General Osteopathic Council Refutes Statement That Spinal Manipulation Does Not Work

Spinal manipulation is but one potential element of the osteopathic treatment package, which also includes guidance on lifestyle, diet and exercise.

A large proportion of patients visit osteopaths for help with back pain including low back pain, neck pain and headaches. All recent scientific research suggests that back pain:

– is rarely a simple problem.
– is influenced by psychological and social factors.
– requires treatment tailored to the patient’s needs.

Research is a high priority within the osteopathic profession and new research is always welcomed by the General Osteopathic Council (GOsC). However, this is a review of research dating back to 2000 and provides no new findings itself. Further, the paper fails to draw on more recent studies. As such, the review is extremely limited, and certainly not helpful to patients or healthcare professionals when making generalisations about osteopathic practice.

Contrary to Professor Ernst’s statement that “� regulation serves as a substitute for research �” the National Council for Osteopathic Research (NCOR) was set up in 2003, following the establishment of the Statutory Register of Osteopaths in 2000. NCOR’s remit is to co-ordinate and develop the evidence-base for osteopathy.

A spokesperson for NCOR said, “A substantial amount of research has been carried out in the last few years, most notably a Medical Research Council (MRC) funded trial on spinal manipulation and exercise therapy for low back pain (UK BEAM trial 2004). This important study provides good evidence to support spinal manipulation for low back pain, particularly when combined with exercise guidance - typical osteopathic management. This suggests that Professor Ernst is out of date with this review.”

In summary, the research design/methodology is not a recognised systematic review, it is limited in terms of scientific value, and the data presented does not support the conclusions made.

This article is in response to:
‘Spinal Manipulation doesn’t work for any condition, new research finds’ Ernst E., Canter P. A systematic review of systematic reviews of spinal manipulation. J R Soc Med 2006;99:189-193

About Osteopathy

– Osteopathy uses many of the diagnostic procedures involved in conventional medical assessment and diagnosis. Its main strength lies in the unique way the patient is assessed holistically from a mechanical, functional and postural standpoint. Treatment is aimed at improving mobility and/or reducing inflammation by using gentle manual osteopathic techniques on joints, muscles and ligaments.

– Patients are given positive advice, related to their lifestyle, about how they use their body. Age is no barrier to osteopathy since each patient is assessed individually and treatment is gentle.

– Osteopaths treat a wide range of conditions, including changes to posture in pregnancy; babies with colic or sleeplessness, repetitive strain injury, postural problems caused by driving or work strain, glue ear in children, the pain of arthritis and sports injuries, amongst others.

Second-hand Smoke Linked To Psychological Problems In Kids

Children whose mothers were exposed to second-hand smoke while they were pregnant have more symptoms of serious psychological problems compared to the offspring of women who had no prenatal exposure to smoke, according to a new University of Washington study.

Writing in the current issue of Child Psychiatry and Human Development, UW psychologists Lisa Gatzke-Kopp and Theodore Beauchaine provide the first evidence linking mothers’ second-hand smoke exposure while pregnant to their children’s attention deficit hyperactivity disorder (ADHD) and conduct disorder. Psychologists call these behaviors externalizing psychopathology and their symptoms include aggressive behavior, ADHD, defiance and conduct disorder, which encompasses truancy, fighting, school failure, breaking rules, substance use, stealing and destruction of property.

The research also supports a 2006 report by the U.S. Surgeon General that found passive smoke exposure poses a substantial risk to the general health of those who breathe the smoke, as well as to the fetuses of pregnant women.

Gatzke-Kopp and Beauchaine compared patterns psychopathology among three groups of 7- to 15-year-old children, all of whom had significant behavioral and/or emotional problems. One group experienced no prenatal smoke exposure. The second was made up of children whose mothers smoked during the final two trimesters of pregnancy. The third consisted of children whose mothers were exposed to second-hand smoke at work or in the home in the last two trimesters during pregnancy. A total of 171 children, primarily boys, and 133 women participated in the project.

The UW researchers found that those children whose mothers had been exposed to tobacco smoke either by smoking or by being around smokers when they were pregnant had more symptoms of ADHD and conduct disorder than children whose mothers spent their pregnancies in a smoke-free environment. However, they did not show more symptoms of emotional disorders such as depression or anxiety.

“This is a matter of severity,” said Gatzke-Kopp, a post-doctoral researcher.

“Children with these disorders have a range of behaviors that stretch from problematic to severe. It is a continuum based on the number of symptoms, and children who were exposed to smoke exhibited more symptoms.”

She and Beauchaine controlled for a number of other factors including family income, parents’ substance use, birth weight and parents’ anti-social behavior, but second-hand exposure to smoking persisted as the primary predictor of conduct disorder and ADHD.

Nicotine, an alkaloid compound in tobacco, is believed to be the chemical that causes these behavior problems in children. Animal studies have shown that nicotine affects brain development during the second and third trimesters of pregnancy, causing changes in brain regions critical to the development of externalizing psychopathology in humans.

“Evidence suggests that the dopamine system in the brain gets over stimulated during pregnancy,” Beauchaine said. Dopamine is a brain chemical that plays an important role in behavior and cognition, among other functions. “

“As a consequence, children who were exposed to smoke in utero have colic and are hard to sooth as infants. As toddlers they are overactive and oppositional. Later on they are irritable, inattentive and low on pleasure.”

Gatzke-Kopp and Beauchaine believe a message needs to be distributed widely that regardless of how women are exposed to tobacco smoke, either directly or second-hand smoke, their unborn children’s behavior can be affected.