Manual therapy and the evidence base

So let’s recap, the world is to complex to understand fully, despite this lack of understanding we can’t default to believing in nothing, as that’s impossible. We are free to choose our beliefs but those choices are determined by the complexity of our psycho-neurological mechanism and its perceptions.
The psycho-neurological mechanism is a pattern perceiver and projector that has evolved to allow us to understand enough to exist in an incomprehensibly complex world.
The social and health sciences accumulate repeated patterns in an attempt to differentiate between irrelevant correlations and causes. Due to the incomprehensibly complex nature of existence the results of these data gatherings only provide us with probabilities.
Alas much of health science still withdraws to reductionism in an attempt to defy complexity. The perfect example being the cocaine and rats experiments. The scientists place rats in a cage with a feeder that feed cocaine and one that provided food. The rats consumed the cocaine until they died. The same experiment was conducted with a fully laid out rat wonder world with wheels and sexual patterns and play grounds and the rats ignored the cocaine. Thus re-defining the causes of cocaine addiction.
The favourite form of reductionism being heralded at the moment is Randomised Control Trials (RCTs). These and the large scale reviews of these RCTs form the basis of evidence based medicine. RCTs suit drug assessment – because a single drug can be administered alongside a placebo by doctors who don’t know what they’re administering to people who don’t know what they’re taking – is it drug or placebo. And a simple answer can be provided.
Manual medicine is in comparison much more complex. People touch each other – heaven forbid – and they touch each other a lot and the full complexity of human interaction takes place. Each individual’s touch is modulated by the touch of the touched and this effects the touch of the toucher in a constant feed back mechanism. The state of mind and body of both weave together and the techniques become unreduceable. Much work has been done to attempt to bring reductive science to manual therapies but none with much success – because this way of assessing manual therapy is fundamentally flawed.
Osteopathy Australia is presently working on an outcome centric project that will hopefully provided a more complex assessment of the effectiveness of Osteopathic treatments and we look forward to their final results.