Best book to read about Osteopathic Medicine

[PeteyHC]

Which one would people recommend the most ??

The D.O.'s: Osteopathic Medicine in America by Norman Gevitz

or

Foundations for Osteopathic Medicine by Robert C. Ward (Editor), et al

or another ??

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[Chocolate Bear]

I can't directly compare the two, but the first one is a FANTASTIC book that all future DOs should read before applying and DEFINITELY before filling out secondaries/interviewing. 👍 👍

 

[PipiChen]

Which one would people recommend the most ??

The D.O.'s: Osteopathic Medicine in America by Norman Gevitz

or

Foundations for Osteopathic Medicine by Robert C. Ward (Editor), et al

or another ??

Get the 2nd edition, highly recommended, very thorough, balanced, and insightful. I read many other books on osteopathic medicine, but I personally felt only this one gave me the whole picture without pointing fingers. Enjoy

 

[nobleheart]

The Difference a D.O. Makes

Bob E. Jones

essential read....

 

[BabyKangaroo]

I remember perusing through these original texts on Osteopathic Medicine and even quoted some pretty cool words by Dr. Still in my interviews/essays. They are really long, but they are the original! And so interesting. I haven't read the book by Norman Gevitz or any other recent book, but I want to before I enter medical school. I just know these texts in these links are the raw compilation of the original theory. The last two links go straight to Still's autobiography and the philosophy of osteopathy. Maybe not that exciting, but worth taking bits and pieces out of.



http://www.meridianinstitute.com/eamt/files/contents.htm
http://www.meridianinstitute.com/eamt/files/still3/st3cont.html
http://www.meridianinstitute.com/eamt/files/still2/st2cont.html

 

[TexasTriathlete]

Big Robbins

 

[Chocolate Bear]

Big Robbins

Who said you could take a break?! Back to the books!!

 

[EastWestN2grt]

To find out about the history of Osteopathic medicine and understand the road this profession has travelled, then Gevitz all the way.

If you want a weapon nearby to smash potential home invaders in the head, or pop ganglion cysts, or if you need a perfect doorstop then FOM is your book....because it sure wont be used otherwise..😉

 

[scpod]

Foundations for Osteopathic Medicine by Robert C. Ward (Editor), et al

Foundations was a "required" book for us that I never even bought. Most of the people I know who tried to read it couldn't get through the first couple of pages. It's not the book to start off with for sure.

 

[binko]

I can't directly compare the two, but the first one is a FANTASTIC book that all future DOs should read before applying and DEFINITELY before filling out secondaries/interviewing. 👍 👍

Based on this rec, I just ordered a copy. Will f/u with thoughts after I read it.

 

[Chocolate Bear]

Based on this rec, I just ordered a copy. Will f/u with thoughts after I read it.

Uh-oh, that's some pressure! 😱 😀

Some stuff gets a little dense with numbers/stats, but is still informative. Make sure you post your thoughts. 👍

 

[thanecyan]

The D.O.'s: Osteopathic Medicine in America by Norman Gevitz

👍

 

[Bleurberry]

The Difference a D.O. Makes

Bob E. Jones

essential read....

Thanks for the recommendation, I think I'll order it, and Dr. Jones' fro is wicked cool.

 

[binko]

The D.O.'s: Osteopathic Medicine in America by Norman Gevitz

I just finished this. It's interesting.

Here's what I wrote on my Facebookshelf about it:

Pretty good book, but it gets bogged down in some very specific details about who was on what board in what year. It also includes a brief history of government healthcare policies, which is such a complicated subject that compressing it to a few pages made it pretty unintelligible. I did really like the last few paragraphs, suggesting the possibility of the DO going from medical minority to medical elite, and what efforts that would entail. The book also piqued (further) my interest in OMM, and made my mind start trying to concoct ways to blind the OMM administration process for research purposes. Definitely an interesting problem

The question it left me with was this:

What the hell *is* the difference between MDs and DOs? Because on this forum, if you try to say there is a difference, many people will say the difference is nonexistent, or only historical. Yet so many of us are applying either solely or preferentially to osteopathic schools. So there's obviously something that still matters, no?

For me it's what the author of this book said in the last few pages, that osteopathy varies not only in its philosophy, but more significantly, in having a philosophy at all.

Oh yeah, one more nice thing about the book is it made me feel warm and fuzzy about my first choice, OU-COM.

 

[Semicolon]

I just finished this. It's interesting.

