Today’s quackery: osteopathic manipulative medicine

Dec 26 2009 Published by under science, skepticism

Andrew Taylor Still, noted as one of the found...

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Andrew Taylor Still lived near Baldwin City, Kansas, during the time of the Civil War. There, he founded the practice of osteopathy in the 1870s after his father and three children died from spinal meningitis. He founded the American School of Osteopathy in Missouri in the 1890s. Still believed that the bone was the starting point to diagnosing pathological conditions and that he could “shake a child and stop scarlet fever, croup, diphtheria, and cure whooping cough in three days by a wring of its neck.” Right.

True osteopathic manipulative medicine, like it’s cousin chiropractic medicine, is bullshit. Claiming to cure or alleviate a pathological condition by manipulating an unrelated system is an affront to common sense. Curing a fever by manipulating the skeletal system is as ludicrous as thinking you can stop a car’s engine from overheating by rotating the tires.

This post isn’t an attack on American osteopathic physicians. As a baby, I was delivered by a DO, and I’m pretty sure he didn’t shake me. While I don’t technically have a regular doctor, I have in the past received very good care from a local doctor who is a DO.

Since it’s quack roots in the 1870s, American Osteopathy has transitioned to a practice that is essentially real, science-based medicine. Modern doctors of osteopathy in the United States are taught but no longer use osteopathic manipulative medicine – the component that is the modern derivative of Still’s baby-shaking pseudoscience. American osteopathic physicians have real degrees from real universities and have equivalent medical training to real doctors.

Chiropractic
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Unfortunately, osteopathy has a context outside of American osteopathic medicine. Osteopathy in the rest of the world has parked itself squarely in the purview of complementary and alternative medicine (CAMP). This D in the DO can stand for diploma, not doctor, and the practitioners are more skilled in bamboozling their clients than they are at practicing any kind of real medicine.

Here’s the thing. Real medicine is based on science. If something is “complimentary” or “alternative” to science, it’s not medicine – it’s crap. If something makes you feel better that shouldn’t, like chiropractic or acupuncture or homeopathy or osteopathic manipulative medicine, it’s called a placebo and it’s unethical to present it as a legitimate treatment for anything.

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29 responses so far

  • robertmayo

    Aaron,

    You are failing to look at the scientific facts of the impact that the skeletal system has on the central nervous system. As an example, if the 1st or 2nd vertebrae are compromised in their alignment, they can impact circulation and nerve function as well as brain stem function, and not only affect muscle function in the body, but systems as well.

    I have no experience with Osteopathic medicine, so I am not really sure what their approach is, and would certainly agree that shaking babies is indeed quackery, but there are very specific methods of chiropractic techniques that have a dramatic effect on many people.

    In a previous career, I have seen many people benefit from one specific technique. Here is a site to consider researching, http://www.nucca.org/

    Your friend,

  • http://www.aarontraffas.com Aaron Traffas

    I recognize that spinal injuries can occur, but I'm going to go to a neurologist or orthopedic surgeon and avail myself of science-based medicine rather than go to a chiropractor and avail myself of pseudoscience-based placebo. Chiropractic uses the same marketing techniques and wholistic-mumbo-jumbo practiced by homeopathy, naturopathy, faith healers and the like. Chiropractors do a better job of making it sound like science, but if it were somehow science-based you would see an acceptance from the medical community. I've never been nor have I heard of anyone who was referred to a chiropractor by any reputable doctor.

    I guess we're going to have to agree to disagree on this one.

  • http://www.aarontraffas.com Aaron Traffas

    I've been reading about the NUCCA. Here's a good article from sciencebasedmedicine.org that discusses this branch of chiropractic. http://www.sciencebasedmedicine.org/?p=606

  • djr

    dear aaron
    i am a UK trained osteopath – 30 years ago. Trained to treat patients with musculoskeletal complaints, not fevers, infections etc. I am trained to take a proper case history and examin the patient so i do not treat spinal metastses, anuerysms etc, but refer these on. Neither do we call ourelves Dr ( the chiros here do).
    E did not seek the CAM label – the media put us in that camp. I think we are no more CA M than dentistry.
    “”It it works its medicine, not CAM”. I have no problem with that, Our profession is currently commiting more resources to trying to find out which cases respond best to what we do. Surely some is placebo, but we need to find out how much.

