Which Osteopathic Techniques Do You Think Work/ Are Complete Bogus?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
CorpuSpongiosum

CorpuSpongiosum

Membership Revoked
Removed
10+ Year Member
15+ Year Member
Joined
Apr 27, 2008
Messages
326
Reaction score
1
WORK: Tension Headaches, Spencer 7, Lower Back stuff, Neck stuff, Joint work, asthma, pneumonia.

BOGUS: Cranial, Cranial, Cranial, somatic dysfunction regarding vertebral segments, fascial release.


BUT this is my personal opinion and unlike AT Still, I don't want anyone to take my word for it, but conduct large randomized trials (double blind I admit is difficult since the operator will know whether he is using technique or not).
Members don't see this ad.
 
Work in the hands of a 2nd year DO student with <200 hours of training: Almost none.

Work in the hands of a seasoned DO who has had years of experience and training in manual medicine: Almost all.
 
I get excited about lymphatic flush, but yeah, where's the data? My immuno textbook breaks thinks down to the cytokine and receptor, and that's what I want to see for lymphatic flush. I want to know if it's appropriate with immunocompromised patients, for example - if you can't flush out more CD4, is there still any point?
 
Members don't see this ad :)
DrMidlife said:
I get excited about lymphatic flush, but yeah, where's the data? My immuno textbook breaks thinks down to the cytokine and receptor, and that's what I want to see for lymphatic flush. I want to know if it's appropriate with immunocompromised patients, for example - if you can't flush out more CD4, is there still any point?
Click to expand...

I agree there should be more research of this type. Perhaps I should qualify my comment above: when I say the techniques work, I mean that someone with lots of palpatory experience can localize a finding and perform a technique to correct it. The clinical significance of this in most cases remains to be proven.

To use your example, there is no question that lymphatic drainage works in a practical sense. This is actually one of the best studied manual medicine techniques - in fact, the hospital I used to work in had a lymph drainage clinic for patients who had had procedure like mastectomy that resulted in impaired lymph flow. Literally, liters of fluid could be drained from a limb by using lymph drainage techniques. So, when done properly, the technique definitely "works".

However, IMO, too often leaps of logic are made between a treatment working in clinical sense and a treatment affecting some type of measurable outcome. For example, lymph drainage moves fluid, but does that mean that it affects immune function and has all the other effects attributed to it? Maybe, but that needs to be proven. Manipulation definitely helps decrease low back pain, but then, so does exercise, a pamphlet about low back pain, or doing nothing. So manipulation works, but is it the best treatment? If so, why?

This problem isn't limited to OMM, it exists throughout medicine. Hormone replacement therapy "works", but upon further study, it just doesn't do most of the things people expected it to do. Zetia lowers cholesterol, so it should reduce plaques, right? You get the idea.

A lot of OMM "works", in the sense that with enough training, you can consistently find and correct all kinds of somatic dysfunctions. How significant this is, is another story...
 
CRANIAL for the "bogus" win...

I really do like most everything I've learned in OMM thus far, but it really turned me off. I was considering applying for an undergrad OMM Fellow position until we started Cranial. I just couldn't (ethically/morally) teach something that I had zero belief in-

Coming in a close 2nd for me is Chapman's points...

HVLA, ME, ST, BLT, even some Still's technique = fine by me!
 
DragonWell said:
Work in the hands of a 2nd year DO student with <200 hours of training: Almost none.

Work in the hands of a seasoned DO who has had years of experience and training in manual medicine: Almost all.
Click to expand...

I have a perfect title for this study:

Placebo More Efficacious in the Hands of Experienced Operator
 
Outside of Muscle Energy and Thoracic/Lumbar and Cervical HVLA, OMM in nonsense. Show some evidence where n is more than 5.
 
Osteopathy always works, sometimes the doctors don't....
 
DrMidlife said:
I get excited about lymphatic flush, but yeah, where's the data? My immuno textbook breaks thinks down to the cytokine and receptor, and that's what I want to see for lymphatic flush. I want to know if it's appropriate with immunocompromised patients, for example - if you can't flush out more CD4, is there still any point?
Click to expand...

There are studies going on looking for that type of information, for example:

http://www.jaoa.org/cgi/content/full/107/12/527

But honestly, I care less about how it works than about the results. My basic sciences career is over now :laugh:.
 
I don't usually get too wrapped up in the spitting contest over Hard Science vs. the "Art" of Manual Medicine, but...

