Of all the conditions that Cranial Osteopaths claim to treat, infantile colic is perhaps one of the most common.
We can see just how common by using a very handy Google Custom Search, this tool can be used to search GOsC members websites for specific search phrases, in this case colic: (See Note at bottom of post for more custom searches and information on Fishbarrel!)
At present this search is returning 9 pages of websites (that may change) and whilst the results include sites that mention colic, rather than specifically offering treatment, the majority of these sites do make varying degrees of treatment claims for colic.
With this claim being so common, you would rightly expect there to be a body of good quality evidence to support it. Well I’ve looked for it before and couldn’t find it, I’ve asked both the GOsC and NCOR if they knew of any and still not found anything conclusive. This is covered in earlier posts:
Osteopathy: A question of evidence pt1
Osteopathy: A question of evidence pt2
NCOR (National Council for Osteopathic Research) have recently been conducting a review of literature and evidence covering cranial osteopathy for a number of conditions and the results of this should be made public soon.
Until then, perhaps the best place to turn to would be the recent article in the April/May edition of The Osteopath The article, published by NCOR is called ‘Osteopathic Studies Investigating the Management of Infantile Colic’ (pages 19 – 21).
The opening paragraph contains a statement that highlights the problem with these colic claims:
“This is a distressing condition for both parent and infant. Anecdotal evidence suggests that osteopaths treat infantile colic successfully, but limited published evidence is available on this topic“
What we seem to have are lots of (cranial) osteopaths offering to treat a distressing condition, but with very limited evidence to support that treatment. So hopefully the article will address these issues.
The NCOR article covers what colic is, how it is assessed, what literature is available for osteopathy and also chiropractic and finally gives their conclusions.
One study that crops up regularly in relation to osteopathic treatment for colic is Hayden et al 2006. This study appears on numerous websites, it was also included in the list of evidence that the British Chiropractic Association’s plethora of evidence (even though it is not chiropractic). The study itself was a small scale, preliminary study with no blinding. The full report is clear that there are some issues with the trial design and potential for bias and despite reporting some positive results, it acknowledges that a larger double-blind study is warranted. This study has also been looked at by the ASA and has been rejected as substantiation for colic claims.
Even if colic is a fairly harmless condition, I fully agree with NCOR that colic can be a very distressing. NHS information on colic can be found here: NHS Choices – Colic
So how do NCOR actually view the level of evidence for the treatment of colic:
So here is a clear statement that there is insufficient evidence to recommend cranial osteopathy (or other manual therapies) for management of colic. It is important to note that these conclusions do not simply relate to the level of evidence required by the ASA/CAP codes when advertising or making website claims, but to the level of evidence available to justify offering osteopathy as a treatment for colic. This has obvious implications for compliance with the GOsC Code of Practice (item 122), but also for the wider issue of osteopathy and Evidence Based Practice. So what next...... These claims would certainly be unacceptable to the ASA, so will we see individual osteopaths taking the easier option of (reluctantly) accepting that there is a lack of evidence and voluntarily removing these claims, or will it take some form of pressure to get them removed. How about the GOsC? Do they continue the slow, but welcome, process of reviewing members websites and offering advice, or do they issue a clear statement that colic treatment and claims cannot be justified. Note: Visit these links fr more information on the Google Custom Searches and the excellent quackery reporting tool 'Fishbarrel' produced by Simon Perry. Fishbarrel - ASA, Consumer Direct and MHRA complaints (Google Chrome browser plugin) Google Custom Searches
Dominic
May 17, 2011
These claims are stupid, but not just limited to osteopaths.
But at least osteopathy admits there is a lack of research other therapists make the same claims and do not even bother to look at the evidence. homoeopaths would never admit that there is no evidence.
Andrew Gilbey
May 24, 2011
Dominic,
The other way of thinking about it is if osteopaths admit that there is not much research and then make the claims anyway, they are knowingly misleading potential customers. At least therapists who make daft claims without having realised they are not supported by evidence are not conciously trying to mislead. So, relatively speaking, osteopaths are the bad guys.
Jenny
June 1, 2011
Someone want to run fishbarrel over this: http://www.being-in-stillness.co.uk ? Looks like she’s a tutor at a cranialsacral college too. I would except my son hasn’t shown me how to install the plugin yet on our home pc…
realworld
June 3, 2011
I know health careworkers who refer colicky babies to osteopaths because what they do works, they risk their jobs in the NHS by doing this, but do it because the clinical evidence speaks for itself. You are never going to find a peer reviewed article in any medical magazine that validates anything but the status quo. Would you expect the Pope, bless im, to suddenly announce that he was wrong?
Can you quote a searchable article that actually says manual therapy has no impact on colic? Colic is not a ‘magical pain syndrome’ it is the consequence of poor ‘food combustion’ leading to gas production from incomplete cleaving. This mechanism is well described in old literature and the public have no problem understanding this logic in correcting the problem. I have never found a medical book that even attempts to describe any eitiology, cause or mechanism so what is the hang up about deciding that only the medical boys have an opinion? Especially when they have no idea what is causing it! They are allowed to have no diagnosis and then prescribe, surely someone who can explain why and sort the problem has got to be a better bet, especially if they have a long line of happy patients!
It is precisely the reason that the public turn to alternatives, that is the total failure of the medics to help that provides the biggest source of referral so you are probably never going to find a patient complaining to the ASA and that is your biggest problem really, no patients are complaining, only people with ‘wierd time’ on their hands! I mean the only way the ASA and TS say in employment is if someone complains, are you sure this site isn’t a job creation scheme because I don’t see piles of disgruntled patients complaining and that is what these quangos were set up to do ‘protect the public’ and they are not doing that are they, maybe we should refer the ASA to the TS and vice versa? That would be interesting use of fishbarrel, maybe it would go into a quantum inward spiral and blow up?
NCOR has no idea what osteopathy is, or was. No one in the profession takes them seriously and as you have seen they have been unable to produce anything above an undergrad literature review, in 10 years!
Any stats on fishbarrel yet?