  • http://www.aarontraffas.com Aaron Traffas

    Dentistry is certainly an accepted science-based practice. Orthropedics is the branch of science-based medicine that deals with musculoskeletal complains. If you're not a doctor, how can you offer to “treat patients”?

  • djr

    In UK osteopaths are regulated by the General Osteopathic Council set up by the Osteopaths Act 1993, Many non doctors treat patients – dentists, chirpodists, opticians.

    Orthopaedics is a mostly surgical discipline. It deals with some musculo-skeletal complaints (so do rheumatolgists) but their approach does not always suit for example soft tissue injuries or conditions involving alterations of normal joint function, postural problems, RSI and others.

  • http://www.aarontraffas.com Aaron Traffas

    In the US, dentists, podiatrists and optometrists are absolutely doctors who practice legitimate, science-based medicine. They receive advanced education and board certification in their specialties, similar to other medical professions and unlike CAM practices of chiropractic, reflexology and acupuncture.

    There is a difference between manipulative therapy and medicine. If a massage makes you feel better, get one but get one from someone who isn't trying to bamboozle you into thinking it's medicine.

    Just because politicians pass a law sanctioning something doesn't mean that it can be accepted by the medical community. The UK has problems with quackery being sanctioned by the government and the libel laws there are absurdly hindering evidence-based reform.

    http://www.senseaboutscience.org.uk/index.php/s…

    I can't find any reference by the global science-based medical community regarding the General Osteopathic Council that says it's legitimate. Can you point me to something in a peer-reviewed, scientific journal that lends credibility to the GOC?

  • physio

    I think that you fail to understand the differences in training between the States and the UK. In the States most people can call themselves “Dr.”. MD's, DO's, dentists, vets, chiros, naturopaths etc.

    In the UK, training is different. Chiros, however do call themselves “Dr”.

    Mostly, if you are medically trained or have a PhD, then you would use the designation Dr, however, some dentists in the UK have started using the title too, although wrongly in my opinion.

    Osteopaths in the UK do not use the title Dr and the old DO degree is no longer available, osteopathic training having been University based for many years now.

    UK osteopaths study for at least 4 years and sometimes 5 years where anatomy, physiology, pathology and differential diagnosis are covered fully. They treat musculoskeletal complaints and not fevers as you refer to in your post which I have to say I feel is extremely misguided – you need to get out there and do your research properly if you are going to write coherently on any subject!

    UK osteopathy is more accepted as part of mainstream medicine and not CAM as you seem to suggest. Many GP practices regularly refer to osteopaths and some even have them on staff. There are also some medical doctors in the UK who are also osteopaths.

  • http://www.aarontraffas.com Aaron Traffas

    “shake a child and stop scarlet fever, croup, diphtheria, and cure whooping cough in three days by a wring of its neck.” (Andrew Taylor Still, Autobiography, New York, 1972, Arno Press)

    The founder of osteopathy claimed to stop a fever by shaking a child. That was my source for the “curing the fever” comment. I didn't claim that modern osteopaths list fevers as something they cure – though many references seem to make a big deal about it being a “natural healing process” of the body.

    I admit I'm not an expert. All I know is that there are a ton of CAM practices, and osteopathy – as Still found it and taught it – is absolutely CAM. As I said in the article, osteopathic medicine in the US isn't CAM since it's not practiced as Still taught it. I'd love to know more about the UK. Here's the source for my understanding of osteopathy in the UK. Please tell me what is incorrect with the following few paragraphs.

