Tuesday, April 10, 2007

What is Osteopathy ?

(You can find a french translation of this article here)

Osteopathy is a manual therapy which was developed at the end of the nineteenth century by Dr Andrew Taylor Still in the US. Dr Still based his discipline on 4 main principles :
- "Life is movement" : therefore any structures that are not moving in your body, are deteriorating or "dying".
- "The Structure governs the function" : and vice versa. If the structure of your body is affected so will be its function (a broken elbow results in a poor elbow motion for example). The opposite is also true : if you spend your life time lifting bricks, you will develope strong, fibrotic back muscles and probably degenerative discs and spondylosis in your lumbar vertebrae.
-"The rule of the artery is supreme" : blood flow is essential to our body and if any structures (muscles, joints, fasciae...) are stiff, rigid these will impair a good vascularisation which will lead to further deterioration.
-A.T. Still believed as well in the "self-healing mechanism of the human body", and that the Osteopath was not treating the patient, but was in fact sign-posting the patient's body towards a better way to "self-heal".

For an Osteopath, the aim of the treatment is to find the "restrictions" of your body and to mobilise them : "Find it, fix it and leave it alone".

"Restrictions" have many different names such as : "Osteopathic lesions", "Hypomobilities", "Somatic dysfunctions" (pseudo-medical term), "subluxations" (chiropractic term). They result from any micro/macro-traumas, environmental factors, diet, pathologies or simple adaptations.
The most important ones are called primary lesions and they will be responsible for a series of compensations called secondary lesions. Very often, the patients' complaints are secondary lesions. This is why a symptomatic approach is rarely effective on the long term ; because the primary lesion is still there and will recreate the same series of adaptations and therefore the same symptoms !
The Osteopath will tend to focus his treatment on finding and treating the primary lesion. By doing so, he's treating the cause of the symptom rather than the symptom itself.

OK, by re-reading myself it looks a bit confusing, let's give an example : A patient comes complaining of a low back pain, the case history reveals a fractured ankle 10 years ago. The patient had an Xray revealing some wear and tear at L5S1. He has been advised to have some physio (ultrasound, massage ...) on his back and to take some painkillers. Few month later the back pain is still pesistent with some gastritis (thanks to the NSAID). The Osteopath will test all the body and find some major restriction on his ankle. For 10 years the patient has been walking with a slight limp which developed an excessive compensation pattern through his pelvis and lumbar spine. As long as nothing is done to improve the mobility of his ankle no improvement can be expected for his back. His ankle restriction is his "Primary lesion", and the L5S1 joint the "Secondary lesion". The Osteopath will then mobilise his ankle as well as probably, knee, hip then low back and within few treatments we can expect a long term improvement.

No comments: