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Scotty, The Naked Time, stardate 1704.3, Episode 7

Bowen Therapy – all fingers and thumbs

Posted by apgaylard on June 19, 2011

I stumbled across Bowen Therapy (aka Bowen Technique, Bowen Work) a few years ago when the other half decided to give it a try.  She found it relaxing and felt it provided a little immediate relief that was soon gone.  Essentially, it was worthless as a treatment for what was ailing her.

This therapy was invented by an Australian called Thomas Ambrose Bowen (1916 – 1982).  Apparently, he referred to himself as an osteopath before the title became regulated in the 1970s.  The therapy that now bears his name involves the gentle manipulation of soft tissue using fingers and thumbs; moving them over muscle, ligament, tendon and fascia.

It’s a fairly common, but definitely second division, complementary therapy.  In the UK, Bowen Therapists can register with the pointless Complementary and Natural Healthcare Council (CNHC).

After our experience of Bowen Technique, I decided to try and see what evidence is available for the effectiveness of this therapy.  I also decided that it was time to see what claims are being made for it.

A bare cupboard

After having a good look, I don’t think that there is really nothing resembling evidence to support the use of Bowen Therapy for anything.  A careful search of PubMed, The Cochrane Database and Google Scholar identified just six relevant references.

Frozen shoulder

Carter (2001) reported the outcome of a pilot study of Bowen Technique (BT) and frozen shoulder.  It used a case series of just twenty patients.  They were given up to five therapy sessions.  Improvements were claimed, but this is an uncontrolled study on a small number of patients.

Just a year later Carter (2002) also reported “the qualitative findings from a larger study … and 20 participants’ experiences of BT”.  The author claimed that:

“BT was experienced as being gentle, relaxing and noninvasive and of help with significantly eliminating and improving the symptoms associated with frozen shoulder.”

However, again, it’s a very small study with no control group.  Oddly it has exactly the same number of participants as the trial reported the year before.  I wonder why a second twenty-patient study was published by the same author within a year.  Could it be the same study?  If not, why do yet another methodologically weak small study?

General health

Dicker published two investigations during 2005 in the obscure Australian Journal of Holistic Nursing.  The first (Dicker, 2005a) documented the effect of offering, “Health Service staff treatments with Bowen Technique.”  An evaluation after nine months apparently, “indicated that the provision of Bowen Therapy for staff might be an effective way of reducing Workcover claims.”

I do wonder why a programme run during 2002 and evaluated nine months later took until 2005 to appear in a low-rent CAM journal.

The second publication (Dicker, 2005b), reported a six-week programme of Bowen Therapy, treating, “31 Hospital and Community Health Service staff in a group setting […] to reduce stress and improve physical health.”

“Quantitative and qualitative data indicated that Bowen Technique was successful in reducing pain, improving mobility, reducing stress, and improving energy, well being and sleep.”

Being as this was a small uncontrolled study looking at a set of indicators, many of which are highly susceptible to expectation effects (pain, stress, energy, ‘well being’ and sleep) it really provides no evidence to support any specific effect from Bowen Technique.

Hamstring flexibility

More recently Marr and co-workers (2010) have produced an RCT for the effect of Bowen Technique on hamstring flexibility.  It was conducted on “120 asymptomatic volunteers”.  So, this trial is not actually assessing Bowen technique for anyone with a problem.  Therefore, it cannot even say anything about treating hamstring injuries.

This renders the details of the trial moot.  However, the volunteers were “were randomly allocated into a control group or Bowen group.”   Three flexibility measurements were made over the course of a week.  The intervention group received one Bowen treatment.  The authors claim that:

“A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group. Continuing increases in flexibility levels were observed over one week. No significant change over time was noted for the control group.”

I do wonder whether being ‘treated’ gives people the confidence to be more active, making the hamstring a bit more flexible, and that this is the effect being measured.

At any rate, all this trial has demonstrated is improved hamstring flexibility in people without a hamstring problem, compared to other people with no hamstring problem who are just left to their own devices: unconvincing, to say the least.