Here's what I wrote on my Facebookshelf about it:



The question it left me with was this:

What the hell *is* the difference between MDs and DOs? Because on this forum, if you try to say there is a difference, many people will say the difference is nonexistent, or only historical. Yet so many of us are applying either solely or preferentially to osteopathic schools. So there's obviously something that still matters, no?

For me it's what the author of this book said in the last few pages, that osteopathy varies not only in its philosophy, but more significantly, in having a philosophy at all.

Oh yeah, one more nice thing about the book is it made me feel warm and fuzzy about my first choice, OU-COM.

The only difference between MDs and DOs these days, as far as I have learned on these forums, is OMM, and that's about it. That may be enough reason for students to pursue osteopathic medicine, as the techniques learned in OMM lab may coincide with one's personal values or goals.

 

[binko]

The only difference between MDs and DOs these days, as far as I have learned on these forums, is OMM, and that's about it. That may be enough reason for students to pursue osteopathic medicine, as the techniques learned in OMM lab may coincide with one's personal values or goals.

I agree, and yet many people I've talked to about it de-emphasize OMM and seem apologetic or embarrassed about it. These people stress that it's "just another diagnostic [and occasionally therapeutic, if they're not too embarrassed to say it] tool" that "DOs can choose to use or not to use". While this is true, it seems to be far from the whole story. Otherwise amalgamation would be/have been no big deal for most DOs.

Not looking to start a war here or anything, just agreeing with the author of the book that osteopathic identity is really undefined at this period in history. Although, I disagree with his implication that osteopathy has unilaterally moved closer to the allopathy in the decades since its founding. To me it seems that the institution of osteopathy incorporated the more traditional methods of healing, particularly medications, only after they had become significantly safer and more effective, as well as more scientifically demonstrable, than they were in A.T. Still's time. Allopathic medicine has also come to recognize (to degrees that vary between institution and individual MDs) that treating the whole patient makes sense, at the very least in the capacity of making interaction with the patient easier and increasing the patient's confidence in the physician.

 

[Semicolon]

I agree, and yet many people I've talked to about it de-emphasize OMM and seem apologetic or embarrassed about it. These people stress that it's "just another diagnostic [and occasionally therapeutic, if they're not too embarrassed to say it] tool" that "DOs can choose to use or not to use". While this is true, it seems to be far from the whole story. Otherwise amalgamation would be/have been no big deal for most DOs.

Not looking to start a war here or anything, just agreeing with the author of the book that osteopathic identity is really undefined at this period in history. Although, I disagree with his implication that osteopathy has unilaterally moved closer to the allopathy in the decades since its founding. To me it seems that the institution of osteopathy incorporated the more traditional methods of healing, particularly medications, only after they had become significantly safer and more effective, as well as more scientifically demonstrable, than they were in A.T. Still's time. Allopathic medicine has also come to recognize (to degrees that vary between institution and individual MDs) that treating the whole patient makes sense, at the very least in the capacity of making interaction with the patient easier and increasing the patient's confidence in the physician.

I would think that they don't emphasize the significance of OMM due to the fact that a very low percentage of DOs actually utilize its techniques. Osteopathic medicine is becoming harder to define because everything that was once in its definition, and what once made it more unique, has either been incorporated into the field of medicine in general, or has lost its following. The next logical question is, "then why are there DOs?"

 

[binko]

The next logical question is, "then why are there DOs?"

Or, "why are there MDs?"

Both parties have made major steps in the other's direction. My point was that we're meeting in the middle, rather than going the whole distance to the allopathic side.

 

[binko]

Or, "why are there MDs?"

Both parties have made major steps in the other's direction. My point was that we're meeting in the middle, rather than going the whole distance to the allopathic side.

I take this back, since I just visited the thread in the pre-allo forum about a hypothetical scientologist medical school and saw this:

I would go to the school if it offered a better medical education than the other schools (since that is what matters). I would not go if they talk about dianetics (or OMM ) and I would not convert.

I know not everyone loves OMM, but really, comparing it to dianetics is uncalled for.

 

[Lokhtar]

I've ordered the first one.

 

[Bleurberry]

I know not everyone loves OMM, but really, comparing it to dianetics is uncalled for.

LOL!!! Ask whoever posted that -
Does that make A.T. Still
Xenu, our intergalactic alien overlord?

 

[binko]

LOL!!! Ask whoever posted that -
Does that make A.T. Still
Xenu, our intergalactic alien overlord?

Oh man, now that would be cool. And would probably make osteopathic medicine way more popular.

 

[NurWollen]

I'm currently reading and enjoying Gevitz's book.

