Traditional bone-setters

Domain XI · Traditional medicine & indigenous healing

What it is

Traditional bone-setting is hands-on care for fractures, dislocations, sprains, and back and joint complaints. It is given by practitioners who are trained within a family, an apprenticeship or a community, not within formal medicine. It is found worldwide. In Ashanti, Ghana, bone-setters treat…

Format

• Phase A: Engagement and cultural assessment (usually sessions 1–2). Goal: understand the problem in the client's terms, including the injury, pain, meaning, help-seeking and the role of family. Tools: the core CFI (16 questions in four domains), selected supplementary modules, and the…
• Phase D: Psychological work on consequences (variable length; typical weekly 50-minute sessions). Goal: address pain-related distress, loss of function or role, grief after amputation, guilt, decisional regret, family conflict, trauma symptoms, or conflict between the client's tradition and…

Who practises it, and how they are trained or regulated

• What it is. Traditional bone-setting is hands-on care for fractures, dislocations, sprains, and back and joint complaints. It is given by practitioners who are trained within a family, an apprenticeship or a community, not within formal medicine. It is found worldwide. In Ashanti, Ghana, bone-setters treat leg, arm and rib fractures, joint dislocations, and waist and spinal problems. They combine plant- and…
• Who holds authority. Authority rests with the family line or lineage that holds the skill or gift, and with communities that recognise the practitioner. Increasingly it also rests with practitioners' associations. In Ghana, regional bone-setter associations were formed by June 2022 through a training programme run by AO Alliance with Komfo Anokye Teaching Hospital (Kumasi) and Tamale Teaching Hospital. Over 200…

Evidence status, as the guide reports it

• Phase B: Physical-safety screening and medical routing (at once if any warning sign; otherwise within Phase A). Goal: make sure a current injury or treatment has medical oversight. Documented complications include non-union, malunion, gangrene leading to amputation, compartment syndrome, infection…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• pushing too hard, which can lead to drop-out from therapy. It is working when the client shifts from "never" to "maybe if…".
• guilt after a patient's bad outcome, and isolation. It is working when the client can weigh their choices about practice in their own terms.
• the interpreter's own views on bone-setting colouring the translation. It is working when the client's answers become fuller and more specific.
• the therapist taking the role of judge of the tradition. It is working when the client has a coherent account that includes both forms of care.
• a relative speaking over the client, and the client's own wishes getting lost. It is working when the family has one agreed plan for warning signs.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.