(You can find a french translation of this article here)
Nothing at all...
In Fact Osteopathy does not treat anything but helps the patient to treat himself. The Osteopath just sign-posts the patient's body towards a different route of adaptation. In short, helping the body to improve itself.
In general, I would say that Osteopathy can "treat" or help with dysfunctions of the body :
"Dysfunction" could be described as a state between health and disease.
Untreated dysfunctions can lead the body toward uneconomical way to adapt a certain pattern. Uneconomical through a mechanical, physical, physiological, energetic (calories) point of view. It is a bit like driving around with a Porsche forgetting to remove your handbrake ! You can expect a poor acceleration, overuse of the brakes and high fuel consumption.
On the long term the body will be more exhausted and this can lead to potential illnesses (eg : infections) or premature ageing (eg : osteoarthritis).
While Osteopathy focusses mostly on the dysfunctions of the body certain pathologies can also be helped or improved (to a certain extent) ; certain types of asthma, gastritis, endomitriosis, Crohn's... Even if A.T. Still reported to treat cases of dysentery, it is unreasonable nowadays to prefer Osteopathy to an allopathic approach for the treatment of any types of infections, diseases or cancers.
"Osteopathy has no limit, only Osteopaths have some" this is a sentence from Idon'trememberwho, and I find it particularly true.
I have met a few people telling me about there symptoms during casual conversations and they say that Osteopathy can't help it because they saw an Osteopath and their problem didn't get any better. I would say that this Osteopath couldn't help you, how many have you tried ? Because you know there are as many different Osteopath(ies) than there are different Osteopaths. That's right, no Osteopath will practice the same way another one does !
The following list includes a series of patients' complaints or symptoms that I could help with :
Common complaints :
-whiplash injury
-neck, shoulder pain/sprain
-lowback pain/spain
-"disc" problem
-"sciatica"
-Thoracic outlet syndrome, carpal tunnel syndrome
-Headaches, migraine
-Temporo-mendibular joint pain
-hip, knee, ankle, foot pain/sprain
-complaints due to wear and tear (osteoarthritis)
-sport injury
-Repetitive strain injury
-gastritis
-IBS
-infantile colic
-stress
Less common complaints :
-Crohn's disease (decrease reoccurence of crisis, improve digestion and stress)
-endomitriosis (in certain cases helped with pain and associated symptoms eg : lowback pain/headaches)
-asthma (mostly with stress or effort induced asthma decrease of frequency and seriousness of attacks)
-kidney stone
-Bell's palsy (helped to recover but need more patients to say how much the treatments help)
-hemiplegia (might help the recovery after the attack, but mostly decrease the aches and pain caused by spastic muscles and body imbalances)
-paralytic syndromes (see above)
-ankylosing spondylitis
-frozen shoulder
-trigeminal neuralgia
These are cases I have treated over the years where I believe my osteopathic treatments have been helpful in the recovery.
Of course not all complaints are "treatable" and when there are not, it is important to check the reasons that could interfere with the improvements. These maintening factors can be due to daily activities, diet, intoxications, lack of sport, poor posture, psychological barriers or underlying pathologies. In this case your Osteopath is able to refer you to the appropriate consultant or to another Osteopath who may have another method of treatment.
Showing posts with label osteopathy. Show all posts
Showing posts with label osteopathy. Show all posts
Saturday, August 11, 2007
Tuesday, July 10, 2007
How Scars influence your posture
(You can find a French translation of this article Here)
Surgeries are not always useful or needed but they do save millions of lives every year.
While allopathic medecine "saves" your life, it brings little attention to the consequence of such a procedure. I don't talk here about the risk inherent to a surgery but about the "post traumatic adaptation" of your body.
My first clinical experience with such a case was when I was an Osteopathic student at the ESO teaching clinic. I was treating Mr G., 67yrs old, for some chronic low back pain. Mr G. couldn't stand for more than 30 minutes without experiencing pain in both thighs. This was a good excuse to avoid the boring food shopping with his wife. He was playing golf twice a week, while the walking and the swing were more supportable than standing still, at the end of the game and for the following few days his back was particularly stiff.
