Explore Pain at the Science Museum

Pain Less is a new exhibition featured in the Antenna – Science News gallery investigating the future of pain relief.

Last year, nearly 6 billion painkillers were sold in the UK. Pain is a constant reality for some people, especially if you're one of the 1 in 5 who suffer from relentless chronic pain.

We treat pain with drugs that haven’t really changed for decades. Is there a better way to control pain?

Explore pain through the stories of extraordinary people who deal with it every day – from the patient who suffers with chronic pain in his missing limb, to the man who feels no pain at all.

How are scientists working to create the perfect pain relief? Geneticists decode DNA to find out how pain works in the body. Neuroscientists examine brain activity to discover how emotion affects how we feel pain. Researchers ask, do we really feel no pain during surgery under anaesthetic? Or do we simply not remember it? How might this affect us?

Pain Less introduces you to the latest pain research, through personal stories, scientific discovery, fascinating objects, films and even games.

Check out their blog to explore the content and creation of Pain Less.

Bowen Therapy - gentle treatment for all ages

Bowen Therapy

How can a therapy that seems to do so little achieve so much?

Many patients receiving a course of Bowen Therapy treatment are genuinely  surprised and often delighted when they notice a significant improvement in their symptoms.  It can seem hard to understand how a treatment which is so gentle and 'light touch' can change the body in so many ways.

Both recent and chronic conditions including muscle and joint aches and pains can be helped by stimulating the receptors in the neuromuscular system using 'Bowen moves'.  

The aim of this therapy is to stimulate the body to speed up its natural healing response.  Sometimes, despite the body having recovered from an injury, the brain has 'locked in' muscle tension and seems unaware that there is a problem with reduced circulation, build up of waste products and unnecessary tightness in some muscles.  

The Bowen Technique offers a gentle reminder to the body that all is not well, and the body seems to take the hint by readjusting the nerve signals to these problem areas.  After a short course of treatment, the nervous system seems to have made subtle changes which affect the blood supply to areas of the body which have been causing unncessary pain.

Bowen Therapy is often reported to help other conditions which the patient wasn't complaining of at the time - for example, someone with back pain having treatment may report that as well as the aching in the low back improving they also noted they were sleeping better, or a student with elbow pain reporting that their concentration levels during exams was better.

If you are suffering from a condition that you think should have resolved by now and your doctor is happy that there is no underlying disease or serious problem, you may want to try a new approach.  Rather than masking your symptoms using pain killing medication, you could try Bowen Therapy to give your body a gentle 'kick start' to recovery - don't wait any longer, give Absolute Health a call on 0116 282 7766 and come in for a free health check and 10% off the cost of your first treatment.  

Back Care Awareness Week 8-12 October 2012

From 8-12 October 2012 it's Backcare Awareness Week, and this year the theme is 'Builder's Back Pain'. 

Focussing on the back problems builders encounter and the also the stresses and strains on construction workers as the building industry has the highest rate of back related injuries.

The aim of the week long event, which is organised by BackCare, the charity for healthier backs, is to raise awareness of the problems back pain can cause, as well as prevention and treatments.

You can visit the Backcare shop and order one (or all!) of their information packs, based on back problems found at home, at work and at play. They also have a great selection of back friendly bags to help ensure that you reduce the chance of any potential problems.

While we might all know the best way to pick up boxes safely, we tend not to think about the effect every day tasks like picking up shopping or children's toys have on our backs.

It's thought that 4 out of every 5 adults will experience back pain at some point in their life, so why not get an information pack and find out what you can do to prevent it?

For treatment information and advice about how to deal with your aches and pains before they turn into something more serious take up our Backcare Awareness Week offer - 3 Osteopathy Treatments for the price of 2 (new patients only).

Drivers at risk of whiplash

15 MILLION DRIVERS AT RISK OF WHIPLASH DUE TO BAD SEATING POSITIONS

Drivers who fail to wear seatbelts correctly are at risk of injury according to the British Osteopathic Association (BOA). While most people are fully aware that wearing seatbelts saves lives the majority are not aware that the way they sit in a car plays a huge part in their personal safety.

