Text: Alexey Vodovozov
IN THE LAST FEW YEARS, IT IS MUCH MORE OFTEN YOU CAN HEAR RECOMMENDATIONS turn to an osteopath - and not only for posture correction or back pain treatment, but also for almost any other problem. There are legends that osteopathy cures diseases of the stomach and intestines, relieves allergies and "improves" immunity. The "specialists" themselves tell patients about the worldwide conspiracy of pharmaceutical companies and that osteopathy is not taught in medical universities on purpose, so that people get sick more. Doctor-toxicologist and medical journalist Alexey Vodovozov figured out where osteopathy came from and how it can be dangerous.
Mark Twain recommends
Osteopathy, if we take the definition of the Russian Osteopathic Association as a basis, is "a holistic manual medical system for the prevention, diagnosis, treatment and rehabilitation of the consequences of somatic dysfunctions, entailing health disorders, aimed at restoring the body's natural abilities for self-correction." Unfortunately, you won't be able to wave your hand towards osteopaths and say - don't pay attention, this is just another variation on the topic of alternative medicine. The fact is that, in accordance with the order of the Ministry of Health No. 700n dated 2015-07-10, osteopathy is a legal medical specialty. And if homeopathy or bioresonance diagnostics can be safely called alternative, osteopathy is already quite official. True, it did not become more scientific because of this.
Osteopaths claim that any pathology in the human body has a certain dysfunction, consisting of three components: biomechanical, rhythmogenic and neural. Scientific medicine more or less agrees with the existence of the neural system: in various diseases, the control, or regulation, of certain processes on the part of the nervous system can really be disturbed. But the other two components are the wonders of parallel universes. Based on the osteopathic theory, with any dysfunction, there is a violation of the compliance and balance of the tissues of the human body (biomechanical component) and a violation of the production and transmission of some internal rhythms, about which evidence-based medicine knows nothing (this is the rhythmogenic component). And if this compound dysfunction is corrected, the disease will recede; for example, you can "straighten" the stomach or put it more symmetrically than the skull bone, restoring the "micromobility of the brain."
"Orthodox" doctors in the 19th century practiced bloodletting and mercury treatment, which sometimes caused more harm to patients than the disease itself, so that the alternatives had a fairly strong position
The osteopathic theory has a very specific author - American physician Andrew Taylor Still - and a specific date of birth - 1874. It is noteworthy that at about the same time, another inventor and dreamer - Daniel David Palmer - invented chiropractic, and, according to their adherents, these two movements should in no way be confused with each other. Although there are quite a lot in common - absolutely the same unscientific basis, only chiropractors still talk about some kind of innate intelligence, the flow of which can be impeded by "subluxation of the vertebrae", which must be adjusted quite intensively.
The creator of osteopathy Still was a doctor, surgeon, and one of the founders of a fairly well-known private university in the United States, affiliated with the United Church of Methodists, Baker University. At the same time, he adhered to the idea that restoration of health does not require the intervention of a doctor - it is enough to help the body restore the "disturbed balance", and he will do the rest himself. Within the framework of this paradigm, homeopaths, hydropaths, Thomsonians and other alternativeists of the 19th century operated. "Orthodox" doctors of that time practiced bloodletting and mercury treatment, which sometimes caused more harm to patients than the disease itself, so that the alternatives had a fairly strong position - after all, if the patient is given homeopathic medicines or "treated" with osteopathy, the main help will be in the absence of additional harm. From the outside, it may look like an effective way of healing - without mercury, laxatives, opium and bloodletting.
Still had personal motives - his wife and three daughters died of meningitis; people die of this disease even today, and the medicine of the 19th century could not do anything. But he felt that it was necessary to create a new medicine that would be better and more effective. It is known that anatomy (that is, the structure of the body and each individual organ) and physiology (functions and processes) are interconnected: each part of the body is designed in such a way as to best perform a specific task. And Still decided that since the structure and function are interconnected, then light and unobtrusive external influences on the structures of the body, primarily on the musculoskeletal system (hence the "osteo", that is, "bone" in the name) are enough to convey information to the internal organs, "Commands" to restore impaired functions. In 1892, the first osteopathic school appeared, in which they began to train specialists for "new medicine", in the same year, Still's fundamental work "Philosophy and Mechanical Principles of Osteopathy" was published.
Mark Twain in 1909, speaking
at the New York State Assembly, directly accused doctors of simply being afraid that osteopaths who "really heal people" would simply destroy the business of "orthodox" medicine
Osteopathy met with organized and fierce resistance from the US medical community. The American Medical Association defined this trend as nothing more than a cult, and the code of ethics of the association implied that a normal doctor could not willingly communicate with an osteopath. The effect turned out to be the opposite, “oppressed and persecuted by official medicine,” alternativeists quickly gained bonus points.
In this they were helped by many politicians, public figures and famous personalities, such as the writer Mark Twain. He came to believe in the effectiveness of the new technique, when the osteopath seemed to alleviate the symptoms of epilepsy of his daughter Jean, as well as the symptoms of chronic bronchitis of Twain himself. The argument “but it helped me” sounded extremely convincing in the mouth of an outstanding person and a recognized master of the word.
“Asking a doctor's opinion about osteopathy is like asking Satan about Christianity,” Mark Twain quipped in 1901, and in 1909, speaking at a New York State Assembly, he directly accused doctors of simply being afraid. that osteopaths who "really heal people" will simply destroy the business of "orthodox" medicine, which can do nothing but hinder everything new. A familiar rhetoric - literally last year we saw it in Russia, when a memorandum on the pseudoscience of homeopathy came out.