The treatment that I was providing were mostly based on deep massages, mobilisation of the spine, hips, knees... Mr G. was feeling some relief from it and was coming back every 3 weeks for a maintenance treatment.
One day, my Osteopathic tutor (Miss Celine Meneteau) entered the treatment room and asked me : "What is the scar your patient does have on the front ? Did you ever stretch it ?" Effectively the patient had a peritonitis 20 years ago and a subsequent 20 cm scar on his abdominal wall, and "no" I never worked on it, and never thought that it could be of any significance regarding my patient symptoms.
I did indeed stretch this scar as well as providing the usual treatment.
3 weeks later, Mr G. reported that he could not escape any more the shopping with his wife because he could stand more than 2hrs and half without any pain. His swing improved of 60 yards (obviously with the same club !).
"Post traumatic adaptation" :
Obviously an open wound is an experience a bit painful. The following weeks after the surgery, the patients will tend to protect their scar adopting an antalgic posture. The aim of this antalgic posture is to decrease the tension around the painful area.
In the case of a Csection, for example, the patient will bend forward and avoid to straighten up or to arch backward. Slowly the patient recovers from her surgery and can sraighten up a bit more, but compare to her initial posture she is now leaning forward. Why is this ? because there are some scar adhesions !
When an abdomen is cut open, you cut different layers of skin, muscles, fasciae... when the healing process takes place, scarring tissues create adherences between these different layers. What was once upon the time smooth, sliding, elastic healthy tissues are now fix, congested, non-elastic ones. This is the beginning of a long chain of problems...
Let's continue with our new mother who just had a Csection :
The first symptoms will be a sensation of heavyness on the lower abdomen, increase frequency of urination, bloating sensation.
Few months later low back pain starts being an issue and can be associated with pain/cramps in the calves. Of course carrying a child is not helping, but the tension of the scar obliges the mother to constantly lean forward. To compensate this imbalance, the extensors muscles of the spine constantly contract to prevent her from falling forward. At the same time when she leans forward, her gravity centre moves forward as well. This increases the pressure at the distal end of her feet. More tension by the calves muscles is needed to bring back the gravity centre. Guess what ! it gives pain/cramp/stiffness in the calves !
Exercise Time, let's have a try :
Please stand up, flat feet on the floor, bend forward a bit then grab an inch of skin underneath your belly button. Now straighten up (gently) stop as soon as you feel uncomfortable in your lower abdomen. As you cannot straighten up completely, you should be able to feel some contraction in your low back muscles. Slowly you will feel your posture shifting forward, and an urge to push down with your toes, now you feel more tension in your calves . Well done ! if you are a man you just discover the post traumatic adaptation of a Csection!
If you continue this little exercise, You will notice that if you want to look straight you have to extend a bit more your neck. On the long term it increases the compression on the facets of the cervical spine which leads to neck pain, spondylosis, headaches...
In this case, if you just manipulate the spine or massage the back you cannot expect any improvement but a symptomatic short term relief. As soon as you will start working on this scar as well as opening the anterior fascial chain, the change in the posture will be tremendous and this will lead to a great improvement of the symtoms.
Patients who had a masectomy and suffer from shoulder pain on the same side few years later, Patients who had an appendicectomy as a child and now you suffer from some sacro-iliac pain on the right side, patients who had a Csection or a hysteretomy and complain from low back pain or neck pain, did you ever think it could come from this old scar ? If it sounds familiar don't hesitate to contact your nearest osteopath or another competent therapist.
Surgeries are not always useful or needed but they do save millions of lives every year.
While allopathic medecine "saves" your life, it brings little attention to the consequence of such a procedure. I don't talk here about the risk inherent to a surgery but about the "post traumatic adaptation" of your body.
