What is Osteopathy?

Most patients consulting osteopaths seek relief from musculoskeletal pain and discomfort. With 4 out of 5 people suffering with back, neck, or joint pain at some point in their lives, patients are increasingly turning to osteopathy for help.

Osteopathy is a drug-free noninvasive manual medicine that focuses on total body health by treating and restoring balance in the different systems at work in the body; such as the musculoskeletal system, which includes the joints, muscles and spine.

Dr. Andrew Taylor Still established the practice of Osteopathy in the late 1800s in the United States of America, with the aim of using manual techniques to improve circulation and correct altered biomechanics, without the use of drugs. Based on simple holistic principles, osteopathy quickly developed into the established complementary medicine we know today.

The philosophy of Osteopathy is what sets it apart from other medical disciplines. The key principles are based on the holistic nature of the body; all parts of the body are designed to function together in an integrated manner. If one part of the body is restricted, then the rest of the body will be forced to adapt and compensate, eventually altering the function of the affected structure, resulting in inflammation, pain, stiffness and in the long term possible serious health conditions.

Osteopaths use a broad range of gentle hands-on techniques including soft tissue stretching, deep tactile pressure, mobilization and joint manipulation. Each of these techniques always aims to restore tissue mobility. Once restrictions are lifted, the reduction of inflammatory stress combined with greater mobility allows the body’s self healing mechanism to function, thus providing the body with the opportunity to heal itself.

Osteopathy is a unique holistic approach to health care. Osteopaths do not simply concentrate on treating the problem area, but use manual techniques to find and treat the cause, thus restoring the balance in the different body’s systems and allowing the body to reach homeostasis, in other words good health and wellbeing.

Structural Osteopathy

Structural osteopathy is the better know facet of osteopathic medicine. Quite often the term is wrongly used to define osteopathy itself. Structural osteopathy describes the diagnosis and treatment of dysfunctions in the musculoskeletal system, in the same way visceral osteopathy relates to the visceral system. Restrictions within the musculoskeletal system can find their origins in diverse structures and tissues; they can take form in dysfunction of bones and joints, muscle tension and fibrosis, fascial adhesions, etc.

Based on specific principles, structural osteopathy recognizes the importance of the interdependence between the body structure and its function. A dysfunction of a joint or tissue, generally characterized by a decrease in mobility and tightness, will affect the biomechanics and overall function of that area. As a result more strain will be put on the surrounding structures which have to compensate. With time and chronicity, the increased stress resulting from the change in function will progressively cause a restriction of the compensating structure as well. Similar to falling dominos the process starts again with compensations arising in another area.

As long as the body has the ability to compensate for the many restrictions in the musculoskeletal system, little or occasional discomfort and twinges will be felt. However if left untreated, chronic compensation patterns will often result in more serious injuries and inflammation of the musculoskeletal system. In the spine, the most common sites affected by acute dysfunctions and injuries are the neck and low back area. Similarly bigger joints such as hips and knees can get inflamed from the added strain resulting from compensation patterns. The more chronic patterns will often result in the early wear and tear and degeneration of the affected joint structure.

The role of the osteopath is not only to diagnoses and treat the local dysfunction of the structure causing pain, but to investigate for any compensation chains in the musculoskeletal system arising from previous traumas and injuries. Once the cause of the dysfunction and compensation is treated and normal biomechanics restored, the body is given the ability to heal itself again and to reachieve balance within the different body systems.

During a structural osteopathic treatment, a wide range of direct techniques such as spinal adjustments, joint articulation and deep soft tissue massages may be utilized by the osteopath in order to release tensions in the musculoskeletal system and restore the body’s biomechanics. Similarly other more gentle techniques, commonly described as indirect techniques, will be used to treat structures for which the practitioner feels are more appropriate, such as with patients suffering with osteoporosis and other chronic conditions. The osteopath will never base his treatment approach on his preferences but will take into account the patient’s medical history and assess what approach the body structure and tissues need.

Common conditions:

  • Low back pain and sciatica
  • Neck pain and headaches
  • Repetitive injuries
  • Tendinitis
  • Arthritis and joint pain
  • Frozen shoulder
  • Sports injuries
Cranial Osteopathy

As visceral osteopathy, cranial osteopathy is an integral part of Osteopathy. Established at the beginning of the 20th century by W.G Sutherland, it is based on the diagnosis and treatment to the involuntary motion of the cranial bones and sacrum.

