Cranial Osteopathy: Is It A Fraud?

[exPCM]

From Two UNECOM Faculty:
INTEREXAMINER RELIABILITY AND CRANIAL OSTEOPATHY
Steve E. Hartman and James M. Norton
We assess the mechanism purported to underlie the health treatment regime labeled "cranial osteopathy" or "craniosacral therapy." We then summarize all published reports on interexaminer reliability associated with this modality, reanalyze some previously published data, and critique Upiedger'si often-cited study. Our own and previously published findings suggest that the proposed mechanism for cranial osteopathy is invalid and that interexaminer (and, therefore, diagnostic) reliability is approximately zero. Since no properly randomized, blinded, and placebo-controlled outcome studies have been published, we conclude that cranial osteopathy should be removed from curricula of colleges of osteopathic medicine and from osteopathic licensing examinations.
http://faculty.une.edu/com/shartman/sram.pdf

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[homeboy]

From Two UNECOM Faculty:
INTEREXAMINER RELIABILITY AND CRANIAL OSTEOPATHY
Steve E. Hartman and James M. Norton
We assess the mechanism purported to underlie the health treatment regime labeled "cranial osteopathy" or "craniosacral therapy." We then summarize all published reports on interexaminer reliability associated with this modality, reanalyze some previously published data, and critique Upiedger'si often-cited study. Our own and previously published findings suggest that the proposed mechanism for cranial osteopathy is invalid and that interexaminer (and, therefore, diagnostic) reliability is approximately zero. Since no properly randomized, blinded, and placebo-controlled outcome studies have been published, we conclude that cranial osteopathy should be removed from curricula of colleges of osteopathic medicine and from osteopathic licensing examinations.
http://faculty.une.edu/com/shartman/sram.pdf

It has been, and always will be, a fraud.
As Elf notes, this article is from '02. There was actually a more in depth systematic review done by some researchers in British Columbia that came to the same conclusion (I've posted the link in some previous posts over the years)...dont' have time to find & repost it now.

You know it's a fraud, I know it's a fraud (been railin' on it for years), and most DOs know it's a fraud, but the line must be toe'd per the AOA & DOctogenerians.

 

[J-Rad]

It's my belief that if you polled most DOs, even those who see a place for OMM in the medical paradigm, one would find widespread incredulity toward so-called "Osteopathy In The Cranial Field (OCF)". I think Hartman and Norton (former professors of mine) did an elegant job stating why it has little plausibility and no inter-examiner reliability. If it has any effect in adults, it might have something to do with superficial musculoskeletal/fascial structures (and if this is the case it might help a little with some oro-facial or other head/neck pain issues), but ultimately it's probably just a pleasant scalp massage (my wife likes it when she has a headache...and no, I don't attempt to feel for any PRI). I agree it should not be a mandatory part of teaching or testing for boards, but, unfortunately, it seems fairly well entrenched.
I will say one interesting research area in OMM which tends to include OCF is its possible use for an adjunctive treatment otitis media in infants/young children and feeding difficulty in newborns/infants. The age of the patients doesn't make the PRM any more plausible, but it does change the fixed-bony-anatomic-relationships issue. The earlier OMM for AOM study (Carreiro and Mills) which had interesting results (but was a small study and had a few methodological weaknesses) is being followed up on currently with a larger, better funded study. None of this changes my agreement with the contention to drop OCF from the curriculum/boards, but I'll give the "field" a research pass for this.

 

[DrWBD]

Of course it is a fraud.

I doubt that the higher-ups in the AOA actually believe that osteopathy in the cranial field is valid. However, it makes it easier to justify the existence of our separate branch of medicine by leaving it, and OMT in general, where it is. After all, if DOs do this and MDs don't, that makes us "distinct" from MDs (even though everything else we do is the same).

 

[Red Beard]

The only thing keeping cranial from being absolute, unequivocal fraud is that its practitioners truly believe its validity. Its not fraud, its blind faith.

Perhaps willful ignorance.

Fraud would be "I know what I'm doing is bull****, but I am going to do it anyway because I want to make money."

There is not one shred of credible evidence in support of its mechanisms or efficacy. Yes, there is an elegant fairytale as to what a cranial rhythm might be, how you might manipulate it if it did exist, and even some "studies" that have been published in "journals" (I use both of those terms very loosely.)