My first clinical experience with such a case was when I was an Osteopathic student at the ESO teaching clinic. I was treating Mr G., 67yrs old, for some chronic low back pain. Mr G. couldn't stand for more than 30 minutes without experiencing pain in both thighs. This was a good excuse to avoid the boring food shopping with his wife. He was playing golf twice a week, while the walking and the swing were more supportable than standing still, at the end of the game and for the following few days his back was particularly stiff.
The treatment that I was providing were mostly based on deep massages, mobilisation of the spine, hips, knees... Mr G. was feeling some relief from it and was coming back every 3 weeks for a maintenance treatment.
One day, my Osteopathic tutor (Miss Celine Meneteau) entered the treatment room and asked me : "What is the scar your patient does have on the front ? Did you ever stretch it ?" Effectively the patient had a peritonitis 20 years ago and a subsequent 20 cm scar on his abdominal wall, and "no" I never worked on it, and never thought that it could be of any significance regarding my patient symptoms.
I did indeed stretch this scar as well as providing the usual treatment.
3 weeks later, Mr G. reported that he could not escape any more the shopping with his wife because he could stand more than 2hrs and half without any pain. His swing improved of 60 yards (obviously with the same club !).
"Post traumatic adaptation" :
Obviously an open wound is an experience a bit painful. The following weeks after the surgery, the patients will tend to protect their scar adopting an antalgic posture. The aim of this antalgic posture is to decrease the tension around the painful area.
In the case of a Csection, for example, the patient will bend forward and avoid to straighten up or to arch backward. Slowly the patient recovers from her surgery and can sraighten up a bit more, but compare to her initial posture she is now leaning forward. Why is this ? because there are some scar adhesions !
When an abdomen is cut open, you cut different layers of skin, muscles, fasciae... when the healing process takes place, scarring tissues create adherences between these different layers. What was once upon the time smooth, sliding, elastic healthy tissues are now fix, congested, non-elastic ones. This is the beginning of a long chain of problems...
Let's continue with our new mother who just had a Csection :
The first symptoms will be a sensation of heavyness on the lower abdomen, increase frequency of urination, bloating sensation.
Few months later low back pain starts being an issue and can be associated with pain/cramps in the calves. Of course carrying a child is not helping, but the tension of the scar obliges the mother to constantly lean forward. To compensate this imbalance, the extensors muscles of the spine constantly contract to prevent her from falling forward. At the same time when she leans forward, her gravity centre moves forward as well. This increases the pressure at the distal end of her feet. More tension by the calves muscles is needed to bring back the gravity centre. Guess what ! it gives pain/cramp/stiffness in the calves !
Exercise Time, let's have a try :
Please stand up, flat feet on the floor, bend forward a bit then grab an inch of skin underneath your belly button. Now straighten up (gently) stop as soon as you feel uncomfortable in your lower abdomen. As you cannot straighten up completely, you should be able to feel some contraction in your low back muscles. Slowly you will feel your posture shifting forward, and an urge to push down with your toes, now you feel more tension in your calves . Well done ! if you are a man you just discover the post traumatic adaptation of a Csection!
If you continue this little exercise, You will notice that if you want to look straight you have to extend a bit more your neck. On the long term it increases the compression on the facets of the cervical spine which leads to neck pain, spondylosis, headaches...
In this case, if you just manipulate the spine or massage the back you cannot expect any improvement but a symptomatic short term relief. As soon as you will start working on this scar as well as opening the anterior fascial chain, the change in the posture will be tremendous and this will lead to a great improvement of the symtoms.
Patients who had a masectomy and suffer from shoulder pain on the same side few years later, Patients who had an appendicectomy as a child and now you suffer from some sacro-iliac pain on the right side, patients who had a Csection or a hysteretomy and complain from low back pain or neck pain, did you ever think it could come from this old scar ? If it sounds familiar don't hesitate to contact your nearest osteopath or another competent therapist.
Friday, July 6, 2007
Different Osteopathic approaches of diagnosis and treatment :
In this post I'll try to explain different modalities of Osteopathic treatment.