Contrary to popular belief, bones forming the skull are not fused with each other and follow a subtle rhythmic movement initiated by different mechanisms within the brain. To this day the origin of the cranial rhythm is still controversial amongst osteopaths.

Cranial osteopaths train for years palpate this fine movement, called the cranial rhythm, which is related with the cerebrospinal fluid production within the 4th ventricle inside the brain.

The cerebrospinal fluid is a bodily fluid that surrounds the brain and acts as a cushion for the central nervous system (brain, spinal cord). Its importance lies in its function; it allows to drain, protect, and regulate the different nervous tissues. The synthesis of is characterised by two phases: the production phase when the CSF is spread in between the meningeal layers. And the absorption phase when part of the CSF is reabsorbed into the venous system.

In a healthy craniosacral system, the CSF pulsates at around 7-14 times a minute and thus defines the physiological cranial rhythm. In the case of tensions, whether of emotional or physical origin, stresses and strains may disrupt the balance in the body’s systems and with time can result in discomfort and may facilitate the occurrence of more specific conditions.

In treating the cranial rhythm, the practitioner will first assess the patient’s rhythm as well as any specific restriction of the structures of the cranial and sacral system. Gentle pressure is then applied to correct and restore the mobility of the affected structure. As a result, the correct function of nervous system and CSF flow can be restored, allowing the body’s powerful self healing mechanism to fully express itself. Cranial osteopathy thus affects the whole body by resetting homeostasis through the different body systems.

With its very gentle approach, cranial osteopathy is suitable for patients of all ages. It is particularly helpful for newborns and babies, as the cranial system suffers immense stress during birth; Babies with conditions such as colic, otitis media and general unsettlement are often affected by cranial tensions.

In adulthood, cranial osteopathy can help to release tensions arising from emotional and physical stress.

Common conditions:

  • Headaches and migraines
  • Chronic conditions
  • Hormonal imbalance
  • Sleeping disturbance
  • Otitis and glue ear
  • Tinnitus
  • Sinus congestion
  • Jaw mal occlusion and dysfunction
Visceral Osteopathy

Similar to cranial osteopathy, visceral osteopathy must not be considered as a separate branch but as an integral part of the osteopathic field. Based on the same philosophic principles, it simply enables the osteopath to assess and treat a wider range of medical and osteopathic conditions, giving more holistic approach to diagnosis and treatment.

A restriction in the mobility of an organ will inevitably result with time with an impairment of the organ’s function. With chronicity the dysfunction may lead to changes in the organ’s structure. For example, a dysfunction of the stomach will often trigger pyrosis or acid reflux. Diagnosed on time, this process is reversible, however if untreated the condition will commonly degenerate and possibly result in ulcers and more serious health problems.

Andrew Taylor Still, the founder of osteopathy considered that "mobility is life"; when regarding visceral osteopathy we find this is especially true. Physiological mobility of an organ is the ability for relative movement within the abdominal/thoracic cavity. This freedom of movement gives the organs enough elasticity enable them to accomplish their digestive, respiratory and circulatory function. The organ’s mobility can be affected by various causes, from intense emotional stress, direct trauma, scar tissue and surgical adhesions, drugs and alcohol, to infections and chronic musculoskeletal problems.

A restriction of the organ will not only affect its own function but as well the surrounding structures; for example a congestion of the liver can give rise to recurring stitches due to its attachment to the abdominal diaphragm. Similarly a visceral dysfunction can trigger symptoms in musculoskeletal system, such as menstruation related low back pain.

In fact due to the relative poor innervations of the organs, visceral problems will most often manifest themselves though referred pain elsewhere in the body; and many persistent chronic musculoskeletal conditions are found to be linked with an underlying dysfunction in the visceral system.

Trough palpation, the osteopath can assess for any dysfunctions and adhesions of the visceral organs altering their mobility and function.