Unfortunately, the following two observations are well documented (don't have references handy, sorry):

1) The largest measured magnitude of cranial motion that has been recorded with sensitive instruments in experiments attempting to validate the cranial mechanism is smaller than the minimum threshold at which human touch can detect motion;

2) There is absolutely zero inter-rater reliability in detecting any supposed cranial rhythm.

From first hand experience, I had several of our cranial instructors (experts in the field from all over the country) palpate my cranium during an hour time period during our cranial course. The variety of responses to my question "what do you feel" was so broad--everything from "you are totally locked up" to "you have excellent motion"--that any shred of belief on my part was instantly destroyed.

 

[J-Rad]

Of course it is a fraud.

I doubt that the higher-ups in the AOA actually believe that osteopathy in the cranial field is valid...

Its not fraud, its blind faith.

I think RedBeards statement is correct. It has almost (if not totally) become religion. And that's why I disagree with Wanna's above statement. I think the sad fact is that the religiously passionate seek power and seem to have the power seat at the AOA table. Which makes the move to mariginalize this overall quackery difficult to (currently) impossible.

 

[BobBarker]

The INTRAobserver reliability of cranial is pretty much O.
http://www.jaoa.org/cgi/content/full/108/9/493?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&title=cranial&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&fdate=9/1/2006&resourcetype=HWCIT

 

[metalmd06]

I completely agree that the basis for OCF is ridiculous. There is no way to measure it, or to quantify its effects scientifically. Other methodologies of OMM that have a physiologic backing (MET, counterstrain, FPR) are much easier to understand and implement. I also agree that OCF should be removed from the curriculum.

However, what do we say to those clinicians and patients who stand by its efficacy? Is it all heresay or are peoples lives actually being positively impacted by treatment with OCF? Is it, regardless of its dubious mechanistic claims, releiving pain that was previously refractory to other treatments? If so, I say people like Dr. Upledger should continue doing what they do, so long as it doesn't lead to negligence in the treatment of patients who are in need of modern medicine. I'm just never going to use it.

Here's another thing I find interesting/funny. Every year the DO degree debate comes up. I'm not trying to re-spark this discussion, but if you go to the website for the Upledger institute (http://www.upledger.com/) you will find that there is a clinician under the therapies tab who is listed as MD, DO (hon.). As osteopathic physicians we are so vigillant about protecting our identity, and yet its undermined by purported honorary degrees. I wonder what the AOA would say about this? Maybe the AOA gave him the honorary degree.

 

[DrWBD]

The only thing keeping cranial from being absolute, unequivocal fraud is that its practitioners truly believe its validity. Its not fraud, its blind faith.

Perhaps willful ignorance.

Fraud would be "I know what I'm doing is bull****, but I am going to do it anyway because I want to make money."

I think RedBeards statement is correct. It has almost (if not totally) become religion. And that's why I disagree with Wanna's above statement. I think the sad fact is that the religiously passionate seek power and seem to have the power seat at the AOA table. Which makes the move to mariginalize this overall quackery difficult to (currently) impossible.

This is just splitting hairs. I agree that there are the osteopathic "cultists" who believe what they do is valid. However, these are a small minority. There are also those in the AOA who I believe willfully promote osteopathy in the cranial field as valid, knowing that it is nonsense, in order to maintain the "separate but equal" distinction that justifies their existence, as I mentioned earlier. This is fraud.

 

[Styria]

Dr. Cross, who was the chair of the anatomy department at UNECOM (where Hartman works) before coming down to DCOM, disagrees with Hartman and asserts that the cranial bones do move, though he has a different mechanism to offer for the motion. So you don't even have agreement of anatomists on this matter.

 

[J-Rad]

Dr. Cross, who was the chair of the anatomy department at UNECOM (where Hartman works) before coming down to DCOM, disagrees with Hartman and asserts that the cranial bones do move, though he has a different mechanism to offer for the motion. So you don't even have agreement of anatomists on this matter.

I like and respect Dr. Cross as well as anyone, but the question is: so what? 1) Link the infinitesimal (if not non-existent) cranial bone motion to a disease process. And convince me that the discriminitive capacity of human touch is truly able to accurately appreciate these micrometer level movements.
2) Explain what it is that one is treating if there is no inter and barely any intra-examiner reliability. Why shouldn't we just learn Reiki and avoid the potential for skin-to-skin bacterial contamination? We'll probably find the same level of intra/inter-examiner reliability and people are just as passionate about energy fields and chakras as they are about PRIs and people (patients) swear it works (and most important pay money for it, Cha Ching$$!) so it's got to be just as good.

