How does an osteopath work?
According to WHO’s 2010 benchmarks for training in osteopathy, osteopathy relies on manual contact for diagnosis and treatment. It respects the relationship of body, mind and spirit in health and disease and lays emphasis on the structural and functional integrity of the body and the body’s intrinsic tendency for self-healing. Osteopathic practitioners use a wide variety of therapeutic manual techniques to improve physiological function and/or support homeostasis that has been altered by somatic (body framework) dysfunction. This means impaired or altered function of related components of the somatic system, including skeletal, arthrodial and myofascial structures and related vascular, lymphatic and neural elements.
Osteopathic practitioners use their understanding of the relationship between structure and function to optimize the body’s self-regulating, self-healing capabilities. This holistic approach to patient care and healing is based on the concept that a human being is a dynamic functional unit, in which all parts are interrelated and which possesses its own self-regulatory and self-healing mechanisms.
Working with the individual
Osteopathy is widely used in Europe and the USA and is included in the healthcare systems of many countries.
Among the ways of caring for health, there are two poles: treating diseases and treating individual people.
The first approach is based on studies of large groups of people: for example, if a medication helped 70% of participants diagnosed with migraine, it is recognised as effective and reaches pharmacies.
Osteopathy is much closer to the second pole: we work with a particular person rather than a diagnosis, considering their lifestyle, needs and personality. If someone comes to us with migraine, we consider what triggered the first attack, previous injuries and operations (not necessarily involving the head), what they are already doing, and how much it helps. An osteopath’s work resembles a detective’s: there are rules and patterns, but what matters most is the result for that individual.
Principles of osteopathy (WHO)
Osteopathy provides a broad range of approaches in the maintenance of health and the management of disease. Osteopathy is grounded in the following principles for treatment and patient management:
- The human being is a dynamic functional unit whose state of health is influenced by the body, mind and spirit.
- The body possesses self-regulatory mechanisms and is naturally self-healing.
- Structure and function are interrelated at all levels of the human body.
A whole-person approach
Medicine’s evolution began by considering body, mind and soul as a single whole, continued with a division into separate specialties, and only now, in the age of evidence-based personalised medicine, are we returning to the understanding that a person is an entire universe whose mysteries cannot be revealed using a single tool.
Modern medicine is once again valuing holistic approaches to preserving health and quality of life. This gave rise to the concept of complementary medicine, which includes osteopathy.
This comprehensive holistic approach makes a formal definition difficult: osteopathy is more than muscular, joint, craniosacral or visceral techniques. It is primarily a philosophy of health based on principles formulated by Andrew Taylor Still in the 19th century.
Dr Taylor Still was the first physician to fully recognise the relationship between structure (anatomy) and function (physiology). Osteopathy is therefore a patient-centred approach to therapy that considers the body as one integrated whole. It includes not only manual techniques, but also other therapeutic interventions, such as selecting exercises and changing lifestyle, which require knowledge of physiology, anatomy and findings from advanced scientific research.
This fundamental approach made it possible for the World Health Organization (WHO) to recognise osteopathy as a branch of complementary medicine.
Osteopathy recognises the individuality of both patient and osteopath. Unlike many other manual therapeutic approaches, it therefore offers a broad range of tools in which everyone can find something that resonates with them. Just as no two snowflakes are identical, no two osteopathic treatment plans can be identical. Because the body is a whole system, it can be approached from different directions to achieve the same result. Osteopathy offers an unlimited range of approaches and modalities, including direct and indirect work with muscles, ligaments, joints, internal organs and the nervous system.
Research and evidence
Many studies report benefits from osteopathic treatment. The approach is highly individualised and results depend on the practitioner, which makes it difficult for systematic reviews to draw clear conclusions. Manual therapy, sports rehabilitation and psychiatry face the same problem. Following a similar discussion in psychiatry, the osteopathic community is debating whether to give greater weight to individual clinical cases than to pooled results from large groups of participants. The argument is that this better reflects how these professions work than the standards of evidence used in acute care.
The article below by osteopath Natalia Ermachenko, PhD, takes a closer look at research in osteopathy and medicine and its limitations.
Read the article