ZOMBIE THREAD ALERT: This thread hasn't been posted on for a while.

To think osteopathy is "woo woo" therapy?

(228 Posts)
candycoatedwaterdrops Wed 01-Jan-14 17:55:00

Apparently, this makes me UR and that it's not comparable to homeopathy. So, MNers what do you think?

CassCade Mon 20-Jan-14 12:54:02

maid, I actually laughed out loud when I read that because I was not surprised at all. I knew you were of the scientific kind. Keep up the good work! ;)

But try osteopathy for yourself...!

MaidOfStars Mon 20-Jan-14 12:49:04

Maid, I like the way you dissected my answer and made comments on each point. You clearly have a very analytical and critical mind and I would definitely commission you to undertake the study
Ha. I'm new here and my posting style may not have caught up smile It probably wouldn't surprise you to find out that I am a scientist....

CassCade Mon 20-Jan-14 12:45:23

Maid, I like the way you dissected my answer and made comments on each point. You clearly have a very analytical and critical mind and I would definitely commission you to undertake the study. smile

But, I answered a vague, opinion-based question of the OP's, asking if she was unreasonable in thinking that osteopathy is a "woo woo" therapy. My answer was to discuss her question, not prove her wrong or right, or show single-handedly that osteopathy "works" or "does not work". The very words "woo woo" in the question suggest she already knows how she feels about it! (Sorry OP, I don't wish to insult you, but have been drawn into discussing what your question literally was and what I personally understood by it!)

Of course, that's a matter of opinion too. ;)

MaidOfStars Mon 20-Jan-14 12:22:52

Maid, I didn't pose that question because it is not that simple. That question is far too broad to answer. Like saying, "Does aspirin work?" You would need a lot more to narrow that question down to begin to answer it

But it is quite simple. We don't ask "Does aspirin work?", for sure. But we do ask "Do people suffering from X type of pain who take X dose of aspirin report better outcomes in terms of pain relief than those taking a placebo pill?". The same way we ask "Do people suffering from X type of pain who visit an osteopath report better outcomes in terms of pain relief than those visiting other types of paid manual therapist?".

Surely the questions you use as examples ("does osteopathy work?") should be "does osteopathy work for me?" , not "Does it work?"

I don't think so. People are immensely unreliable in reporting subjective outcomes (which is why, in the absence of reliable clinical indicators, pain is measured as "reported" rather than "measured" and there are extensive stats surrounding such reports, in order to normalise them). We will never ascertain truth if we rely on people to teach it to us from their personal conviction. The best we will ever achieve is "This person believes it to be true". That's not good enough to make any conclusions, although it may satisfy some peoples' threshold for value.

no one treatment or therapy works exactly the same for every person

Many do. Ibuprofen counteracts localised inflammatory effects, mediated by prostaglandin synthesis in response to damage. That's going to apply to everyone who takes ibuprofen.

I was not talking about opinions on holocaust denial and do not see why you have brought that into a discussion about an request for information on people's opinions of a therapy

Because you asserted the value of subjective opinion alongside or over medical fact. By extension, you should also value subjective opinion alongside or over other facts.

Also, I would like to know who commisions the scientific testing

Well, that's a very interesting question. Of course, it is usually initiated by those with vested interests in selling their product. This then generates a community-wide response (largely composed of those without vested interests) to analyse, criticise and repeat or negate such results.

CassCade Mon 20-Jan-14 12:00:12

Maid, I didn't pose that question because it is not that simple. That question is far too broad to answer. Like saying, "Does aspirin work?" You would need a lot more to narrow that question down to begin to answer it. I was not talking about all the facts in the world being down to a matter of opinion. I was replying to the question "am I being unreasonable to think that osteopathy is 'woo woo' therapy?"
Surely the questions you use as examples ("does osteopathy work?") should be "does osteopathy work for me?" , not "Does it work?", as no one treatment or therapy works exactly the same for every person.

I was not talking about opinions on holocaust denial and do not see why you have brought that into a discussion about an request for information on people's opinions of a therapy.