    From http://en.wikipedia.org/wiki/Osteopathy#United_…

    –
    The first osteopathic college was established in the UK in 1917 by John Martin Littlejohn, a Scot who had studied under Andrew Taylor Still. Littlejohn altered the osteopathic curriculum to include the study of physiology. The UK school he founded, the British School of Osteopathy, was the first osteopathic education institution outside the USA, and it still exists today, now located in Borough High Street, Southwark. British osteopaths use manipulative techniques based on the philosophy of Andrew Taylor Still, but do not receive medical or surgical training and are not physicians. Some medical doctors do undertake osteopathic training as a postgraduate interest. The profession is subject to statutory regulation following the passing of the Osteopaths Act in 1993. The General Osteopathic Council (GOsC) was established by the act to regulate the profession. Most medical services in the UK are delivered through the state funded National Health Service, osteopathy is largely excluded from this with most osteopaths working in private practice. Several large studies in the UK have produced evidence that demonstrates positive clinical and cost effectiveness of manipulation in the management of lower back pain, the latest being the UK Back pain Exercise And Manipulation (UK BEAM) trial.[32][33] The physical manipulation condition of the UK BEAM trial involved “… a package of techniques representative of those used by the UK chiropractic, osteopathic, and physiotherapy professions.”
    Some UK osteopaths are also naturopaths, with one osteopathic college offering a dual training in osteopathy & naturopathy (the British College of Osteopathic Medicine) and another offering a post-graduate programme (the College of Osteopaths).
    In 2005 the General Medical Council of Great Britain announced that U.S.-trained DOs would be accepted for full medical practice rights in the United Kingdom. This decision was an important departure from the United Kingdom's long-standing tradition of exclusively manual, or “traditional” osteopathy.
    In the United Kingdom, courses in Osteopathy have recently become integrated into the university system. Instead of receiving a Diploma in Osteopathy (DO), with or without a Diploma in Naturopathy (ND), graduates now become Masters of Osteopathy, or Bachelors of Osteopathy, or Bachelors of Science in Osteopathy, according to the institution attended:[34] but these degrees do not lead to prescribing rights and in this case Osteopathy and Osteopathic Medicine are synonymous. There is one “cross-over” institution, the London College of Osteopathic Medicine[35], which teaches osteopathy only to those already qualified in medicine. Before using the title of “osteopath,” graduates have to register with the UK regulatory body by statute; the General Osteopathic Council.

    –

  • physio

    Well, actually a fever is the body's natural response to a lot of viral or bacterial infections. Pyrogens are are fever inducing. Heat tends to kill, which is why when you get flu your temperature rises as a response – your immune system is working.

    As for the other, yes, UK osteopaths are not doctors in the same way that US trained osteopaths are, however they are still independent practitioners. They do have a vast training in anatomy, physiology, pathology and differential diagnosis and know when it is appropriate to refer elsewhere and not to treat.

    Osteopathy is sometimes available on the NHS – but not always and most GP practices will refer for low back pain etc. when they are ill equipped to deal with it.

    There are several osteopathic colleges in the UK, but the training is based in science and all osteopathic students learn science and research methods. Osteopathy is not just about manipulation either, although that is taught – they do learn other soft tissue techniques too – a lot are the same as I use as a physiotherapist.

    In the UK, osteopaths are generally accepted as mainstream and not CAM, as homeopaths, herbalists and even chiros are.

    The training is not still based on Still's concepts, but the teaching is scientifically based and is up-to-date, not based in the past.

    There is a training school also – The London College of Osteopathic Medicine which teaches osteopathy exclusively to medical doctors in the UK. A lot of doctors do learn osteopathy so that they are able to help their patients more.

  • dwtbones

    Sheer ignorance at its best. Pick up a book on the subject and you would see that it has nothing to do with the spine and everything to do with affecting the nerves. Just like an electrical circuit, nerves transmit signals to and from the brain. If this signal is interfered with then wherever that nerve goes the end organ, tissue or cell will not function the best it can. Chiropractic is only concerned with removing interference so the brain can send the signals and receive the signals from the body to maintain homeostasis. Nothing more nothing less.

  • http://www.aarontraffas.com Aaron Traffas

    Read my post. It was about osteopathy, which its own practitioners claim is related to the skeletal system.

    I'll get to how chiropractic is sheer woo quackery in a future post, don't worry. Until then, please stay on topic.

