Osteopaths on the loose...

[Pebble]

It does however demonstrate the possibility of birds.

There is evidence of somatovisceral effects elsewhere, and one cannot but agree, they have not been at all well defined.

How a hopeful little bird on the horizon relates in the social context of offering osteopathic treatment for visceral disorders is arguable.

As I say, I have not made my own mind up, so I am certainly not presuming to win any arguments on this question.

It is not open minded to latch on to a fanciful tenuous connection, and then to assert that without definitive evidence against the proposed connection, treatments based on a slightly related hypothesis may well be reasonable.

The point I have made above is that the level of supportive evidence must meet certain standards. All organs (skin included) have direct or indirect connections with the autonomic nervous system, so intense stimuli in any part of the body will feed into the autononic system - but it does not follow that said stimulus has chronic effects, nor that the response becomes the dominant influence on any aspect of automonic output. Further it certainly does not follow that limited attention to one of the potential sources of input (the musculoskeletal system) is the appropriate intervention in all cases.

So when you have shown, for example, that the frequency of chest wall malalignment or muscle spasm significantly exceeds expectations in people with hypertesnion or asthma or dyspepsia, you have met the first target. When you show in animal models that reproduction of these abnormalities reproduces the required visceral abnormalities, target 2 achieved. When you show that these abnormalities precede disease manifestations, target 3. When you show that relief of abnormality reverses the condition reliably in animal models tasrget 4. Then you are ready for credible pilot clinical trials.

[Smith]

It is not open minded to latch on to a fanciful tenuous connection, and then to assert that without definitive evidence against the proposed connection, treatments based on a slightly related hypothesis may well be reasonable.

"Latch onto" : osteopaths have observed phenomena that suggest this connection for more than a century.

"fanciful tenuous", "slightly related": arbitrary and tendentious value judgements.

"open minded": it is not open-minded to suggest that the truth paradigm you have learned in "over 20 years of clinical research" (quoting liberally from memory from an early post - please correct if wrong) is the absolute right and that anybody who does not adhere strictly to the code you have learned, or looks outside it, is stumbling around in murky confusion.

It is not open-minded to suggest a hypothesis is unreasonable because it is unproven and does not meet with one's preconceptions even though it is not, anatomically or physiologically, implausible.

The point I have made above is that the level of supportive evidence must meet certain standards.

Must? What are you saying? Please clarify: Is skepticism about deciding what is scientifically plausible, or about telling people what they must and mustn't be allowed to think or do or have?

Where I reside, if you tried to ban crystal healing or "bioresonance therapy" or "medical dowsing" or ... etc. etc. ... on the basis of lack of proof and scientific implausibility, as you are suggesting, people would be up in arms.

Must? Should? Shouldn't? What's it all about?

So when you have shown, for example, that the frequency of chest wall malalignment or muscle spasm significantly exceeds expectations in people with hypertesnion or asthma or dyspepsia, you have met the first target. When you show in animal models that reproduction of these abnormalities reproduces the required visceral abnormalities, target 2 achieved. When you show that these abnormalities precede disease manifestations, target 3. When you show that relief of abnormality reverses the condition reliably in animal models tasrget 4. Then you are ready for credible pilot clinical trials.

Please provide a similar plan for the proof of say, NSAIDs in low back pain,
or even better, the use of stimulants in ADHD.

[davidrodway]

Sorry to interupt the flow but i thought it might be of interest that the members poll on the osteopathy site Sacral Musings on the question "Do you support the BCA in their proceedings against Simon Singh?" has now concluded and the results are in. Interesting
;

[Pebble]

"Latch onto" : osteopaths have observed phenomena that suggest this connection for more than a century.

"fanciful tenuous", "slightly related": arbitrary and tendentious value judgements.

"open minded": it is not open-minded to suggest that the truth paradigm you have learned in "over 20 years of clinical research" (quoting liberally from memory from an early post - please correct if wrong) is the absolute right and that anybody who does not adhere strictly to the code you have learned, or looks outside it, is stumbling around in murky confusion.

It is not open-minded to suggest a hypothesis is unreasonable because it is unproven and does not meet with one's preconceptions even though it is not, anatomically or physiologically, implausible.



Must? What are you saying? Please clarify: Is skepticism about deciding what is scientifically plausible, or about telling people what they must and mustn't be allowed to think or do or have?

Where I reside, if you tried to ban crystal healing or "bioresonance therapy" or "medical dowsing" or ... etc. etc. ... on the basis of lack of proof and scientific implausibility, as you are suggesting, people would be up in arms.