Evidence-based medicine often has questionable results when it is relying on subjective reports to form those results; ie; "Do you feel better, Mrs. Smith? How much better on a scale of 1 to 10?" Her 5 is not going to be the same as yours or mine.
Also, I would like to know who commisions the scientific testing!

MaidOfStars Mon 20-Jan-14 11:26:01

For what it's worth, I think these "does x therapy work or doesn't it" discussions are like those we used to read in the teenage magazines, about which band is the best - it's all a matter of opinion

You've proposed a scientific question - does X therapy work? - and we have an excellent set of methods by which to answer that question. Indeed, such methods have been employed extensively to answer questions like "Does osteopathy work?", "Does homeopathy work?" and "Does Nurofen work?". The answers to these scientific questions that have been tested methodically and rigorously across many trials are "no more than any other manual therapy" (osteopathy), "no more than placebo" (homeopathy) and "exceeds the placebo effect in relieving pain" (ibuprofen).

This is evidence-based medicine. It is an objective measure of a specific and testable question (just like all science questions).

We cannot employ the same methods to decide which is the best band, because we all have a different idea of what makes a good band i.e. it is subjective.

You are entitled to your own opinions, but you are not entitled to your own facts. If you allow opinion to override known fact (that has been established via extensive research and study), then we really don't have any integrity to reject the Holocaust denier or to prevent creationism being taught in our schools. It is a very dangerous position to take.

CassCade Mon 20-Jan-14 09:28:44

For what it's worth, I think these "does x therapy work or doesn't it" discussions are like those we used to read in the teenage magazines, about which band is the best - it's all a matter of opinion. I think that osteopathy is not a religion, to believe in. Nor is physiotherapy and nor is nurofen. Sometimes things (osteopathy, nurofen, physiotherapy, chiropractic, acupuncture) work, sometimes they don't. Person A's pain is not the same pain as person B's pain. How do we compare pain? We can't! Pain and how people feel before and after any treatment or therapy is completely subjective and you can't easily compare people's pain levels scientifically. This is also because their pain levels, their personalities and the reasons for their pain (not to mention their age, medical history and occupation) are all vastly different. We're not lab mice. Also, not all osteopaths are the same, as not all doctors are the same - some are good, some are may be not so good, some may be terrible! You can't just say blankly something either doesn't work or does work - it's like comparing all car drivers, and saying if they can drive, then they must all have the same level of driving ability. It's not that straightforward. Some therapies work for some people, and not for others. Like homeopathy, which definitely worked on my daughter's exzcema. It was 60-70% better within 48 hours. I was amazed. She was 4 and wouldn't know what a placebo was. Haven't tried it for anything else, but I still wouldn't make a blankly sweeping statement shouting, "Homeopathy works! So there!!!"

provocateur Sat 18-Jan-14 01:09:08

I have not seen so much misinformation anywhere else on the internet.
If you want to know the answer regarding if osteopathy is effective, look at the evidence. Here is a start point: www.osteopathy.org.uk/uploads/effectiveness_of_manual_therapies_the_uk_evidence_report.pdf

Dambusters Mon 06-Jan-14 21:11:03

I can't speak for chiro but alots of osteopaths and most of the degrees now see trying to teach evidenced based.

Most technique are remaining the same but of the reason for their effectiveness is changing.

In the US osteopaths are medical doctors.

There is a huge overlap on the manual therapies and as all are heading towards an evidence based practice this overlap will increase.

CairoPrapstar Mon 06-Jan-14 18:44:37

sorry, didn't mean to be misleading. Of course they have a lot of treatment experience upon graduation just not manipulation as such.

In reality many chiros probably mobilize as much as they manipulate joints just because of the many and varied relative and absolute contraindications (inflammatory arthropathy to name just one).

Slubberdegullion Mon 06-Jan-14 18:34:11

MSk physios thankyou dyac.

Musculoskeletal

Slubberdegullion Mon 06-Jan-14 18:32:21

Manipulation: A passive, high velocity, low amplitude thrust applied to a joint complex within its anatomical limit* with the intent to restore optimal motion, function, and/ or to reduce pain.