My 2 cents
- The body does have certain inter-related parts
- Manual Medicine is an option to address mechanical dysfunctions
- MM works better for some patients than for others
- Some "Artist" (Docs/Therapist) are better at it than others
- Sweeping generalizations should not be made about ALL MM techniques or various providers...+/- to each...We should not over or under estimate the effects of various MM techniques
- There is plenty of research on the subject, but could be better designed...The nature of MM does not always lend itself to meet the rigors of scientific method...Continued efforts should be made to study those areas that can be objectified.
- Patients care more about their personal results than RCT...Payors justifiably want both.


I think we can all agree that mechanical dysfunctions most likely have some aspect of a mechanical solution...If not for PMR, DO's, PT's, DC's, ATC, MT & Personal Trainers, who else is making efforts towards addressing these issues?

Overly Extreme Statement Alert:
MSK complaints make up a HUGE number of PC visits. For those that are so adamant that Manual Medicine has no place in the area of Education/Medicine/Science/Society... I ask, "What are the options for these patients?"
Note: Surgery & Drugs kill far more in an hour than corrective exercise ever have or will (I am not anti-meds/surgery by any means, I have a healthy respect for both in a time & place).

Conclusion:
An absences of evidence does not mean the evidence of absence...Think about it.

If you are interested in what research has been done on the matter, check out http://manualmedicine.blogspot.com/
 
Ibuprofen and Tylenol w/codeine for all!
 
Another vote for: Chapman's points (oh, massage the tapioca balls away)

As for cranial: We learned a few techniques in our first year class. 4th ventricle compression actually slows my breathing (in an OMG I can't breath sort of way)....so I know it's doing something...I'm just not sure it's a good thing.
 
Members don't see this ad :)
Cranial. Classmate was just "feeling" on me. I sat up and immediately fell over, my hamstrings started cramping, and I started shaking. Doc had to work on my head for 20 minutes to fix what my poor classmate screwed up. I hadn't had the spins that badly since first year in college the first time around. It was pretty nasty. So does it fix stuff? I dunno. But it sure messed me up for a while.

I never felt anything I could match to anything else. Felt an odd rhythm and tapped it out for the doc training me, and he had no clue what I was feeling.

I call bunk. But don't touch my head.
 
ShyRem said:
Cranial. Classmate was just "feeling" on me. I sat up and immediately fell over, my hamstrings started cramping, and I started shaking. Doc had to work on my head for 20 minutes to fix what my poor classmate screwed up.
Click to expand...

This is what frustrates me. Just when everyone thinks there no possible way any of this nonsense works, stories like your's come out. I mean, it sounds like you must have been skeptical to start with so we can't play the "placebo effect" card here. So how else can your experience be explained? I don't think simply treating the fascia outside your skull would have such profound effects as you describe. But the skull bones fuse after childhood! How could they move? And how could it be palpable even if they do move 0.01 pm? And why is there no reliability from one doctor's diagnosis to the next? Maybe they do move in very small amounts and maybe it can be palpated by very experienced and skilled docs, but perhaps we have the whole theory as to why and how wrong? Who knows.
 
I don't think the fused bones move. Lymphatics maybe? Nerve stimulation? I have no idea. I don't think it works how they say it does, but don't touch my head.
 
For me, if I see good results with something, then I'll use it. Cranial helped fix a personal chronic problem that many doctors/specialists couldn't help. So I'm a firm believer
 
J1515 said:
This is what frustrates me. Just when everyone thinks there no possible way any of this nonsense works, stories like your's come out. I mean, it sounds like you must have been skeptical to start with so we can't play the "placebo effect" card here. So how else can your experience be explained? I don't think simply treating the fascia outside your skull would have such profound effects as you describe. But the skull bones fuse after childhood! How could they move? And how could it be palpable even if they do move 0.01 pm? And why is there no reliability from one doctor's diagnosis to the next? Maybe they do move in very small amounts and maybe it can be palpated by very experienced and skilled docs, but perhaps we have the whole theory as to why and how wrong? Who knows.
Click to expand...

Placebo can often be very subtle. Even if we're thinking "There's no way this could work" there could be an inkling of subconscious doubt that maybe it will work.

My thinking is that he must have messed with shyrem's carotid arteries somehow, though, which could explain the symptoms she reported.
 
JohnUC33 said:
For me, if I see good results with something, then I'll use it. Cranial helped fix a personal chronic problem that many doctors/specialists couldn't help. So I'm a firm believer
Click to expand...

I didn't know that cranial could treat E.D.

That's awesome! :thumbup::thumbup::thumbup:
 
misparas said:
I didn't know that cranial could treat E.D.