The two extreme ways of treatment are the minimalist approach and the other one is the maximalist approach. The minimalists will tend to push the diagnosis at the extreme and the treatment at its minimum, while the maximalists will tend to treat and diagnose at the same. The ratio in % I give is purely indicative.
Mechanical link (95% diagnosis, 5% treatment) :
Paul Chauffour and Eric Prat developed this approach in which they are looking for the Primary lesion and treat it, hoping for a decompensation of all Secondary restrictions.
They divide the body in 8 different unities :
-the spine and pelvis
-the anterior thorax
-the limbs (arms and legs)
-the cranium
-the viscerae (organs)
-the cardio-vascular system
-the intra-osseus lines of force
-the skin
Each of these unities will reveal one or two major restrictions. So which one is the one to treat ? Paul and Eric use the "inhibitory balance" to find out : if you apply a gentle pressure on two dominant restrictions the adaptation will soften under your fingers while the predominant lesion will still be dense. After finding the major restriction, the "Primary Lesion", you treat it with a "recoil" technique ( a swift flick of your thumb). The major restrictions found earlier should have soften, if not, then treat again the most dominant one. Each treatment comprises of around 350 to 400 tests and only 1 to 3 recoils !!!
This example of treatment has been reported to me by 3 of my colleagues who where watching a "mechanical link" demonstration :
The patient was having some pain in the right shoulder if he abducted his shoulder to more than 90 degrees. The Primary lesion was a spasm of the right femoral artery ! After correction of this spasm with a recoil, the patient could lift his shoulder without any pain or restriction.
This sounds incredible ? this is just one example. Even chronic cases seem to respond as well from this type of treatment.
This approach fits perfectly with A.T. Still statement : "find it, fix it, leave it alone..."
Gilette's approach (80% diagnosis, 20% treatment) :
This protocol of treatment has been developed by a Chiropractor (Gilette) but been presented to us during our osteopathic course by an Osteopath Mr Desjardins. Even if I am not so keen on chiropractic in general, I must say that I find this approach quite interesting.
The "philosophy" of this approach is that the pelvis is the major area of compensation between the descending forces of the upper body and the ascending forces coming from the legs. Therefore if the pelvis is not able to compensate then problems occur.
The diagnosis is fairly straight forward :
specific diagnosis of the pelvis pattern
-gross mobility testing of the thoracic spine
-testing of the occiput-atlas joint
The treatment is fairly straight forward :
-specific stretches of the pelvic ligaments
-mobilisation of the major group in restriction of the thoracic spine (HVT/Staircase)
-the occiput-atlas is seen as a barometer of the spine ; if after the previous corrections it is still restricted then manipulation of this level will be needed.
The pelvis and the thoracic spine is then reassessed.
With this methods you can treat a patient in less than 20 minutes. Mr Desjardins told us that it was the most effective type of treatment he ever practiced. Some of my colleagues use it and are convinced of its effectiveness.
Personally I still hope that I am a bit more than just a pelvis and a spine... But if you want to keep your practice simple and be able to see more than 80 patients a week this is certainly the way !
The Three Unities (75% diagnosis, 25% treatment) :
I have learned this approach from David McGinn at the CIDO. But I am still confused about who was the original author of this approach (dear colleagues please help me out with this one).
The aim of this method of diagnosis is to divide the body in three unities :
-Unity 1 : this is the locomotion unity, involving the lumbar spine from L3, the pelvis and the legs
-Unity 2 : this is the action and balance unity, involving the arms, the head and the cervical spine down to T4
-Unity 3 : this is the vital unity as well as the junction between the two other unities. It comprises the thoracic spine, upper lumbars as well as all the ribs.
Global tests permit to know quickly if a unity is involved or not. If a unity is involved then specific testing will reveal the predominant Osteopathic lesions.