What the hell *is* the difference between MDs and DOs? Because on this forum, if you try to say there is a difference, many people will say the difference is nonexistent, or only historical. Yet so many of us are applying either solely or preferentially to osteopathic schools. So there's obviously something that still matters, no?

For me, the difference in Osteopathic Medicine is not a supposed different philosophy about treating patients. Honestly, the "treat the whole patient not the disease" sounds like a marketing thing. As has been stated many times on this forum, any physician, MD or DO, who does not treat the whole patient is simply a bad doctor. As far as OMM is concerned, I think it would be fun-a way to make people feel better, much the same as chiropractic- but not a serious medical tool for seriously ill patients.

Where Osteopathic medicine does, however, appeal to me, is in the general, overall attitude of its practitioners. It seems, from my admittedly limited experience, that DO's are often (not always) a little less high-strung than some MD's. They seem more well rounded, and less gunner-like. A DO that a saw as a patient and then shadowed told me that in his osteopathic residency, he felt that he was treated better in residenct that were the doctors in some MD-residencies he'd worked with. He felt that in the AOA-residency, his personal needs were more taken care of; they were more understanding of his family's needs and his personal needs. Yes, they worked him into the ground, but, he said, they treated him like a human being.

This appeals to me because, coming from CA, where everyone seems to be a gunner, I appreciate the less high-strung atmosphere that I hope to find in osteopathic medicine.

 

[binko]

Yeah, I have noticed in looking at DO schools that they seem to extend the "see the whole patient not just the illness" attitude to their students too – they "see the whole student not just the GPA/MCAT" or whatever.

It really comes down to whether the staff love their jobs, though. Certainly there are many MDs who love what they do, but in my extremely limited experience, people at the one DO school I've been around a lot seem to like teaching, whereas people at the one MD school I've been to seem to resent the very existence of the students for taking away time from their research.

 

[Buckeye(OH)]

Based on this rec, I just ordered a copy. Will f/u with thoughts after I read it.

You are in Athens. I promise you OU has it at the library. Why would you buy something you will read once?

 

[Buckeye(OH)]

Yeah, I have noticed in looking at DO schools that they seem to extend the "see the whole patient not just the illness" attitude to their students too – they "see the whole student not just the GPA/MCAT" or whatever.

It really comes down to whether the staff love their jobs, though. Certainly there are many MDs who love what they do, but in my extremely limited experience, people at the one DO school I've been around a lot seem to like teaching, whereas people at the one MD school I've been to seem to resent the very existence of the students for taking away time from their research.

Do yourself a favor. Don't get caught up in anecdotal "evidence" like that. You are doing yourself a dis-service. There are plenty of DOs and DO students that dont give two ****s about teaching those junior to them.

Once in residency, a DO resident is just as likely to blow you off as an MD resident.

Ive always told myself I didnt want to be a dick resident that didnt teach.....we'll see if I can keep myself true.

 

[binko]

Do yourself a favor. Don't get caught up in anecdotal "evidence" like that. You are doing yourself a dis-service. There are plenty of DOs and DO students that dont give two ****s about teaching those junior to them.

Once in residency, a DO resident is just as likely to blow you off as an MD resident.

Ive always told myself I didnt want to be a dick resident that didnt teach.....we'll see if I can keep myself true.

I wasn't considering it "evidence", just using it to decide between specific med schools.

 

[binko]

You are in Athens. I promise you OU has it at the library. Why would you buy something you will read once?

I never know how long it will take me to finish a book. Also I often finding myself wanting to lend or give away the books I've read to friends so they'll read it too and we can discuss.

 

[spicedmanna]

Both parties have made major steps in the other's direction. My point was that we're meeting in the middle, rather than going the whole distance to the allopathic side.

I'd argue that there is but one practical entity, which is that of a physician. The practice of medicine has evolved to the point where there is not really any true philosophical or functional disparity between the two historical traditions.

You speak of the two as if you could walk into a room and tell the difference w/o knowing their corresponding degree initials, but practically and in most instances, you won't be able to do that. The functional approach is going to be identical, as both are going to practice to the exact same standard of care in treating a patient, i.e., going to do the same work up, come up w/ the same differentials, initiate the same treatment, and do the same follow-up.

It's true that OMT remains a distinguishing characteristic, but few DO's actually use it regularly and I doubt it would be practical for many of the specialties that DO's enter into. I'm sure there are a myriad of reasons for this. If most DO's used OMT, I'd say you have a point, but since most do not, then there truly isn't going to be a functional difference. Anyway, it seems to me that OMT is the last bastion of the claim to distinctiveness for DO's (or more to the point, the AOA).

