Osteopathy: For Crying Out Loud..

Posted on May 17, 2011

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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!)

GOsC Members Websites – Colic

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  

 
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Posted in: ASA, Osteopathy