Osteomyology

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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] Osteomyologists are 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, cannot join as they do not meet professional or training standards, or who have been suspended or struck off from these statutory bodies.[2]

Contents

[edit] 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.[2] 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 chiropracric 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.[3]

Clemens created the name from the joining of Osteo = bone, Myo = muscle and ology, a study.[4]

Osteomyologists have no defining philosophy other than being allowed to practice 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.[5]

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.[6]

[edit] Efficacy

[edit] Effectiveness of Treatment

There is no reliable evidence available regarding the effectiveness 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. 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,[7]

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.

There is some evidence that Chiropractic practices when compared to sham treatments shows clinically significant improvement in short-term pain relief for acute low back pain. However, when compared with conventional treatments there were no significant benefits.[8] There is some evidence that osteopathic treatment is helpful for low back pain. For other conditions, the evidence is not compelling.[8]

[edit] Associated Risks

Spinal manipulation is associated with frequent, mild and temporary adverse effects,[9] including new or worsening pain or stiffness in the affected region.[10] Rarely, spinal manipulation, particularly on the upper spine, can also result in complications that can lead to permanent disability or death. [9][11] 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.[9] The Osteomyology Association web site makes no mention of how it collates data on adverse reactions and complications from its own practitioners.

[edit] Controversies

[edit] 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.[12] The Association of Osteomyologists is currently working on a framework for voluntary self-regulation for its members.[13]

[edit] Professional standards

The WHO state that the safety and quality of chiropractic practice depends mainly on the quality of training of the practitioner. [14] 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 physics medical disciplines".[15] This is a much broader and looser requirement than the statutorily regulated profession of chiropractic.[16]

[edit] Professional conduct

Concern over the history of chiropractic professional conduct was one of the chief concerns leading to proper regulation of the profession. Ernst and Singh have noted that chiropractors are twice as likely to be subjected to disciplinary actions as doctors and the rate for fraud was nine times higher. Sexual boundary transgressions were three times higher than for doctors.[5] Despite the lack of statutory professional regulation, osteomyologists have found themselves subject to various types of regulatory investigation. In each case, proclaiming to be an osteomyologist was an attempt to avoid specific legislation aimed at osteopaths and chiropractors. For example,

  • James McLeish, who runs the Morningside Natural Health Centre in Edinburgh, has been investigated by Edinburgh City Council Trading standards officers after advertising "osteopathy" in the window of his clinic. The General Osteopathic Council initiated the investigations. McLeish claimed to be an osteomyologist. A GOsC spokesperson said "Just because someone wears a white coat does not mean they are a qualified health worker".[17]
  • In 2007, the Advertising Standards Authority found that Robert Delgado of the Optimum Health Centres, North Finchley, had made untruthful and unsubstantiated claims in advertising stating that "There are many scientific studies that show that spinal adjustments can actually improve your immune system by up to 200%, naturally and without drugs". The ASA stated that the evidence supplied by Delgado was "insufficient to support the claim or to show that spinal therapy had a stimulating effect on the immune system". The ASA also noted that Delgado's "use of the title 'Dr' gave the impression that Robert Delgado was a registered medical doctor. Because he was not, we concluded that the claim could mislead".[18] A very similar ASA ruling was made against Christian Farthing of the Ideal Spine Centre in Canterbury who had been suspended from the chiropractor register and now advertised as an osteomyologist. Farthing was told not to refer to serious or prolonged medical conditions in advertsing and not to imply that he was a Doctor or chiropractor.[19]
  • Peter Proud, an ex chiropractor from Stourbridge, was investigated by the General Chiropractic Council (GCC) for "unacceptable professional conduct" including the administration of unjustified X-rays and inappropriately calling himself 'Dr'.[20] Peter Proud decided to reincarnate himself as an osteomyologist. The GCC found that he "abused the trust of his patients, and coercing them, through alarmist scare tactics, into excessively protracted and unjustified treatment plans". The GCC removed Proud from their register. His reaction was "This is wonderful news, I have previously requested to be permanently removed from the register as I don't want anything to do with their association."[21]
  • Fiona Judson of Evesham was fined £1000 and ordered to pay £1,997,37 costs after being found to be advertising herself as an osteopath when not registered with the General Osteopathic Council. Judson said she was registered with the Association of Osteomyologists and said "she described herself on the phone as one (osteopath) as she said it was easier than explaining what a osteomyologist was."[22]

[edit] See also

[edit] 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 Interview with Osteomyologist's Founder and Chairman Dr. Alan Clemens Pt1. Brightcove.[1]
  3. ^ Julie Stone, Joan Matthews (1997). Complementary Medicine and the Law. Oxford University Press, p 152. ISBN 0198259719. 
  4. ^ The Philosophy of Osteomyology .[2]
  5. ^ a b Simon Singh, Edzard Ernst (2008). Trick or Treatment?: Alternative Medicine on Trial. Bantam Press, p 147, 169. ISBN 0593061292. 
  6. ^ Directory of Osteomyologists .[3]
  7. ^ Ernst E, Canter P H. (2006). "A systematic review of systematic reviews of spinal manipulation". J R Soc Med 99 (7): 192–6. 
  8. ^ a b Ernst, Pittler, Wider (2006). The Desktop Guide to Complementary and Alternative Medicine. Elsevier, p 313, 343. ISBN 0723433836. 
  9. ^ a b c Ernst E (2007). "Adverse effects of spinal manipulation: a systematic review". J R Soc Med 100 (7): 330–8. PMID 17606755. 
  10. ^ 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. PMID 17906581. 
  11. ^ 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. 
  12. ^ Complementary and Natural Healthcare Council (CNHC).[4]
  13. ^ Osteomyology Voluntary Self Regulation (VSR) Working Group.[5]
  14. ^ WHO guidelines on basic training and safety in chiropractic
  15. ^ The Association of Osteomyologists.[6]
  16. ^ GCC: Recognised qualifications.[7]
  17. ^ Watchdogs to launch hotline to vet medics; Patients can check The Sunday Herald 25 July 2004
  18. ^ ASA Adjudications: Optimum Health Centres 19 December 2007
  19. ^ ASA Adjudications: Ideal Spine Centre 20 February 2008
  20. ^ NOTICE OF FINDINGS BY THE PROFESSIONAL CONDUCT COMMITTEE OF THE GENERAL CHIROPRACTIC COUNCIL 22 January 2007
  21. ^ Specialist Struck Off Martyn Smith Stourbridge News
  22. ^ `Osteopath' fined £1,000 Cotswold journal 18th May 2006

[edit] Further reading

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