 

[breezey]

Dr. Cross never taught the cranial portion of the anatomy class at UNECOM. Dr. Hartman did. And to say he is the "Chair of the anatomy department" isn't saying much since there are like, ten full time faculty in the whole place.

 

[Handy388]

Dr. Cross, who was the chair of the anatomy department at UNECOM (where Hartman works) before coming down to DCOM, disagrees with Hartman and asserts that the cranial bones do move, though he has a different mechanism to offer for the motion. So you don't even have agreement of anatomists on this matter.

guy sounds like a shining beacon of science right here.

 

[ShyFly]

I had to do an OMT rotation in my 3rd year and all they did was cranial. I saw the stuff work on some incredible things (chronic headaches, poor suck in an infant, asthma, etc.) It may have very well been placebo but they had a waiting list that went as far out as 6 months.

 

[J-Rad]

guy sounds like a shining beacon of science right here.

His contention that cranial bones may move in small increments (and there are other anatomists who agree) does not necessarily mean he contends that there is a PRI, craniosacral reciprocal motion, or that it of specific clinical significance. He may believe that, but it's 1) been a few years since I interacted with him, but 2) I don't remember him making any wild claims of the significance of the motion (I vaguely recollect him talking about it on occasion)

 

[HopefulDoc2007]

http://www.youtube.com/watch?v=gyQ57X3YhH4

I realize Richard Dawkins can be a very polarizing figure and I disagree with many of his views. (Let's try not to let this convo move to religion please.) However, in this series "Enemies of Reason" he looks a superstition and alternative medical practices with a very skeptical point of view and actually comes to some good conclusions. I suggest everyone watch the whole series as it has been a while and I can't remember which ones talk about alternative medicine/practitioners. Those are the sections I think you can apply to cranial. I don't think it is a fraud. I know it is not a valid technique. It has more in common with religion than evidence based medicine (which is the standard of care in the US).

 

[HopefulDoc2007]

If you do some reading of the books written by the people responsible for cranial theory it is pretty easy to see how rooted in mysticism and hogwash these therapies were and are today.

 

[felix2]

i don't trust them at all!

 

[MomRNtoDO]

My challenge for those who completely disregard cranial is to not touch your head the next time you have a headache/migraine or sinus infection. I would daresay most people instinctively try to put themselves into a position of ease when they are in pain. Sometimes when we have been trained in techniques shown to work, we are helping people to find that ease faster and more accurately. I would not so adamantly be opposed to something just because you can't do it. Some people can some can't. I can't feel the CRI every time (most of the time), but I can definitely get results for my son with migraines.😉

 

[Handy388]

My challenge for those who completely disregard cranial is to not touch your head the next time you have a headache/migraine or sinus infection. I would daresay most people instinctively try to put themselves into a position of ease when they are in pain. Sometimes when we have been trained in techniques shown to work, we are helping people to find that ease faster and more accurately. I would not so adamantly be opposed to something just because you can't do it. Some people can some can't. I can't feel the CRI every time (most of the time), but I can definitely get results for my son with migraines.😉

we have enough quacks in medicine.

 

[Powdermonkey]

I like and respect Dr. Cross as well as anyone, but the question is: so what? 1) Link the infinitesimal (if not non-existent) cranial bone motion to a disease process. And convince me that the discriminitive capacity of human touch is truly able to accurately appreciate these micrometer level movements.
2) Explain what it is that one is treating if there is no inter and barely any intra-examiner reliability. Why shouldn't we just learn Reiki and avoid the potential for skin-to-skin bacterial contamination? We'll probably find the same level of intra/inter-examiner reliability and people are just as passionate about energy fields and chakras as they are about PRIs and people (patients) swear it works (and most important pay money for it, Cha Ching$$!) so it's got to be just as good.