Must? Should? Shouldn't? What's it all about?



Please provide a similar plan for the proof of say, NSAIDs in low back pain,
or even better, the use of stimulants in ADHD.

If your view is that osteopathy resides within the undergrowth with crystal healing and homeopathy, then fire away - your view makes perfect sense.

Smith was I believe trying to argue that in respect of musculoskeletal conditions it is more respectable, and evidence based - even if it is the physiotherpists that collected this evidence. However, when it comes to other conditions, there may be evidence gaps, but that many hold that plausibility explains continued extraction of money from the gullible while evidence is collected.

My argument is that in this context, the plausibility needs to be of a level that means something. What in your view makes the connections plausible enough to justify milking the gullible while awaiting real evidence - assuming you are unhappy with the current level of proof?

PS NSAIDs for lower back pain - no problem, do I really need to reherse that for you? ADHD not really my area so I shall have to pass.

[JJM]

"Latch onto" : osteopaths have observed phenomena that suggest this connection for more than a century.

Doctors observed the benefits of trepaning, bleeding and violent purgatives for many centuries. This is a frequent observation here; yet it does not catch on with osteopaths. It is a fact (not a philosophy) that the treatments I just cited were common, and supported by "observation" and which were dropped when science was applied to medicine.

"fanciful tenuous", "slightly related": arbitrary and tendentious value judgements.

You use those (italicized) words; but I don't think they mean what you think they mean. Is it an "arbitrary and tendentious value judgement" to be opposed to child abuse? Or is it the result of education and thoughtful consideration?

"open minded": it is not open-minded to suggest that the truth paradigm you have learned in "over 20 years of clinical research" (quoting liberally from memory from an early post - please correct if wrong) is the absolute right and that anybody who does not adhere strictly to the code you have learned, or looks outside it, is stumbling around in murky confusion.

See last sentence, above.

It is not open-minded to suggest a hypothesis is unreasonable because it is unproven and does not meet with one's preconceptions even though it is not, anatomically or physiologically, implausible.

See if you can spot the contradiction in that sentence.

I came to this thread uncertain about the merits of UK osteopaths. However, the more you guys post the more certain I am that UK osteopathy is as bogus as chiropractic, homeopathy and faith healing. None of your organizations can supply a plausible reason to believe what you claim nor data supporting. You are reduced to arguing "philosophy" that you think supports your position.

[JJM]

Originally Posted by JJM
DRodway wrote "All ages are treatable from new born to the very elderly. Trouble can arise from birth problems, growth disorders, developmental problems, ... We see patients with: ... sinusitis ... M.E. (‘chronic fatigue syndrome’), irritable bowel syndrome ..."

Well we do treat all ages, and safely.

Sorry, I was not specific (and I must say, I expected the unartful dodge inre "all ages"). The question is what reliable evidence do you have that said treatments are effective and safe?

{snip} The next bit is surely just standard information , you can check in any orthodox orthpaedic book.

No, you make a claim, you provide the reliable support, that you endorse (those are the rules), with reference to the original literature (not reviews nor textbooks). And don't forget the primer I gave you (above) concerning sample size, blinding and controls.

[Smith]

If your view is that osteopathy resides within the undergrowth with crystal healing and homeopathy, then fire away - your view makes perfect sense.

More mischief. My point, which I suspect you DID understand, is the same one I made in one of my first posts:- there are many people who WANT access to alternative therapies because they believe in them, and they do not hold science in high esteem. Call it ignorance if you like but it is a fact of life. No it is not my own stance, but it is my opinion that other people's views and motivations are worthy of respect. Efforts to prescribe and proscribe socially by the strict scientific rule-book will inevitably founder.

Smith was I believe trying to argue that in respect of musculoskeletal conditions it is more respectable, and evidence based - even if it is the physiotherpists that collected this evidence. However, when it comes to other conditions, there may be evidence gaps, but that many hold that plausibility explains continued extraction of money from the gullible while evidence is collected.

I believe you believe wrongly. The first sentence there is what YOU argued, I didn't! I acknowledged the lack of evidence for the use of osteopathy in non musculoskeletal conditions, made some general considerations and later one specific assertion about plausibility (you didn't agree, and I bow to your wisdom about the scientific requirements). The words "extraction of money" and "gullible" are yours, not mine.

"Physiotherapists collected the evidence...": The UK BEAM trial involved physios, osteos and chiros. The corresponding author is a professor of general practice.