The result of a survey by the BOA, released ahead of Back Care Awareness week (8 – 12 October) has found over one in ten drivers (13%) sit too far back for their seatbelt to offer effective protection in a frontal crash.  To be effective, the belt should be sitting over the bones of the pelvis and not the stomach preventing internal injuries and in contact with the shoulder to prevent a serious neck injury.  Sitting too far from the belt can often lead to submarining - where the occupant slips under the belt which can cause catastrophic injuries.

Half (45%), 15 million, of all UK drivers do not drive in position where their head is close enough to the head restraint or they sit too far back for their seatbelt to be effective, so that in an accident, they would be at risk of sustaining a serious whiplash injury. Furthermore, only 6% of people adjust the head restraint regularly, despite the fact that most people travel in a variety of vehicles (as drivers, passengers and in taxis for example) and half of all drivers surveyed (51%) said they never adjusted their head rest at all.

Head restraints work by catching and supporting the head in the event of a rear end crash and so reduce the chance of permanent soft tissue damage. A correctly adjusted head restraint should be as close to the back of the head as possible and as high as the top of the occupant's head, meaning head movement in relation to their body is reduced as the car and seat is punted forward when hit from behind. In addition the driver's seat should be at the correct distance so that a properly positioned seat belt is low across the hips and pelvis, with the shoulder belt firmly across the chest and collarbone.

Receiving a serious chest injury as a result of being hit by an air bag during an accident is also a very real possibility for one in seven drivers (14%) who admitted sitting too close to the steering wheel. Drivers with a gap of less than 12 inches between themselves and the steering wheel when driving are at risk of receiving the full force of an airbag deploying in a crash involving the front of the vehicle.

Airbags have to inflate very quickly (some at over 200 mph) in order to protect the head and chest of drivers and passengers in the event of a frontal crash.  Therefore an airbag needs enough space in front of the steering wheel in order to inflate properly. People who are shorter than around 5' 2" (1.57m) often sit too close to the steering wheel and may be injured by the inflating airbag.  A safe distance is around 12 inches - the size of an A4 piece of paper placed lengthways.

Danny Williams, BOA Council Member, said: "While most of us are aware that seatbelts save lives, it's fair to say that the majority of us don't know that the way we sit in a vehicle also plays a huge part in our safety and wellbeing.
"The position of the head restraint, how far or close we sit to the steering wheel and how long we spend sitting at the wheel without having a break can cause long-lasting neck and back injuries."

Matthew Avery, Crash Research Manager at Thatcham, said: "Vehicle safety has moved on at a pace with numerous new technologies now available designed to help avoid or mitigate injury during a collision. Whilst many seats and head restraints perform well in protecting the occupants, this research goes to show that too many drivers are still subject to avoidable risks by not taking the time to adjust their head restraints correctly."

Reduce Anxiety and Stress with Hypnotherapy

Hypnotherapy - help for anxiety and stress disorders

Hypnotherapy is commonly used to relieve stress and anxiety, as people look for natural, safe alternatives to medication.  


Stress and anxiety are a normal part of our natural defences, and enable us to deal with demanding and taxing situations.  This may be in any part of our lives including in the home, family life or in the work place.  Chronic stress and anxiety are both considered medical conditions, due to the potential for them to lead to further health complications.

What is Hypnotherapy?

Hypnotherapy is a form of psychotherapy that aims to make use of the untapped potential of the unconscious mind to effect real world changes.  This is primarily achieved through the use of hypnosis, which is an altered state of consciousness or trance.  This state can be used to relieve a range of conditions and ailments including: smoking, weight issues, poor sleep, concentration, pain, phobias and stress.  Most hypnotherapists will use their voice to induce a state of hypnosis.  It is not possible to become trapped in a trance, though you may feel the need to sleep if you are especially relaxed. 