We have the dean of the OMT department (DCOM) as well as a current 3rd year/fellow who has a Ph.D. in anthropology or something like that working on a project that will link the motion (or lack thereof from fusion) of the cranial bones to the fusion of L5/S1. Just because you guys dont believe it and wont take the time to learn/believe in it doesnt mean it isnt there or doesnt work. They have 80 year olds with completely open cranial sutures and an open L5/S1 and they have 25 year olds with cranial sutures almost completely fused up and a fused L5/S1. Is there a relationship? Maybe. Thats why they're studying it. Trying to figure out if a disease process causes one or the other, etc. It was presented at the AOA poster conference last year as well as this year. Oh, and they got all of their skeletons from the Bass Bone Collection at the Body Farm at the University of Tennessee Knoxville. They had upwards of 80-100 skeletons if I remember correctly.

Do you use balanced ligamentous at all? Do you use myofascial releases? What about counterstrain? OMT at all? Just because you're not good at it or because you can't do it does not mean its not real. It just means you havent practiced it enough to feel it. Does it work? I have a few classmates and friends who suffer from migraines who are made better from cranial manipulation. Then again some of them have only gotten better when they went off of gluten, etc.

Just my $0.02.

 

[Handy388]

We have the dean of the OMT department (DCOM) as well as a current 3rd year/fellow who has a Ph.D. in anthropology or something like that working on a project that will link the motion (or lack thereof from fusion) of the cranial bones to the fusion of L5/S1. Just because you guys dont believe it and wont take the time to learn/believe in it doesnt mean it isnt there or doesnt work. They have 80 year olds with completely open cranial sutures and an open L5/S1 and they have 25 year olds with cranial sutures almost completely fused up and a fused L5/S1. Is there a relationship? Maybe. Thats why they're studying it. Trying to figure out if a disease process causes one or the other, etc. It was presented at the AOA poster conference last year as well as this year. Oh, and they got all of their skeletons from the Bass Bone Collection at the Body Farm at the University of Tennessee Knoxville. They had upwards of 80-100 skeletons if I remember correctly.

Do you use balanced ligamentous at all? Do you use myofascial releases? What about counterstrain? OMT at all? Just because you're not good at it or because you can't do it does not mean its not real. It just means you havent practiced it enough to feel it. Does it work? I have a few classmates and friends who suffer from migraines who are made better from cranial manipulation. Then again some of them have only gotten better when they went off of gluten, etc.

Just my $0.02.

ok.....not this crap again.

 

[J-Rad]

...I would not so adamantly be opposed to something just because you can't do it. Some people can some can't. I can't feel the CRI every time (most of the time), but I can definitely get results for my son with migraines.😉

Do you use balanced ligamentous at all? Do you use myofascial releases? What about counterstrain? OMT at all? Just because you're not good at it or because you can't do it does not mean its not real. It just means you havent practiced it enough to feel it. Does it work? I have a few classmates and friends who suffer from migraines who are made better from cranial manipulation. Then again some of them have only gotten better when they went off of gluten, etc.
Just my $0.02.

Seriously? You both are putting this forth as an argument? Please understand the logical fallacy behind that, but just to play along:
Many osteopathic physicians' (osteopaths' if you prefer) career paths take them in a direction in which they are no longer going to use OMM regularly and I happen to be one of those people. If you care to look through my post history you'd find that I am not an OMM basher. I'd like there to be more solid data, but I believe many people derive benefit from OMM and that there is more solid physiologic basis for many of the techniques than people give them credit for (BTW Norton would tell you that lymphatic pump techniques have solid physiology behind them, particularly those that change the intrathoracic pressure dynamics). Truthfully, I miss OMM for multiple reasons but now I find most opportunity to practice it on family and friends and the occasional Quasimodo-postured intern that was too painful to watch; but that has been the nature of my career path*. I would admit that my skills in this field are now rusty (far from irreparably so) but make no mistake, I used all those techniques and I was damn good at all of them. I'd put my med-school skills ups against yours any day. I TAd OMM (I was not allowed to apply for the OMM fellow position d/t military commitment) and not only passed all sections with ease, but was noted to be quite good by the instructors both in class and on OMM rotation. I went to a school that, in my estimation, did a great job in integrating OMM/OPP into the general medical paradigm and neither over or under-estimated its usefulness. I studied under Carreiro (OMM for otitis media study past and ongiong), Buser (dean of PCSOM), Pasquarello (one of the Harvard OMM CME instructors and pres. of AAO), Newman (rising star), Hensel (nee Pim, now NMM/OMM residency director at TCOM), Goldbas (a Northeast OMM legend. He was actually quite impressed with my palpatory skills with BLT/BMT on my OMM rotation when we were doing inpatient work) and other luminaries. So (to reiterate that) while this little digression in Schwartz comparisons is really a logical fallacy, I can assure you that mine as big as yours. And my opinion of cranial still stands. I felt the CRI and, frankly, I think I was feeling something from within my own fingertips, as studies would suggest. As I've stated elsewhere I think that there can be an effect on external fascial and muscular tissue of the head with cranial techniques (probably why, yes, my wife still likes me to do it when she has a headache) but the described MOAs out there are more religion and mysticism (with an appropriately religious devotion by many practitioners) than science. It does not belong in the curriculum of DO schools and is an anchor unto the reputations of all osteopaths. It, like many things, can be learned as post-graduate continuing education.
And, Rose, the last part of your statement above doesn't exactly help your cause.

