on a degree programme in this pseudoscience.
    What a waste of their time and money – and public money.
    The osteopaths will be delighted though, at the apparent legitimacy from gaining ‘university college’ status. As Edzard says, this could well be the precursor to full university status.
    More generally, I suspect we could be witnessing the start of a resurgence in degrees in woo in the UK, following the dropping a few years ago by most universities of degrees in mumbo jumbo, or more specifically homeopathy, that resulted from David Colquhoun’s expose of ‘quackademia’.

  • Well, what else will we have to sell to the rest of the world in our glorious post-Brexit future? (Other than cluster bombs…)

    • How about retaining academic integrity on principle alone? Perhaps not fashionable, but inherently worthwhile.

      • Higher education has been getting it in the neck for decades, mind, being largely reduced to an extended babysitting service for middle-class swing voters. I doubt this crap is even close to its endpoint, alas.

  • Actually, the best osteopaths function in a way that’s indistinguishable from physiotherapy. It’s true that the evidence base for physio is pretty slim too, but it doesn’t involve mystical quackery (apart from those deluded physiotherapists who have adopted acupuncture). The problem is (as usual) that their regulatory body does nothing about those who make outrageous claims

    • Just as chiro has done, osteo has (mis)appropriated modes of treatment from medically allied professions to try to give themselves a veneer of respectability. I would call it unprincipled thievery.

  • So I am to assume ‘Osteopathy’ (a DO in the US) is NOT an MD-equivalent-degree in the U.K.??
    Both my GP and general surgeon are DOs and practice identically to an MD…neither do any untoward theatrics.

  • In the US an osteopathic physician D.O. is a fully licensed physician with a professioal degree (D.O.). The medical training is according to the standard of M.D. which is a professional degree too.

    Osteopathic physicians receive a training in OMM (Osteopathic Manipulative Medicine) too to treat functional disorders of the movement apparatus. Their is nearly no evidence to this OMM and only about 5% of osteopathic physicians use OMM in their practice.

    European or Commonwealth osteopaths are totally different educated and are called “osteopathic manipulators” by osteopathic physicians of the States to point out the difference.

    European osteopathic manipulators use OMM plus “visceral osteopathy” which was added to OMM in the 1980 by French osteopaths and so called “osteopathy in the cranial field” or “craniosacral osteopathy”.

    Visceral osteopathy is the old Thure Brandt Massage in the version of the old French gynecologist Henri Stapfer who suggested to lift the organs to prevent uterus prolaps. There is no evidence to this at all. Such an approach has a risk to cause inner bleedings.

    Cranial osteopathy developed out of Mesmerism (magnetic healing) plus phrenology and was used to provide symmetric skulls.

    In the 1950 there were techniques for one to 4 osteopaths working on a child’s skull. As Upledger’s Cranio-sacral therapy took over that market cranial osteopathy switched it’s techniques to soft-touch too. It’s a nice experience but why call this a therapy?

    Their is no evidence to osteopathy in the cranial field at all and the explanations used in the training are switching between esoteric and pseudo-scientific.

    Sorry to say but under such circumstances a B.Sc. or M.Sc. in osteopathy in Europe to me is equivalent with any other similar degree in religious “science”.
    But nowadays you might receive a B.Sc. or M.Sc. in anything that’s relevant for marketing.

  • If you know the details and strong effort of European / Commonwealth osteopathic manipulator’s (“osteopaths”) lobbyism in all governments to become a legalized and officially recognized profession in all national health systems all over Europe it’s really interesting obvious how much there is a need to put “evidence” into the foreground in advertisement of European/Commonwealth osteopathic manipulator’s education to camouflage the Trojan horse of pseudoscience by teaching VM or even Craniosacral.

    Because of all the titles BSc (ost) and MSc (ost) and all the overwhelming evidence in Osteopathic Manipulative Medicine some regional and even national governments stopped to use the term “alternative medicine” in their internal documents and correspondece in context with European / Commonwealth Osteopathic Manipulators.