While others may not agree w/ me, my own experience of OMT is that it is good for particular MSK complaints and it can be used effectively as adjunctive treatment. I do like a lot of the techniques, for example, INR, Still's, BLT, FPR, MFR, ME, HVLA, etc., and can see myself using them for certain complaints, but as a scientist, I really find some of the other techniques, concepts, and claims to be very questionable. In some ways, some of these aspects do seem like Dianetics to me. I am embarrassed that we cling to some of these techniques, truly. Judge for yourself.

There is also the claim that DO's are more patient-oriented, or treat the whole patient, etc. I wouldn't be so quick to buy into that. It might have been the case many years ago, but now, I'd say that one's bedside manner, or the approach to treating a patient, has more to do w/ one's personal attitude than one's degree. If you are using that as the reason to attend a DO school, I can tell you that I am receiving no special training that I consider highly influential in that area, which my allopathic counterparts aren't also receiving (not that I think you can be effectively trained in this area in a classroom, but that's a whole other argument). I am getting about 3 hrs of OMT training a week, which my allopathic counterparts are not getting, unless they are taking some sort of elective at their school. I suppose you could argue that I am getting additional training and earlier exposure to touch therapy and it's associated elements. Make of that what you will.

 

[binko]

I'd argue that there is but one practical entity, which is that of a physician.

Right, that was more or less what I was saying.

You speak of the two as if you could walk into a room and tell the difference w/o knowing their corresponding degree initials, but practically and in most instances, you won't be able to do that. The functional approach is going to be identical, as both are going to practice to the exact same standard of care in treating a patient, i.e., going to do the same work up, come up w/ the same differentials, initiate the same treatment, and do the same follow-up.

In my personal experience with MDs and DOs, you can tell the difference. Maybe not at a cocktail party, but after watching doctors interact with a few patients I have been able to see clear differences (again, in my own very limited experience) in subtle but important ways. I have seen the DO's touch their patients a lot more, even when not doing a full OMM procedure. The ones I've shadowed tend to also do more general diagnostic palpation than the MDs. In my experience MDs tend to palpate when they're looking for a specific thing, whereas DOs are more likely to palpate just to check for whatever might be lurking.

It's true that OMT remains a distinguishing characteristic, but few DO's actually use it regularly and I doubt it would be practical for many of the specialties that DO's enter into. I'm sure there are a myriad of reasons for this. If most DO's used OMT, I'd say you have a point, but since most do not, then there truly isn't going to be a functional difference. Anyway, it seems to me that OMT is the last bastion of the claim to distinctiveness for DO's (or more to the point, the AOA).

All of the DO's I know who have a job that involves actually seeing patients use OMM for both diagnostic and therapeutic purposes. Again, that's a very limited sample, and I do know one DO who is the head of an educational department at a hospital and as far as I know she doesn't see patients. But I have shadowed a DO seeing patients twice and seen her use OMM twice. My husband and I have also been patients of two DOs and one or both of us have received OMM from each of them. The first one, we didn't even know was a DO when we first visited him, he was just on a list our insurance gave us.

A caveat to this is that all of the DOs I know with the exception of the non-patient-seeing one are graduates of OUCOM, so perhaps it's a specifically OUCOM thing to promote OMM more than is typical in the profession at large. The OUCOM students I know are really excited about OMM as well and have told me they definitely plan to use it in their practice once they graduate.

But anyway, my point is that because of my personal experience I hold OMM in higher importance than others with different experiences seem to. Which is fine, not all DOs or pre-DOs have to feel the exact same way about OMM. I think the fact that even some DOs care about it and practice it makes a huge contribution to medicine, though, and particularly to the range of choices that patients have. I think keeping that range as fully-stocked as possible with any methods that increase patient confidence in the physician is a good thing (provided none of the methods do harm or are contrary to medical science). This is totally in the realm of opinion, though, so please don't mistake my musings for attempting to argue facts.

While others may not agree w/ me, my own experience of OMT is that it is good for particular MSK complaints and it can be used effectively as adjunctive treatment. I do like a lot of the techniques, for example, INR, Still's, BLT, FPR, MFR, ME, HVLA, etc., and can see myself using them for certain complaints, but as a scientist, I really find some of the other techniques, concepts, and claims to be very questionable. In some ways, some of these aspects do seem like Dianetics to me. I am embarrassed that we cling to some of these techniques, truly. Judge for yourself.

