Laura Thomason is Project Leader of the Good Thinking Society, and mother of two. She explains everything you need to know about cranial osteopathy, and to be aware of misleading claims.
For weeks, every night has been a battle. After hours of screaming and no end in sight, you’re prepared to try just about anything. When a sympathetic friend suggests cranial osteopathy, is it worth at least considering it?
Cranial osteopathy (or the very closely related cranio-sacral therapy) has been recommended for everything from feeding problems, colic and sleep difficulties in young babies, to glue ear, asthma and even autism and ADHD in older children.
If that seems too good to be true, you might not be too surprised to learn that there is no convincing evidence to support such claims.
What is cranial osteopathy?
Cranial osteopathy is often offered by your local osteopath, who probably spends most of their time working on musculoskeletal problems in adults. It is based on a theory proposed in the 1930s by William Sutherland, who believed that the skull is not a rigid structure, but that the bones move in a “cranial rhythm”.
By detecting and gently manipulating this rhythm, practitioners claim to diagnose and treat a wide range of conditions. The movement is so small that practitioners believe it takes a very finely developed sense of touch to feel it.
In fact, there is no such movement. Cranial rhythm has never been demonstrated to exist. What’s more, the very concept is at odds with our modern-day understanding of how the body works.
“Cranial osteopathy assumes that there are 'cranial rhythms' that can be influenced by the therapist. There is no good evidence to support this assumption” - Edzard Ernst, Emeritus Professor of Complementary Medicine, University of Exeter
Cranial rhythms might be nonsense, but does cranial osteopathy work?
A friend of mine was convinced that cranial osteopathy cleared up her child’s colic. The websites she recommended were full of positive testimonials.
Personal recommendations can seem persuasive, especially when you desperately want to believe that this could be the answer to your prayers.
But remember that colic will clear up with or without cranial osteopathy. Indeed, most of the problems cranial osteopathy is used for tend to resolve or improve with time. So perhaps these testimonials are from parents who would have seen the same benefit without cranial osteopathy.
Are we only hearing one side of the story? Osteopaths’ websites are unlikely to include testimonials from people who feel they have wasted their money. Imagine an astrologer who claims to be able to determine the sex of a child by examining the horoscope of the mother.
By luck, our maternity mystic will be right half the time, will post all the positive testimonials on a website and others will be persuaded to seek out pregnancy astrology.
To be confident of whether a treatment really works, we need to carefully consider the evidence from scientific tests, in the form of clinical trials.
Unfortunately, many of the trials of cranial osteopathy for babies are flawed. For example, some don’t compare cranial osteopathy against a ‘control’ treatment.
This approach is likely to lead to positive results, even if the treatment doesn’t work, because babies typically improve with time regardless of any therapy. There are very few high-quality trials on the use of cranial osteopathy and the results from those are not promising.
“Cranial osteopathy has not been shown to be effective beyond placebo for childhood conditions. in my view, it is therefore irresponsible to claim otherwise” - Edzard Ernst, Emeritus Professor of Complementary Medicine, University of Exeter
How can osteopaths make such bold claims?
As there is no good evidence to support such claims, osteopaths should not be advertising to treat any common infant or childhood condition.
Yet our research shows that more than a quarter of osteopaths are willing to treat these conditions. The fact that these claims are so prevalent suggests there is a serious and widespread problem within the profession.
We have been sharing our concerns over these misleading claims with the General Osteopathic Council, which is the regulator responsible for setting and maintaining standards of osteopathic practice and conduct in the UK. We have sent the GOsC details of hundreds of osteopaths who appear to be in clear breach of their own standards, and the GOsC seems to agree that there is a problem.
“We strongly advise you to act now and review all your advertising” - Joint letter from General Osteopathic Council, Committee of Advertising Practice and Advertising Standards Authority, sent to all registered osteopaths (September 2015)
Together with advertising regulators, the GOsC sent a letter in September 2015 to every osteopath in the country, enclosing detailed guidance on advertising. Osteopaths were warned to avoid advertising to treat certain conditions, including common infant and childhood conditions such as colic, wind, sleep disturbance and glue ear.
Although there have been some improvements since then, misleading advertising remains a big problem across the profession.
What’s the harm?
Even if you understand that the treatment is unproven, is there really any harm in at least giving it a try?
As cranial osteopathy tends to be very gentle, it would be unlikely to cause any direct harm. But a typical course of treatment could last six or more weeks, at a cost of around £40 per half hour session. This is quite simply a waste of time and money.
And do you really want somebody who is at odds with mainstream medical opinion treating your baby? How will you know if they are also offering misleading advice about other areas, such as diet or vaccination?
Medicine, and childhood health, has many grey areas. There are many complicated questions and few simple answers. However, with respect to cranial osteopathy, the message is clear – it does not work.
In many cases, there will unfortunately be no easy solution, but your midwife or health visitor could give valuable support, providing practical advice in managing and coping with the behaviour and reassuring you that it won’t go on forever.
And if your baby is suffering from an undiagnosed condition, visiting a cranial osteopath instead of consulting your GP or health visitor could lead to a delay in identifying the problem and getting your baby the treatment they need.
Cranial osteopathy is best avoided: it is an unproven treatment, based on a concept that does not exist. If you have any concerns about your child’s health, you should talk to your midwife, health visitor or GP.