    But let’s have a closer look on how the most traditional eldest and extraordinary school of osteopathic education all over Europe and the Commonwealth is teaching right now in 2017! This school is a “luminous role model” the shining example par excellence for all the younger schools in Europe and The Commonwealth.

    It’s the honorable British School of Osteopathy now University College of Osteopathy and to be granted both University College title and the power to award their own degrees like MSc (Ost) .

    They advertise as “evidence-based” but that’s misleading because they teach VM Visceral Manipulation as a CORE SUBJECT.

    In the foreground they talk a lot about “evidence” on their web page
    … “We’re the largest osteopathic educational institution and our evidence-informed approach …”
    … “We support an evidence informed approach to our teaching..”

    But if you look behind for details in
    you can see the pseudoscientific Trojanic Horse in reality e.g. like:
    “page 10 of 18, …
    year 2 Unit CORE osteopathic capabilities for clinical practice 2 ….
    3. … You are also required to demonstrate a developing ability to apply a range of other osteopathic techniques including functional and VISCERAL” !!!

    So riding the Trojan horse of alternative quack VM under the banner of evidence and statutory title as University College that’s disenchanting obvious an unbounded cheek.

  • Hi everyone,
    I am an Osteopath of 20years standing and I trained at the former BSO. Before you all write in to call me a quack please think about the following:
    I learned Anatomy from Grays Anatomy (the book not the tv series) any problem with that = I doubt it. I learned Physiology from among other texts Tatora and Grabowski (set text for all medical students) any problem? No. I learned Neurology from Pattons Clinical Neurological Differential Diagnosis – problem there? and I was taught clinical anatomy by the esteemed Professor Hutchinson of Guys Medical School and in their disection lab where we studied human cadavers assisted by post graduate surgery students. Is this quackery? Because if it is then so is medicine and it clearly is not.
    There are 5 basic principles to the application of Osteopathy;
    1) A good blood supply is healthy for the human body
    2) musculoskeletal structures that are in good structural condition provide for good function
    3) The structures and systems of the human body are interrelated
    4) The human body has a great capacity for self healing (immune system anybody?)
    5) The body has self regulatory mechanisms – Homeostasis
    No medic would argue with any of these principles because they are obviously true.
    The difference between an Osteopathic approach and a medical approach is simply that Osteopaths look at the body as a whole whereas doctors tend to look at structures and systems in isolation. Both are completely valid and both have their place in our healthcare. If I need an operation to remove a tumour I’m off to see my consultant surgeon and my oncologist. If I have a persistent mechanical back pain problem then its the Osteopath for me. It really is about time we started talking and working together for the good of everyones health and stopped throwing rocks because we all live in glass houses.
    Congratulations BSO you so deserve this recognition for educating some of the finest healthcare professionals in the world.

    • 1) A good blood supply is healthy for the human body = PLATITUDE
      2) musculoskeletal structures that are in good structural condition provide for good function = PLATITUDE
      3) The structures and systems of the human body are interrelated = PLATITUDE
      4) The human body has a great capacity for self healing (immune system anybody?) = PLATITUDE
      5) The body has self regulatory mechanisms – Homeostasis = PLATITUDE

    • Do the BSO offer a money-back guarantee?

    • The textbooks you mention are, of course, not quackery. However, it is not the textbooks that you have read that are the issue, but the lack of connection between the science in these books and your activities.