The med students I know who like OMM a lot now, initially felt this way upon entering med school. I think the exact phrasing was "What is this voodoo ****?!" Again, it might be taught with a different slant at OUCOM than other places, or the people who are willing to talk to lowly pre-meds might be self-selected on how enthusiastic they are or whatever.

There is also the claim that DO's are more patient-oriented, or treat the whole patient, etc. I wouldn't be so quick to buy into that. It might have been the case many years ago, but now, I'd say that one's bedside manner, or the approach to treating a patient, has more to do w/ one's personal attitude than one's degree. If you are using that as the reason to attend a DO school, I can tell you that I am receiving no special training that I consider highly influential in that area, which my allopathic counterparts aren't also receiving (not that I think you can be effectively trained in this area in a classroom, but that's a whole other argument).

I agree that there's no curricular difference in this respect, but I think DO students might be self-selecting for attributes that improve bedside manner, sort of a self-fulfilling prophecy. There can be a correlation without causation. Just a hypothesis.

Also in my personal experience as a patient, I felt much more "heard" by my DO's than by my MD's. Totally subjective, might also have to do with the fact that the DO's tended to be younger.

Make of that what you will.

What I make of it: there are so many confounding factors that there's barely any point in talking about any of it. And yet I can't seem to shut up. 😎

 

[Lokhtar]

The med students I know who like OMM a lot now, initially felt this way upon entering med school. I think the exact phrasing was "What is this voodoo ****?!" Again, it might be taught with a different slant at OUCOM than other places, or the people who are willing to talk to lowly pre-meds might be self-selected on how enthusiastic they are or whatever.

Just like dianetics....



Anecdotal evidence does not matter. It has to be proven for it to be anything other than crap. You're smacking a hundred years of evidence based medicine in the face if you go down that route. And there has been some evidence that OMM is effective in certain situations. Things like cranial, on the other hand....

 

[binko]

Just like dianetics....



Anecdotal evidence does not matter. It has to be proven for it to be anything other than crap. You're smacking a hundred years of evidence based medicine in the face if you go down that route.

Manipulative therapy for lower extremity conditions: expansion of literature review.
Brantingham JW, Globe G, Pollard H, Hicks M, Korporaal C, Hoskins W.
J Manipulative Physiol Ther. 2009 Jan;32(1):53-71.
PMID: 19121464 [PubMed - in process]

CONCLUSIONS: There are a growing number of peer-reviewed studies of manipulative therapy for lower extremity disorders.

Call me when you find a peer-reviewed Dianetics journal on pubmed.

 

[Lokhtar]

You notice I said it has been shown to be effective in certain cases. I pointed out cranial as something which is quack.

 

[binko]

You notice I said it has been shown to be effective in certain cases. I pointed out cranial as something which is quack.

Ah yes. I'll agree with you on that one.

 

[Semicolon]

Hold on, hold on...are you people saying Tom Cruise is a D.O.?!

 

[binko]

Hold on, hold on...are you people saying Tom Cruise is a D.O.?!

I think we're saying that he's a cranial case.

 

[Bleurberry]

Hold on, hold on...are you people saying Tom Cruise is a D.O.?!

THAT WOULD MAKE A.T. STILL XENU, INTERGALACTIC LEADER AND OVERLORD!!! Wait, so if that's the case, then how come they don't make us sign that contract pledging our souls to Scien-Osteopathy for a billion gillion years? Hmm... Oh I get it now, Ah-HAH!,
that's where CRANIAL comes in... they found some way to brain wash us using palpation...!

Curriculum should reflect the positive question mark about cranial, and not teach with authority mechanisms that haven't been substantiated by EBM. I don't personally think Anecdotal evidence is pure nonsense when clinical practitioners are the ones reporting it, and neither does evidence based medicine protocol. Evidence Based Medicine, after all, says when no other evidence is present, anecdotal should be evaluated and considered, it's just lower on the priority totem pole is all. Now if there's piling EBM that is leading us to prove cranial has no positive outcomes (and not just that the mechanisms are different than once hypothesized in the 50's) I'll jump on the cranial dismissing bandwagon faster than you can blink. But I haven't seen it yet, so I reserve judgement.
A.T. Still is not Xenu. That is all for now. Xenu out.

 

[Lokhtar]

Curriculum should reflect the positive question mark about cranial, and not teach with authority mechanisms that haven't been substantiated by EBM. I don't personally think Anecdotal evidence is pure nonsense when clinical practitioners are the ones reporting it,

Yes, it is. Anecdotal evidence is that for a reason. The whole point of anecdotal evidence is In the sense that it should be not taught or held as anything other than an extremely tentative hypothesis.