  • pete

    I think you are a bit confused about OMM and osteopathic medicine. I am a student in the US in a DO school. I, along with most of my fellow classmates hate OMM. It is not something i intend to ever use in my practice. However, you have stated in a few of your posts how “osteopathy is quackery”. Saying this lumps together OMM and osteopathic medicine all together. I am going to do my residency and fellowship in cardiothoracic surgery. So I will be an osteopathic physician, but I am sure you are in agreement that my specialty is not bullshit. So what im saying is, its ok to say OMM is nonsense, but saying osteopathy is nonsense is a different story. As you said, you would go see a neurologist or an orthopedic surgeon for your problems, but they may very well be osteopathic physicians. The terminology you are using is incorrect. I dont know your background, are you a physician?

  • pete

    ohh sorry, i see now that you in fact have nothing to do with academia but are instead a chubby retard who resembles an even uglier version of jimmy pop. good luck with your band champ hahaha

  • pete

    I think you are a bit confused about OMM and osteopathic medicine. I am a student in the US in a DO school. I, along with most of my fellow classmates hate OMM. It is not something i intend to ever use in my practice. However, you have stated in a few of your posts how “osteopathy is quackery”. Saying this lumps together OMM and osteopathic medicine all together. I am going to do my residency and fellowship in cardiothoracic surgery. So I will be an osteopathic physician, but I am sure you are in agreement that my specialty is not bullshit. So what im saying is, its ok to say OMM is nonsense, but saying osteopathy is nonsense is a different story. As you said, you would go see a neurologist or an orthopedic surgeon for your problems, but they may very well be osteopathic physicians. The terminology you are using is incorrect. I dont know your background, are you a physician?

  • pete

    ohh sorry, i see now that you in fact have nothing to do with academia but are instead a chubby retard who resembles an even uglier version of jimmy pop. good luck with your band champ hahaha

  • http://www.aarontraffas.com Aaron Traffas

    You know, it's too bad you went straight to the ad hominem – I was going to agree with your previous post and thank you for helping me with my terminology. I think we very much agree on OMM. From what I understand, there is a big difference between American Osteopathy and osteopathy as it's practiced elsewhere in the world. I made it a point in my initial post to note that American Osteopathy has transitioned from it's roots in OMM into a real, science-based medicine, and I believe modern DO are certainly valid medical doctors.

    I may be fat and ugly, but I'd like to think I'm not a retard. You're right that I no longer have anything to do with academia, but I like to think that advocating science and the scientific method isn't just a job for academia. The dangers of pseudosciences like OMM and homeopathy need to be attacked from as many angles as possible.

  • Guest

    Osteopathic physicians in the US are real doctors and by the way they are as hard to get into as MD schools. If you think Osteopathic medicine is BS try telling to that to each state medical board, most major universities, the US military, etc. OMM is used to treat musculoskeletal disorders and nothing else, its not chiropractic medicine. Thanks for spreading more ignorance and bullshit Aaron.

  • Johnny

    HAHA .. pete.. Im a real MD, and osteopathy is for people who cant get into real medical school.

  • http://www.aarontraffas.com Aaron Traffas

    Did you even read my post? I made a clear distinction between the US and elsewhere, and even noted that I was delivered as a baby by a D.O. Please read the source material before trolling.

  • Guest

    I did read your post, I can tell you that OMM is not used to treat a fever or some other unrelated disorder, its used to treat musculoskeletal dysfunction. If OMM is quackery, why is Harvard integrating some of it into its curriculum? There is considerable discrimination against US trained DOs particularly in the Pacific Northwest, You are from the Midwest where DOs are more common. OMM in Osteopathy is nothing like Chiropractic, that is quackery. The US state medical boards are among the most anal people out there, and every state recognizes DOs as equivalent to MDs in terms of practice. Most DOs also complete residency training with Allopathic MDs.

