Does osteopathy help infantile colic?

Date Last Updated: 03/08/06
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Treatment in brief
Osteopathy is a system of diagnosis and treatment that mainly focuses on bones, muscles, and their related tissues. Practitioners perform manipulations of these tissues to treat a wide range of problems. The practice of osteopathic medicine may involve massage, mobilisation and spinal manipulation.

Some osteopaths also practice a technique known as cranial osteopathy or craniosacral therapy. Gentle pressure applied to parts of the skull and the lowest part of the back is thought to affect and restore people’s health.

The condition
A common definition of infantile colic is excessive crying in an otherwise healthy and thriving baby. This is crying that lasts at least 3 hours a day, on at least three days a week, for at least 3 weeks (‘the rule of three’). The crying typically starts in the first few weeks of life and ends by 6 months. There may be other symptoms; including pulling feet up to their stomach, flatulence, a bloated abdomen after feeding or inconsolable high pitched crying. (Lucassen, Assendelft et al. 1998; Lucassen, Assendelft et al. 2001; Wade and Kilgour 2001)

Background
Osteopathy was developed in the late 19th century by Andrew Taylor Still in the United States. It is a system of diagnosis and treatment that mainly focuses on the muscular and skeletal systems and their associated tissues. Practitioners perform manipulations of bones, muscles, and connective tissue to treat a wide range of problems. They work with their hands for diagnosis and treatment.

The practice of osteopathic medicine may involve massage, mobilisation and spinal manipulation. Osteopaths believe that the body has an inherent ability to heal itself, that the structure and function of the body are closely related and that problems in one organ affect other parts of the body. The traditional osteopathic view is that perfect alignment of the musculoskeletal system eliminates obstructions in blood and lymphatic flow, which in turn maximises health. To ensure perfect alignment, a range of manipulative techniques have been developed. Examples include high-velocity thrusts, myofascial (muscle tissue) release, muscle energy techniques, counter strain, craniosacral therapies and lymphatic drainage stimulation.(Vickers and Zollman 1999) For a more detailed description of various techniques, see Lesho 1999.

Some osteopaths also practice a technique known as cranial osteopathy or craniosacral therapy. It is based on the idea that subtle rhythmic pulsations of the cerebrospinal fluid can be felt in the cranial bones and sacrum and that this gives the practitioner information about the person’s health. Gentle pressure applied to parts of the cranium and sacrum is thought to affect these pulsations and restore the persons health.(Green, Martin et al. 1999; Lesho 1999; Vickers and Zollman 1999)

There is a low incidence of serious adverse effects from osteopathic manipulations.(Lesho 1999) The most important potential ones are stroke and spinal cord injury after manipulation of the cervical spine.(Vickers and Zollman 1999) Adverse events have also been reported in head-injured patients following craniosacral therapy.(Green, Martin et al. 1999) More common adverse events (25–50% of all patients) are mild pain, discomfort, or headache and fatigue. Three quarters of these resolve in 24 hours.(Vickers and Zollman 1999)

The evidence
There is level three evidence from one study that cranial osteopathy can benefit infants with colic. In the study it decreased the amount of inconsolable crying by about 1½ hours and increased the amount of total sleep by just under 1½ hours in infants with colic. Also there is evidence that the time spent holding and rocking the infant was reduced. No adverse events were reported. The effect appears small, so it is unclear how much impact this treatment may have on families and infants well-being. Larger, double blind studies need to be done.

Other important issues
Even though the effect of the treatment in this study are small, all 14 infants treated with osteopathy improved; 4 required no more treatment after week two and 6 more did not need treatment after week three. The remaining 4 (29%) showed only mild symptoms of colic at the end of the study.

Key Messages

There is level three evidence from one study that cranial osteopathy can benefit infants with colic.

Key: Levels of evidence

Source
The information in this summary was developed by assessing

Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colic. Complement Ther Clin Pract 2006;12(2):83-90.

Additional references

Green, C., C. W. Martin, et al. (1999). A systematic review and critical appraisal of the scientific evidence on craniosacral therapy. Vancouver, British Columbia Office of Health Technology Assessment.

Lesho, E. P. (1999). "An overview of osteopathic medicine." 477-84.

Lucassen, P. L., W. J. Assendelft, et al. (1998). "Effectiveness of treatments for infantile colic: systematic review.[erratum appears in BMJ 1998 Jul 18;317(7152):171]." Bmj 316(7144): 1563-9.

Lucassen, P. L., W. J. Assendelft, et al. (2001). "Systematic review of the occurrence of infantile colic in the community. [Review] [47 refs]." Archives of Disease in Childhood 84(5): 398-403.

Vickers, A. and C. Zollman (1999). "ABC of complementary medicine. The manipulative therapies: osteopathy and chiropractic. [Review] [0 refs]." Bmj 319(7218): 1176-9.

Wade, S. and T. Kilgour (2001). "Extracts from "clinical evidence": Infantile colic.[erratum appears in BMJ 2001 Sep 22;323(7314):674]. [Review] [25 refs]." Bmj 323(7310): 437-40.

Date prepared 12 June 2006

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