The point of anecdotal evidence is not that the outcome that was noticed didn't happen, it's that it is impossible to separate cause and effect, and impossible to notice if an effect is statistically significant, without having a controlled study. Impossible, no matter how trained you are or who you are. Evidence from a clinical practitioner does not automatically introduce controls and statistical significance if there is none. You could be a Nobel Laureate, and your anecdotal evidence is still irrelevant, except as perhaps a starting point of inquiry. It doesn't work the other way around.

Evidence Based Medicine, after all, says when no other evidence is present, anecdotal should be evaluated and considered, it's just lower on the priority totem pole is all.

That's the point isn't it - it should be evaluated and considered. Not accepted, and taught. Certainly not for a century.

Now if there's piling EBM that is leading us to prove cranial has no positive outcomes

It should be the other way around - you should not accept it until such positive outcomes. But even if true, and cranial works despite its impossibility, look at some papers by a scientist working at an osteopathic school. (Source)

 

[Chocolate Bear]

But even if true, and cranial works despite its impossibility, look at some papers by a scientist working at an osteopathic school. (Source)

Link failed.

 

[binko]

I really think "alternative" therapies in general have not been evaluated enough. I personally believe that OMM has a valid basis, as well as some things I use for my personal health, such as garlic to treat and acidophilus pills to prevent infections. When I'm a doctor, I definitely plan to try to organize some valid scientific studies to evaluate the efficacy of the stuff that I suspect is valid but can't prove.

One reason I think OMM has "gotten away with" being practiced so long without its efficacy being unequivocally proven, is its extremely low risk of negative effects combined with the fact that it's a pleasant treatment to receive.

That's no excuse for the lack of studies though. It's true that we are at a point in history where osteopathy kind of needs to get with it and prove itself by the methods currently accepted as scientific.

 

[Lokhtar]

Link failed.

Sorry 🙂

http://faculty.une.edu/com/shartman/

 

[Bleurberry]

Sorry 🙂

http://faculty.une.edu/com/shartman/

Err.. okay, I have heard mixed views about his study. Were you overly impressed with his study? But he is hardly an impassionate observer, too, if that's what you were getting at. Just look at his other articles on the same page that you cited.

But here's my question; is anyone refuting that there's a cerebral-spinal pulsivity? That's what he's refuting. Whatever. I don't want to overstep my bounds. But check out http://www.neurosurgeon.org/publications/clinical/53/pdf/cnb00106000048.pdf

I don't think it pays to be outright dismissive, and you haven't dissuaded me yet with Hartman's opinion piece. Then again, I'll be putting my money where my mouth is at PCOM and doing/reading the research.

 

[Lokhtar]

I have no problem with research, but it's putting the cart before the horse to do something for a hundred years without having even shown it works, let alone explaining it mechanistically. You don't have to start medical school to start reading the research. And I'm refuting that your skull permits microsocopic movements of the type in question, and studies have shown there is very little reliability in people's ability to find such a rhythm:

BACKGROUND AND PURPOSE. The evaluation of craniosacral motion is an approach used by physical therapists and other health professionals to assess the causes of pain and dysfunction, but evidence for the existence of this motion is lacking and the reproducibility of the results of this palpatory technique has not been studied. This study examined the interexaminer reliability of craniosacral rate and the relationships among craniosacral rate and subjects' and examiners' heart and respiratory rates. SUBJECTS. Participants were 12 children and adults with histories of physical trauma, surgery, or learning disabilities. Three physical therapists with expertise in craniosacral therapy were the examiners. METHODS. One of three nurses recorded heart and respiratory rates of both subject and examiner. The examiner then palpated the subject to determine craniosacral rate and reported the findings to the nurse. Each subject was examined by each of the three examiners. RESULTS. Reliability was estimated using a repeated-measures analysis of variance and the intraclass correlation coefficient (2,1). Significant differences among examiners and the scatter plot of rates showed lack of agreement among examiners. The ICC was -.02. The correlations between subject craniosacral rate and subject and examiner heart and respiratory rates were analyzed with Pearson correlation coefficients and were low and not statistically significant. DISCUSSION AND CONCLUSIONS. Measurements of craniosacral motion did not appear to be related to measurements of heart and respiratory rates, and therapists were not able to measure it reliably. Measurement error may be sufficiently large to render many clinical decisions potentially erroneous. Further studies are needed to verify whether craniosacral motion exists, examine the interpretations of craniosacral assessment, determine the reliability of all aspects of the assessment, and examine whether craniosacral therapy is an effective treatment. [Wirth-Pattullo V. Hayes KW. Interrater reliability of craniosacral rate measurements and their relationship with subjects' and examiners' heart and respiratory rate measurements.