*As an aside, someday, when more time is on my side I'd like to help out with putting forth data on OMM and I think I can bring it in even to my world.

 

[Powdermonkey]

Seriously? You both are putting this forth as an argument? Please understand the logical fallacy behind that, but just to play along:
Many osteopathic physicians' (osteopaths' if you prefer) career paths take them in a direction in which they are no longer going to use OMM regularly and I happen to be one of those people. If you care to look through my post history you'd find that I am not an OMM basher. I'd like there to be more solid data, but I believe many people derive benefit from OMM and that there is more solid physiologic basis for many of the techniques than people give them credit for (BTW Norton would tell you that lymphatic pump techniques have solid physiology behind them, particularly those that change the intrathoracic pressure dynamics). Truthfully, I miss OMM for multiple reasons but now I find most opportunity to practice it on family and friends and the occasional Quasimodo-postured intern that was too painful to watch; but that has been the nature of my career path*. I would admit that my skills in this field are now rusty (far from irreparably so) but make no mistake, I used all those techniques and I was damn good at all of them. I'd put my med-school skills ups against yours any day. I TAd OMM (I was not allowed to apply for the OMM fellow position d/t military commitment) and not only passed all sections with ease, but was noted to be quite good by the instructors both in class and on OMM rotation. I went to a school that, in my estimation, did a great job in integrating OMM/OPP into the general medical paradigm and neither over or under-estimated its usefulness. I studied under Carreiro (OMM for otitis media study past and ongiong), Buser (dean of PCSOM), Pasquarello (one of the Harvard OMM CME instructors and pres. of AAO), Newman (rising star), Hensel (nee Pim, now NMM/OMM residency director at TCOM), Goldbas (a Northeast OMM legend. He was actually quite impressed with my palpatory skills with BLT/BMT on my OMM rotation when we were doing inpatient work) and other luminaries. So (to reiterate that) while this little digression in Schwartz comparisons is really a logical fallacy, I can assure you that mine as big as yours. And my opinion of cranial still stands. I felt the CRI and, frankly, I think I was feeling something from within my own fingertips, as studies would suggest. As I've stated elsewhere I think that there can be an effect on external fascial and muscular tissue of the head with cranial techniques (probably why, yes, my wife still likes me to do it when she has a headache) but the described MOAs out there are more religion and mysticism (with an appropriately religious devotion by many practitioners) than science. It does not belong in the curriculum of DO schools and is an anchor unto the reputations of all osteopaths. It, like many things, can be learned as post-graduate continuing education.
And, Rose, the last part of your statement above doesn't exactly help your cause.

*As an aside, someday, when more time is on my side I'd like to help out with putting forth data on OMM and I think I can bring it in even to my world.

J-Rad,

I completely agree with you. I see both sides of the fence, and I'm still trying to form my own opinions about it. I completely agree with you that OMM in general needs volumes more EBM and studies done to validate its usefulness. On the other hand, some of the more, lets call them, agnostic techniques are absolutely amazing. When I ran my first marathon back in May I had to stop 3 times to fix my anterior fibular heads myself on the side of the road. By the end of the race they were absolutely killing me. But back at school my ankles, knees and hips were looked at and the problem was fixed with OMT.

I had back pain from hurting myself in highschool roughly 8 years ago. Had MRIs, PT, everything and none of it helped. I had a sacral shear and a dysfunctional SI joint. After treatment once a week for about 7 weeks, 8 years of hurt and not being able to run very far was gone.