That's awesome! :thumbup::thumbup::thumbup:
Click to expand...

Yes, your mom has been overjoyed:D (been awhile since i've used a "yo mama" joke but I just couldn't resist here)
 
Maybe, but even my instructors said "we don't really know what's going on.... but it definitely does something"
 
Worst: Cranial, Cranial, Cranial.
 
I herniated a disc in my back about 25 years ago. I am usually symptom free but I got roped into going to a water slide park about 10 years ago and threw my back out. My back was stiff and "S" shaped for about two weeks. I took a bike ride to loosen it up but hit a rut and because I was so stiff I couldn't keep my balance and was thrown from the bike with a thud.

I scraped my leg as a result of the fall and took a hot shower to clean the wound and felt a "crack" in my lower back in the shower. I got out of the shower and felt like a million bucks.:)
 
Umm...I begin school this fall so I probably do not understand the complete scope of this discussion but it seems like some really do not believe in OMM. Being that this is an osteopathic thread, how can you be a student of osteopathic medicine and not believe in OMM. Perhaps those that think some facets of OMM don't work just have not seen it work. I agree, data would be nice but OMM is one of the major factors that distinguishes osteopathic from allopathic medicine. If I felt the OMM was useless and a bunch of "touchy/feely" stuff, I would not consider spending 4 years of time/money to learn that skill/philosophy.

Again..haven't started medical school yet...just some thoughts
 
No dipping into the kool-aid before you start school!

Just because one attends a DO school does not automatically mean they believe in, practice, or like OMM. It's just another hoop for many on their way to becoming licensed physicians.

I believe that OMM is effective in treating 'somatic dysfunctions'. Will that have any impact on how I practice medicine? No. For me, it was as useful as a 2 year seminar in scientology.

youngtraumadoc said:
Umm...I begin school this fall so I probably do not understand the complete scope of this discussion but it seems like some really do not believe in OMM. Being that this is an osteopathic thread, how can you be a student of osteopathic medicine and not believe in OMM. Perhaps those that think some facets of OMM don't work just have not seen it work. I agree, data would be nice but OMM is one of the major factors that distinguishes osteopathic from allopathic medicine. If I felt the OMM was useless and a bunch of "touchy/feely" stuff, I would not consider spending 4 years of time/money to learn that skill/philosophy.

Again..haven't started medical school yet...just some thoughts
Click to expand...
 
If you read the thread carefully, very few are saying OMM doesn't work. We are saying that certain aspects of OMM don't seem to work or don't work as folks say they should work.

There's an awful lot of OMM that works really well when applied in the correct situation by someone that does it correctly.
 
youngtraumadoc said:
Umm...I begin school this fall so I probably do not understand the complete scope of this discussion but it seems like some really do not believe in OMM. Being that this is an osteopathic thread, how can you be a student of osteopathic medicine and not believe in OMM.
Click to expand...

That's funny...

Saying how can you not "believe in OMM" highlights one of my pet peeves with certain aspects of osteopathy.

It's amazing how the unproven aspects of a supposed medical therapy bring out religious zeal in the "believers." You just have to have faith and exercise faith that cranial works and it'll magically manifest it's truth to you.

I have seen people cry when testifying of the power of cranial. It's pretty messed up. Science is fact. Religion is faith.

Chaplains don't send people a bill for a visit. We shouldn't be able to bill for the unproven OMM techniques out there. If you want to teach a technique and bill for it, you should have some quality research to back it up. None of this n=2 crap.

I only applied to only D.O. schools and am down with the D.O. thing. I will be very happy with my degree. I even like many aspects of OMM. However, I am embarrassed by many of my colleagues who are "believers."

I'm sorry if I have offended anyone with my heathen rantings, and await the wrath of the osteopathic gods.
 
I love the word "bogus"

Strage things are afoot at the circle K
 
I don't buy any of these supposed OMM techniques................except cranial.
 
You must log in or register to reply here.
Next unread thread

Similar threads

DoctorDean
Osteopathic Medical Student Opportunity-OMS1/OMS2
Replies
11
Views
1K
DoctorDean
DoctorDean
D
want to know resources to help with classes in do schools, which school is strongest?
Replies
1
Views
446
Goro
Goro
E
Step 2 for DO osteopathic students?
Replies
5
Views
2K
JimBone905
J
parasiteeater13
How do away rotations work?
Replies
3
Views
878
BobbyKoch
BobbyKoch
G
What do students think of NBOME?
Replies
27
Views
2K
Goro
Goro
Top