      1) A good blood supply is healthy for the human body- yes. The issue is what regulates blood supply and can you induce changes in blood supply by MSK manipulation? What about when the issue is not due to blood supply, such as in OA or RA?
      2) musculoskeletal structures that are in good structural condition provide for good function-Here, you surely mean tissue structure. If a bone is fractured and displaced, it will go through the process of bone healing and remodeling. Thus, a bone “out of place ” functions perfectly well, thank you very much. If you mean gross anatomy, and the process or remodelling is not enough, then manipulation by a properly trained orthopaedic surgeon is what is required.
      3) The structures and systems of the human body are interrelated- What a naive, basic statement. So? It does not mean that if I pull your hair your toe nails will fall as well.
      4) The human body has a great capacity for self healing (immune system anybody?)-Yes, so why do they need your manipulative help?
      5) The body has self regulatory mechanisms – Homeostasis- Yes, again. So? The mere principle or realignment is absurd. If you got a CT of a series of vertebrae and then “manipulated” them and got another CT, you would detect exactly ZERO change. Manipulation is evident when a fracture or a dislocation needs reducing, that is it.
      Correct, no one can argue with the 5 principles above, because they are scientific facts. However, these are in no way related to your conclusions.
      It is so boring to have the “practitioners” of “complementary medicine” recite the “we look the patient as a whole” myth. You cannot look at the hole patient, because you do not understand the hole patient. The difference is that medics have evolved and through study and research have developed a body of knowledge that continuously grows. Osteopaths and all the other glorified mesmerizers grab a few scientific facts and derive practices which have no connection with the real world. You are very wrong, they are not both equally valid. REAL medicine works hard to evolve through evidence and audit. You just make promises without any scientific basis. If you have mechanical back pain, then you can benefit from the services of an appropriately trained orthopedic surgeon and if not necessary, then any form of treatment will be as good as any other (Physio etc etc). Face it, you live in a world were you seek ways to confirm your biases, as you have no evidence or science based explanations of why anything you do should be taken seriously.

      • Juan de Dios Robinson very well said.

        The problem is not the European osteopathy. They are considering themselves as “alternative medicine” as the British GOsC was mainly involved in publishing the WHO benchmarks for training in osteopathy which comes under the WHO project for alternative and complementary medicine.

        I asked some US osteopathic physicians D.O. to change this five principles and to put the principles of evidence based medicine instead of the five principles on top of their list. They refused to do so 🙂

        The problem with osteopathy is clear in Europe it is pseudoscientific and partially esoteric quack according to the WHO regulations (WHO benchmarks for training in osteopathy) and in US it is a normal training of physicians in evidence based medicine PLUS such alternative quackery.

        This would be the same if in Europe a physicist’s training would include evidence based medicine AND homeopathy regularly and both would count similarly for exam.

        In everyday practise such US osteopathic physicians might change very fast between medicine and quack more than normal educated M.D.s as all physicians do worldwide who are trained in quackery. It’s all about business and profiteers and academic titles. University College M.Sc. ost will sell pretty well. Much better than just “School for alternative and complementary medicine”.

      • Wrong.

        It is osteopathic practice which DOES stand the test of the real world. We have millions of happy patients around the globe with a vast range of complex and chronic problems helped to a greater or lesser extent, and an excellent safety record, despite Ernsts efforts to dredge up stats of harm from it seems mainly malpractice cases. The market wouldn’t have kept us going this long otherwise. Don’t ask me, ask the patients, they are the purpose of it all.

        Ineffectiveness and danger doesn’t need closing down with such effort as this. It closes itself down unless propped-up by government support and vast amounts of public money. See where I am going with this yet?

        No hospital, no drug can compare. The ‘scientific’ medicine you seem to think is the pinnacle of reason has such a disastrous track record of failure and tragedy nobody in their right mind pays their own money for it. It is very good at symptom management and life-threatening emergencies, true, but that really is it.

        Ok, it is true we are not comparing like-for-like: we have our own area of ‘interest’, in effect what has not been hoarded and monopolised by pharma. But it wasn’t always thus. History shows what works, so do satisfied and healthy patients living full lives without disease. Not big shiny buildings.

        And no, we do not give credit to manipulation for healing. As always, mother nature is behind that. She has the sharpest tools in the box, not us. The question is why our ‘placebos’ and ‘spontaneous recoveries’ seem to favour our patients not those of medicine. Again, not like for like so we may never know. I just know where I go first of all as a patient – because of my own real world experience (don’t knock real world experience, you brought it up).