Source

If you start from a position that it has to be disproven, you're not doing science. The burden is on extraordinary claims to prove themselves.

Other studies have found no evidence to support it, and in one study, it was found to do harm. Here is another:

OBJECTIVES: The objective of this research was to review critically the scientific basis of craniosacral therapy as a therapeutic intervention. DESIGN: A systematic search for and critical appraisal of research on craniosacral therapy was conducted. Medline, Embase, Healthstar, Mantis, Allied and Alternative Medicine, Scisearch and Biosis were searched from their start date to February 1999. MAIN OUTCOME MEASURES: A three-dimensional evaluative framework with related appraisal criteria: (A) craniosacral interventions and health outcomes; (B) validity of craniosacral assessment; and (C) pathophysiology of the craniosacral system. RESULTS: The available research on craniosacral treatment effectiveness constitutes low-grade evidence conducted using inadequate research protocols. One study reported negative side effects in outpatients with traumatic brain injury. Low inter-rater reliability ratings were found. CONCLUSIONS: This systematic review and critical appraisal found insufficient evidence to support craniosacral therapy. Research methods that could conclusively evaluate effectiveness have not been applied to date.

Source

And another about the reliability of palpating craniosacral motion:

BACKGROUND AND PURPOSE: The main purpose of this study was to determine the interrater and intrarater reliability of measurements obtained during palpation of the craniosacral rate at the head and feet. Palpated craniosacral rates of head and feet measured simultaneously were also compared. Subjects. Twenty-eight adult subjects and 2 craniosacral examiners participated in the study. METHODS: A within-subjects repeated-measures design was used. A standard cubicle privacy curtain, hung over the subject's waist, was used to prevent the examiners from seeing each other. RESULTS: Interrater intraclass correlation coefficients (ICCs) were .08 at the head and .19 at the feet. Intrarater ICCs ranged from .18 to .30. Craniosacral rates simultaneously palpated at the head and feet were different. CONCLUSION AND DISCUSSION: The results did not support the theories that underlie craniosacral therapy or claims that craniosacral motion can be palpated reliably.

Source

I don't have a PhD yet, but I'm scientist enough not to trust things that have not been proven. Appeal to authority does not work for me, and I don't give a crap about anecdotal evidence, no matter who it comes from.

I really think "alternative" therapies in general have not been evaluated enough.

No, they have, but there is often publication bias, as in, if the study does not prove your point, you don't publish it. I've seen this myself in certain alternative therapies (you don't want to be the practitioner discrediting your own practice). Things like homeopathy have shown no benefit through repeated meta-analysis.

Alternative medicine, by definition, does not work. If they worked, we would use it. More charitably, alternative medicines, by definition, have not been proven to work. We don't have to understand its mechanism to use it - hell, we still don't quite completely understand the mechanism of anesthesia drugs, but we use them all the time. It has to be proven to work, not necessarily how for modern medicine to adopt it. If you can prove dianetics, cranial, or the flying spaghetti monsters can cure disease x or y, prove it, and it will be adopted by modern medicine.

 

[spicedmanna]

Curriculum should reflect the positive question mark about cranial, and not teach with authority mechanisms that haven't been substantiated by EBM.

The problem is that many school continue to do just that w/ Cranial OMT, teach w/ authority what hasn't been properly substantiated. Seriously, there's no point in commenting unless you tried learning it.

I don't personally think Anecdotal evidence is pure nonsense when clinical practitioners are the ones reporting it, and neither does evidence based medicine protocol. Evidence Based Medicine, after all, says when no other evidence is present, anecdotal should be evaluated and considered, it's just lower on the priority totem pole is all.

I would very pretty hesitant to treat someone on that basis, however, especially if there were other treatments available that had good evidence to support it's use. I imagine most, except those on the fringes, would agree.

Now if there's piling EBM that is leading us to prove cranial has no positive outcomes (and not just that the mechanisms are different than once hypothesized in the 50's) I'll jump on the cranial dismissing bandwagon faster than you can blink. But I haven't seen it yet, so I reserve judgement.
A.T. Still is not Xenu. That is all for now. Xenu out.

Giving a sugar pill, a standard practice among clinicians until relatively recently, might have positive outcomes for particular scenarios, too, and it's probably harmless for most. I'm putting cranial into that same category for now. Cranial OMT has been proposed as a preventive measure against otitis media. It's probably harmless for most patients and may have some placebo effects, but at least one study shows that there isn't any significant benefit from using it to prevent that condition. I don't know. Make of it what you will. I don't buy it as an effective technique, especially when there are better ones out there. Using it adjunctively is probably harmless though.