Stress and Anxiety

Stress and anxiety often lead to one feeling overwhelmed, which is when the body’s natural defences are triggered, and the hormone cortisol is released into the blood.  This has the effect of raising heart and breathing rates – in preparation for the stress of the situation at hand.     If not properly managed this scenario can lead to a perpetual feeling of pressure or nervous tension, which can be exhausting for sufferers.  Addictions, phobias, poor work performance and poor sleep patterns can result. Both conditions can be better managed by including the following coping strategies into your life:

• Plenty of exercise
• Healthy diet and eating
• Ample sleep
• Sufficient rest and relaxation time; and by
• Limiting stress or stressful situations in your life 
• Other disciplines such as yoga, meditation and hypnotherapy are increasingly utilised alongside these techniques to aid recovery and healing.

Hypnotherapy often leads to a very relaxed state being reached, so is potentially beneficial in relieving stress and anxiety.

Read more about Hypnotherapy at Absolute Health clinic: click here

Special Offer for new Osteopathy patients!

Now that Summer is here, we are getting more active.  Playing more sports and working harder in the garden can contribute to muscle or joint injuries.  

If this happens to you, give yourself a few days rest and if your pain or discomfort isn't getting better after a week, don't wait any longer before getting help. 

An Osteopathy treatment can give your body a gentle nudge in the right direction to speed up your recovery.  

For a limited time, new Osteopathy patients will receive 15% off the cost of initial consultation and treatment (normally £46, discounted price £39.10).

Mention the Absolute Health blog offer to get your discount - valid until end of September 2012.

Back pain, sciatica and disc problems

Back pain affects almost everyone at some time, causing restricted movement and untold misery, stress and discomfort. It also causes millions of people to take valuable time off work, costing companies enormous sums in sick pay and lost production.

What causes back pain?

• poor lifting or incorrect carrying of heavy weights
• poor posture
• unsuitable seats or beds
• sports or other injury
• stress
• pregnancy
• general 'wear and tear'

Osteopathic manipulation has been recognised as highly effective in treating back pain, and the Royal College of General Practitioners issued guidelines for GPs in 1996 which recommended manipulation within six weeks of onset for the relief of acute low back pain.

Osteopaths are trained to identify and treat the specific cause of your back pain, and once you have been treated, they may also advise you on an appropriate rehabilitation and maintenance care plan to prevent a recurrence.

The bones of your spine protect the spinal cord; if they lose their normal motion or position, this can irritate the nerve roots that branch from the spinal cord to the organs and tissues of your body. Sciatica is a general term describing pain in the sciatic region, which extends from the base of the spine down the back and side of the leg. Unless there is a specific injury to this region, pain here is 'referred' from other areas. (The irritation of the nerve in one area can sometimes lead to pain, known as 'referred' pain, in other parts of the body). The nerves that supply the sciatic region come from the lower back.

In order for the spine to be flexible, the vertebrae are joined together by soft tissue structures known as discs and ligaments. Each disc is made up of two parts - a central soft core and outer rings of tough cartilage. The discs allow movement and also help to absorb shock. A slipped disc is the rather inaccurate term used to describe the condition, often in the lower back, where trauma or 'wear and tear' have caused damage to the outer rings of cartilage, so that the core is squeezed outwards. This can eventually result in a bulge which can press on the spinal cord, the nerve root or the nerve itself. It can cause excruciating pain, either in the back or referred elsewhere - for example in the lower leg or foot. Osteopathic treatment can mobilise the spine to reduce any inflammation around the spinal cord or nerves.

Trigger points (sometimes referred to as 'fibrositis') are very common and related to back pain. They occur in the neck or shoulders (often caused by bad posture or stress) or sometimes in the buttock area at the base of the spine. Painful 'knots' form within muscles which have gone into spasm - a reaction which the body triggers in order to tighten muscles round a problem area to prevent further injury. This is why the condition so often occurs in patients who have had a back pain problem for some time.

Your Osteopath will therefore use manipulation to adjust the relevant joint, and also deep massage and soft tissue work to relieve the condition. Since the 'knots' of muscle are often very tender, the soft tissue treatment may be painful at first.

"23 and 1/2 hours" - watch this video!

A Doctor-Professor answers the old question "What is the single best thing we can do for our health?" in a completely new way. Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael's Hospital.