  • http://medicaidphysician.zoomshare.com/2.shtml Medicaid Doctors

    I’m not finished read this yet, but it’s so fabulous ‘n I’ll back again when I was finished my job :D

  • Milfhunter

    i’m a student at an osteopathic school, and although johnny’s comment to pete was rude (almost certainly indicating that johnny is fucktard who’s eating yet another bag of ruffles before he masturbates porn…again), he does have a point. The intellectual quality of student at an osteopathic institution is without a doubt less than that of an osteopathic institution. But who cares. First that’s a trend that is true on average but not always, and last time i checked medicine isn’t fucking theoretical physics. Good doctors don’t always equal smart doctors, although everything else being equal, smart is better. But then again, “all else being eqaul” is a hypothetical qualifier that never, ever pans out in real comparisons. Anyway Johnny, I fucked ur mom.

  • Milfhunter

    i’m and osteopathic student, first off. and i’d like to say for teh record, that osteopathy is total fucking bullshit. basically Physical therapy for retards touted as magically curative ubertreatment. Fuck that shit.

  • Milfhunter

    also. to address the issue of whether or not osteopathy is bullshit. i think my opinion as an osteopathic student should count for something. Here it goes: Osteopathy is total fucking bullshit. It’s basically physical therapy for retards touted as magically curative ubertreatment. I curse the day when i have to go practice OMT with all of the witch doctor, money wasting, retards who run the Oseopathic part of my education. I can promise any DO that they won’t be doing any more good than placebo, and moreover wasting patients’ money, if they spend a lot of time using the O in their DO.

  • http://profile.yahoo.com/4V2YKI6Z3Y4RA7MBRRTCNIKDXQ Cyathea Moon

    I suggest you to back and study your physics and chemistry, then sit down and contemplate quietly and patiently about what I am about to say: In this universe, at least based upon what we have known so far, everything is about physics and math. Regardless of what kind of doctor you are, let me ask you, how do drugs work??? They are molecules that have certain physical/chemical properties and they interact with w/e inside our body on a microscopic scale. The concepts and methods derived from Osteopathic Medicine may appear to be novel but they are just working on a larger scale. Physical manipulation, the environment or extracellular/body stimulation do have effects on the inner part of your body, thus apply fundamental effects. Why do you jog, swim or bench? Why do doctors know how big your liver is just by tapping it? I suggest you to go read The Inner Canon of Huangdi. Yes, the materials and concepts are completely new and from another culture, but these concepts were established thousands of years ago for ancient Chinese medicine. Based on how you look, how you sound and how you act, the doctors would have a general idea of what might be wrong with you. Very good doctors will get more info from the answers you gave to them; The best physicians will know what IS wrong with you just by looking at you, whether you believe it or not. Translate this into modern medicine or science, gene expression, which is something on the inside, would give you something on the outside, same concept. So maybe you don’t recognize these philosophies, but wasn’t there a time when the smartest people on earth though that we were the center of the universe? Up until less than a century ago that everyone thought atom was the smallest particle that we could split? So are you telling me that you are so unbelievably arrogant that you can’t even open your heart and mind this teeny tiny bit to accept the possibility that what you thought and believed was wrong???? Best.

  • Mike

    You are the one who is bullshit, if Osteopathic Medicine was bullshit, I guess you can call Richard Jadick a bullshit artist because of him, 30 US Marines who would have died, survived the Battle of Fallujah, he was on the cover of Newsweek with an ironic title “Hero MD”. Typical Democrat dumb fuck.

  • http://www.aarontraffas.com Aaron Traffas

    Hi, Mike.

    I don’t call Dr. Jadick a “bullshit artist” – if you’ll read the article, I make the distinction between the D.O. given in the United States and those given elsewhere. Dr. Jadick received his degree from an accredited institution in New York (
    https://en.wikipedia.org/wiki/Richard_Jadick ) and thus likely saved so many men by using science and not by trying to crack their backs or manipulate their bones. I wasn’t familiar with Dr. Jadick until now, but he sounds like a hero to me. Politics doesn’t enter into my opinions about science, but thanks for increasing my ad hominem count by one.

  • Daniebury

    An American DO practicing OMT on me helped my brain surgery go more smoothly than my surgeons ever thought it would. Physical therapy can’t do many of the things OMT can. Maybe instead of knocking it down, you bashers should try it!