The practitioner will treat the affected organ using a combination of gentle massage and soft tissue techniques as well as more subtle functional techniques to release deeper tissues. Although sometimes mildly uncomfortable, visceral examination and treatment is generally pain free because of the use of light touch. It is suitable for all patients, from babies with digestive difficulties, to adults with visceral or menstrual pain.

Common Conditions:

  • Constipation/diarrhoea
  • Nausea and vomiting
  • Heartburn and digestive problems
  • Repetitive respiratory tract infections
  • Menstrual and premenstrual pain
  • Gynaecological conditions
  • Infertility
Sport Injuries

No matter the level of sport practised, all of us have suffered from sport injuries at some point in our lives. As the physical demand on the body increases with activity, mild aches and pains might/should occur while practicing sports; however persistent and recurrent discomfort if left untreated can result in potentially serious injuries.

Sport injuries can be divided into two different categories: acute and chronic injuries.

Acute injuries generally have a traumatic onset. These injuries are very common in impact and adrenaline sports. Practicing any sport which involves sudden impacts such as football and rugby; increases the incidence of sports injuries; ankle and knee sprains, fractures, joint subluxation and dislocation or haematoma are unfortunately very common.

In the event a severe acute traumatic sports injury, it is always best to consult your GP to assess the severity of the injury using medical imagery; X-rays will show injuries to bones and scans enable to assess any damage to soft tissues.

Chronic injuries are often the result of repetitive strain. Frequently occurring without any trauma, the lesser severity often gives a much better prognosis than traumatic injuries. Chronic injuries are generally the consequence of the incapacity of the body to effectively cope and compensate for the strain inflicted by the sport activity.

Injuries such as recurrent muscle and tendon strains and joint inflammation will generally occur with prolonged misuse of the affected structure. Inappropriate technique or occasionally structural abnormalities such as old fractures and congenital deformities will increase the localised strain on the musculoskeletal system. Very often chronic sports injuries are the long term result of untreated precedent acute sports injuries, which have resulted in the alteration of the normal biomechanics of the body.

Osteopathic treatment will vary depending on the type and severity of the injury. Serious injuries such as ruptured tendons and fractures do not necessitate osteopathic treatment until the body has healed. For injuries of lesser gravity, osteopathic treatment will aim to reorganise and rebalance tensions in local musculoskeletal tissues resulting for the injury. As well specific stretches and strengthening exercises may also be given for rehabilitation purpose.

But more importantly, using a holistic approach the osteopath assesses for any compensation patterns arising from other traumas, which compromise the integrity and function of the affected joint and muscle.

Osteopathy for the elderly

Arthritis is a general name which includes different orthopaedic conditions; it refers to the inflammatory condition of a joint.

True inflammatory arthritis refers to pathological conditions, such as rheumatoid arthritis; however the term has been popularised and is now commonly used to describe degenerative arthritis, also known as osteoarthritis or “wear and tear”.

Degenerative arthritis is in fact a mechanical condition, in which a joint is unable to withstand the stress applied to it and with time will wear down and degenerate.

Osteoarthritis will thus predominantly affects weight bearing joints; such as knees, hips and the lumbar spine. Due to its great range of movement the cervical spine is also an extremely common site for arthritis of the spine or spondylosis. In fact research as shown that the first signs of degeneration commonly appear in the neck as early as 25 years of age!

Primary osteoarthritis is an inevitable process with aging. As we get older, our body systems loose in vitality and efficacy; resulting in slower and less efficient tissues draining, repairing and growing. There will arise an imbalance between the strain and forces applied on the joint and the healing ability of this latter, this disharmony in the homeostasis then leads to degenerative changes.

Secondary osteoarthritis is the long term consequence of an injury to the joint; whether of traumatic, pathological or congenital onset. Secondary wear and tear appears as a result of an alteration of the joint structure and thus its function due to injury. For example, with a fracture of tibial plateau of the knee, once healed the bone’s shape will have been altered, due to possible callus formations. Stress forces will be shifted and give rise to a change in the use of the joint. Consequently, repetitive strain from walking and running will increase the cartilage erosion and thus its degeneration.

Osteopathic treatment of arthritic joints follows the same holistic philosophy as for any other condition.

On a local level, the practitioner will utilise soft tissue techniques on the surroundings muscles and fascia, combined with functional techniques to balance the tensions in the joint capsule and ligaments.