This video reminds us that the best way to stay healthy remains one of the simplest.  At least, there seems to be plenty of time to do it, when put this way!


Click on the following link to view Dr. Evans' website:
www.myfavouritemedicine.com/23-and-a-half-hours/


or watch the video here:

The Great British Pain in the Neck

• Britons are more likely to suffer from neck pain
• Massaging the spine is more effective than medicine in short and long term

People living in Britain are among those most likely to suffer neck pain according to an article* published in January 2012 which states those living in high-income countries are more susceptible to the problem than those living in low or middle-income countries. The study of neck pain treatment, published in Annals of Internal Medicine, also reveals that women are more likely than men to experience neck pain and that the problem is particularly prolific among office and computer workers.

Britons are exceptionally hardworking and driven with the UK ranked as the 13th most prosperous country out of the 130 countries measured in the 2011 Legatum Prosperity Index. Much of the work in high-income countries including the UK is conducted at a desk where ergonomics and stress are common factors that can result in neck pain and exacerbate existing conditions. 

According to the article, spinal manipulation, which is practiced by osteopaths and some other health practitioners, was more effective at relieving symptoms than medication. Medication, whether over-the-counter or prescribed by GPs, is often a popular choice among time-poor workers who are reluctant to take time off for expert treatment. However patients who were taught self-massage techniques rather than solely having to rely on treatment provided by professionals also benefitted more than those taking medication.

Kelston Chorley, Head of Professional Development at the British Osteopathic Association says: “These research findings are positive for individuals, employers and employees. Pain relief medication can be expensive and learning self-massage techniques mean individuals can be empowered to help manage their pain. Further, where medication is ineffective, this can result in ongoing problems that could have been resolved earlier and may even worsen as a result.  This can mean people have to take time off work for extended periods.

“An osteopath will usually provide some initial treatment to help correct any underlying cause for the condition and will always provide self help strategies for neck pain so patients can manage their condition in the future.”

The article also says that mobilisation, described by the BOA as repetitive movements of joints to free up restrictions and increase the movement of joints and surrounding tissues, may be a better first treatment for non-specific neck pain than manipulation, described as unlocking restricted joint and surrounding tissues with a single highly specific movement, which can be an uncomfortable experience for some patients.

Kelston from the BOA concludes: “In many cases of acute or chronic neck problems manipulation is not always the first line of treatment by an osteopath. Using a combination of soft tissue massage, mobilisations and self help exercises often proves to be a more appropriate solution than the “neck clicking” commonly associated with manipulation.”

About the British Osteopathic AssociationThe British Osteopathic Association (BOA) is the professional association for osteopaths in the UK, acting as an independent representative body whilst promoting osteopathy to the general public and government. The BOA is committed to supporting, protecting and caring for its members and promoting opportunities for individual and professional development in osteopathic practice. There are nearly 4,000 osteopaths on the UK register who carried out over seven million treatments last year, and many of these are members of the British Osteopathic Association.  For more information and to search for an osteopath, visit the website www.osteopathy.org

* To read the article in full visit: http://www.annals.org/content/156/1_Part_1/1.abstract?aimhp

Teachers at risk of pain!

Teachers are at particular risk of developing musculoskeletal disorders (MSD) such as neck, back and shoulder pains, new research has revealed. 


A report from the British Osteopathic Association found that there was a high prevalence of teachers reporting problems such as a pain in the back, neck and upper limbs and believes this is due to the stressful working conditions, large class sizes and lack of resources faced by teachers. 


"Psychosocial factors have also been positively associated with MSD among school teachers, and the current review suggest that psychosocial factors such as high workload / demands, high perceived stress level, low social support, low job control, low job satisfaction and monotonous work are most likely associated with MSD among school teachers," the report reads. 


The research revealed that nursery school teachers are more likely to suffer from lower back pain due to the time spent on tasks which involve sustained periods of kneeling, stooping, squatting or bending. School teachers spend a significant amount of time in a 'head down' posture such as reading, marking assignments on writing on a whiteboard, so are most likely to suffer from a wider variety of problems including pain in the back, neck and upper limbs. 