As a general rule the Primary lesion should be found in all positions (standing, sitting, prone, supine, sidelying) and its correction should result in an increase of mobility of the other secondary restrictions.
I find this method of diagnosis really interesting and relatively minimalist. From your findings you can use the type of treatment you want. The major reproach I can think of is that the visceral and the cranial systems are not really integrated. A few other tests are needed for the diagnosis to be a bit more precise.
My Osteopathic Approach (40% diagnosis, 60% treatment):
I generally spend a good 15 min of the treatment (out of 40 mins) to test and diagnose a chain of tension to work on. The method of practice will change according to the body morphology. The fitter the patient is, the more precise the diagnosis will be and the more minimalist the treatment will be. If the patient is not as fit as he could be, the treatment will tend towards a maximalist approach (GOT approach, see below).
My assessment is based on the "Three Unities" (see above) while integrating fully the visceral system.
The treatment will generally be focused first on the visceral system, which removes the major part of the musculo-skeletal restrictions. After a reassessment I treat the remaining Osteopathic lesions from bottom to top.
I generally keep the cranial approach towards the end of the treatment unless I have found that area to be the main focus of my treatment (eg :TMJ, stressed patient, emotional trauma...).
The General Osteopathic Treatment (10% diagnosis, 90% treatment) :
Also known as Total Body Adjustment, the GOT, as practiced in the UK, has been introduced by John Martin Littlejohn and his student John Wernham. GOT is the British classical Osteopathy.
It is a routine of treatment based on 10 different principles :
- routine
- rhythm
- rotation
- mobility
- motility
- articular integrity
- coordination
- correlation
- stabilization
- mechanical law
The aim of the treatment is to literally "shake" your body by mobilizing every one of your joints from head to toe. It may be associated with some HVT ("cracking" techniques) through the spine. By mobilizing the whole body, an harmonization of all structures takes place. It improves the plasticity and elasticity of the tissues therefore enhances the adaptability of the body to its surrounding environment.
One may argue that the diagnosis is 100% part of the treatment, as the GOT practitioner diagnoses and treats at the same time. This is true, but this is the case for any type of techniques, because 90% of the treatment is spent in treating the patient, GOT is the most maximalist Osteopathic approach.
Of course these are not the only way to treat a patient, but the most well-known, or interesting that I have met during my Osteopathic Journey. Every Osteopathic practitioners evolve between a more minimalist or maximalist approach depending on the patient they treat.
Monday, June 25, 2007
Is cervical spine manipulation dangerous ?
Yes Cspine manipulation is dangerous, but not that dangerous...
The risk is about 1/1.5million. It seems quite a lot but in fact you have more chances to die being struck by lightning !
Taking pills (NSAID) may seem safer, but in fact 16000 deaths a year in the US alone are attributed to the use of these painkillers. This gives a ratio of 500/1m people dying from gastric bleeding from taking anti-inflammatories. I won't even start to talk about liver intoxication associated with paracetamol.
So what is dangerous about it ?
in fact the danger comes from the rupture of the cervical artery or from a migration of atherothrombosis during the cervical manipulation which leads to a CVA or death.
Caution must be taken with :
The cause of your neck pain may not come from your neck !
This little test can be performed on yourself or on your patient. The patient sits on the table and you ask him to look over the right and left shoulder, check the rotation and ask the patients to notice when they feel the pain. Now, place your hands underneath the diaphragm and gently lift it up (liver, stomach...) and ask your patient to rotate his head again. Any change in the rotation or in the pain indicate that there is probably no need to manipulate the Cspine, the problem is coming from somewhere else. Yes this may sound odd but a gastritis, an anterior tilt of the liver, a Csection scar... can create neck pain.
Is it a problem if I "crack" my neck myself ?
It is not such a problem if you manage to do it at the right spot ! Often we tend to manipulate the part which is painful and this is not necessarly the right vertebrae or part of the body to manipulate. By moving the vertebral joint you will make it looser, if you manipulate it too often this joint will become hypermobile. To stabilize it, muscles will contract, this is painful and you feel the urge to crack it again... a splendid vicious circle. In other words, if you keep "cracking" the same vertebrae I seriously doubt that this is the right one to move and this will cause you other problem on the long run.