Does it work? I'm a believer. Does cranial work? I think in some very rare cases it may, yes. Should I drink the kool-aid and blindly believe that you can fix anything with it, absolutely not. I don't think you're saying that OMT doesnt work, just that you think cranial is sham. On that we'll have to just agree to disagree... at this point. I may quickly join your side next semester when we start to get all the cranial stuff in OMT lab.

Just as an aside, one of our docs is planning on going up to a facility very near us early next year and using one of the laser doppler flow meter MRI machines, they will be measuring the fluctuations of blood/fluid flow rates through the arteries and veins. They are going to simultaneously have numerous docs who say they can "feel" the CRI calling out the rhythm and what its doing to see if it lines up and if the fluctuations are actually something that can be felt. To play devil's advocate for a minute - If all of the docs feel the CRI, and its in a rhythm that matches up with what the patients body is doing.... then what? Does that make it real?

 

[Handy388]

J-Rad,

I completely agree with you. I see both sides of the fence, and I'm still trying to form my own opinions about it. I completely agree with you that OMM in general needs volumes more EBM and studies done to validate its usefulness. On the other hand, some of the more, lets call them, agnostic techniques are absolutely amazing. When I ran my first marathon back in May I had to stop 3 times to fix my anterior fibular heads myself on the side of the road. By the end of the race they were absolutely killing me. But back at school my ankles, knees and hips were looked at and the problem was fixed with OMT.

I had back pain from hurting myself in highschool roughly 8 years ago. Had MRIs, PT, everything and none of it helped. I had a sacral shear and a dysfunctional SI joint. After treatment once a week for about 7 weeks, 8 years of hurt and not being able to run very far was gone.

Does it work? I'm a believer. Does cranial work? I think in some very rare cases it may, yes. Should I drink the kool-aid and blindly believe that you can fix anything with it, absolutely not. I don't think you're saying that OMT doesnt work, just that you think cranial is sham. On that we'll have to just agree to disagree... at this point. I may quickly join your side next semester when we start to get all the cranial stuff in OMT lab.

Just as an aside, one of our docs is planning on going up to a facility very near us early next year and using one of the laser doppler flow meter MRI machines, they will be measuring the fluctuations of blood/fluid flow rates through the arteries and veins. They are going to simultaneously have numerous docs who say they can "feel" the CRI calling out the rhythm and what its doing to see if it lines up and if the fluctuations are actually something that can be felt. To play devil's advocate for a minute - If all of the docs feel the CRI, and its in a rhythm that matches up with what the patients body is doing.... then what? Does that make it real?

look, there's only one small hitch about the cranial osteopathy.

cranial bone is fused together after infancy. You've seen it, I've seen it, cranial is complete crap.

 

[Powdermonkey]

look, there's only one small hitch about the cranial osteopathy.

cranial bone is fused together after infancy. You've seen it, I've seen it, cranial is complete crap.

Actually they arent fused. The sutures allow movement. If you dont believe it, no skin off of my back. Don't use it.

 

[Handy388]

Actually they arent fused. The sutures allow movement. If you dont believe it, no skin off of my back. Don't use it.

and actually one day I'll have a laugh with my surgical residents at the P&S about how some DOs believe in cranio osteopathy.

I won't be using it, I am an allo student.

 

[Powdermonkey]

and actually one day I'll have a laugh with my surgical residents at the P&S about how some DOs believe in cranio osteopathy.

I won't be using it, I am an allo student.

Thanks for the intellectual input to the conversation in that case.

 

[JeetKuneDo]

and actually one day I'll have a laugh with my surgical residents at the P&S about how some DOs believe in cranio osteopathy.

I won't be using it, I am an allo student.

Someone's a tiny bit insecure.

 

[JaggerPlate]

Someone's a tiny bit insecure.

Someone's account is finally on hold after a year of joining the forums just to bash DOs at every turn. Early X-mas present in my book.

 

[hooperg]

Someone's a tiny bit insecure.

Yea, that guy has some serious issues. I predict that in four years, just prior to graduation from Columbia, he'll be sitting in his room cutting his wrists because it's not Harvard.

 

[JaggerPlate]

Yea, that guy has some serious issues. I predict that in four years, just prior to graduation from Columbia, he'll be sitting in his room cutting his wrists because it's not Harvard.

Graphic.

 

[Powdermonkey]

Someone's account is finally on hold after a year of joining the forums just to bash DOs at every turn. Early X-mas present in my book.

Yeah, wth was that all about??

 

[JaggerPlate]

Yeah, wth was that all about??