According to the latest figures from the Labour Force Survey 2010-2011, musculoskeletal disorders were responsible for 15 sick days per case. "Physical stress imposed on the body by protracted periods of poor posture, sitting on chairs designed for children not adults etc. will produce muscle and joint imbalances, strains and soft tissue stresses which become habitual leading to more chronic recurring pains and episodes of pain," says Osteopath Kelston Chorley, Head of Professional Development at the British Osteopathic Association. "It is the chronic build up of strain and habitual bad posture that leads to many of the problems that osteopaths frequently see related to the teaching profession - particularly towards end of term. Osteopathy, as recommended by NICE guidance for low back pain, can have a very beneficial outcome both in the acute period of pain but more importantly, preventing the acute episode from turning into a chronic condition". 


Earlier this year, 96 per cent of teachers who responded to a Teacher Support Network e-newsletter survey said their health and wellbeing had been affected by their workload. 


"I have chronic neck pain which is mostly ignored or laughed at at work. I have to beg people to help me do things, which is humiliating at the very least," explained one respondent at the time. 


"I have constant exhaustion, forgetfulness, sore throats, aching body every day," added another. 


Are you struggling with back, neck or shoulder pains at school? 


Here are some helpful tips for teachers from the British Osteopathic Association:  


Health tips for teachers 


The main problem for primary and nursery teachers is that they are stuck in static postures and need to move their bodies around. With teachers of older children the problem tends to be stress. Both make the body stiff and tense. The following exercises done at the end of every working day will help teachers to combat the daily strains on their bodies from working in a physically strained environment. 

• To loosen your neck, turn it slowly and gently from side to side ten times
• To relax tense shoulders, roll them 15 to 20 times. 
• Lie on your back on the floor and bring your knees to your chest, hug them, then release your arms while keeping you legs in the same position. Twist your legs gently across the left of your body, hold for a few seconds. Bring back to the middle then twist your legs over to the right. Release your legs back to full extension on the floor. Repeat this 15 times. 
• Regular exercise such as swimming - anything to get the whole body moving 
• Start an after-school exercise club for teachers! 

Download the British Osteopathic Association's free app which has video exercises individuals can follow to loosen their neck, back and shoulders:

iTunes: http://itunes.apple.com/gb/app/osteopathy/id427802141?mt=8&ls=1

Android: https://market.android.com/details?id=com.oakley.osteopathy

Want to try Osteopathy?

Absolute Health clinic in south Leicester is offering a free consultation and initial treatment to any teacher in the area.  

When you book 3 treatment sessions in advance you only pay for 2. Save £46!

Offer applies to new patients only.  Payment by cheque, debit card or cash - book in clinic or over the phone - 0116 282 7766.

Offer ends 31st October 2012.

  

Osteopathy helps headache and migraine

Is osteopathic manipulation effective for headaches?

Ashley C. Keays, DO, MPH; Jon O. Neher, MD;

Valley Family Medicine, Renton, Wash

Sarah Safranek, MLIS

Health Sciences Library, University of Washington, Seattle

Evidence-based answer It can be. Spinal manipulative therapy (SMT), a component of osteopathy, has been shown to be variably effective for the treatment of headaches. For the prophylactic treatment of cervicogenic headaches and for acute tension headaches, SMT is superior to placebo. For tension headache prophylaxis, research shows a trend toward better outcomes with amitriptyline than with SMT. For migraine prophylaxis, SMT has an effect similar to amitriptyline (strength of recommendation: B, based on a systematic review of various quality studies).

Clinical commentary 3 osteopathic techniques that work for my patients Charles Webb, DO Oregon Health and Science University, Portland Headaches often have more than one cause—physical, psychological, and pharmacological—and each requires treatment. I start by systematically eliminating specific headache triggers. Meanwhile, I find osteopathic manipulative treatment to be an easy and timely intervention to abort headache symptoms and improve patient well-being. I use a variety of manipulation techniques, including cervical soft tissue massage, occipital decompression, and myofascial unwinding. Cervical soft tissue massage of the paraspinal tissues helps relieve the spasms of tension headaches. Occipital decompression involves using the fingertips to manually stretch the paraspinal tissues at the base of the occiput; it works well in my experience to abort migraine headaches. I teach patients to use a rolled up hand towel behind their neck to do occipital decompression at home, which helps prevent further headaches. Myofascial unwinding is a technique that literally unwinds the tissues encasing muscles in spasm.

