Osteopathy – Overview
Osteopaths believe most of the pain and problems we suffer stem from abnormalities of body posture and mechanics. Osteopathy looks at the soft tissues, especially the fascia, as a major determinant of joint function, rather than the other way around. By correcting abnormal and dysfunctional movements, many of the imbalances that cause pain will decline, allowing the body to heal. Osteopathy is based on the tenet that given the opportunity, the body is very capable of self-healing, adjusting and self-repair.
What kinds of conditions benefit most from osteopathy?
Any painful structural condition, particularly if chronic, may respond to osteopathy, especially when treatment starts in a relatively early phase. An osteopathic approach works best in cases where there’s no obvious lesion dictating standard medical treatment. Conditions that respond to osteopath:
- Back pain
- Carpal tunnel
- Tennis elbow
- Plantar fasciitis
- Patellofemoral syndrome
- Chronic migraine
How do you diagnose patient symptoms?
Like medical doctors, we rely very much on history. Asking the proper questions can unmask about 80-90% of the root of the problem. I ask patients about their activities — both at home and at work — and I also want to know about their diet, sleep patterns, and how they handle stress. This is followed by a thorough physical, a look at any imaging studies or lab work, and then a presumptive diagnosis is made. I monitor the individual carefully while starting treatment to gauge whether there are any improvements, which would confirm the diagnosis.
Our approach is to step back and assess the entire patient. Symmetry, ease and efficiency of movement are noted. We do a neurologic and orthopedic examination — not just for the presenting area but also for all the areas that may influence or be affected by the painful part.
The physical exam is a search for underlying abnormal forces that cause structural malalignments. For example, many patients with back pain have abnormalities of their gait, including weakened plantar fascia (so-called fallen arches) and/or abnormal leg, knee and hip movements.
Osteopaths usually find several problems, all triggering other issues in a vicious cycle. As a result, we place special emphasis on the spine because of the role it plays in stabilizing the body. Every level is assessed for movement in all three dimensions.
The physical exam includes a test of the range of motion of the joints, both passive and active. Most importantly, soft tissues are examined for dysfunctions such as muscle over- or under-activity, inflammation, scar tissue, poor local circulation, congestion, abnormal nerve function.
Osteopathic Treatment for Chronic Pain Relief
Osteopathy treatment depends on the patient’s needs. The focus is on fascial release using techniques such as strain/ counter strain, proprioceptive neuromuscular facilitation and muscle energy techniques.
Proprioreceptive neuro facilitation is a hands-on technique where the therapist matches and counters the muscle contraction effort of the patient to achieve an isometric type of exercise.
The carefully ordered application of osteopathy therapy can correct the firing pattern of muscle groups providing balance to the soft tissues around a joint. The idea behind all these approaches is to apply a tiny but precise amount of force to promote movement of tissue fluids and to release compression and other abnormal forces acting on the muscles and joints.
Osteopaths also do osteoarticular adjustments, using a low-velocity, low-amplitude movement. It’s a gently applied impulse aimed at allowing the strained articulation to return to its natural position and function.
To clarify, we would look at the joints only after correcting the fascia abnormalities as much as possible.
The osteopathic treatment would consist of manual therapy to free restricted tissue around the low back and SI joints. Any other contributing factors, e.g. in the legs, need to be addressed as well.
The patient is given a series of home exercises to reinstate the correct muscle firing patterns and to prevent the problem from returning. These exercises may change as the patient’s muscles strengthen over time.
Custom orthotics can help support abnormally lax plantar and ankle joint ligaments, which might be triggering compensation up to the entire kinetic chain.