Rehabilitation from chronic stroke

Finally, Duncan and colleagues (2011) looked at the use of Bowen Therapy for rehabilitation in chronic stroke.  This pilot study was based on a case series of just fourteen “people with chronic stroke” who were offered thirteen Bowen therapy sessions over a three-month period.

The authors reported that:

“Motor assessments of the 13 people who participated showed improvements—gross motor function trended to improvement; SF-36 role-physical, physical health summary scale and total SF-36 scores showed statistically significantly improvements. However, grip strength reduced.”

So, just thirteen patients completed the trial.  I count eight outcome measures in the paper:

“Barthel Index, Motor Assessment Scale (MAS), Grip strength, Nine-Hole Peg Test (9-HPT), Timed Up and Go (TUG), Key Pinch Test, Mini-Mental State Examination (MMSE) and the SF-36.”

Only changes in MAS (p= 0.019) and the SF-36 (p=0.034), appear to reach statistical significance.  The authors also broke down the SF-36 into its constituent elements.  Of the eleven elements, only three reportedly reached statistical significance (Role-Physical (p=0.018), Social Functioning (p=0.047), Physical Component Summary (p=0.023)).

However, if a basic correction for multiple inferences were applied (Bonferroni) none of these results would be statistically significant.

So, it’s a small case series that most likely shows no benefit from Bowen Technique.  The authors conclude:

“In this pilot study, Bowen therapy was associated with improvements in neuromuscular function in people with chronic stroke. At this stage of study, it is not possible to conclude that there is definite benefit; however the results suggest that exploration through further research is appropriate.”

 And I think that this is overstating the case.

So, the sum total of the formally published evidence base for Bowen technique amounts to this:

  • one or is it two (?) small uncontrolled trials for frozen shoulder from a single author (Carter 2001, 2002),
  • an uncontrolled intervention to try and reduce staff absence (Dicker, 2005a),
  • a small uncontrolled study on a range of issues with strong psychological components (Dicker, 2005b),
  • an RCT showing improved hamstring flexibility in people with no hamstring problems (Marr et al 2010) and
  • a tiny case series that doesn’t show Bowen technique helps stroke rehabilitation (Duncan et al, 2011).

So, it’s safe to say that there is no evidence that Bowen technique can help with any specific medical condition.

Scraping the barrel

However, there are references on Bowen websites describing other research, though they are typically presented without citations and do not seem to tie in with any papers listed on PubMed.  So, they are not credible sources.  They are partisan and not even published in the credulousCAMliterature.  So this ‘evidence’ is not really the bottom of the barrel, it’s more like the soggy soil underneath.

However, a quick trawl through the low level and web ‘publications’ is instructive.

Developing Research Strategies?

Starting with a low-level publication: the “Developing Research Strategies Conference” – this was summarised by Lewith (2005) and included several contributions from Bowenists.

Wright and Orton talked about plans for testing “… Bowen Neurostructural Integration Technique (NST) for Post treatment Trauma in Cancer Patients” using a pragmatic pilot study and just twenty subjects.  Six years on, and I cannot find a trace of this trial.

Nikke Ariff described work on migraine and asthma.  This used thirty-nine and twenty-three subjects respectively.  The trails appear to be unblinded and uncontrolled, using questionnaires and diaries to record subjective measures.  These have not been published anywhere I can find and are too small and methodologically weak to provide meaningful evidence.

The presenter also mentioned, “a new protocol to study pre-menstrual syndrome.”  I have not found any evidence of this work being completed either.

Alistair Rattray presented his work on childhood asthma.  After claiming success in treating a two-year old child in 1999, he apparently claimed, “Over the past 5 years, with over 100 cases to look back on, the initial hopes have been well rewarded.”  Rattray described three cases, which he claimed were “typical.”

Essentially this is a poorly reported small case series.  No proper trials have appeared to date.

It’s worth bearing in mind what asthma is.  According to asthma UK:

“Asthma is a condition that affects the airways – the small tubes that carry air in and out of the lungs.

When a person with asthma comes into contact with something that irritates their airways (an asthma trigger), the muscles around the walls of the airways tighten so that the airways become narrower and the lining of the airways becomes inflamed and starts to swell. Sometimes, sticky mucus or phlegm builds up, which can further narrow the airways.

