Well, to make this thread more useful, can a current student or someone with experience explain this to me:
Why is cranial still used and taught? Are there any empirical studies demonstrating any benefit or efficacy? Other components of OMM make more sense and have been studied, and I personally think are useful, but I still have a hard time getting my head around cranial. Norman Gevitz's book made it sound like cranial wasn't an original component of OMM but a small fanatical minority, that most other osteopathic physicians disliked and disagreed with, pushed forth cranial during a time when the profession was trying to increase its distinctiveness while the California school and the "modernists" were pushing more evidence based medicine, and some how cranial ended up sticking and was voted for favorably at an AOA conference when even at the time there were serious fundamental scientific issues with cranial. So how has it survived to this day without more thorough questioning? Thanks.
I think Gevitz hit the nail on the head - it's a small minority who, unfortunately, are pretty powerful and vocal within the DO community. The overwhelming majority of students, new physicians, etc, I speak to (even the ones who like OMM for the most part) want nothing to do with it. I have a few thoughts about it:
1. It's a misnomer, and I do think there are instances where osteopathic manipulation can be applied to the head and neck (I know a few people who have received mainstream OMM treatments for jaw issues with good success and it obviously has a place for cervical manipulation and influencing the muscles that attach to the occ region), but after spending a quarter in OTM, I have a hard time believing that the sutures of the skull can be manipulated or that a primary rhythmic pulse can be palpated (if it does exist). Frankly, this is the issue everyone has with OMM, and I tend to agree.
2. I do believe it will be removed or moved to an 'elective' only portion of the curriculum overtime. I even seem to remember a few years back some professors at UNECOM wrote an editorial explaining how it can't be backed by research, it's not scientifically sound, so it probably should be dropped. Combine this with the attitude of the docs that will become the 'future' of the AOA, and you can see how it could definitely be altered over time.
3. It's something a lot of people use to judge OMT as a whole, and I think this really hurts its visibility, integration into mainstream care, etc, etc.
I don't know the specifics on this, but there were a few OMT fellows at DMU that were saying you received more cranial training there than other schools, which they thought was a good thing. So, there are clearly people who are into cranial and believe that it works. This could be a result of the level of training in that specific area. Better training usually results in a better understand, which then leads to an increased incorporation of the techniques and improved results.
I think OMT is plagued by the fact that it is difficult to conduct double blind studies, and really assess efficacy of specific somatic lesions being treated vs. placebo/massage, but I have seen a number of studies that incorporate EMG and palpitation, that demonstrate physiological abnormalities/differences in regions of somatic lesions determined by OMT. I don't recall any cranial studies though...
As an aside, in response to the shenanigans and pointed responses in this thread, I should state that I am very interested in OMT and feel it will offer patients a viable alternative to standard treatments, that can reduce durations of med management for chronic pain, among other applications. (I did state this above, but still feel a number of responses were directed towards me... 🙄) I also feel the additional emphasis on anatomy is paramount to a strong understanding of the physical system that is a completely integrated unit. If you start to throw things out of kilter, you will increase the demands on the system and potentially tax the system to a point that makes it more susceptible to other potential complications.
However, I stand by my statement that think instructors discussing radiating energy from their hands that has been captured on film should not be taking place in a medical school curriculum. This is the voodoo type of stigma DO's spent so long trying to steer clear of that led people to believe the cultist label throughout the better part of the 20th century.
I agree with some of the issues regarding OMT research. Not only is it essentially impossible to set up a double blind study, but the inter reliability between practitioners is far too subjective. Additionally, many DO schools don't have much research funding, so this only hurts the cause and tends to make people fall back on the 'I know a guy who was cured by x OMT treatment, ergo it works,' mentality, which we all know is bad science.
Altogether, in my very novice opinion, there are a lot of cool, good, valid, etc, things within OMT. However, I do think the entire treatment modality could use some streamlining, standardization, and dismissal of techniques that are practiced out of respect or traditional opposed to proven science. Frankly, I'd love to be part of the solution in this situation!
