Philosophy and characteristics of osteopathy.
Osteopathy offers a wide range of approaches to maintaining health and disease management. Osteopathy is based on the following principles for the treatment of the patient:
- The human being is a functional dynamic unit, whose state of health is influenced by the body, mind and spirit;
- The body has mechanisms of self-regulation and natural self-healing;
- The structure and function are interrelated at all levels of the human body.
In this framework, osteopaths incorporate current medical and scientific knowledge in the application of osteopathic principles in patient care. Osteopaths recognize that the clinical signs and symptoms of each patient are the consequences of the interaction of many physical and non-physical factors. Emphasis is placed on the dynamic interrelation of these factors and the importance of the therapist-patient relationship in the therapeutic process. The form of health care is about focusing on the patient, rather than focusing on the disease.
Structural diagnosis and osteopathic manipulative treatment are the essential components of osteopathy. Osteopathic manipulative treatment was developed as a means to facilitate the normal mechanisms of self-regulation/self-healing of the body, addressing areas of tension, stress or tissue disorder, which can prevent normal neural, vascular and biochemical mechanisms.
The practical application of this approach is based on various structure-function relationship models described below. Osteopaths use them to collect and structure diagnostic information and to interpret the meaning of neuro-musculo-skeletal findings for the patient’s general health. Osteopathy is therefore not limited to the diagnosis and treatment of musculoskeletal disorders, nor does it emphasize the alignment of the joints and the radiological evidence of structural relationships. Osteopathy is more interested in how the biomechanics of the musculoskeletal system integrates and supports the physiology of the entire body.
Although manual techniques are used by various professions of manipulative therapies, the only way where osteopathic manipulation techniques are integrated into the patient’s management, as well as the duration, frequency and choice of technique, are distinctive aspects of osteopathy. Osteopathic manual treatment employs many types of manipulation techniques, including the spine and impulse techniques, as well as gentle techniques.
Structure-function relationship models.
Five main models of structure-function relationships guide osteopaths in the diagnosis and treatment approach. These models are usually used combined to provide a framework for interpreting the meaning of somatic dysfunction within the context of objective and subjective clinical information. The chosen combination is adapted to the patient’s differential diagnosis, co-morbidities, other therapeutic regimens and response to treatment.
The Structure-Function Biomechanical Model.
The biomechanical model considers the body as an integration of somatic components that are related as a mechanism for posture and balance. Imbalances or stress within this mechanism can affect the dynamic function, increase energy expenditure, alter proprioception (the proper sense of the relative position and movement of the neighboring parts of the body), change the structure of the joints, prevent neurovascular function and alter the metabolism. This model applies therapeutic approaches, including manipulative osteopathic techniques, to allow restoration of posture and balance and efficient use of musculoskeletal components.
The structure-respiratory/circulatory function model.
The respiratory/circulatory model is interested in maintaining the extracellular and intracellular environment through the unrestricted supply of oxygen and nutrients, and in the elimination of cellular waste products. Stress in tissues or other factors that interfere with the flow or circulation of any body fluid can affect tissue health. This model applies therapeutic approaches, including manipulative osteopathic techniques, to deal with dysfunction of respiratory mechanics, circulation and flow of body fluids.
The structure-neurological function model.
The neurological model considers the influence of spinal facilitation, proprioceptive function, the autonomic nervous system, and the activity of nociceptors (pain fibers) on the function of the neuroendocrine immune network. The relationship between the somatic and visceral (autonomous) systems is of particular importance.
This model applies therapeutic approaches, including osteopathic manipulation techniques, to reduce stresses or mechanical stress, balance neuronal information, and reduce or eliminate nociceptive conduction.
The Structure-Function Bio-psycho-social model.
The bio-psycho-social model recognizes the various reactions and psychological stress that can affect the health and well-being of patients. These include environmental, socio-economic, cultural, physiological and psychological factors that can influence the disease. This model applies therapeutic approaches, including osteopathic manipulation techniques, to deal with the effects and reactions of the different types of bio-psycho-social stress.
The Structure-Function Bio-Energy Model.
The bio-energy model recognizes that the body tries to maintain a balance between that of production, distribution and energy expenditure. Maintaining this balance helps the body in its ability to adapt to different stress factors (immunological, nutritional, psychological, etc.) This model applies therapeutic approaches, including osteopathic manipulation techniques, to address the factors that have the potential to deregulate production, distribution or energy expenditure.