 

[Bleurberry]

The problem is that many school continue to do just that w/ Cranial OMT, teach w/ authority what hasn't been properly substantiated. Seriously, there's no point in commenting unless you tried learning it.

Right! So I'm done. But let me just say that I'm inclined to remain open minded about cranial precisely because posters, and it's usually the same ones over and over, always cite the same 2 or 3 articles, and cherry pick the hell out of this conversation. I never see the same posters bring anything from the other side of the arguement to bare. And that bothers me, makes me suspicious. So I appreciate your point, I hope you appreciate mine.

 

[Bleurberry]

I'm going to PM you re: this convo. 😛

I have no problem with research, but it's putting the cart before the horse to do something for a hundred years without having even shown it works, let alone explaining it mechanistically. You don't have to start medical school to start reading the research. And I'm refuting that your skull permits microsocopic movements of the type in question, and studies have shown there is very little reliability in people's ability to find such a rhythm:

Source

If you start from a position that it has to be disproven, you're not doing science. The burden is on extraordinary claims to prove themselves.

Other studies have found no evidence to support it, and in one study, it was found to do harm. Here is another:

Source

And another about the reliability of palpating craniosacral motion:

Source

I don't have a PhD yet, but I'm scientist enough not to trust things that have not been proven. Appeal to authority does not work for me, and I don't give a crap about anecdotal evidence, no matter who it comes from.

No, they have, but there is often publication bias, as in, if the study does not prove your point, you don't publish it. I've seen this myself in certain alternative therapies (you don't want to be the practitioner discrediting your own practice). Things like homeopathy have shown no benefit through repeated meta-analysis.

Alternative medicine, by definition, does not work. If they worked, we would use it. More charitably, alternative medicines, by definition, have not been proven to work. We don't have to understand its mechanism to use it - hell, we still don't quite completely understand the mechanism of anesthesia drugs, but we use them all the time. It has to be proven to work, not necessarily how for modern medicine to adopt it. If you can prove dianetics, cranial, or the flying spaghetti monsters can cure disease x or y, prove it, and it will be adopted by modern medicine.

 

[spicedmanna]

...But let me just say that I'm inclined to remain open minded about cranial...

Cool. I think that's a good way to approach it.

 

[Bleurberry]

Cool. I think that's a good way to approach it.

Thanks Manna,

 

[Bleurberry]

Alternative medicine, by definition, does not work. If they worked, we would use it. More charitably, alternative medicines, by definition, have not been proven to work. We don't have to understand its mechanism to use it - hell, we still don't quite completely understand the mechanism of anesthesia drugs, but we use them all the time. It has to be proven to work, not necessarily how for modern medicine to adopt it. If you can prove dianetics, cranial, or the flying spaghetti monsters can cure disease x or y, prove it, and it will be adopted by modern medicine.

I just think you're coming across a bit naive, and I don't intend to rile you, it's just an opinion about the positions you've taken in this thread.
Vioxx should be used as an analgesic in some cases, for knee and hip replacement, in conjunction with other medications, right? Sure, I mean there's 21 studies from a reputible Tuft's researcher physician who's said so since the 1990's... all of his studies have been retracted and his charts, graphs, and tables are all being burned, because he's admitted to fraud. I almost admire the confidence in your ability to assess research studies that demonstrate efficacy beyond a shadow of a doubt, in leiu of all of the scandal's that have broken in the past 25 years, inside and outside of the FDA.

http://online.wsj.com/article/SB123672510903888207.html?mod=googlenews_wsj

 

[Lokhtar]

I don't understand the point in what you say. Some studies are invalid therefore studies aren't needed to prove validity? That's dianetics territory there my friend. I would not go to any physician who did not base his recommendations on evidenced based medicine, and if he did give anecdotal evidence, he would have to explicitely say as much and the reason why EBM is not available. I have been to see cancer specialists about a 100 times, everywhere from Sloan Kettering to UPENN to MD Anderson, and you bet your ass I want studies to back up what they say. And thankfully, at academic research centers, they do have studies to back things up. If some guy said it works because he said so, I'd leave that office right at the moment.


What you've shown is a perfect example of how a system works, where we can retract studies and there is a high level of oversight and reproducibility necessary. I've done enough research to know that it is done by humans too, with all its pitfalls. But peer reviewed is the best system we have, and it works very well.