Osteopathy is a tricky subject:
- Osteopathic manipulations/mobilisations are advocated mainly for spinal complaints.
- Yet many osteopaths use them also for a myriad of non-spinal conditions.
- Osteopathy comprises two entirely different professions; in the US, osteopaths are very similar to medically trained doctors, and many hardly ever employ osteopathic manual techniques; outside the US, osteopaths are alternative practitioners who use mainly osteopathic techniques and believe in the obsolete gospel of their guru Andrew Taylor Still (this post relates to the latter type of osteopathy).
- The question whether osteopathic manual therapies are effective is still open – even for the indication that osteopaths treat most, spinal complaints.
- Like chiropractors, osteopaths now insist that osteopathy is not a treatment but a profession; the transparent reason for this argument is to gain more wriggle-room when faced with negative evidence regarding they hallmark treatment of osteopathic manipulation/mobilisation.
A new paper authored by osteopaths is an attempt to shed more light on the effectiveness of osteopathy. The aim of this systematic review evaluated the impact of osteopathic care for spinal complaints. Only randomized controlled trials conducted in high-income Western countries were considered. Two authors independently screened the titles and abstracts. Primary outcomes included ‘pain’ and ‘functional status’, while secondary outcomes included ‘medication use’ and ‘health status’.
Nineteen studies were included and qualitatively synthesized. Nine studies were from the US, followed by Germany with 7 studies. The majority of studies (n = 13) focused on low back pain.
In general, mixed findings related to the impact of osteopathic care on primary and secondary outcomes were observed. For the primary outcomes, a clear distinction between US and European studies was found, where the latter RCTs reported positive results more frequently. Studies were characterized by substantial methodological differences in sample sizes, number of treatments, control groups, and follow-up.
The authors concluded that “the findings of the current literature review suggested that osteopathic care may improve pain and functional status in patients suffering from spinal complaints. A clear distinction was observed between studies conducted in the US and those in Europe, in favor of the latter. Today, no clear conclusions of the impact of osteopathic care for spinal complaints can be drawn. Further studies with larger study samples also assessing the long-term impact of osteopathic care for spinal complaints are required to further strengthen the body of evidence.”
Some of the most obvious weaknesses of this review include the following:
- In none of the studies employed blinding of patients, care provider or outcome assessor occurred, or it was unclear. Blinding of outcome assessors is easily implemented and should be standard in any RCT.
- In three studies, the study groups differed to some extent at baseline indicating that randomisation was not successful..
- Five studies were derived from the ‘grey literature’ and were therefore not peer-reviewed.
- One study (the UK BEAM trial) employed not just osteopaths but also chiropractors and physiotherapists for administering the spinal manipulations. It is therefore hardly an adequate test of osteopathy.
- The study was funded by an unrestricted grant from the GNRPO, the umbrella organization of the ‘Belgian Professional Associations for Osteopaths’.
Considering this last point, the authors’ honesty in admitting that no clear conclusions of the impact of osteopathic care for spinal complaints can be drawn is remarkable and deserves praise.
Considering that the evidence for osteopathy is even far worse for non-spinal conditions (numerous trials exist for all sorts of other conditions, but they tend to be flimsy and usually lack independent replications), it is fair to conclude that osteopathy is NOT an evidence-based therapy.
16 Responses to New review confirms: osteopathy is NOT evidence-based
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“Evidence based medicine is not restricted to randomised trials and meta-analyses.”
Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71-72.
and who said it is?
You. Read your own conclusion.
really – care to cite the exact wording that you refer to?
if not, you might be called a liar – and we don’t want that, do we?
Your conclusion of a professsion not being evidence based is based upon a research review of one therapeutic approach.
I see!
not a liar then – but evidently a bit too daft to understand simple conclusions.
perhaps you read them again and then compare then to your claim.
i understand the difference between being research based and evidence based…do you?
you have given enough evidence that you understand very little indeed
if you want to continue to look silly, sobeit.
This is a new study which seems to proof with evidence that osteopathy for newborn babies and children is a panacea. The European and Commonwealth osteopathic manipulators are very proud if it!
Info about OSTINF Study
https://bv-osteopathie.de/wp-content/uploads/2019/01/PresseInformation-OSTINF-Studie-1.pdf
https://bv-osteopathie.de/2019/01/10/kinderosteopathie-studie/
https://www.osteopathie.de/ostinf
https://www.osteopathie.de/osteopathie-forschung
“Specialised” osteopaths for children are educated in “Cranial Osteopathy” and “Visceral Osteopathy” as core subjects in the training of “osteopathy for children”. There is no evidence for this techniques at all.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147986/
https://www.ncbi.nlm.nih.gov/m/pubmed/29452579/
How come that such “techniques” in this OSTINF study suddenly become “effective”? I guess this is the result of the body’s “self-healing” of the reported problems for which such an approach is claimed to be effective. I guess that the same amount of babies were “healing” in the same time without any manual osteopathic approach.
So that’s the real effect. Because a child’s body does it by it’s own it’s very clever, to claim such healing effects for one’s own therapeutic approach.
Now we have the proof: The study shows the main osteopathic principle:
“Time heals all”
That’s the reason why osteopathic manipulatirs claim to address the “self-healing-power”. They make money with something that a body does by it’s own.
That’s very clever and very effective for their income!
Osteopathy has been integrated into the NHS since 2017- in so far as an AHP can be an Osteopath?
Can someone clarify this for me?
So many titles under your name, so little knowledge in that brain of yours. Quite a shame. Let me guess…you think just drugging people with pharmaceuticals does the trick huh?
https://edzardernst.com/2012/12/ad-hominem-attacks-are-signs-of-victories-of-reason-over-unreason/
Replace osteopathy with prayer.
If you can’t demonstrate that your preferred fantasy is any more effectice than a placebo, why should we even consider it?
EMB and the scientific method are the most reliable methods that we have so far to evaluate and understand the world that we live in. If osteopaths claim something, it should be able to hold scrutiny. If not, it’s just snake oil peddling. Same as homeopathy.
And yes, îd rather encoueage BIG BAD pharma that actually works and does something, rather than throwing my money and life away to quacks and snake oil peddlers, which prey on the naiveté and lack of logical/critical thinking of the public.