        Whatever you say about your own naive view of osteopathic principles – in theory – in practice people are happy with the results. And that is where any scientific discussion must start and end – the real world experience of people. We can’t keep telling patients their experience is scientifically invalid, just because we don’t like the horror stories they tell of medicine or the glowing reports they give of something else. It is not scientifically acceptable to do so.

        Almost everybody you meet has some kind of nightmare story to tell of medical care. All those billions spent on research and still medical science has failed on almost all of its promises in the area of chronic disease (a very large part of medical practice). Don’t get me started on the genome project…

        There is only so much time you can expect the human race to keep living on dangerous drugs, promises and false hope of cures ‘just around the corner’ that always have been, always will be, and threaten to bankrupt the economy.

        • a nice opinion!
          any evidence?

          • The test of the market is a pretty strong one, as I said above. When all is said and done, it is a consumer issue whether or not ours is an acceptable therapy. Consumers don’t generally care about the science, they care about a solution to their problem. They don’t ask for our evidence base, they ask what we are going to do about it. And it is they who pay our wages, not E Ernst.

          • congratulations!
            you just created a new type of healthcare: COMMERCE-BASED MEDICINE!
            the Nobel committee should be informed.

          • Sorry, I can’t claim the credit. it’s called patient centred. Do you work for free Professor? I doubt it. The difference is in private complimentary practice we get paid by our clients directly, so if we don’t offer them what they are actually looking for we don’t eat. Seems like a pretty good incentive to do a great job if you ask me. If doctors were paid by results what do you think would happen?

          • yes, I do work for free since I am retired!
            (“complimentary practice”? are you sure you don’t mean complementary???)
            and ‘patient centred’ certainly does not mean what you think.

          • Yes pardon my spelling. But seriously, do you set your alarm to go out in the rain and dark to meet patients and help them in order to put bread on your table? And would you be out on the street if you were unable to deliver results?

            It wasn’t me who wanted to talk about ‘the real world’, but I think we should. Really we should.

            Because in the real world market forces are highly relevant. People go to hospital because they have no choice. We hear their stories of that experience week in and week out. They come to us because they DO have a choice. And for those who can’t come to terms with that fact this is most unsettling to their ivory towers.

  • Hi again,
    Just a by-the-by on the subject of evidence based practice.
    I am completely in favour of evidence based treatment and over the years I have stopped using some treatment protocols because of little or dubious evidence for their effectiveness.
    I do think this should apply across the board though. For instance, a few years ago I fractured my tibia/fibula quite badly and whilst still in hospital a doctor tried to prescribe Ibuprofen for me! For those who don’t know the use of anti-inflammatory drugs in cases of fracture is strictly prohibited because research has shown conclusively that it permanently retards healing and this is irreversible. Check the NICE guidelines or Google it if you want to be sure. Oh I refused naturally, despite being a badly educated quack! (Osteopath).

    • could you show us the evidence, please?

    • @Denise Payne

      Check the NICE guidelines or Google it if you want to be sure.

      Well, you could have done that yourself, and learnt that a large study published in 2005 did not confirm the interpretation of older studies that NSAID’s increased the risk of non-union of fractures. Previous studies had shown a correlation between NSAID use and non-union, but the causation was misinterpreted. Non-union was the causal factor, not the NSAID’s.
      You might also have found that NICE do recommend NSAID’s for pain relief in fracture patients, except in the frail and elderly, which of course is for other reasons. NSAID’s do not cause non-union, the pain of non-union increases NSAID use.
      NSAID’s have biological effects that theoretically inhibit healing, but this effect has been shown to be clinically negligible.

    • For those who don’t know the use of anti-inflammatory drugs in cases of fracture is strictly prohibited because research has shown conclusively that it permanently retards healing and this is irreversible. Check the NICE guidelines or Google it if you want to be sure.

      I checked the NICE guidelines, as you suggested. Here’s what NICE had to say last year about pain management in non-complex fractures.

