What is osteopathy: an effective treatment or a placebo

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

Finding out whether to believe this popular wellness technique will heal your body.

What is osteopathy

Osteopathy is a field of medicine that is based on the perception of the body as a whole. It is aimed at helping the patient with manual methods. The literal translation from Greek is "bone disease": ὀστέον - "bone" + πάθος - "disease".

Osteopathy can be attributed to manual therapy - the effect on the patient occurs only with the help of the hands. But this method of treatment differs from massage, bone-setting and chiropractic in that it works not with the effect (specific symptom), but with the cause. That is, the goal is to improve the anatomical and functional indicators of the body as a whole.

The following sections of osteopathic therapy are distinguished:

• Craniosacral - is responsible for the restoration of micromobility of the brain and spinal cord and surrounding tissues.
• Fascial - regulates the activity of the musculoskeletal system by acting on the fascia (connective tissue membranes that cover muscles, organs, blood vessels and nerves).
• Visceral - aimed at eliminating violations in the mobility and work of internal organs.

It is believed that osteopathic techniques are most effective at the initial stage of the disease, when irreversible changes in an organ or system have not yet developed.

Osteopath services are not included in the list About the Program of state guarantees of free provision of medical care to citizens for 2020 and for the planning period of 2021 and 2022 of services provided under the compulsory medical insurance program. Prices for such treatment in Moscow, St. Petersburg, Yekaterinburg and other large cities range from 1,500 to 20,000 rubles for an appointment lasting 60 minutes.

How osteopathy began and became official

The founder of osteopathy is the American doctor Andrew Taylor Still. He took HISTORY - Andrew Taylor Still, MD, DO as an orderly in the Civil War, and studied medicine under his father. When Still's wife and four children died of meningitis, he decided that traditional medicine was not without its shortcomings, and delved into the study of the structure of the human body. The doctor devoted 30 years to this and acquired successful manual therapy skills.

By the time he became famous, Still rejected the possible infectious nature of diseases and explained everything by anatomical and physiological disorders. He believed that osteopathic techniques could completely cure any disease.

In 1892 Still founded the A. T. Still University American School of Osteopathy. Subsequently, similar schools were opened in England and France.

In Russia, the first educational institution teaching osteopathy appeared. History of the school in 1994 in St. Petersburg - Russian Higher School of Osteopathic Medicine.

In 2003, the Ministry of Health of the Russian Federation approved osteopathy: this technique was first recognized as a method of treatment in our country.

At the end of 2012, osteopathy was included in the nomenclature of positions on the approval of the nomenclature of positions of medical workers and pharmaceutical workers of medical workers. In September 2013, this area of therapy was included in the list of specialties in the training programs for doctors in residency. In October 2015, an order was issued on the nomenclature of specialties for specialists with higher medical and pharmaceutical education on the inclusion of osteopathy in the nomenclature of specialties of higher medical education. So, since 2015, only a doctor can be called an osteopath. In January 2018, an order was published on the approval of the procedure for the provision of medical care to the population in the "osteopathy" profile, on the approval of a unified procedure for the provision of medical care to the population in the "osteopathy" profile.

But the abundance of these official documents says absolutely nothing about the effectiveness of this type of therapy.

Is osteopathy effective?

On the website of the Journal of the American Osteopathic Association, one of the articles presented in which the activities of osteopathic physicians are licensed. These are Russia, China, Canada, USA, Brazil, Argentina, Great Britain, Sweden, Finland, Italy, Austria, Germany, Poland and some African countries. It should be remembered that licensing does not mean proof of the effectiveness of any industry - it is necessary to control the activities of doctors at the state level.

WHO still refers to the WHO Traditional Medicine Strategy 2014–2023 as osteopathy to alternative, or traditional medicine. The opinions of other experts are also not inclined in favor of this kind of therapy. For example, Vasily Vlasov (Doctor of Medical Sciences, Professor, member of the Commission COMMISSION FOR FIGHT AGAINST Pseudoscience under the Presidium of the Russian Academy of Sciences for Combating Pseudoscience of the Russian Academy of Sciences) in his interviews and articles equates Elena Malysheva in the dispute about osteopathy with alternative medicine without any - any evidence base:

Vasily Vlasov

This is not a scientific practice, but one of the ways to provide paid medical services, and health care benefits from it as much as from the department of theology in medical universities.