That guy has been a DO troll since day 1. I've seriously never seen someone go so long with such a blatant agenda and not be put on some sort of hold sooner. It's nuts. I don't even know if it's against TOS to discuss it or whatever, but it was just absurd.

 

[MSSM2013]

That guy has been a DO troll since day 1. I've seriously never seen someone go so long with such a blatant agenda and not be put on some sort of hold sooner. It's nuts. I don't even know if it's against TOS to discuss it or whatever, but it was just absurd.

don't believe in cranial unless they can give us mechanism of action and randomized clinical trials.

 

[hooperg]

I think 95% of both Osteopathic medical students and Osteopathic physicians (the non-quacks anyway) hold no stock in cranial. It's fine and dandy to learn its origins and history for posterity, but it is simply junk science unless repeatable clinical research can qualify it otherwise.
Remember, NORAD still tracks Santa Claus, but I doubt the DoD believes there really is a sleigh. 🙂
Merry Christmas!

 

[MomRNtoDO]

Why do we have to have people who repeatedly lump those DOs that believe in OMM philosophy with quacks? I don't understand. No I don't believe cranial will work for everyone and everything. No I don't believe we should ignore proven Western medicine in lieu of OMT, but it has its place.

There are many who are seeing the benefits of OMM, and some MD Orthopods are seeing the benefits of the techniques we use regularly. Will it not be considered quack medicine if enough allopaths decide it is cool to use?

 

[DO3]

I was told at one of my interviews that there is going to be some interesting research coming out about cranial osteopathic techniques. It has something to do with real-time xrays showing that the cranial bones can in fact be manipulated. Whether or not the techniques get results or not is another matter.

 

[vanbamm]

I think one of the true ways of trying to rationalize this entire notion, is the real time x-rays. There is a lot of contradiction within literature, and most of it comes down to beliefs. You will get the clinical responses from patients, but often times it is neither going to be entirely in one direction or the other.

As we age, we calcify. Proven fact. If you think I am wrong, find out otherwise. So manipulation of the cranial bones, while it may appear to be some sort of far off therapy...it is , but it isn't. Yes, cranial bones do come together and "fuse". If you look at a cranial x-ray, this is the way it would appear, and so you would assume, and believe after so many anatomy and physiology lectures, that this is the way it is. In fact, the innate abilities of the body are not fully understood.

Break down circadian rhythm. You can't. You know it is there, but it is more or less a concept that we know exist based on outward activity. Much like an EKG. We know the rhythms of the heart based on electrodes that read and provide the picture. We know the circadian rhythm exists because we can read it based on activity of an indivdual. The cranial rhythm, while appearing to be out there, is really just obscure. You need to stop looking at it so scientifically and breaking it down into some sort of interpretable terminology. Within the cranium, we have CSF, blood, and brain. The pulsations exist due to the constant change in pressures and activity. So really, the question of cranial rhythm is not about whether or not it exists, but whether or not it is independent of other factors, and whether or not manipulation of THOSE factors in turn, changes cranial rhythm.

 

[futIDdoc]

You need to stop looking at it so scientifically and breaking it down into some sort of interpretable terminology. Within the cranium, we have CSF, blood, and brain. The pulsations exist due to the constant change in pressures and activity. So really, the question of cranial rhythm is not about whether or not it exists, but whether or not it is independent of other factors, and whether or not manipulation of THOSE factors in turn, changes cranial rhythm.

If this is what you consider critical thinking in medicine I pray to god that you never treat me or any person I know.

 

[mabish71DO]

If this is what you consider critical thinking in medicine I pray to god that you never treat me or any person I know.

The bottom line is there is no evidence that cranial or much of OMM is scientifically valid. In modern medicine we practice evidence based medicine. There is no evidence that it works so we should not waste time on it, period. There have been studies on it showing that it does not do a anything. Here are some things for you to chew on.
http://www.chiroandosteo.com/content/pdf/1746-1340-17-10.pdf


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1564028/

 

[mabish71DO]

I think 95% of both Osteopathic medical students and Osteopathic physicians (the non-quacks anyway) hold no stock in cranial. It's fine and dandy to learn its origins and history for posterity, but it is simply junk science unless repeatable clinical research can qualify it otherwise.
Remember, NORAD still tracks Santa Claus, but I doubt the DoD believes there really is a sleigh. 🙂
Merry Christmas!