Mobilization: A manual therapy technique comprising a continuum of skilled passive movements to the joint complex that are applied at varying speeds and amplitudes, that may include a small-amplitude/ high velocity therapeutic movement (manipulation) with the intent to restore optimal motion, function, and/ or to reduce pain.

Taken from this site

Physiotherapy undergraduates are taught how to mobilise joints, but (afaik, it's been a while since I was one) not use high velocity thrust techniques on joints. A lot of MSk physics will learn this on post graduate courses.

Just wanted to clear that up as although your statement Cairo that physio graduates have no hours of practical experience with manipulation is technically correct, it's a little misleading to the lay person who doesn't know the difference between mobilisation and manipulation of a joint.

CairoPrapstar Mon 06-Jan-14 17:57:09

I should qualify that with it depends where you study - there are currently two places to study chiropractic in the UK its four years if you study in Wales but 5 years if you study in Bournemouth both programs follow roughly the same curriculum, I'm not sure why there is a difference in time

CairoPrapstar Mon 06-Jan-14 17:04:47

The difference between chiropractic and physiotherapy is mainly at undergraduate level - chiropractic is is a four year undergraduate masters degree; yes all of the anatomy, physiology, pathology, orthopaedics etc is the same but chiros also learn radiology - taking and reading x-rays for the evaluation of pathology not subluxations, they are bollox IMO. The practical aspects of the undergraduate courses are probably very similar up to a point, but chiros learn to manipulate joints - mainly the spine but also extremities - this is not part of the physios undergraduate program though they are free to learn it at post graduate CPD course and many do. The result is that by the time a chiropractor graduates they will have well over 2000 hours worth of practical experience with manipulation where a physio will have none.

Both chiropractors and physiotherapists are good at treating acute and chronic extremity joint problems however physios probably exceed most chiros in rehabilitation of these types of injuries (unless the chiro has taken CPD in this area) Most chiros will exceed physios in the treatment of back pain (unless the physio has taken CPD in this area).

All chiropractors graduate being able to take and read x rays but in practice only a few actually take them as the equipment is expensive.

One big difference is that all chiropractors (99.9%) work in the private sector as primary health care providers straight from graduation where as most physios are employed by the NHS for at least a few years before they set up in private practice. This gives them some advantages but also some disadvantages.

MaidOfStars Mon 06-Jan-14 13:33:38

People make 280 million visits to Chiros a year in the US and Canada according to google.

Well, you can't legislate for a fool and his money....

Seriously, I don't understand the need for three different types of manual therapist. Most chiropractors and osteopaths do fairly similar things (or rather, are actually only effective for very similar things) and combine their manipulations with heat/massage/electro/etc. This could all be covered by a physio, no? Get rid of the woo stuff altogether, and start practicing evidence-based medicine?

I assume there are chiropractors on this thread. Would any of you admit to believing that "subluxations" exist (in a chiropractic sense)? Do you offer X-rays to diagnose them, despite the official position being that they are aren't visible by X-ray? I understand that many chiropractors are moving away from that (and other woo) so my question is: what now distinguishes you from a physio?

dozeydoris Mon 06-Jan-14 08:14:03

People make 280 million visits to Chiros a year in the US and Canada according to google.

PigletJohn Sun 05-Jan-14 20:05:28

my health insurance paid for Osteo as long as it was for a temporary condition caused by an injury.

I asked my GP before going, he approved, thought it might help. as painkillers were certainly useless. I can't remember if he was asked to agree a referral or support the claim. The insurers seemed quite happy.

CairoPrapstar Sun 05-Jan-14 19:42:06

I googled Demartini, I'm not sure I understand your point. He has clearly set himself up as a life coach guru type, he sounds barmy but I suppose he is from the US.
This is what most chiropractors I know use for reference to recent research. It is run by a Canadian chiro who is clearly not woo, yes it costs but its worth every penny IMO.
In the states osteopaths are a bit different to in the UK. Most uk insurance companies will cover you for treatment for chiro and physio, I don't know about osteo, sorry.

dozeydoris Sun 05-Jan-14 18:50:13

I went to a chiropractor for frozen shoulder, he helped that but later cured a longstanding fixed hip I'd had for years, due to overdoing pilates exercises prob, a misaligned symphisis jt, amazing imo.