      “Initial pharmacological management of pain in adults (16 or over)
      For the initial management of pain in adults (16 or over) with suspected long bone fractures of the legs (tibia, fibula) or arms (humerus, radius, ulna), offer:
      oral paracetamol for mild pain
      oral paracetamol and codeine for moderate pain
      intravenous paracetamol supplemented with intravenous morphine titrated to effect for severe pain.
      Use intravenous opioids with caution in frail or older adults.
      Do not offer non‑steroidal anti‑inflammatory drugs (NSAIDs) to frail or older adults with fractures.
      Consider NSAIDs to supplement the pain relief in recommendation 1.1.4 except for frail or older adults.”

      So ibuprofen (a NSAID) is fine for adults except for frail or older people. Do you fall into that category?

      I searched Medline for articles containing the keywords NSAID fracture healing. According to the most recent review this search turned up (Marquez-Lara et al. JBJS Reviews 2016, DOI: 0.2106/JBJS.RVW.O.00055, PMID: 27500434): “This systematic review highlights the limitations in the current understanding of the effects of NSAIDs on bone healing. Thus, withholding these medications does not have any proven scientific benefit to patients and may even cause harm by increasing narcotic requirements in cases in which they could be beneficial for pain management.” So much for “research has shown conclusively that it permanently retards healing and this is irreversible”.

      You’ve made two patronising comments today. Your first, as has already been pointed out, is a mass of platitudes (plus the tiresome old chestnut about doctors not looking at the body as a whole). The second contains some flat statements of fact which 10 minutes of searching revealed to be complete bollocks. Thank you for reminding me why I hold osteopathy in low esteem.

  • European and Commonwealth osteopathic manipulator’s trainings always start with the brainwashing sentence that “Osteopathy is a philosophy a science and an art” as second step you have to incorporate the platitudes shown in the posts above as “philosophy” … then you learn anatomy anatomy anatomy to believe that having learned enough anatomy everything like visceral manipulation and craniosacral techniques to heal diseases of the inner organs like lactose intolerance or infectious diseases or multiple sclerosis could be done by balancing the tissues related and according to the platitudes mentioned above.

    This is why the US government listed oldfashioned osteopathy (only done by OMM/OMT) officially !!! as a medical sect together with homeopathy and christian science until the 1940ties.

    In the US the osteopathic profession then changed their training programs from “osteopath” to “osteopathic physician” and during WW 2 the became fully licensed physicians in any medical field. OMM/OMT is used only by 5% of the osteopathic physicians but it still is the door for pseudoscience in this profession.

    European and Commonwealth osteopathic manipulators consequently refuse to notice such fundamental changes and follow the road of oldfashioned osteopathy and of platitudes riding the trojan horse of quackery esoteric and pseudoscientific explanations and a lot of senseless and partially dangerous bogus techniques..

    Is a booming business worth to sell B.Sc. and M.Sc. for such a religion ???… It is interesting to follow the efforts and actions of lobbyism and of hidden persons to put pressure onto European governments to implement this pseudoscience as a profession in the European health systems.
    They are partially very successful much more than the Homeopaths as you might see here in the example of becoming a university college…

  • Interesting….
    I recently came upon a thoroughly comprehensive reduction-to-absurdity of the ‘works’ of Irvin Korr (in the journal of Osteopathy) the foundational researcher of osteopathy in the 20th century. He was responsible for the exquisitely science-sounding Stuff that supposedly was responsible for the profound effects of manipulation & eliminating the Osteopathic lesion e.g. gamma motor uptake inhibition and the like.
    Problem is, like Palmer and Hahnamann critical thinking was utterly impaired by mis-placed faith in magic and a distinct agenda irrespective of the fact he was a PhD.
    In the US such magic has been successfully dis-engaged from the profession, something Chiropractic and Osteopaths in Europe are unable to achieve….since of course they have NO fall back position. It’s magic all the way down….

