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.
Within that framework, osteopathic practitioners incorporate current medical and scientific knowledge when applying osteopathic principles to patient care.
Osteopathic practitioners recognize that each patient’s clinical signs and symptoms are the consequences of the interaction of many physical and nonphysical factors. It emphasizes the dynamic interrelatedness of these factors and the importance of the patient-practitioner relationship in the therapeutic process. It is a patient–centred, rather than disease-centred, form of health care.
Structural diagnosis and osteopathic manipulative treatment are essential components of osteopathy. Osteopathic manipulative treatment was developed as a means of facilitating normal self-regulating/self-healing mechanisms in the body by addressing areas of tissue strain, stress or dysfunction that may impede normal neural, vascular and biochemical mechanisms.
The practical application of this approach is based on several structure-function relationship models described below. Osteopathic practitioners use these to gather and structure diagnostic information and to interpret the significance of neuromusculoskeletal findings for the overall health of the patient. Osteopathy is thus not limited to the diagnosis and treatment of musculoskeletal problems, nor does it emphasize joint alignment and radiographic evidence of structural relationships. Osteopathy is more concerned with the manner in which the
biomechanics of the musculoskeletal system are integrated with and support the entire body physiology.
Although manual techniques are used by various manipulative therapy professions, the unique manner in which osteopathic manipulative techniques are integrated into patient management, as well as the duration, frequency and choice of technique, are distinctive aspects of osteopathy. Osteopathic manipulative treatment employs many types of manipulative techniques, including spinal thrust and impulse techniques, as well as gentle techniques.
(Reference: WHO: Benchmarks for training in osteopathy, P 3, 2010.)
The philosophy and science of osteopathy is based upon the following four principles:
1. Structure and Function are Interrelated
From the smallest cell to the largest bone, all of anatomy is alive and in constant dynamic, rhythmic motion. Blood flows, lymphatics drain and cerebral spinal fluid fluctuates. The heart beats and the ribcage expands and contracts with each respiration. Each and every organ gently moves as it functions. Each and every structure has its own inherent rhythmic activity. This is the living anatomy that osteopathic physicians feel with their hands. When this motion becomes impaired, the tissues will not function as they were intended. As a result of this altered motion, symptoms develop, and disease may even occur. Dr. Still described this process in the following way, “Disease is the result of anatomical abnormalities followed by physiologic discord.”
Dr. Still described the body as being like a machine. It has interrelated parts that need to be in proper position and to move correctly for optimal function. For example, taking a deep breath may be difficult if the ribs, diaphragm or parts of the spine do not move well. When breathing is impaired, lymphatic drainage (necessary for clearing congestion and inflammation) will also be impaired. This may lead to the development of asthma or respiratory infections.
A dramatic example of how well osteopathic physicians understand the importance of the structure and function relationship is the influenza epidemic of 1917-1918. Approximately 30,000,000 people died worldwide. In the U.S., osteopathic physicians treated their patients with osteopathic manipulation and were quite successful in decreasing mortality from the disease. In fact, while hospitals run by MD’s reported a 30 to 40 percent mortality rate, osteopathic hospitals reported a mortality rate of less than one percent.
2. The Body is a Single Dynamic Unit of Function
There are many unifying systems within the body. The circulatory system supplies blood to every tissue and organ. The nervous system connects and integrates all of the body’s functions.
A third unifying system is comprised of a connective tissue matrix called fascia. The fascia is a continuous sheath of living tissue that connects the body front to back, head to toe. It surrounds every muscle, organ, nerve and blood vessel. A primary function of this fascial system is to support and lubricate. Thus, the circulatory system, the nervous system and the fascia all help to organize the body into a unified continuous whole. No single part exists independent of the whole. When even a small part of the body does not function optimally, the entire person is affected.
Consider the circulatory system. Dr. Still stated, “The rule of artery and vein is universal in all living beings, and the osteopath must know that and abide by its rulings, or he will not succeed as a healer.” 3 Dr. Still used these words to describe the essential need for optimal fluid exchange. When blood and other fluids flow freely, the tissues can perform their physiologic functions without interference. When injury or disease occurs, the result can be a twisting or compression of all tissues, including the circulatory system. The blood and fluid flow becomes obstructed and areas of the body may become under- nourished and vulnerable. This effect may be a significant factor in causing disease. It is similar to trying to water a garden with a kinked hose. The water will not flow properly and the garden will not receive its proper nutrition.
Understanding this concept of functional unity allows osteopathic physicians to diagnose and treat their patients as a functional whole. This may explain why an osteopathic physician may treat an area that is fairly distant from the area of pain or injury.
3. The Body Possesses Self-Regulatory and Self-Healing Mechanisms
The human body is always working to maintain a state of balanced function. For example, blood pressure, blood sugar and the heart rate are actively kept within a normal range. When there is a laceration or tear in the tissues, a physician can assist by cleaning the wound and bringing the edges together, but healing occurs by the action of inherent forces and processes within the body.
Dr Still stated, “All the remedies necessary to health exist in the human body.” 4 He understood that within the tissues, there is an inherent wisdom, a wise all-knowing restorative force, an intelligence within every cell that keeps the body well. When a state of discord arises, this healing force acts to restore functional balance and harmony. Sometimes the body’s self-healing forces can be impaired or impeded by disease or structural imbalance. The osteopathic physician is trained to augment these intrinsic mechanisms to help the body to better and more quickly heal itself.
4. Rational Treatment is Based on Applying These Principles
Osteopathic treatment applies these principles with a sound and thorough knowledge of anatomy and physiology. An osteopathic medical approach to treatment typically integrates osteopathic manipulation to restore structural freedom in the tissues, enhance fluid flow throughout the body, and creates the optimal setting for healing to occur.