These reactions cause the airways to become narrower and irritated – making it difficult to breath and leading to symptoms of asthma.”

It’s hard to see how gentle superficial soft-tissue manipulation can do anything significant for the muscles around the walls of the airways.

So, comparing these plans with the publications currently available shows no real progress in establishing anything approaching evidence since 2005.

European College of Bowen Studies

The ECBS website boasts that it is, “Europe’s leading Bowen school” and that, “On this site you will find the most comprehensive source of information about Bowen on the web.”  If this is true, then it would be reasonable to expect that this site would provide the strongest evidence in support of Bowen Therapy.

Tellingly, it’s a rag-tag collection of unpublished research, unfulfilled hopes and newspaper coverage.

There is an interview with Helen Kinnear and Julian Baker about their “Frozen Shoulder Research Programme”.  They apparently undertook a controlled trial with 100 subjects.  Various positive results are presented; it’s unfortunate that this doesn’t seem to have been properly reported in a peer reviewed journal.  I wonder why.  If this work is a good as the authors’ seem to think, why wouldn’t they want to get it published?

The asthma research is a re-print of an article from The Times from November 2003, entitled, “The Bowen Technique: Kick the inhaler into touch” and some claims about a trial in development by Alistair Rattray.

On migraine they claim, “Nikke Ariff recently completed The Bowen Technique National Migraine Research Program” based on thirty-nine participants.  Odd that this is the same number of subjects mentioned at the the “Developing Research Strategies Conference” (Lewith, 2005).  It sounds like “recently completed” means before 2005?  Anyway, it’s not properly published, small, unblinded with no control group.

Under “Lymphoedema” they reproduce an article by Eilish Lund from the British Lymphology Society Newsletter.  It’s a scanty report of a number of cases.

Finally, they promise that something is “coming soon” for Fibromyalgia.

And that is that.  Not a peer-reviewed journal paper among them.

That doesn’t seem to hold anyone back though …

This lack of evidence doesn’t seem to have held back Bowen Therapists and professional associations from making wild and occasionally dangerous claims.

A decade ago Long, Huntley and Ernst (2001) surveyed the opinion of 223 professionalCAMorganizations, to elicit their opinion on, “Which complementary and alternative therapies benefit which conditions?”  Two of the three Bowen organizations consulted responded.  At lease one of these identified:

Headaches/migraine

Back pain

Respiratory problems (incl. asthma)

Musculoskeletal problems

Menstrual/PMT

Skin problems incl. exzema

Chronic fatigue/ME

Neck/shoulder pain

Irritable Bowel Syndrome (IBS)

Sports injuries

It is an outrageous list of claims, given the available evidence, let alone plausibility.

The European College of Bowen Studies claims, under the heading, “What Responds Well to The Bowen Technique?”, that:

“The most common presentation is back pain and here Bowen excels. […]. Frozen shoulders are a particular favourite as are neck pain, hayfever, asthma and migraines. Sports injury is a field of remedial therapy that is becoming very aware of The Bowen Technique. Not only do sportsmen report fewer injuries when treated regularly but they also notice an increase in performance. […].” [emphasis mine]

Which is pretty immodest; claims to be able to treat asthma are downright dangerous.  How can rubbing soft tissue with thumbs and fingers help with hayfever?

The Bowen Association UK has an even more impressive list:

“Here is a list of just some of the conditions we have been able to assist with:

Allergies

Baby and childhood problems

Back problems

Bladder problems, bedwetting

Bowel problems

Digestive problems

Dizziness

Ear Problems

Fatigue

Fluid retention

Foot problems

Frozen shoulder

Headaches (migraine, sinus)

Bedwetting, incontinence

Jaw problems (grinding of teeth, misalignment etc)

Knee and hip restrictions, misalignments

Menstrual and other female problems

Pelvic tilt, leg length, hip imbalance

Poor mobility

Repetitive Strain Injury

Respiratory problems

Skeletal and muscular problems from lumbar to neck

Sports injuries

Stress”

The Bowen Therapy Professional Association is not to be outdone, reproducing an equally ridiculous list:

Can Bowen Therapy help me?

