|Other natural treatments for
Author/s: J. Ricker Polsdorfer
Osteopathy is a system and philosophy of health care that separated from traditional
(allopathic) medical practice about a century ago. It places emphasis on the
musculoskeletal system, hence the name--osteo refers to bone and path refers to disease.
Osteopaths also believe strongly in the healing power of the body and do their best to
facilitate that strength. During this century, the disciplines of osteopathy and
allopathic medicine have been converging.
Purpose of Osteopathy
Osteopathy shares many of the same goals as traditional medicine, but places greater
emphasis on the relationship between the organs and the musculoskeletal system as well as
on treating the whole individual rather than just the disease.
Precautions for Osteopathy
Pain is the chief reason patients seek musculoskeletal treatment. Pain is a symptom,
not a disease by itself. Of critical importance is first to determine the cause of the
pain. Cancers, brain or spinal cord disease, and many other causes may be lying beneath
this symptom. Once it is clear that the pain is originating in the musculoskeletal system,
treatment that includes manipulation is appropriate.
Description of Osteopathy
Osteopathy was founded in the 1890s by Dr. Andrew Taylor, who believed that the
musculoskeletal system was central to health. The primacy of the musculoskeletal system is
also fundamental to chiropractic, a related health discipline. The original theory behind
both approaches presumed that energy flowing through the nervous system is influenced by
the supporting structure that encase and protect it--the skull and vertebral column. A
defect in the musculoskeletal system was believed to alter the flow of this energy and
cause disease. Correcting the defect cured the disease. Defects were thought to be
misalignments--parts out of place by tiny distances. Treating misalignments became a
matter of restoring the parts to their natural arrangement by adjusting them.
As medical science advanced, defining causes of disease and discovering cures, schools
of osteopathy adopted modern science, incorporated it into their curriculum, and redefined
their original theory of disease in light of these discoveries. Near the middle of the
20th century the equivalance of medical education between osteopathy and allopathic
medicine was recognized, and the D.O. degree (Doctor of Osteopathy) was granted official
parity with the M.D. (Doctor of Medicine) degree. Physicians could adopt either set of
However, osteopaths have continued their emphasis on the musculoskeletal system and
their traditional focus on "whole person" medicine. As of 1998, osteopaths
constitute 5.5% of American physicians, approximately 45,000. They provide 100 million
patient visits a year. From its origins in the United States, osteopathy has spread to
countries all over the world.
Osteopaths, chiropractors, and physical therapists are the experts in manipulations
(adjustments). The place of manipulation in medical care is far from settled, but millions
of patients find relief from it. Particularly backs, but also necks, command most of the
attention of the musculoskeletal community. This community includes orthopedic surgeons,
osteopaths, general and family physicians, orthopedic physicians, chiropractors, physical
therapists, massage therapists, specialists in orthotics and prosthetics, and even some
dentists and podiatrists. Many types of headaches also originate in the musculoskeletal
system. Studies comparing different methods of treating musculoskeletal back, head, and
neck pain have not reached a consensus, in spite of the huge numbers of people that suffer
The theory behind manipulation focuses on joints, mostly those of the vertebrae and
ribs. Some believe there is a very slight offset of the joint members--a subluxation.
Others believe there is a vacuum lock of the joint surfaces, similar to two suction cups
stuck together. Such a condition would squeeze joint lubricant out and produce abrasion of
the joint surfaces with movement. Another theory focuses on weakness of the ligaments that
support the joint, allowing it freedom to get into trouble. Everyone agrees that the
result produces pain, that pain produces muscle spasms and cramps, which further
aggravates the pain.
Some, but not all, practitioners in this field believe that the skull bones can also be
manipulated. The skull is, in fact, several bones that are all moveable in infants.
Whether they can be moved in adults is controversial. Other practitioners manipulate
peripheral joints to relieve arthritis and similar afflictions.
Manipulation returns the joint to its normal configuration. There are several
approaches. Techniques vary among practitioners more than between disciplines. Muscle
relaxation of some degree is often required for the manipulation to be successful. This
can be done with heat or medication. Muscles can also be induced to relax by gentle but
persistent stretching. The manipulation is most often done by a short, fast motion called
a thrust, precisely in the right direction. A satisfying "pop" is evidence of
success. Others prefer steady force until relaxation permits movement.
Return of the joint to its normal status may be only the first step in treating these
disorders. There is a reason for the initial event. It may be a fall, a stumble, or a mild
impact, in which case the manipulation is a cure. On the other hand, there may be a
postural misalignment (such as a short leg), a limp, or a stretched ligament that permits
the joint to slip back into dysfunction. Tension, as well as pain, for emotional reasons
causes muscles to tighten. If the pain has been present for any length of time, there will
also be muscle deterioration. The osteopathic approach to the whole person takes all these
factors into account in returning the patient to a state of health.
Other repairs may be needed. A short leg is thought by some to be a subluxation in the
pelvis that may be manipulated back into position. Other short legs may require a lift in
one shoe. Long-standing pain requires additional methods of physical therapy to
rehabilitate muscles, correct posture, and extinguish habits that arose to compensate for
the pain. Medications that relieve muscle spasm and pain are usually part of the
treatment. Psychological problems may need attention and medication.
Risks of Osteopathy
Manipulation has rarely caused problems. Once in a while too forceful a thrust has
damaged structures in the neck and caused serious problems. The most common adverse event,
though, is misdiagnosis. Cancers have been missed; surgical back disease has been ignored
until spinal nerves have been permanently damaged.