| HISTORY
Osteopathy,
from the Greek osteon (bone) and pathos (disease), was developed
by Dr. Andrew Taylor Still of Virginia, who was an army doctor in the Civil
War. Prompted by the tragic deaths of his wife and three of his children from
meningitis, in 1872 he devised osteopathy to stimulate the body's self-healing
powers.
In
1892 Dr. Still founded the American School of Osteopathy. Despite initial
opposition from the conventional medical establishment, the therapy proved
popular, receiving a major boost during the flu epidemic of 1919, when the
mortality rate for patients in osteopathic hospitals was far below that in
conventional hospitals. In 1917 one of Still's pupils, Dr. John Martin
Littlejohn, founded the British School of Osteopathy in London.
In
the US, osteopaths have been licensed as conventional doctors since 1972. In
the UK, osteopathy gained official recognition with the passing of the
Osteopathy Act in 1993. Osteopathy is popular in Japan, Australasia, North
America, and Europe.
KEY PRINCIPLES
The
organs of the body are supported and protected by the musculoskeletal system
(see opposite). If this system of joints and muscles is correctly aligned and
working well, the tissues of the body, including the brain and nerves, will be
healthy, and the circulatory, lymphatic, and digestive systems will function
properly. Osteopaths aim to improve the mobility of the joints and soft tissues
using various manual techniques.
An
osteopath will be as concerned about why there is a fault in the musculoskeletal
framework as with the physical problem itself, and will look for the reasons
behind the problem. For this holistic approach, lifestyle and mental and
emotional health are seen as important factors influencing physiological
health.
EVIDENCE & RESEARCH
There
has been a considerable amount of research into osteopathy in the US, though
not to a consistently high standard. Much evidence is anecdotal and most
osteopaths accept that more clinically controlled trials need to be carried
out. Research studies are under way in the UK, including Department of Health
pilot projects to test the possibility of doctors referring National Health
Service (NHS) patients to osteopaths and chiropractors. In 1994 , the
Clinical Standards Advisory Group recommended that manipulation should be
available for NHS patients with acute back pain, and that doctors should work
more closely with osteopaths, chiropractors, and physiotherapists.
Two
studies, published in the US and UK in 1988 and 1990 respectively, showed that
osteopathic manipulation could improve recovery time for lower back pain
patients. During the 1940s, an American physiologist used electrical
measurements to confirm osteopaths' claims of increased activity in muscles.
MEDICAL OPINION
With
official recognition as doctors for over two decades, American osteopaths are
part of the medical mainstream, and osteopathy is increasingly being integrated
into the practice of medicine worldwide. Although perhaps a third of doctors in
the UK refer patients to osteopaths, some are still reluctant to do so,
especially when the patient's problem is not musculoskeletal. The establishment
of the UK General Council of Osteopaths in 1996 should build a basis for strong
cooperation with the medical profession.
CONSULTING
A PRACTITIONER
At
the first consultation the practitioner will ask how your symptoms began and
what activities make them worse. He will ask about your medical history,
especially any past injuries, about any medication you are taking, including
homeopathic and herbal remedies, and about your lifestyle, work, and emotional
health.
Be
prepared to undress to your underwear, so that the practitioner can see as
much of your body framework as possible. You may be offered a gown if you feel
uncomfortable. In order to assess the way you hold yourself and how the joints
are functioning, you may be asked to stand, sit, and lie down on a treatment
table. The practitioner will probably examine your muscles for stresses and
strains and will ask you to bend in various ways while feeling your spine.
Standard medical tests are carried out, and arrangements are made for X rays or
blood tests where necessary.
This
assessment enables the practitioner to make a diagnosis, and decide whether
osteopathy can help or whether you should be referred to another specialist.
Any
osteopathic treatment will be tailored to your individual needs and adapted as
treatment progresses. It may consist simply of soft tissue treatment, using
cradling and light pressure, or it may involve vigorous manipulation of the
joints, necessitating some rather unusual positions. Discomfort caused by
muscle spasm can disappear after one session, but most patients need a course
of treatment.
The
main osteopathic procedures range from gentle manipulation of the joints,
taking the limbs through their full range of movement, to an abrupt
high-velocity thrust that, although painless, can cause the joint to
"click" disconcertingly. Other techniques include positioning you so
that tension from areas of strain or injury is spontaneously released, "muscle
energy techniques," in which you release muscle tension by working against
resistance provided by the practitioner, and visceral manipulation, in which
the practitioner uses touch and pressure to pinpoint and relieve problems in
the internal organs. The practitioner may recommend exercises and relaxation
techniques to follow at home or work.
Lower
(or lumbar) back pain is a common problem, and one for which osteopathy is
often used. Sitting habitually in a slouched position, lifting heavy objects
incorrectly, and sports or other injuries all frequently cause lower back pain.
The practitioner examines the spine to identify areas of stiffness. He uses
soft tissue treatment to relax the area and then may perform precise
manipulations, which may be accompanied by a "click" as joints are
restored to their full range of movement.
Sprains,
stiffness, and injuries such as whiplash or the locking of a vertebra in the
neck can be treated with osteopathic manipulation, shown here, or by soft
tissue treatment. This uses light massage and rhythmic stretching techniques
designed to improve joint mobility by decreasing muscle tension and improving
blood supply to the tissue.
PRECAUTIONS
- Do not have
osteopathy if you have bone cancer or any bone or joint infection, such as
osteomyelitis.
-
Avoid vigorous
osteopathic manipulation if you have badly prolapsed disks.
CRANIAL OSTEOPATHY
An
American osteopath, Dr. William Garner Sutherland, developed cranial osteopathy
in the 1930s. At that time, it was believed that the bones of the cranium (the
part of the skull around the brain) fused by adulthood and could not be
adjusted. According to Dr. Sutherland, however, these bones, which are separate
in babies and young children, do retain flexibility. He also believed that the
cerebrospinal fluid, which nourishes and protects the membranes encasing the
brain, spinal cord, and sacrum, pulses at a rate of about 6-15 times per
minute. This cranial rhythmic impulse (CR1) is difficult to measure with
equipment, but practitioners claim to be able to sense it by touch.
Disturbances in the flow of fluid are said to
reflect pressures on the cranial bones or injuries and tension in the body,
which can be eased by delicate manipulation of the cranial and spinal bones to
restore the CR1 and boost blood circulation and drainage of lymph and sinus
fluids in the head.
Cranial
osteopathy may be used for the same conditions as osteopathy, and can be
combined with other osteopathic methods. It seems particularly successful on
young children with colic, middle ear effusion (glue ear), and recurrent
infections, and is often used on babies to correct distortions in the cranial
bones caused during birth. If these are not eased back into place, or are
knocked slightly out of position later in life, it may lead to physical
problems.
Other variations focus less on the bones than
on other parts of the cranial system. The reflex approach aims to relieve
stress patterns in the body by stimulating nerve endings in the scalp and
between the cranial bones. The sacro-occipital technique, preferred by
chiropractors, combines elements of cranial osteopathy with craniosacral techniques.
|
Compatibility