[…] Bowen is suitable for all ages, from a baby with colic to an elderly person with arthritis, and there are no known contra-indications.

This remarkable technique can be quick and effective in helping the following:

Muscular and skeletal problems in neck, shoulder, hip, knees, ankle and back, including sciatica

Frozen shoulder, tennis and golf elbow, R.S.I. and carpal tunnel

Whiplash and sports injuries

Problems with posture and body alignment

Migraine and recurring headaches

Bell’s Palsy, Multiple Sclerosis, Parkinson’s Disease and the difficulties suffered by stroke victims

Respiratory, bronchial and related conditions such as hayfever and asthma

Digestive problems such as IBS

Arthritis

Hormonal, pregnancy and fertility problems

Stress management, ME, fatigue and sleep problems.

Bowen can be of assistance in many cases of emotional stress, where relaxation is a prime factor in easing pain and anxiety. It is also often a great help in improving the quality of life for those who are terminally ill.”

Worryingly, they have a separate list for children:

“Some conditions which have been reported to respond well to Bowen Therapy include:

Allergies, ADD, ADHD, Autism, Asthma, Bed-wetting, Cerebral Palsy, Chest infections, Clicky Hips, Colic, Constipation, Croup, Dyspraxia, Eczema, Glue-ear, Growing Pains, Headaches, Muscular-Skeletal Issues, Panic Attacks, Psoriasis, Sinusitis and Stress.

It may also aid posture, balance and coordination and the after effects of trauma e.g. difficult birth, accident, family breakdown, death of a loved one.”

Scandalously, Bowenist Alastair Rattray even thinks that Bowen can be used in emergency situations like, major asthma attack, panic attacks and “chest tension in a case of anaphylactic shock.”

(For helpful advice from Asthma UK see:What to do in an asthma attack)

What to make of it?

Despite what Bowen therapists and professional organizations claim, there is no evidence that Bowen Therapy / Technique or Work can help with any medical condition.

I hear that it can be a nice, relaxing experience.  As such it might make someone feel a little better for a short while.

The claims made on various Bowen websites are nothing more than wishful thinking, a shared healing delusion.  At least now, in theUK, the Advertising Standards Authority (ASA) can have these extravagant claims removed.  This could spare people from wasting time and money on this nonsense.  It might even save lives.

Useful Information

Frozen Shoulder, NHS Choices

Frozen Shoulder, Patient.co.uk

Asthma – NHS Choices

Asthma UK

Disclaimer

I try to make sure that what I write is both accurate and fair.  If you think that I have got anything wrong please let me know.  If you are right I will happily change what I have written.

This is not medical advice.  If you need that see a properly qualified and registered doctor.

References

Carter B. A pilot study to evaluate the effectiveness of Bowen technique in the management of clients with frozen shoulder. Complementary therapies in medicine. 2001 Dec;9(4):208–215. Available from: http://dx.doi.org/10.1054/ctim.2001.0481.

Carter B. Clients’ experiences of frozen shoulder and its treatment with Bowen technique. Complementary therapies in nursing & midwifery. 2002 Nov;8(4):204–210. Available from: http://dx.doi.org/10.1054/ctnm.2002.0645.

Dicker A. Bowen technique–its use in work related injuries. The Australian journal of holistic nursing. 2005 Apr;12(1):31–34. Available from: http://view.ncbi.nlm.nih.gov/pubmed/19175268.

Dicker A. Using Bowen technique in a health service workplace to improve the physical and mental wellbeing of staff. The Australian journal of holistic nursing. 2005 Oct;12(2):35–42. Available from: http://view.ncbi.nlm.nih.gov/pubmed/19175262.

Duncan B, McHugh P, Houghton F, Wilson C. Improved motor function with Bowen therapy for rehabilitation in chronic stroke: a pilot study. Journal of primary health care. 2011 Mar;3(1):53–57. Available from: http://view.ncbi.nlm.nih.gov/pubmed/21359262.