John Snyder, MD and Fellow of the American Academy of Pediatrics, in his article Osteopathy in the NICU: False Claims and False Dichotomies smashes one of the studies allegedly confirming the effectiveness of osteopathy in children. In drawing conclusions, he urges: "It is time to recognize that osteopathy does not exist and to focus our efforts on improving the evidence-based approach to medicine."

Of course, much more often in the media there are interviews with osteopathic doctors who convince Is osteopathy safe? Myths and truths us in the effectiveness of the appropriate techniques, or articles about the benefits of osteopathy (especially on women's 10 myths about osteopathy forums and sites). As a rule, all of them mention the legalization of this area of therapy in the Russian Federation and bypass the question of the evidence base.

By the way, it simply does not exist: existing studies do not confirm the effectiveness of osteopathy.

For example, data from the Cochrane Systematic Review suggest Spinal manipulative therapy for chronic low-back pain that osteopathic techniques have a short-term beneficial effect on chronic low-back pain. However, in their conclusions, the authors note that it is not possible to reliably compare these results with placebo use. And they point out that osteopathy does not demonstrate a significant clinical effect in comparison with other forms of intervention.

Another systematic review shows The effects of osteopathic treatment on psychosocial factors in people with persistent pain: A systematic review that osteopathic techniques sometimes help reduce anxiety and psychological discomfort in patients with chronic pain. However, in some cases there was no improvement in the mental state of patients, and in others, the result was comparable to the effect of a normal conversation with a doctor without other types of intervention. The authors acknowledge the great heterogeneity of the groups in the review (by age, sex and localization of pain syndrome) and the use of various osteopathic techniques (lack of standardization in the experimental group). In addition, 10 out of 17 studies in this review were not "blind": "blind" studies are more objective, since patients are not privy to the details of the trial. All of these conditions are critical in order to determine the validity of the conclusions.

The authors of another review, who studied works on the influence of osteopathy on the course of chronic inflammatory diseases, say Chronic Inflammatory Disease and Osteopathy: A Systematic Review about the impossibility of assessing its effectiveness. The fact is that the studies reviewed were also not "blind", the groups of participants were heterogeneous in gender, age and diagnosis, and there were no control groups. In addition, the works did not describe the method of exposure and did not mention side effects.

In addition, there is very little recent research on osteopathy at this time. Most of the works that consider the effect of osteopathy on the body are a retrospective analysis of data from various clinical trials.

The UK National Health Service mentions Evidence - Osteopathy on its website that while many people report good results after treatment with osteopaths, it is not always clear how effective the treatment actually was and whether it was a placebo effect.

The article The paradox of sham therapy and placebo effect in osteopathy "The paradox of sham therapy and the placebo effect in osteopathy", based on a systematic review, draws conclusions about the lack of evidence base for osteopathy and the necessary measures to correct the situation.

Foreign and domestic studies have not revealed significant negative health effects of osteopathy. But in almost all of them there is an indication that the test does not comply with international standards GOST R 52379-2005. Good clinical practice.

conclusions

At all stages of the development of medicine, there were generally accepted methods of treatment, which were then rejected for lack of evidence of their effectiveness. So, hernias and convulsions were treated by Esmarch's Mug: the history of invention with "tobacco enema", hemorrhoids - with red-hot iron. Skeletons from the closet of Russian history. Bloodletting A Brief History of Bloodletting has been a panacea for all diseases for a long time. In the 1930s, Dr. Alexey Andreevich Zamkov tested the drug on the basis of the urine of pregnant women. And for about 10 years, urine therapy NON-TRADITIONAL WAYS OF RECOVERY OF THE MODERN CITIZEN: URINOTHERAPY was the official method of treatment in the USSR.

There is no consensus on osteopathy. However, most of the relevant studies do not support its effectiveness. And the results of many trials, in which the positive effect of such therapy is noted, cannot be called reliable due to violations of the rules for their conduct.

Most likely, harm from osteopathy can be only if the patient refuses traditional methods of diagnosis and treatment. The patient and the doctor may simply waste time. But the choice is always yours.