(http://en.wikipedia.org/wiki/Spinal_manipulation#Risks_of_upper_cervical_manipulation
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=3239547&dopt=Abstract
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8583176&dopt=Citation
http://www.bmj.com/cgi/content/full/316/7146/1724)
The risk is about 1/1.5million. It seems quite a lot but in fact you have more chances to die being struck by lightning !
Taking pills (NSAID) may seem safer, but in fact 16000 deaths a year in the US alone are attributed to the use of these painkillers. This gives a ratio of 500/1m people dying from gastric bleeding from taking anti-inflammatories. I won't even start to talk about liver intoxication associated with paracetamol.
So what is dangerous about it ?
in fact the danger comes from the rupture of the cervical artery or from a migration of atherothrombosis during the cervical manipulation which leads to a CVA or death.
Caution must be taken with :
- patients suffering from High Blood Pressure (walls of arteries are more rigid and/or presence of cholesterol)
- patients suffering from high cholesterol
- patients suffering from hyperlaxity or connective tissue disorder (eg: Marfan syndrome)
- patients suffering from vertebral atery occlusion syndrome
The cause of your neck pain may not come from your neck !
This little test can be performed on yourself or on your patient. The patient sits on the table and you ask him to look over the right and left shoulder, check the rotation and ask the patients to notice when they feel the pain. Now, place your hands underneath the diaphragm and gently lift it up (liver, stomach...) and ask your patient to rotate his head again. Any change in the rotation or in the pain indicate that there is probably no need to manipulate the Cspine, the problem is coming from somewhere else. Yes this may sound odd but a gastritis, an anterior tilt of the liver, a Csection scar... can create neck pain.
Is it a problem if I "crack" my neck myself ?
It is not such a problem if you manage to do it at the right spot ! Often we tend to manipulate the part which is painful and this is not necessarly the right vertebrae or part of the body to manipulate. By moving the vertebral joint you will make it looser, if you manipulate it too often this joint will become hypermobile. To stabilize it, muscles will contract, this is painful and you feel the urge to crack it again... a splendid vicious circle. In other words, if you keep "cracking" the same vertebrae I seriously doubt that this is the right one to move and this will cause you other problem on the long run.
(http://en.wikipedia.org/wiki/Spinal_manipulation#Risks_of_upper_cervical_manipulation
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=3239547&dopt=Abstract
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8583176&dopt=Citation
http://www.bmj.com/cgi/content/full/316/7146/1724)
Sunday, June 24, 2007
Physiotherapy, Chiropractic, Osteopathy: What to choose ?
The patient is often confused between these three therapies and doesn't know what to expect from these different approaches.
Physiotherapy : the physiotherapist is a specialist in rehabilitation. After an injury (fracture, surgery, CVA...) the physio will rehabilitate the patient with massages, mobilisations, ultra-sound, exercises or even teach a patient to use crunches. His approach is generally symptomatic and his recommendations are often statisticly based (eg : in chronic low back pain a series of 3 push ups, 5 sit ups and 7 pulls of the right ear lobe improve the symptom by 47% over a period of 7 weeks. Please don't try this at home, this is just an illustrative example !!!).
Why is this ? I believe that physiotherapists are the right hand of the medical field and have been formed to fit the medical way of thinking. Therefore anything they do must be proven effective and safe, even merely effective is fine as long as it is safe.
The problem is that proving something is hardwork, time consuming, money consuming, and often another study will few months later proves the opposite to be true. A study is often too specific or too global to be constructive.
This approach avoid to talk about the "Unicity" of the patient. It does mean that if two patients complain from the "same" areas or symptoms they will be given the same treatment regardless the root of the problem which is not necessarly the same. The outcome of the treatment is therefore not as effective as it could be : it does not address the root of the problem but the treatment is as safe as it can be.