Lewith G. Abstracts of the developing research strategies conference 28 April 2005. Complementary Therapies in Medicine. 2005 Sep;13(3):217–225. Available from: http://dx.doi.org/10.1016/j.ctim.2005.06.006.

Long L, Huntley A, Ernst E. Which complementary and alternative therapies benefit which conditions?  A survey of the opinions of 223 professional organizations. Complementary therapies in medicine. 2001 Sep;9(3):178–185. Available from: http://dx.doi.org/10.1054/ctim.2001.0453.

Marr M, Baker J, Lambon N, Perry J. The effects of the Bowen technique on hamstring flexibility over time: A randomised controlled trial. Journal of Bodywork and Movement Therapies. 2010 Sep;Available from: http://dx.doi.org/10.1016/j.jbmt.2010.07.008.

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14 Responses to “Bowen Therapy – all fingers and thumbs”

  1. As thorough as ever!

  2. I feel it my duty to reply to this being a Bowen therapist myself, it would seem that you are unjustly condemning something which you have no actual on hands experience with.
    I very rarely treat people these days because I have another style of work, however when i do i generally say to people its subtle but its profound, one in 10 people it is 100% effective and one in ten people it does nothing for and each person in between is incrementally between that scale, the people that have had profound changes always amaze me because to be honest if you dont give a treatment for 6 months and then you treat someone, the moves are so subtle that it just feels like your prodding someone in the back with your fingers and thumbs, when they come back the following week they nearly always state that there is a change. The reason for these changes are that, in the brain there is no release mechanism for a muscle that is in spasm and the Bowen somehow facilitates this action, its simple.
    The one in ten scale seems to be acurate for most alternative therapies and even mainstream ones to be honest, when people come to me they have heard about me, as i don’t advertise, these people will generally have gone and tried the mainstream approach, all manner of physio chiro, osteo, acupuncture etc, and im just on their rounds.
    I only ever treat people 3 times then i say go away let it settle down and call me. Generally they call me about a year later and say my back hurts again can you sort me out please.
    Due to client confidentiality i cannot give too much info but here a just a couple of situations that occured that i think are 100% due to the BT.
    This i only found out the other day actually.
    A guy came to me about five years ago for a couple of sets of sessions he had a bad back thats all i remembered about him, till i spoke to the guy that referred him and he reminded me of the story and updated me on the situation, he and a friend had a fall in the 60’s and his friend died, during the time since he’d been to see every man and his dog, came to see me for about 6 sessions in all and all of his pain went away, i was amazed when i heard this because i thought it just didn’t work on him thats why he never called back.
    Another girl came to me with a sore neck her boyfriend brought her cos it worked on him before, she came 3 times and on the 3rd time she said it didn’t hurt anymore so i asked her why she came, and said she should have phoned and cancelled, so me her and her boyfriend get chatting, it turns out she’s got asthma, used 3 pumps a day, so i said id put in the asthma moves, now you have to appreciate that this was the first time i had ever given a treatment for asthma, i did the moves they left.
    Two years later her man phones me to sort his back out again, i do his treatment asked him about the asthma situation with his missus and apparently she stopped using the pumps that day and never went back to them, yes it could be psychosomatic or placebo, but after using the Bowen for so long I know its the Bowen.
    The thing i have found with the Bowen is that it depends on the root cause of the condition that is presented as to whether or not the Bowen is effective, i find that general sports injuries and work related injuries that are muscular in origin the Bowen is hugely effective but if a condition is more deep set as in from an emotional source as in “body armour a study by De Bonno” or it has a psychological, or lifestyle based cause then the Bowen seems to be effective still at easing the physical condition but a dietary change or counselling route has to be exercised as a possible relief from the conditions presenting, the thing about the body and its dysfunction is that it takes many years to break down this wonderfully strong vehicle we have and the one thing that rules it all is the mind, the Bowen works on the Neurological system which is the extension of the brain so it can only work as the rate that the subjects own mechanisms for healing will allow.
    I cannot convince anyone of anything and i wouldn’t want to but personally I believe the above article from personal experience, is just wrong.
    We all have our own minds and our own experience, make yours up from your own.
    One more little case study and this has happend to me more times than i can remember.
    I was chatting to someone from my past about 3 months ago we got chatting he had tennis elbow i gave him a two min treatment, apparently he was taking the mickie out of me later about what i did, he told me this a month later while apologising for the fact that he was laughing at me behind my back, because two days after, the pain that he’d had for 18 months vanished and he could go back to rock climbing, i’m treating his Mum for something soon.
    Spread good news its much more rewarding.
    And yes i know im not hugely articulate and im crap at punctuation and these words that i put up here are far from a scientific study, but im not an idiot and neither are the people that come to see me.

    • apgaylard said

      Thanks for the comment. Just to be clear: I’m not saying anyone is stupid. As I mentioned above my wife used Bowen. She used it for some considerable time to no real effect. So we could trade positive and negative anecdotes, but I don’t think this is very productive or will provide any useful insights.

      So, how do we decide if our expectations, the natural history of what ails us, recall bias or some other facet of the human condition is misleading us? This is something that we are all vulnerable to, after all.

      The answer is: well designed trials. This is where Bowen appears to come up short. If you have references to any trials that I’ve missed, then please provide the details: I’m always interested in learning something new. If there is more reliable positive information, I’ll share it. Also, if you think I’ve made any specific errors, please be sure to point them out.

      On the other hand, I think that it’s important to avoid wishful thinking and fanciful speculation when it comes to matters of health. I’m sorry, but your comment just boils down to unsupported assertions and anecdotes. Not at all convincing I’m afraid.

      A final caution: asthma is a potentially life threatening condition and it is possible for asthmatics to feel better (due to the placebo effect) even when they are actually doing worse (see http://www.nejm.org/doi/full/10.1056/NEJMoa1103319). This condition needs proper medical care, not unproven ‘therapies’.

      • mandysalomon said

        Hi, wonderful that you have undertaken an evidence-based assessment. Thank you.
        Being a social scientist, I was looking for credible studies on Bowen, as I had one highly successful treatment a week ago and have another follow-up this week. The mad crazy thing is that two days following my first session, ii was free of chronic hip pain. Of course I was sceptical but … It appears to have worked.

      • onlinecultures said

        Hi, wonderful that you have undertaken an evidence-based assessment. Thank you.
        Being a social scientist, I was looking for credible studies on Bowen, as I had one
        successful treatment a week ago and have another follow-up this week. The mad crazy thing is that two days following my first session, I was free of chronic hip pain. Of course I am sceptical, but … it appears to have worked. An important outcome for me is that this supports my own sense that I have a soft tissue problem that can be helped by stretching and yoga along with Bowen therapy – not cortisone injections, which was the GP-directed path I was advised to take.
        The older I get, I am 54, the more I am inclined towards the idea that the body has potential to heal itself beyond that which is generally understood. I look to current research into brain plasticity, and also the capacity of the body to accept stem cells as indicators…so, why not neural messages to stimulate the body’s healing processes? More evidence-based research into Bowen is surely warranted. Thanks for the opportunity to discuss.

      • apgaylard said

        Thanks Mandysalomon / Onlinecultures. I am glad that you found some relief for your chronic hip pain. The difficulty,as I’m sure you know, with our individual experiences is that we are never in the position to be sure that it’s a specific part of ‘what we did’ that caused ‘what we experienced’. Chronic issues can sometimes (and I’m not saying that this is necessarily true in your case) ebb and flow, in terms of their severity. As social creatures, interactions with caring therapists can make us feel better. Also, we are prone to remember the times things that we have a commitment to (e.g. like and or paid for) seemed to ‘work’ rather than the times they did not.

        This is why we need clinical trials. By taking the experiences of many people together and comparing these to the experiences of people who are getting the benefits of time and attention (and some sort of ‘dummy therapy’ if possible), though not the specific intervention, the actual effect of a therapy can be tested. This is one place that Bowen falls down – the supporting evidence is just not there. Add to that basic implausibility for many of the claims (i.e. asthma), and consumers are well advised to be cautious.

        My concern is that consumers don’t get objective information about these sorts of therapies and therapists make extravagant claims (i.e. treating asthma). As a basic consumer rights issue those selling a service should provide a fair account of the likely performance of the service and avoid making claims for which they have no objective evidence. I don’t see why Bowen therapists (or any other healthcare provider) should be able operate in any other way.

        You ask, “why not neural messages to stimulate the body’s healing processes?” I guess that my answer would be: where’s the evidence that the human body works that way? I’m not a doctor and I could be wrong, but I don’t think that this view fits with what is known about the way we work. My other questions would be: does something like Bowen actually send any “neural messages”? Can these be specific to a disease or injury?

        In general, it’s hard not to agree with a call for more research. However, usually medical ethics does require that interventions tested on people have had their basic plausibility demonstrated (e.g. do they conflict with what is already known or not? in vitro, animal studies). I wonder if Bowen can pass this test?

        A final observation is that my wife’s condition was only improved after a (neuro) consultant referred her to a good physiotherapist. Neither a number of GPs or many months of Bowen therapy helped.

        Anyway, thanks for the comment, it made me think. And I’m glad that you are feeling better.

  3. Hello. I am hugely sceptical of alternative therapies, generally needing evidence to believe (and for the most part, avoiding them!) but I had to post a comment on this. My mother recommended Bowen (and she is equally sceptical) after she had 2 sessions which, in 20 years, was the most effective treatment she has ever tried. I have used physiotherapy, massage, traditional medications, marijuana, yoga, pilates and swimming – all of which had some impact, no doubt, but the immediate effect (admittedly unpleasant the day after while I had a bit of a ‘release’) is difficult to argue with. My mother, for her part, spent 5 hours walking around shops the weekend after her second treatment, something I have not seen her do in over 10 years.

    I agree that some controlled study would be useful, but we are constantly learning how much we DON”T know about the body, how much we have yet to understand. I think that in assessing alternative treatments such as Bowen, it would be helpful to approach the writing in a much more open way, that invites discussion and question (as it should – in order to have the much needed evidence) but the overall tone of your article suggest that those who benefit from this treatment have been duped in some way…. As an educated, successful, inquisitive professional, I don’t feel that I am easily fooled….

    Finally, it may interest you to know that my condition is called Hypermobility Syndrome, a condition that affects the connective tissue, the facsia…this is one of the things that Bowen ‘claims’ to work on. My condition affects every part of my body; joints, muscles, stomach, heart, kidneys, eyes, sinuses (and breathing)….you name it – all through the facsia. If I can have such a variety of problems through a single fault in my genes, why shouldn’t stimulating this part of my body result in a variety of improvements?

    PS. Many GPs offer/recommend Bowen.

    • apgaylard said

      Hi Kim,

      Thanks for your comment. I’m glad that you and your mother-in-law are feeling better.

      While I agree that there is much yet to understand about the human body and what ails it, I think that it’s important not to discard what is already known and, I’m afraid that some of the claims that I’ve come across for this therapy do. This takes me to the core of my post: it’s not critical of those who chose to use Bowen (after all my wife has!) but rather those who make marketing claims that have no real substantial basis. What I’ve found is that the majority of the claims are (to be polite) highly speculative and yet are not presented as such. I believe that whatever the product or service sold potential customers should not be mislead, otherwise informed choice is undermined.

      In this context well-conducted fair trials are not just “useful” they are essential, otherwise we don’t know whether our individual experiences are the product of chance, the natural history of a condition, the misattribution of an occurance to a cause (part of the human condition I’m afraid) or the proposed therapy. It’s really not a matter of being “fooled” in the usual sense.

      As for GPs offering or recommending Bowen, I’m afraid this doesn’t give us a reliable indication of the therapy’s effectiveness: not a few GPs actually recommend homeopathy!

      Anyway, I hope that you continue to feel better.

  4. I am a sceptic. I am very active and swim a mile 3 x a week and go to the gym for a couple of hours 3 x a week and walk my dog 3 hrs a week. I teach full time. I am 60. In 2011, I had a bad fall and after 11 painful months on crutches, I had knee surgery 10 months ago and returned to full activity within 6 months but then had a relapse after 4 months with chronic pain in my hip and knee. My GP increased my drugs and pain killers. I was pretty immobile and on crutches even to get from my bed to the toilet. I was told to have more surgery or stay in pain and on crutches for life. I had one Bowen session and immense pain relief. After the second session, 5 days later, I was off crutches except as a back up for walking over 1/2 mile or so. I still do not believe it, but the relief has not been incremental or imaginary, but life-changing. I wish other people the same good fortune.

    • apgaylard said

      Hi Chrissie,

      Thanks for your comment. I’m sorry to hear that you’ve been through such a rough time and I’m happy to hear of your good fortune.

      Let’s hope that an enterprising Bowen academic/therapist conducts a fair trial on chronic hip/knee pain like yours. If it can really help in the way you describe, then the results would be very clear.

      Please accept by best wishes for your continuing recovery.

  5. I agree with the writer of this article. It’s the claims that these uneducated purveyors of the Bowen technique make that damages it’s credibility. Unfortunately anyone can learn the Bowen technique whereas it should be reserved in the domain for professional therapists who understand the pathomechanics of disease, specifically musculoskeletal disorders. Then you wouldn’t have uneducated and so-called bowen therapists saying it can cure anything because they actually had the experience of relaxing someone with MS and their symptoms improved, likely their mobility for a period of time. That doesn’t mean it cured MS, but it doesn’t stop these so-called bowen therapists from claiming it does. For the record, I use bowen technique in my practice as a chiropractor, but I’m very careful how I present it. In my opinion it’s not more than a soft tissue technique that can, if used properly, bring some needed relaxation to people. The therapeutic benefits of relaxation are well documented, and so it’s no surprise that some people actually end up having a reduction in symptoms. It it what we call best-practice for all conditions? No it is not, but it can be a very valuable tool.

  6. Sadly not a thorough article and not obe thst would pass scientific muster but it’s safe to say you’ve never undertaken any kind of clinical trial.

    Your tone and words are sneering and condescending and not the tone of an impassioned observer but of someone who has written a skewed and judgmental piece. Ironic that at the same time you do clearly point out how many studies and trial have been done and that none of them have shown a harmful element. Compared to the majority of treatments currently available this is actually quite an impressive array.

    The hamstring study examined the literature currently available and makes clear the implications for increasing flexibility and the significant impact this has. The study group was very large and the week follow on results has implications for a wide range of presentations.

    Research does not always follow the line of ‘finding things that are wrong to make right’ but instead explores what is happening, in order for others to follow.

    The stroke study again was significant in respect of the data available for patients in the same range. You could take six patients with brachial plexus issues and due to the severity of the problem and the lack of available treatment changes in 4 of them would be massively significant. So it’s not about the numbers, it’s about the literature reviews that explain the methodology.

    I agree that wild claims need to be modified and care taken, but all your evidence presented here does suggest that Bowen has positive effects. That you don’t like it or that it doesn’t fit with your agenda is obvious but bias shouldn’t get in the way of something being explored more.

    In future I suggest you present a more balanced view rather than leading inexperienced readers into conclusions that of your personal making.

    But thank you for your interest.

  7. apgaylard said

    Nice try. However, your comment presents a somewhat perverse misreading of my post. Let me point out the obvious: the post is about whether or not there is robust evidence to support the claims made by various Bowen practitioners and UK Bowen organisations to be able to treat a wide range of medical conditions. It’s not about the implications of these studies for future research.

    In this light, it is very clear that the studies that you mention are insufficient to support the use of Bowen to treat any medical condition. That’s not to say they don’t shed light on future research questions and processes.

    A fair reading of the literature shows that there is no robust evidence to support any claims to treat any medical condition. As a matter of fact, a later review by the ASA has come to the same conclusion (here and here). Interestingly, the only claim they view as supportable is:

    “… that the Bowen technique could improve flexibility, in the short term, of hamstring muscles in healthy, fit adults aged 18-50 years with no musculo-skeletal symptoms …”

    Of course, this is a claim with respect to healthy adults.

    That you feel the need to misreprepresent the theme of this post speaks volumes as to the strength of your criticisms. Though, if you do actually have any additional evidence, I’d be pleased to see it.

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