PS NSAIDs for lower back pain - no problem, do I really need to reherse that for you?

Well, just curious really, as to how targets 1, 2, 3 and 4 were achieved before clinical trials were set up, when medicine recognises no specific abnormalities in much LBP.

[Smith]

Is it an "arbitrary and tendentious value judgement" to be opposed to child abuse? Or is it the result of education and thoughtful consideration?

I was talking, actually, about Pebble's rapid assertion that the research connecting the neck muscles to blood pressure has a "fanciful tenuous connection" to osteopathic treatment of non-musculoskeletal conditions.
That view is biased, as is mine. Do you really think scientists are immune from bias?

See if you can spot the contradiction in that sentence.?

Nicely supercilious. Depends how you read it I'd say. However, if you really want to play those schoolboy games, why don't you see if you can spot the sense in it?

you guys

You seem to do a fine line in wild generalisations. "You guys" are all fools or cheats or preferably both. Same as chiropractors anyway, no better
than those guys last century drilling away at people's heads.

Well, I'm off to my work now, helping people. Just go and find a new bit for my drill and... now where did I leave that leech pot...? Down boy!

[Pebble]

"Physiotherapists collected the evidence...": The UK BEAM trial involved physios, osteos and chiros. The corresponding author is a professor of general practice.



Well, just curious really, as to how targets 1, 2, 3 and 4 were achieved before clinical trials were set up, when medicine recognises no specific abnormalities in much LBP.

In respect of your first point, just because people want to be hoodwinked, is not a reason for giving them what they want. This may mean customers of CAM are happier in the short term (they get what they want), but it does not equate to evidence for efficacy.


The UK Beam trial is the end point - ie.e clinical trials, what physios did was evaluate the impact of different musculoskeletal therapies on various conditions, including invovlement in some animal models to demonstrate potential efficacy.

LBP: Need some history books to fully answer, but suffice to say that the first clinical trial I can find was 1968:

A clinical trial with indomethacin (indomee(R)) in low back pain and sciatica.
Goldie I.
Acta Orthop Scand. 1968;39(1):117-28. No abstract available.
PMID: 4239771 [PubMed - indexed for MEDLINE]


The analgesic effects of NSAIDS had been demonstrated in animal models and humans in the preceding decades.

So 1. Is lower back pain more common in people with LBP when compared to the normal population?
2. Are there animal models of lower back pain? Yes including models of Ankylosing spondylitis.
3. Can you demonstrate that injury or inflammatory conditions precede back pain? Yes in certain groups, not in others. However the principle can be demonstrated reliably, even if not applicable to chronic low back pain with no evidence of pathology.
4. Can one demonstrate that NSAIDs relieve pain? yes even in this situation.

The problem I see is that this is the wrong question. In terms of most chronic low back pain, the nature of the underlying abnormality is poorly understood, and may be a host of conditions rather than one. Thus no therapy can be reliable without better fundamental research as to the nature of LBP. In the mean time all treatment of LBP without definable pathology is guess work directed really at pain relief rather than treating the cause, and presently none of the suggested options is strongly supported by evidence.

[JJM]

{snip} I came to this thread uncertain about the merits of UK osteopaths. However, the more you guys post the more certain I am that UK osteopathy is as bogus as chiropractic, homeopathy and faith healing. None of your organizations can supply a plausible reason to believe what you claim nor data supporting. You are reduced to arguing "philosophy" that you think supports your position.

{snip} You seem to do a fine line in wild generalisations. "You guys" are all fools or cheats or preferably both. ...

Quoting-out-of-context and "strawman" bound up together. Do you know what those mean?

[Smith]

Nah, I'm just a dumb quack.

BTW your knowledge of osteopaths is seriously incomplete if you have not received osteopathic care or talked to osteopaths' patients.

[Matt]

Nah, I'm just a dumb quack.

BTW your knowledge of osteopaths is seriously incomplete if you have not received osteopathic care or talked to osteopaths' patients.

yeah just like nobody can have any knowledge of particle physics because we can't speak to an electron or be accelerated to a significant fraction of the speed of light.

[Croydon Bob]

BTW your knowledge of osteopaths is seriously incomplete if you have not received osteopathic care or talked to osteopaths' patients.

You might as well claim that I can't see that a plane has crashed unless I have flown in the plane or spoken to some of the passengers.

[Smith]

No, my affirmation is not like either of those examples.

[Matt]

No, my affirmation is not like either of those examples.

Yeah it's spelled differently