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 This suggests that Professor Ernst is out of date with this review.”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.

Spinal Manipulation Not Effective for Colic

Here’s an interesting article I ran across last year and saved because spinal manipulation is often claimed as a treatment for colic. Science has proven this to be absolutely false.

New Research Finds Spinal Manipulation Doesn’t Work For Any Condition

A study to be published in next month’s issue of the Journal of the Royal Society of Medicine has raised serious questions about the efficacy of spinal manipulation treatment.

Spinal manipulation is commonly practiced by chiropractors and osteopaths. It is a popular form of manual treatment for back and neck pain with an estimated 16,000 licensed chiropractors in the UK.

“There is little evidence that spinal manipulation is effective in the treatment of any medical condition,” said Professor Edzard Ernst of the Peninsula Medical School at Exeter.

“The findings are of concern because chiropractors and osteopaths are regulated by statute in the UK.

“Patients and the public at large perceive regulation as proof of the usefulness of treatment. Yet the findings presented here show a gap and contradiction between the effectiveness of intervention and the evidence.”

Professor Ernst’s paper examined all systematic reviews published on spinal manipulation between 2000 and May 2005. Sixteen papers were included in the research relating to the following condition: back pain, neck pain, primary and secondary dysmenorrhoea, infantile colic, asthma, allergy and cervicogenic dizziness.

“Collectively these data did not demonstrate that spinal manipulation is an effective intervention for any of these conditions, except for back pain where it is superior to sham manipulation but not better than conventional treatments,” write the authors.

“Considering the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.”

The study also highlights the risk of spinal manipulation treatment.

“Spinal manipulation [SM] has been associated with frequent, mild adverse effects and with serious, probably rare implications,” write the authors.

“Therefore the risk-benefit balance does not favour SM over other treatment options such as therapeutic exercise. This statement is not in agreement with several national guidelines�but we suggest that these guidelines be reconsidered in the light of the best available data,” they conclude.

Professor Ernst said the findings confirm fears that in ‘alternative’ medicine regulation often serves as a substitute for research.

“Previous studies have shown that regulation of chiropractors was followed by a decrease in research activity,” said Professor Ernst.

“The evidence presented here should be seen as a wake-up call to the chiropractic profession.

“One way forward is more rigorous clinical trials to test the efficacy of spinal manipulation, after all, the treatment is not without risk and chiropractors must demonstrate why it should be a recommendable medical treatment option,” Professor Ernst said.

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For more information about spinal manipulation and why you should not see a chiropractor for any condition — whether it is colic, back pain, neck pain or any other medical condition — be sure to read this excellent article by a former chiropractic patient entitled, Don’t I Need a Chiropractor?