I agree...but its probably more like 99.9% of DOs think cranial is bunk.

 

[ShyRem]

I'm not convinced about cranial at all. I think it may work on kids, but who knows how much of the "effect" is a hands on soothing or muscular soothing effect. Infants I think it might work on... they have moldable heads.

Now, having said that, when we were learning our intro to cranial, my partner did something during the learning process and I became instantly nauseated and had about the worst vertigo EVER. Couldn't stand up without falling over. One of the faculty came over and worked on me for about 15 minutes while I was just about dry heaving and having the worst bed spins I have ever had and all of a sudden when she was just about done it was all gone. All gone. And I was really tired. Never had anything like that before - not the initial reaction nor the end reaction.

So I don't think it works how they say it does, but it does something. And no one touches my head anymore.

 

[Styria]

So I don't think it works how they say it does, but it does something. And no one touches my head anymore.

If those symptoms did occur again, would you go back to her?

 

[JaggerPlate]

If this is what you consider critical thinking in medicine I pray to god that you never treat me or any person I know.

Well he's a chiropractor who refuses to properly identify himself in these forums while giving unsolicited medical opinions.

 

[digitlnoize]

I'm not convinced about cranial at all. I think it may work on kids, but who knows how much of the "effect" is a hands on soothing or muscular soothing effect. Infants I think it might work on... they have moldable heads.

Now, having said that, when we were learning our intro to cranial, my partner did something during the learning process and I became instantly nauseated and had about the worst vertigo EVER. Couldn't stand up without falling over. One of the faculty came over and worked on me for about 15 minutes while I was just about dry heaving and having the worst bed spins I have ever had and all of a sudden when she was just about done it was all gone. All gone. And I was really tired. Never had anything like that before - not the initial reaction nor the end reaction.

So I don't think it works how they say it does, but it does something. And no one touches my head anymore.

I have a classmate who reports very similar symptoms from when she had cranial therapy done prior to coming to med school. She says the exact same thing you do: "it does something."

We haven't started cranial yet, but when we do, it will definitely be "interesting."

 

[vanbamm]

Prove it wrong. The manipulation is taught because it works.
Your short response reinforces my thoughts.

 

[futIDdoc]

Prove it wrong. The manipulation is taught because it works.
Your short response reinforces my thoughts.

You seem to lack an understanding on how science actually works. The burden is on the practitioners to prove it correct. Also remember that extraordinary claims require extraordinary evidence, so don't come back with some weak publication from a journal that has the word chiro or OMM in its title. One last thing, the plural of anecdote is not data so no case reports, only RCTs. Otherwise, go take a real physio and neuroanatomy course and join reality.

 

[vanbamm]

You seem to lack an understanding on how science actually works. The burden is on the practitioners to prove it correct. Also remember that extraordinary claims require extraordinary evidence, so don't come back with some weak publication from a journal that has the word chiro or OMM in its title. One last thing, the plural of anecdote is not data so no case reports, only RCTs. Otherwise, go take a real physio and neuroanatomy course and join reality.

The research is partly on the practitioners to document what evidently works in practice. I agree that some manipulation does not jive with what we know about anatomy, neuro, and physiology but it remains in practice because it works...just like a number of drugs that are prescribed. While some things can be defined as principle, some things will remain theory but that does not mean it is false. If you are in DO school, I suggest you look into the literature of Dr. Robert Fulford, described as one of the best D.O.'s of his time until he passed away a few years ago. He still managed to help people through manipulation ( while still employing other common practices of treatment) after no one else could help them. The man basically couldn't retire because of the referrals.
And thanks for your advice, but I'm more than fluent in both neuro. and physio.

 

[futIDdoc]

I agree that some manipulation does not jive with what we know about anatomy, neuro, and physiology but it remains in practice because it works...

Nice, by your own admission you believe in a treatment for which you have no rational explanation. I recant my previous statement that you should take a neuro and physio course, perhaps a study of formal logic may be more appropriate.

I am an allo student, however the reason I posted osteo forum is that the credulity and gullibility you display are pox on medicine. Lucklily most of my DO brethren see the light on using cranial as a therapy and the whole osteo world is moving closer to the allo one. I have four friends that go to DO school and they either openly laugh at cranial or recoil in horror b/c its is still taught. Judging by the response in the thread, dare I say they are not in the minority either.