Osteomyology

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Alternative medicine · Glossary · People

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Osteomyology (sometimes Neurosteomyology) is a form of alternative medicine found almost exclusively in the United Kingdom and is loosely based on aggregated ideas from other manipulation therapies, principally chiropractic and osteopathy.^[1][2] Osteomyologists are often therapists who have usually been trained in osteopathy or chiropractic but take on the title osteomyologist after they have refused to be regulated by the General Osteopathic Council (GOsC) or the General Chiropractic Council (GCC) for political or philosophical reasons, or cannot join as they have not submitted the required papers to the governing bodies to meet professional or training standards.^[3][4]

Origin and philosophy

The term osteomyology was invented by Alan Clemens in 1992 whilst he was training to be an osteopath. He came up with the name "as a joke" and made all his fellow students Fellows of the Association of Osteomyologists.^[4] This was a response to news that the UK government was about to bring in new legislation requiring all chiropractors and osteopaths to be registered with new governing bodies. The new acts were not universally welcomed by the grassroots of the professions. The acts did not forbid the various practices of chiropractic and osteopathy, but protected the titles of osteopath and chiropractor to those registered with the new organisations. By taking on the title Osteomyologist, practitioners can advertise their various spinal manipulation without being in breach of the legislation.^[5] It has been estimated that 4 to 5% of osteopaths were denied registration as osteopaths because they were not up to date with training or would not conform to current accepted safe practice. Many of those continued practising as osteomyologists.^[6]

Clemens created the name from the joining of Osteo = bone, Myo = muscle and ology, a study.^[7]

Osteomyologists have no defining philosophy other than being allowed to practise their own versions of manual therapy without restriction by a statutory regulatory authority. Practitioners are encouraged to blend other forms of alternative medicine into their work such as aromatherapy, reflexology and Bach flower remedies. Practitioners may bring beliefs about healing from other practices such as the pseudoscientific belief in Vertebral subluxation from chiropractic or notions of fluid blockages from osteopathy.^{[8][verification needed]}

Alan Clemens now runs the The Association of Osteomyologists and provides professional insurance and marketing services for members. Members of the Association designate themselves with the letters MAO (Member of the Association of Osteomyologists) after their name. Members are expected to partake in continuing training programmes and can present evidence of ongoing training in any alternative medicine. No code of conduct is made public and there is no published method by which members of the public can make concerns known about members. The organisation does not publish membership figures, but their site would suggest that there are several hundred members.^{[9][verification needed]}

Efficacy

There is no reliable evidence available regarding the effectiveness or risks of treatment given by osteomyologists as a distinct practice. However, there is a wide range of evidence regarding the efficacy of the various constituent manual therapies that osteomyology draws upon.

Effectiveness

In 1996, Ernst and Canter published a systematic review of the evidence base for various spinal manipulation (SM) techniques, including "chiropractors, osteopaths, physiotherapists and other healthcare providers mostly (but not exclusively) to treat musculoskeletal problems." They concluded,^[10]

In conclusion, we have found no convincing evidence from systematic reviews to suggest that SM is a recommendable treatment option for any medical condition. In several areas, where there is a paucity of primary data, more rigorous clinical trials could advance our knowledge.

However, from other reviews, there is some evidence that Chiropractic practices (when compared to sham treatments) show clinically significant improvements in short-term pain relief for acute low back pain. However, when compared with conventional treatments there were no significant benefits.^[11] There is some evidence that osteopathic treatment is helpful for low back pain. For other conditions, the evidence is not compelling.^[11]

Associated risks

Spinal manipulation is associated with frequent, mild and temporary adverse effects,^[12] including new or worsening pain or stiffness in the affected region.^[13] Rarely, spinal manipulation, particularly on the upper spine, can also result in complications that can lead to permanent disability or death.^[12][14] The incidence of these complications is unknown, due to rarity, high levels of under-reporting, and difficulty of linking manipulation to adverse effects such as stroke, and has been noted as a particular concern.^[12]

Controversies

Legal status

Osteomyology is not a statutorily regulated form of alternative medicine. Anyone can describe themselves as an osteomyologist without meeting any requirements for training or professional standards. The newly formed UK voluntary regulation body, the Complementary and Natural Healthcare Council (CNHC) will not play any role in the regulation of osteomyologists.^[15] The Association of Osteomyologists is currently working on a framework for voluntary self-regulation for its members.^[16]

The Advertising Standards Authority concluded that the Association of Osteomyologists was not a statutory or recognised health and medical professional body and merely allowed osteomyologists to share knowledge.^[3]

Professional standards

The WHO states that the safety and quality of chiropractic practice depends mainly on the quality of training of the practitioner.^[17] As osteomyologists are often practitioners who refuse to be subject to statutory regulation regarding training and practice, it is difficult to ensure that their standards meet minimum guidelines. The Association of Osteomyologists claim to allow membership to anyone who has "degree qualifications in one of the physical medical disciplines".^[18] This is a much broader and looser requirement than the statutorily regulated profession of chiropractic.^[19]

