Autism: Osteopathy vs. Integrative Medicine

I am medical doctor by training. In my practice patients often ask me what is the difference between osteopathy and integrative medicine. This question makes me believe that patients conflate the practice of osteopathy with that of integrative medicine. This may be the case as both osteopathy and integrative medicine provide a “whole body approach” designed to treat the person, not just the disease. Adding further confusion is the fact that in some cases an osteopath may also be a practitioner of integrative medicine.

Integrative medicine claims to pursue a holistic approach to treating a patient. It targets the body, mind, and spirit and is keen on using alternative interventions such as herbal medicines, diets/nutritional supplements, massage, yoga, and/or biofeedback.  Unfortunately the safety and effectiveness of many of these approaches have not been the subject of rigorous scientific studies. In the end some of these approaches may be detrimental as they prevent the patients from partaking in other, more suitable, interventions and tend to provide a financial drain on the family. However, integrative medicine seems to have been well received within the autism community with practitioners receiving referrals by word of mouth from patients.

Osteopathic medicine is the legal equivalent of an MD. They can practice all disciplines of medicine but have a special emphasis on musculoskeletal manipulation. Currently 6% of practicing physicians are osteopathic doctors and 20% of medical student attend an oseteopathic medical school. Osteopathy was introduced by Dr. Andrew Taylor Still in 1874. Back then bloodletting, mercury dosing and blistering were common medical interventions.  Dr. Taylor Still was concerned by the lack of effectiveness of the available interventions and deduced that a different philosophy was needed when approaching a patient.  In essence, he believed that the person is a unit comprised of body, mind, and spirit and that the body is capable of self-regulation and healing.  It is not the job of the body to get sick, but to get better. In 1892 Dr. Taylor Still Still opened the first Osteopathy School in Kirksville, MO, and by 1973 Doctors in Osteopathy became eligible for licensure in all 50 states.

Doctors in Osteopathy primarily focus on primary care and serve in rural locations. Osteopathic students take an additional 200 hours of musculoskeletal and Osteopathic Manipulative Treatment (OMT) training. By comparison, services for Integrative medicine practitioners are flourishing in the urban environment.  These practitioners may be certified by the American Board of Integrative Medicine after having completed an approved fellowship in Integrative Medicine or having graduated from an accredited 4-year naturopathic college. Some practitioners of Integrative Medicine are Chiropractic doctors.

Osteopathy has had the dubious distinction of promoting the manipulation of the cranium as a way of treating autism.  This intervention (called craniosacral therapy) has been heavily promoted at the Autism One annual congress (see http://bit.ly/1TEkds9 ). They believe that autism is caused by wobbling or maladjustment of the sphenoid and temporal bones. The idea has no basis in reality and is insulting to anybody with a basic knowledge of anatomy. However, integrative medicine is not unscathed from useless/dangerous interventions. As an example, they have heavily promoted the use of chelation to “detoxify” the body from heavy metals.  Serious side effects of this intervention (primarily when using a chelating agent called EDTA) include heart failure, a sudden drop in blood pressure and permanent kidney damage.

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