Spinal subdural haematoma after lumbar spinal manipulation

Spinal manipulation has been associated with a wide range of serious complications. Usually, they occur after neck manipulations. Neurologists from Morocco just published a case-report of a patient suffering a subdural haematoma after lumbar spinal manipulation. A previously healthy 23 years-old man was receiving spinal manipulation for chronic back pain by a physiotherapist when he […]

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Suffering from back pain? Walk to your therapist, don’t accept (or pay for) treatment, but walk straight back home again

We all know that there is a plethora of interventions for and specialists in low back pain (chiropractors, osteopaths, massage therapists, physiotherapists etc., etc.); and, depending whether you are an optimist or a pessimist, each of these therapies is as good or as useless as the next. Today, a widely-publicised series of articles in the […]

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Visceral osteopathy is implausible and does not work … SO, LET’S FORGET ABOUT IT ONCE AND FOR ALL

Lock 10 bright people into a room and tell them they will not be let out until they come up with the silliest idea in healthcare. It is not unlikely, I think, that they might come up with the concept of visceral osteopathy.

In case you wonder what visceral osteopathy (or visceral manipulation) is, one […]

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Larry Nassar – doctor of osteopathy (“intravaginal manipulations are an approved osteopathic treatment”)

We probably all heard about the horrific stories related to Larry Nassar who, on January 24, 2018, was sentenced to 40 to 175 years in a state prison in Michigan after pleading guilty to the sexual assault of numerous minors. But few of us, I think, had any idea that they relate to alternative medicine. This […]

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Is it time for chiropractors and osteopaths to look for other jobs?

This overview by researchers from that Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, UK, was aimed at summarising the current best evidence on treatment options for 5 common musculoskeletal pain presentations: back, neck, shoulder, knee and multi-site pain. Reviews and studies of treatments were considered of […]

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THE MANITOBA REVIEW OF UPPER NECK MANIPULATION

This is a fascinating new review of upper neck manipulation. It raises many concerns that we, on this blog, have been struggling with for years. I take the liberty of quoting a few passages which I feel are important and encourage everyone to study the report in full: The Minister of Health, Seniors and Active […]

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Cervical artery dissection and stroke related to chiropractic manipulation

The authors of a recent paper stated that cerebellar and spinal cord injuries related to cervical chiropractic manipulation were first reported in 1947. By 1974, there were 12 reported cases. Non-invasive imaging has since greatly improved the diagnosis of cervical artery dissection and of stroke, and cervical artery dissection is now recognized as pathogenic of […]

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Osteopathy making a mockery of academia and evidence-based healthcare

The TIMES HIGHER EDUCATION (THE) reported yesterday that the British School of Osteopathy (BSO) has won university college title, meaning that it could be on the road towards full university status. University college title, awarded by the Privy Council on the advice of the Department for Education (DfE) and the Higher Education Funding Council for England, is usually seen as a step towards full university status. The London-based BSO already secured degree-awarding powers and access to Hefce public teaching and research funding in 2015. The BSO will be known, from September, as the University College of Osteopathy...

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Spinal manipulation for acute low back pain, a new meta-analysis is “damning it with faint praise”

The question whether spinal manipulative therapy (SMT) is effective for acute low back pain is still discussed controversially. Chiropractors (they use SMT more regularly than other professionals) try everything to make us believe it does work, while the evidence is far less certain. Therefore, it is worth considering the best and most up-to-date data.

The aim of this […]

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Chiropractic? Osteopathy? No, thanks!

Alternative medicine suffers from what might be called ‘survey overload’: there are far too much such investigations and most of them are of deplorably poor quality producing nothing of value except some promotion for alternative medicine. Yet, every now and then, one finds a paper that is worth reading, and I am happy to say that this survey (even though it has several methodological shortcomings) belongs in this category...