Massage therapist with a raised price tag
The American Medical Association fought against osteopathy for a long time, but in the end it took the “if you can't win - lead” path, allowing osteopaths to become real doctors and recognizing osteopathic schools as medical schools. In return, osteopaths were able to load full responsibility for patients - as it should be for licensed doctors. As a result, since the sixties, osteopaths in the United States have turned into family doctors who practice some kind of manual techniques.
This approach has gained momentum. Under the slogan "do what you want, but bear medical responsibility for the consequences of your actions" osteopathy was legalized in 1993 in Great Britain, later in Canada, France, Belgium, Germany, Australia, Switzerland, New Zealand, Portugal, Egypt and India. In all countries where osteopathy became official, approximately the same picture was observed: some osteopaths gradually moved to scientific rails, concentrating on various methods of relaxation, rehabilitation after injuries, work with contractures (limitation of movement in the joint). In this case, they turned out to be covered from the legal side - recommendations and guidelines that were previously actively used by specialists in physiotherapy exercises, massage, sports medicine and other related specialties.
In fact, in a randomized controlled trial, osteopathic manipulations were not only ineffective, but also reduced the effectiveness of rehabilitation
One osteopath briefly described the essence of movement in an interview: “A chiropractor is a massage therapist with a raised price tag. An osteopath is a chiropractor with a raised price tag. " That is, some of the adherents of osteopathy have successfully merged into mainstream medicine, leaving only a facade attractive for especially impressionable patients, for which they are ready to pay extra. The advantage of this approach is that an osteopath has a medical education and the opportunity, if something happens, to ask him through the court as an ordinary doctor.
In the USSR, osteopaths began active work during the perestroika period. The starting point is the lecture of the famous American osteopath Viola Fraiman at the Turner Research Institute of Orthopedics and Traumatology in Leningrad in 1988. The author of this material was present at it - everything was presented very “tasty”, harmonious and logical, and some Soviet doctors, who were not spoiled by the alternative, got fired up with a new idea, went to the USA to gain experience. The fact that in 1992 Fryman was accused of official inconsistency for negligent and unprofessional treatment of a patient, a one-week-old baby, was no longer of interest to anyone: the grains of weeds that fell on fertile soil began to swell violently. As a result, by 1994, the first Russian non-state osteopathic school was created in St. Petersburg, in 2003 the Ministry of Health officially recognized osteopathy as a treatment method, in 2012 the documentary registration of the specialty began, which ended three years ago.
What is your evidence
Like any alternative technique, even if legalized, osteopathy has big problems with the evidence base. The authors of one of the few scientific reviews on the topic concluded that "there is no clinically significant difference between osteopathic and other interventions to reduce pain and improve function in patients with chronic lower back pain." If we analyze the results of studies in which the effectiveness of osteopathic manipulations has been shown, numerous design violations, errors in statistical processing of results, or simply misinterpretation of the data obtained are necessarily found. In one of the analyzes, it turned out that in fact, in a randomized controlled trial, osteopathic manipulations were not only ineffective, but also reduced the effectiveness of rehabilitation, although the authors, of course, argued the opposite.
And even convinced osteopaths are increasingly saying that there is a lack of well-conducted research. Otherwise, osteopaths run the risk of being stuck in the wheels of history - after all, scientific medicine continues to develop at an impressive pace.
There are contraindications
Osteopathy, of course, can also do harm. Directly - hardly, osteopaths are not chiropractors who are ready to "set" the vertebrae and twist the patient's head so that the vertebral artery is damaged and a stroke develops. Fortunately, osteopaths are much more cautious - perhaps that's why they legalized them, not chiropractors. And legalization, in turn, led to the fact that osteopaths got rid of the statement about the absence of contraindications. Previously it was "possible for everyone without exception", now - "there are a lot of contraindications."
For example, the official website of the Russian Osteopathic Association provides an impressive list of contraindications: these are a variety of infections, fever, diseases of the skin, blood, heart and lungs, benign and malignant tumors, and much more. A separate line mentions acute and subacute inflammatory diseases of the brain and spinal cord and its membranes - myelitis, meningitis and others, which is especially interesting in the context of the birth of osteopathy as a way of miraculous healing, including from meningitis.
If you want to see an osteopath, first, make sure that this is not contraindicated for you. Also inquire about the availability of all the necessary documents such as a diploma and license. And of course, keep in mind that there will be no miracles
The indirect harm from osteopathy, as is usually the case in such cases, can be done in two ways. The first is the diagnosis of a non-existent disease and its treatment for a tangible amount of money. A characteristic sign of "divorce" can be considered the words of an osteopath about the need to straighten a certain internal organ, correct the symmetry of the skull bones, and restore a certain craniosacral rhythm. The second is a waste of time with a real-life disease, when the help of a specialized specialist is required. This mainly concerns diseases from the list of contraindications - in the event that the osteopath does not bother to inform the patient about it.
If you have a burning desire to see an osteopath, first make sure that this is not contraindicated for you. Also inquire about the availability of all the necessary documents such as a diploma and license. And, of course, keep in mind that there will be no miracles - you can simply be helped to relax. If this is exactly what is needed, you can turn to an osteopath, and in all other cases it is better to start with specialists with a more scientific background.