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].