Regulatory offences

Osteomyologists have found themselves subject to various types of regulatory investigation. The Advertising Standards Authority has taken action against practitioners, for such offences as making untruthful and unsubstantiated claims in advertising about the extent of scientific support for the therapy,^[20] or referring to serious medical conditions in their advertising.^[3][20][21] In November 2008, the Committee of Advertising Practice issued advice about the advertising from osteomyologists warning that they should not mislead on their status or training and that if they wanted to claim to offer manipulation or chiropractic techniques they must hold suitable, relevant qualifications to undertake such therapy and robust substantiation for the efficacy of claims for the therapy.^[2]

Several practitioners have been investigated by the General Osteopathic Council for advertising as osteopaths.^[22][23] The Times ran an investigation in 2004 into 'illegal chiropractors' and found many osteomyologists describing themselves as chiropractors to prospective customers.^[24]

A chiropractor being investigated by the General Chiropractic Council (GCC) for multiple instances of unprofessional conduct was found by the council to have "endeavoured to evade the GCC’s jurisdiction by denying that he is a chiropractor" calling himself instead an osteomyologist.^[25]

See also

• Conventional medicine, alternative medicine and evidence-based medicine
• False advertising in health care

References

1. ^ Randi, James (1997). An Encyclopedia of Claims, Frauds, and Hoaxes of the Occult and Supernatural. Saint Martin's Press Inc. ISBN 0312151195. 
2. ^ ^{a b} Committee of Advertising Practice, AdviceOnline: Ailments, Treatments and Therapies: Osteomyology 21 November 2008
3. ^ ^{a b c} ASA Adjudications: Optimum Health Centres 18 September 2008
4. ^ ^{a b} Interview with Osteomyologist's Founder and Chairman Dr. Alan Clemens Pt1. Brightcove.[1]
5. ^ Julie Stone, Joan Matthews (1997). Complementary Medicine and the Law. Oxford University Press. pp. 152. ISBN 0198259719. 
6. ^ House of Commons Hansard Debates for 25 October 2000: Osteopaths Act 1993 [2]
7. ^ The Philosophy of Osteomyology
8. ^ Simon Singh, Edzard Ernst (2008). Trick or Treatment?: Alternative Medicine on Trial. Bantam Press. pp. 147, 169. ISBN 0593061292. 
9. ^ Directory of Osteomyologists
10. ^ Ernst E, Canter P H. (2006). "A systematic review of systematic reviews of spinal manipulation". J R Soc Med 99 (7): 192–6. doi:10.1258/jrsm.99.4.192. PMC 1420782. PMID 16574972. http://jrsm.rsmjournals.com/cgi/content/full/99/4/192. 
11. ^ ^{a b} Ernst, Pittler, Wider (2006). The Desktop Guide to Complementary and Alternative Medicine. Elsevier. pp. 313, 343. ISBN 0723433836. 
12. ^ ^{a b c} Ernst E (2007). "Adverse effects of spinal manipulation: a systematic review". J R Soc Med 100 (7): 330–8. doi:10.1258/jrsm.100.7.330. PMC 1905885. PMID 17606755. http://www.jrsm.org/cgi/content/full/100/7/330. 
13. ^ Thiel HW, Bolton JE, Docherty S, Portlock JC (2007). "Safety of chiropractic manipulation of the cervical spine: a prospective national survey". Spine 32 (21): 2375–8. doi:10.1097/BRS.0b013e3181557bb1. PMID 17906581. 
14. ^ Vohra S, Johnston BC, Cramer K, Humphreys K (2007). "Adverse events associated with pediatric spinal manipulation: a systematic review". Pediatrics 119 (1): e275–83. doi:10.1542/peds.2006-1392. PMID 17178922. http://pediatrics.aappublications.org/cgi/content/full/119/1/e275. 
15. ^ Complementary and Natural Healthcare Council (CNHC)
16. ^ Osteomyology Voluntary Self Regulation (VSR) Working Group
17. ^ WHO guidelines on basic training and safety in chiropractic
18. ^ The Association of Osteomyologists
19. ^ GCC: Recognised qualifications
20. ^ ^{a b} ASA Adjudications: Optimum Health Centres 19 December 2007
21. ^ ASA Adjudications: Ideal Spine Centre 20 February 2008
22. ^ Watchdogs to launch hotline to vet medics; Patients can check The Sunday Herald 25 July 2004
23. ^ `Osteopath' fined £1,000 Cotswold journal 18th May 2006
24. ^ Back off: Handle with care The Times 17 January 2004
25. ^ Notice of Findings by the Professional Conduct Committee of the General Chiropractic Council 22 January 2007

Further reading

• Shapiro, Rose (2008). Suckers: How Alternative Medicine Makes Fools of Us All. Harvill Secker. ISBN 1846550289.