Australasian Science: Australia's authority on science since 1938

Does Osteopathy Have Better Scientific Credentials Than Chiropractic?

By Des Wiggins

A continuing misperception exists among healthcare providers: that the origins of osteopathy are less pseudoscientific than its 19th century counterpart, chiropractic.

I was reminded of this problem again last month. A patient was referred by a local GP with the clear directive that she was to receive osteopathic treatment, not chiropractic. Questioned, the patient narrated how her doctor considered that osteopathy had a “scientific” basis. In his words, “Osteopathy was not 19th century nonsense like chiropractic”. After all, the practice had been assimilated into mainstream medicine in the 20th century.

As a registered osteopath and chiropractor who is well versed in the “real” history of both modalities, I find this stance puzzling given how analogous the origins of the two treatments really are.

The founder of osteopathy, Andrew Taylor Still (1874), and the founder of chiropractic, Daniel David Palmer (1896), both contended that the germ theory of disease was invalid, and simultaneously advocated that drugs, surgery and vaccination were dangerous and unnecessary. Both claimed that all disease was the result of misalignments within the skeletal system, particularly the spine. These misalignments supposedly interfered with the flow of an intangible circulating inner force (Still’s “mind” and Palmer’s “innate intelligence”), and correcting these misalignments could cure disease. Elements of several metaphysical religions (spiritualism, Swedenborgianism and Christian science) provided the foundation for their respective philosophies, with both men claiming to have received guidance from beings from the ‘spirit-world”.

A “miraculous” cure – which strangely received no mention in the media of the time – ostensibly introduced each modality. The cure of a 4-year-old boy with “bloody flux” (Macon County, Missouri, 1874) involved “moving some of the hot [heat] in the spine to cold [places]” (osteopathy), while Harvey Lillard’s 17-year deafness (Davenport, Iowa, 1896) was cured by correcting the misalignment of Lillard’s “4th thoracic vertebra” (chiropractic).

From these examples it is reasonable to ask why osteopathy is viewed as having less pseudoscientific origins than chiropractic. The answer appears to lie in the premise that Andrew Still was a medical practitioner. Histories of osteopathy typically report that Still studied medicine by serving an apprenticeship under his father, completed additional medical coursework at the College of Physicians and Surgeons in Kansas City, Missouri, in 1895–96, served as a surgeon in the Union Army during the Civil War, and became a licensed MD in the State of Missouri in the early 1860s. Modern osteopathic colleges in America continue to promote Still’s medical background as fundamental to his conclusion that the musculoskeletal system played a vital role in health and disease and that the body contained all the elements needed to maintain health if properly stimulated by manipulation. However, these beliefs are based on misinformation, not evidence.

Our current knowledge of Still’s medical apprenticeship rests solely on his personal account. There is no evidence that he obtained a certificate after his indenture under his father. This is unusual because certificates of completion had been given to medical apprentices since the late 1700s as evidence of a level of medical competency.

Contrary to popular belief, Still was not a surgeon or physician in the Union army. Civil War records list Still as a “private” (not an NCO, the designated rank of physicians), describing him as a “hospital steward”. Moreover, Still also listed himself as a hospital steward in a 1907 affidavit when seeking an increase in his army pension.

Claims that Still attended the College of Physicians and Surgeons in Kansas City, Missouri in 1865–1866 are simply incorrect because the College was not established until 1869.

Notwithstanding, osteopathic colleges particularly in America, continue to promote that osteopathic manipulative techniques such as “craniosacral therapy” – a deeply intuitive technique claiming that the “craniosacral system” follows a rhythm, and the skull bones accommodate its pulse – can “enhance the body’s capacity to heal”. Honest elements within the current profession reject this stance as a “biologically implausible mechanism that has no diagnostic reliability and offers no hope that any direct clinical effect will ever be shown”.

Moreover, despite studies in 2018 showing that a popular osteopathic technique known as “visceral manipulation” lacks sound evidence regarding its efficacy, elements within modern osteopathy continue to promote it as efficacious, based on anecdotal evidence. However, as Kernaghan & Kurvilla (1982) noted, “the plural of anecdote is not data”.

Therefore, the answer to my question, “Does osteopathy have better scientific credentials than chiropractic?” is “No”.

Des Wiggins is a practising chiropractor and osteopath.