Chiropractic : Here is a joke for you ... what is the difference between a chiropractor and an osteopath ? 60 000 $ a year.
Chiropractic has been developed in the US at the end of the 19th century by Dr Palmer. Chiropractors claims that the source of our problems comes from the nervous system. Therefore corrections of "subluxed" vertebrae tend to lead us towards balance and recovery. Chiropractors will use spinal manipulations, ultra-sounds, massages, TENS, or other "high-tech" equipments. Often the massage, US, TENS(...) is given by a PA (physician assistant), then here comes the Chiropractor who will manipulate the spine. The chiropractor may need to see you up to 3 times the first week then will decrease the frequency of the treatments.
Physiotherapy : the physiotherapist is a specialist in rehabilitation. After an injury (fracture, surgery, CVA...) the physio will rehabilitate the patient with massages, mobilisations, ultra-sound, exercises or even teach a patient to use crunches. His approach is generally symptomatic and his recommendations are often statisticly based (eg : in chronic low back pain a series of 3 push ups, 5 sit ups and 7 pulls of the right ear lobe improve the symptom by 47% over a period of 7 weeks. Please don't try this at home, this is just an illustrative example !!!).
Why is this ? I believe that physiotherapists are the right hand of the medical field and have been formed to fit the medical way of thinking. Therefore anything they do must be proven effective and safe, even merely effective is fine as long as it is safe.
The problem is that proving something is hardwork, time consuming, money consuming, and often another study will few months later proves the opposite to be true. A study is often too specific or too global to be constructive.
This approach avoid to talk about the "Unicity" of the patient. It does mean that if two patients complain from the "same" areas or symptoms they will be given the same treatment regardless the root of the problem which is not necessarly the same. The outcome of the treatment is therefore not as effective as it could be : it does not address the root of the problem but the treatment is as safe as it can be.
Chiropractic : Here is a joke for you ... what is the difference between a chiropractor and an osteopath ? 60 000 $ a year.
Chiropractic has been developed in the US at the end of the 19th century by Dr Palmer. Chiropractors claims that the source of our problems comes from the nervous system. Therefore corrections of "subluxed" vertebrae tend to lead us towards balance and recovery. Chiropractors will use spinal manipulations, ultra-sounds, massages, TENS, or other "high-tech" equipments. Often the massage, US, TENS(...) is given by a PA (physician assistant), then here comes the Chiropractor who will manipulate the spine. The chiropractor may need to see you up to 3 times the first week then will decrease the frequency of the treatments.
Personnally I am far from convinced that a back pain necessarly comes from a "subluxed" vertebrae but if you believe that the key of your problem comes from your spine, well then go for it. If you are not getting any better then make your next stop the Osteopath ;)
Osteopathy : Any traumas, injuries, sugeries, infections you had in the past are affecting your body in some way today by creating some restrictions and series of compensations. After a while your body cannot compensate any more, you bend forward to pick up a pen and "click", a vertebrae moved a bit too much and you just suffer from an acute facet lock. Now, is it just a vertebrae or a whole pattern of compensations, interactions, fascial connections, visceral dysfunctions, nutritions(...) that is responsible for your agony ? I would like to believe that we just need to correct a vertebrae, as it would make the work a bit easier, but the human is a little bit more complicated.
Generally an Osteopath will spend between 30 and 40 min with you and only you. During that time at least 40% of the treatment is spent in diagnosis in order to understand where the problem is coming from, this allows a more accurate treatment.
Osteopaths only use their hands, as machines tend to be imprecise and often scare the patient.
Personally I will never see a patient more than once a week and rarely more than 3 times the first month. Some Osteopaths are even reluctant to do more than one treatment every other week. (for some more details about the treatment content please check the other posts !)
What ever therapist you see do no hesitate to try different ones and stick with the one you feel the most appropriate. If you do not feel any improvement after 2-3 sessions, look for another approach or opinion.
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