  EVIDENCE SUMMARY

For cervicogenic headaches: Spinal manipulative therapy reduces pain

Three studies¹ evaluated SMT for treatment of recurrent cervicogenic headaches). A multicenter trial²randomized 200 patients with cervicogenic headaches to either SMT (8–12 sessions over 6 weeks) or placebo. The SMT group had significantly reduced pain (at 1 week, effect size [ES]=0.7; 95% confidence interval [CI], 0.3–1.2; and at 12 months, ES=0.4; 95% CI, 0.0–0.8) and fewer headaches (ES=0.7; 95% CI, 0.3–1.1 at both time points) than placebo.

FAST TRACK Spinal manipulative therapy reduces the pain of cervicogenic headaches

Another RCT³ with 105 patients compared SMT (3 times a week for 3 weeks) with placebo. The SMT group reported significantly less pain after 3 weeks (ES=2.2; 95% CI, 1.7–2.7).

A third trial⁴ randomized 30 patients to either SMT, mobilization (small oscillatory movements to a joint within its normal range), or wait-list placement. At the end of treatment, there was a nonsignificant trend toward greater pain reduction in patients receiving SMT than either those receiving mobilization (ES=0.4; 95% CI, –0.5 to 1.4) or those on the wait list (ES=0.6; 95% CI, –0.4 to 1.5).

For tension-type headaches: Results are mixed

Two trials⁵ investigated the efficacy of SMT on tension-type headaches. The first, an RCT with 150 patients with recurrent headaches, compared SMT (2 sessions per week) with amitriptyline (10 mg daily week 1, 20 mg daily week 2, then 30 mg daily) for 6 weeks. At the end of 6 weeks, the SMT group reported a nonsignificant trend toward more headache pain (ES for SMT vs amitriptyline= –0.4; 95% CI, –0.8 to 0.0), but fewer side effects. They had similar headache frequency and medication use.

Another study⁶ of 22 patients compared SMT with 2 different controls (palpation and rest) for acute tension-type headache. The SMT group was significantly more likely to experience immediate improvement (ES=1.8; 95% CI, 0.4–3.2).

For migraine: Spinal manipulative therapy is similar to amitriptyline

In 1 trial⁷ of migraine prophylaxis, 218 patients were randomized to either 14 sessions of SMT for 2 months or oral amitriptyline (titrated up weekly during the first month and continued at 100 mg daily over the second month). The headache index (a measure of daily pain intensity) was equivalent in both groups in the last 4 weeks of treatment (ES for SMT vs amitriptyline= –0.1; 95% CI, –0.5 to 0.3).

A month after both therapies were stopped, there was a nonsignificant trend toward a lower headache index in the group that had received SMT than the group that had received amitriptyline (ES=0.4; 95% CI, 0.0–0.8). Ten percent of the medication group withdrew from this study due to side effects; no side effects were reported from SMT.⁷

Another RCT⁸ of migraine prophylaxis with 88 patients compared SMT twice weekly for 8 weeks with mobilization techniques. At 8 weeks post-treatment, there was a nonsignificant trend favoring SMT over mobilization in decreasing pain (ES=0.4; 95% CI, –0.2 to 1.0).

Recommendations from others

FAST TRACK For migraine, spinal manipulative therapy is as effective as amitriptyline

The National Headache Foundation⁹ states that “the value and cost-effectiveness of chiropractic, osteopathic medicine, and physical therapy in migraine have not been proven in clinical trials. Conflicting results and poor clinical trial design limit the ability to judge the effectiveness of manipulative treatments. Physical therapy, although limited in its study, has proven more effective than manipulative treatment in selective cases.”

References
1. Biondi DM. Cervicogenic headache: a review of diagnostic and treatment strategies. J Am Osteopath Assoc 2005;105(4 Suppl 2):16S–22S.
2. Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002;27:1835–1843.
3. Whittingham W.  The efficacy of cervical adjustments (toggle recoil) for chronic cervicogenic headaches [PhD dissertation]. Melbourne, Australia: Royal Melbourne Institute of Technology; 1997.
4. Bronfort G, Nilsson N, Hass M, et al. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2004;(3):CD001878.
5. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. Amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. J Manipulative Physiol Ther. 1995;18:148–154.
6. Hoyt WH, Shaffer F, Bard DA, et al. Osteopathic manipulation in the treatment of muscle-contraction headache. J Am Osteopath Assoc 1979;78:322–325.
7. Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. J Manipulative Physiol Ther 1998;21:511–519.
8. Parker GB, Pryor DS, Tupling H. Why does migraine improve during a clinical trial? Further results from a trial of cervical manipulation for migraine. Aust N Z J Med 1980;10:192–198.
9. Mauskop A, Graff-Radford S. Special treatment situations: alternative headache treatments. In: Standards of Care for Headache Diagnosis and Treatment.Chicago, IL: National Headache Foundation; 2004;115–122.

March 2008 · Vol. 57, No. 3: 190-091

From the Family Physicians Inquiries Network

The Journal Of Family Practice ©2008 Quadrant HealthCom Inc.

Osteopathy vs. Chiropractic

The outspoken critic of Complementary Medicine - Professor Edzard Ernst - recently commented in a blog on the 'Pulse Today' website.  Although I don't often agree with Ernst's findings, there is some interesting information below:

Osteopathy - how different is it to chiropractic?

31 October 2011

In the past, several commentators have suggested that I repeatedly single out chiropractors and attack them continuously and unfairly. My critics argue that osteopaths do more or less the same things as chiropractors, based on the same, poor evidence, yet I never seem to make a fuss about osteopaths.

This, they believe, is unfair. Chiropractors, in particular, seem to feel that I have an axe to grind. I think these allegation are misleading – and here is why.

According to their own General Chiropractic Council (GCC) survey¹ the vast majority of UK chiropractors believe that they can treat non-spinal (visceral) conditions effectively. For instance, 63% of them claim to be able to treat infant colic¹. According to the corresponding General Osteopathic Council (GOC) survey², very few UK osteopaths seem to believe they can treat such conditions.

The GCC survey² also reveals that close to 100% of all chiropractors use high-velocity thrusts regularly. By contrast, the GOC survey³ suggests that this is done by only 47% of the UK osteopaths. As it is this technique which is suspected to cause the dramatic complications⁴ which continue to be reported e.g.⁵, the difference is, in my view, highly relevant.

Independent evaluators of the existing data will arrive at the conclusion that the evidence-base for the effectiveness of osteopathy is not much different from one for chiropractic³. But, at least, osteopaths treat non-spinal conditions less frequently, and – most crucially – they use hazardous techniques less often than their chiropractic colleagues.

What follows, I think, is obvious: GPs who feel that a patient might benefit from spinal manipulation/mobilization should consider the above evidence carefully when deciding whether to refer this patient to a chiropractor or to an osteopath.

Reference List

  (1)   General Chiropractic Council. Consulting the profession: A survey of UK chiropractors. (http://www.gcc-uk.org/files/link_file/ConsultTheProfession.pdf). London: General Chiropractic Council; 2004.

  (2)   General Osteopathic Council. Snapshot Survey 2001 Results. 2001.

  (3)   Ernst E, Pittler MH, Wider B, Boddy K. The Desktop Guide to Complementary and Alternative Medicine. 2nd edition. Edinburgh: Elsevier Mosby. 2006.

  (4)   Terrett AGJ. Current concepts in verebrobasilar complications following spinal manipulation. Iowa, USA: NCMIC Chiropractic Solutions; 2001.

  (5)   Kelley A. Ada man, 29, dies of stroke after chiropractic treatment. 2011;www.newsok.com [Accessed 26-06/2011].