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New advertising guidelines for UK osteopaths

Recently, the UK Advertising Standards Authority (ASA) together with the UK General Osteopathic Council (GOsC) have sent new guidance to over 4,800 UK osteopaths on the GOsC register. The guidance covers marketing claims for pregnant women, children and babies. It also provides examples of what kind of claims can, and can’t, be made for these patient groups.

Regulated by statute, osteopaths may offer advice on, diagnosis of and treatment for conditions only if they hold convincing evidence. Claims for treating conditions specific to pregnant women, children and babies are not supported by the evidence available to date...

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Osteopathy for gynaecological and obstetric disorders? | Edzard Ernst

Some osteopaths – similar to their chiropractic, naturopathic, homeopathic, etc. colleagues – claim they can treat almost any condition under the sun. Even gynaecological ones? Sure! But is the claim true? Let’s find out.

The aim of this recent review was to evaluate the effects of the osteopathic manipulative treatment (OMT) on women with gynaecological and obstetric disorders. […]

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A new systematic review of chiropractic for low back pain: far less encouraging than chiros make us believe | Edzard Ernst

Low back pain (LBP) is a ‘minor complaint’ in the sense that it does not cost patients’ lives. At the same time, LBP is amongst the leading causes of disability and one of the most common reasons for patients to seek primary care. Chiropractors, osteopaths, physical therapists and general practitioners are among those treating LBP patients, but there is only […]

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Osteopathy revisited | Edzard Ernst

Osteopathy is a confusing subject about which I have reported regularly on this blog (for instance here and here).

Recently, I came across a good article where someone had assessed 100 websites by UK osteopaths. The findings are impressive:
57% of websites in the survey published the ‘self-healing’ claim
70% publicised the fact they offered […]

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NICE no longer recommends acupuncture, chiropractic or osteopathy for low back pain | Edzard Ernst

On this blog, I have repeatedly pleaded for a change of the 2010 NICE guidelines for low back pain (LBP). My reason was that it had become quite clear that their recommendation to use spinal manipulation and acupuncture for recurrent LBP was no longer supported by sound evidence.

Two years ago, a systematic review (authored by a chiropractor and published in […]

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Spinal manipulation/mobilisation for neck pain: caution is warranted | Edzard Ernst

Chiropractors and osteopaths have long tried to convince us that spinal manipulation and mobilisation are the best we can do when suffering from neck pain. But is this claim based on good evidence?

This recent update of a Cochrane review was aimed at assessing the effects of manipulation or mobilisation alone compared with those of an inactive control […]
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An early critique of Osteopathy and Chiropractic | Edzard Ernst

This is a true gem which I found on Medline. The article was published 91 years ago by Holburt Jacob Waring (1866 – 1953) in the BMJ. I hope you enjoy it. This article does not need a comment, I think. Its author was one of the most prominent surgeons of his time. Apparently he was known and […]
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Craniosacral therapy: wild assumptions, flimsy science and wrong conclusions | Edzard Ernst

Alternative medicine encompasses many bizarre treatments, but one of the weirdest must be craniosacral therapy (CST). The assumptions underlying CTS are: light manual touch of the head moves the joints of the cranium; this movement stimulates the flow of the cerebrospinal fluid; the enhanced flow has profound and positive effects on human health. None of […]

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Osteopathy for migraine? | Edzard Ernst

Osteopathy is a difficult subject. In the US, osteopaths are (almost) identical with doctors who have studied conventional medicine and hardly practice any manipulative techniques at all. Elsewhere, osteopaths are alternative healthcare providers specialising in what they like to call ‘osteopathic manipulative therapy’ (OMT). As though this is not confusing enough, osteopaths are doing similar […]

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Osteopathic manipulative therapy for chronic neck pain is not an evidence-based approach | Edzard Ernst

Nonspecific neck pain is extremely common, often disabling, and very costly for us all. If we believe those who earn their money with them, effective treatments for the condition abound. One of these therapies is osteopathy. But does osteopathic manipulation/mobilisation really work?

The objective of a recent review was to find out. Specifically, the authors wanted to […]

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