However it is on the more global approach that the osteopath will achieve the most changes; by assessing for and treating possible chronic compensation patterns arising from previous traumas, which have altered the biomechanical function of the musculoskeletal system and resulted in an increase in the stress forces applied to the joint and thus its deterioration.  

Osteopathy however, as any other kind of treatments, will not be able to cure and reverse the joint degeneration. At best it will facilitate blood/venous/lymphatic drainage, favour joint mobility and muscle relaxation, and remove any excessive stress on the joint. Osteopathic treatment will at best slow down and reduce further degeneration of the joint.

The osteopath’s aim will be to decompress affected joints with traction and articulation; break down chronic muscle fibres using deep inhibition; increase arteriovenous supply to the area; balance spinal and skeletal tensions and advise patients about simple exercises and life style changes that may transform and improve the quality of their daily lives.

In occasional cases, surgery may be necessary and patients will be referred to a specialist.

Osteopathy for babies and children

In osteopathy, we commonly say that birth is the first trauma of life. In regards to the physical and the psychological stress endured by the body throughout the birth process, one can appreciate the importance of osteopathic treatment for newborns. The osteopathic approach for treating babies and infants recognizes the exceptional strain imposed not only on the baby’s cranium but on the whole body during birth. The efficacy of cranial osteopathy for newborns and children has long been appreciated by the midwifery world and is now commonly encouraged my many midwifes.

The human skull is made up 29 different bones which assemble via relatively mobile sutures to form the cranium, face and jaw. The full ossification of these bones occurs progressively throughout the first decade of life. At birth all bones are still only composed of cartilaginous tissue with scattered ossification points. During the passage through the pelvic canal, the cranium undergoes tremendous compressive forces; as a result the bones of the cranium slightly overlap compressing the different sutures. The elasticity and mobility of the cranial tissue permits the head to absorb and slightly mold to pelvic structures in order to ease the passage through the birth canal. Often residual tensions and restrictions in the cranium will persist with either rapid or on the contrary complicated deliveries

In the event of the need for forceps and ventouse; the cranium will suffer even greater trauma. In the case of forceps delivery it is very common for the device to compress, bruise and restrict the cranial and facial bones. Ventouse delivery on the other hand will not create any compression lesions as it is a suction device. In the majority of cases, it will result in sub dermal swelling or haematoma of the superficial cranial tissues. Although the swelling usually heals within a few days, the pulling forces generated by the technique will often cause tensions and restrictions in the fascia of the head and neck

In the unfortunate event when natural delivery fails, emergency caesarian delivery is necessary. By this time, foetal distress is generally present. Osteopathic treatment will then help to relieve the stress and shock locked in the newborns body. Similarly an elective caesarian delivery will tend to be very traumatic for the foetus; although cranial tensions resulting from the pelvic delivery are avoided; the body still suffers immense shock, often characterized by tensions around the diaphragm and solar plexus. This results from the unawareness of the foetus of the whole process. With normal deliveries, when "ready" the foetus will engage in the pelvic, and throughout the delivery will have some awareness of the birth process. On the other hand, with elective c-sections, the foetus usually isn’t ready; without any warning, it is taken out of the mother’s protecting womb into the cold, having to breathe and feed on its own. The shock resulting from the sudden and unprepared change of environment will lock into the body tissues, around the diaphragm in particular. Frequently elective c-section babies are found to be unsettled especially when lying on their back and may present colic symptoms.

During the first few weeks of life, the baby will settle in his/her body, and the body’s self healing mechanisms will unwind the majority of the strains and restrictions endured by different tissues during the birth process. Most symptoms will start after that period and are the result of the body’s inability to release deeper restrictions. This period is the ideal time for osteopathic treatment, as it will complete and aid the self healing forces at work and will release tensions before they reach any state of chronicity.

In the later stages of childhood, it is common for untreated chronic cranial tensions to affect the child’s wellbeing. The most common affliction is ear infection which is often aggravated by restrictions in the temporal bones and cranial base. Similarly a chronic dysfunction of the diaphragm may alter the body’s immune system as well as the local drainage of the lungs and thoracic cage, giving rise to recurring chest and respiratory tract infections.