Haven't had such success with osteopath.

Chiropracy is claimable on health insurance in US, don't think they have osteopaths much.

nicename Sun 05-Jan-14 11:09:50

I have had treatments that weren't effective from a traditional doctor. DS recently had a prescription from one doctor which was dismissed as 'no use' by the next doctor we saw. My mum had some awful misdiagnosis' from doctors and was on pretty nasty medication for years (plus medication to counter the side effects) as a result.

Nothing is 100% and have met some doctors who have had some very odd ideas about illness and treatments.

I can't see what is woo about someone who is trained looking at your body/posture etc, asking you about your pain/treatment/habits and diagnosing cause and treating appropriately. My osteo streaches and massages, then gives relevant exercises depending on the location/cause of pain/injury. She has never burned a candle, muttered an incantation or suggested herbal medication!

Stress can hurt your back! Its because you tense yourself and don't sleep well. Also you don't tend to look after yourself well and your posture goes to pot.

Itstartshere Sun 05-Jan-14 09:49:27

I am rubbishing other treatments because of what I've read about them. About what some of them claim, about the lack of evidence. Same as lots of people on this thread who value their osteopaths but wouldn't go near a cranial sacral therapist - it's about evidence. Google Dr John Demartini, chiropractor. Total and utter bullshit, woo. No evidence at all. Totally legitimate for me to rubbish 'other treatments' which have no evidence base and at worst do harm.

tshirtsuntan Sun 05-Jan-14 09:46:35

If you get a good one they can be really helpful, I saw a guy about back pain and he told me how I sit, lie and sleep ( including thumb sucking!) Just by looking at my back, the manipulation really helped, .....didn't cure the thumb sucking though grin

dozeydoris Sun 05-Jan-14 09:37:57

Well, I said that I think some things do work. And some things are a placebo. Which would explain why some people have success with some things and others don't.

And, of course, some practitioners are better than others, or more experienced in certain fields, if it fixes your problem good, but seems daft to rubbish other treatments usually on the strength of one lot of treatments or even one treatment. If it works for you stick with it.

Itstartshere Sun 05-Jan-14 09:18:52

*Well Itstartshere, you prove my point I think, much of all medicine is placebo, your osteopathy cures you but you won't touch chiropracy???

I have visited osteopaths but really pushing my back about isn't going to cure anything, if things moved whilst being pushed about we would all be wrecks with joints and bones misaligned, the truth is it takes a car accident before things start moving about and causing eg paralysis.

But if you believe someone has 'moved' something into place so that you must therefore feel better you will.*

dozen, my osteopath doesn't cure me, I wouldn't have been visiting for 15 years if they offered a cure. Not do they move my joints. I never have stuff cracked or manipulated. I have a condition affecting my soft tissue, my muscles get very, very tight so movement gets very restricted. My osteopath is an absolute expert at taking one look at me.and saying which muscles are causing the problems, she then gives me a very specific treatment, sometimes it's a case of very slowly and gently stretching one limb to encourage things to loosen, sometimes it's massaging the muscle insertion point. I have particular issue with my piriformis which needs a deep massage. It's mostly massage, the reason it's so great is that it's so targeted, they have such superb knowledge of how things work and don't work. (Example I get issues with where my diaphragm inserts, she works on loosening my hip flexor in addition to my ribs because there is a link)

Every chiropractor I've come across wants to crack joints (no thanks) and speak bollocks which is clearly woo. Every osteopath I've seen has offered me the very gentle but targeted and effective massage which I rely on to keep mobile. It isn't rocket science. I'd never see someone who has crystals and homeopathy in the corner for sale too.

If it absolutely was just the placebo effect I'd keep going. My pain is horrendous sometimes, and osteopathy is all that helps.

dozeydoris Sun 05-Jan-14 06:12:21

I read a book called 'Healing Back Pain' by Dr John Sarno, also his book the Mindbody Prescription where he flags up chronic back pain being contributed to by stress. Worth a read if you are desperate with chronic pain.

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