    • Michael Kenny are you shure that “such magic has been successfully dis-engaged from the profession” ??? In US OMM trainings (which is a faculty they all have to join during the training) they are following the European pseudoscientific and partially esoteric explanations and are learning Visceral Manipulation and Craniosacral Osteopathy to treat babies.. look at the WHO benchmarks for training in osteopathy. In discussions with US osteopathic physicians about such behavior they don’t accept any critical comment, As soon as I am pointing out that all of their “self healing” explanations and techniques in cranial and visceral are related to vitalism mesmerism phrenology and Thure Brandt massage they are calling this an offence and are accusing me to support the M.D. profession in their fight against the D.O. profession. It’s documented in my linkedin account.

  • European and Commonwealth osteopathic manipulators nowadays are fascinated by the endless net of fascias and like to travel through it with magic touch… most of them even don’t know Korr’s name … especially the French “osteopaths” practice Visceral Manipulation regularly doing rectal and intravaginal techniques to heal infertility. They “travel” through the reproductive system via intravaginal and cranial touch through the skull to “twist the pituitary gland” and to “reduce tension on the glands and to harmonize the hormons”

    … pseudoscientific magic …

  • Frank Odds they already added this in Polarity “therapy” and in Cranial Osteopathy and much more e.g. “liquid light” look at the books and notes of Rollin Becker D.O. (US) e.g.
    he is the Guru 🙂 of pseudoscientific terminology in US osteopathic physician’s OMM/OMT.

  • People who use terms such as “Ivory Towers” during a discussion of evidence are raising a “straw Man”. On the other hand, stating that market forces in any way justify offering FALSE hope and promises to patients is a non sequitur. Just because there is a large demand for a product, it does not make that product useful, healthy, effective or safe. It is not about “Ivory Towers”, it is about you been aware that, despite no evidence to support your claims, you offer the service as being a valid treatment for “x or y”, knowing full well that “market forces” will present you with people who do not know any better. The fact that you mention the power of market forces despite that you know there is no evidence base for your activities, makes your activities morally questionable.

    • Juan De Rios Robinson very well said. I guess as soon as the medical profession will develop an evidence based approach to functional disorders of the movement apparatus considering the problems of compensation patterns in movement and posture all of such vitalistic and iatromechanistic nonsense will pass away.

      • There is your “straw man” again. Charging the medical profession with not using evidence , when osteopathy has no basis at all, in reality, is the epitome of hypocrisy. No matter how many imperfections you try to highlight in real medicine, what you practice is voodoo. Get real!

  • Just about history of bone setting to add a broader view to the problem that manual osteopathic and chiropractic explanations are still based on iatromechanics and vitalism:
    In India in Kalari the are using such techniques
    and in Iran and the whole middle East

    I myself documented such traditional bone setting in the tribal areas of Pakistan and from Kosovo and from Sweden and Norway and France and Northern Germany coast side Northern Sea they were called Knochenbrecher bone-setter kotknackare ( before chiropractic in Sweden) rebouteux a.s.o.

    I had clients from Turkey Morocco Egypt Tunisia who reported me that there are still bone-setters serving where they have a Hamam (old public institutes for bathing) or it still is a service of hair dressers in Turkey.

    But all cultures traditionally connected to the Northern Sea were doing bone-setting

    So osteo-pathy and chiropractic changed the former secret family tradition into a business concept of teaching such techniques to EVERYBODY willing to pay for such an education that’s all

    What was new was the pseudoscientific explanation claiming that they can heal ANY DISEASE without drugs (drugless healing movement coming up with the paradigm of the First Industrial Revolution of mechanics and steam engines and kinematographs) which is utter nonsense because traditional bone-setters are using a lot of remedies (and magic – which is the root of vitalism)

  • Björn Geir could you please give a hint if possible about the history of traditional kotknackare related to the hard daily work of the country side and the costal area of fishermen and sailing BEFORE the chiropractic (and now osteopathy) took over that field in the Scandinavian Area? (it’s well documented for UK. and I do not mean Thure Brandt Massage and Swedish Massage therapy and Swedish Gymnastics which is different)

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