Osteopathy was born in the late 19th century based on an ideology of Andrew Taylor Still, an American physician, who devoted many years of his life studying human body. His method included meticulous dissection of corpses in order to get a better knowledge of its structures and functions, he was fascinated by alternative treatments and their beneficial effects, he spent a lot of time practicing it, to find different modalities to promote health care.
To understand the birth of this ideology it is necessary to contextualize it, considering the medical beliefs of the time and the related therapies, little was known about many pathologies and treatments were often a source of further aggravation. Still believed that osteopathy was a necessary discovery because the current medical practices of his days often caused significant harm and conventional medicine had failed to shed light on the etiology and effective treatment of disease.
The origin of this ideology is not linked to a specific moment but rather the consequence of various events and observations that led Still to notice the involvement of the musculoskeletal system in most of the dysfunctions and pathologies of the organism. He believed that behind most of the symptoms complained by patients there was a dislocation, asymmetry, stiffness or any other disorder of myofascial system and joints. This kind of disorders would impact the proper function of the organism causing alteration of correct mobility, reduction of fluid flow and malfunction of nervous system ultimately affecting homeostasis. The crucial involvement of musculoskeletal system is the reason behind the therapeutic approach developed by Still, who focused is treatment on manual body adjustment, that is also why a detailed anatomical knowledge was fundamental to him.
There were quite a few obstacles to the birth and consequent evolution of osteopathy, first by the medical institutions of the time reluctant to this innovation and secondly due to differences within the osteopathic world which, after all, persist even today. However, despite conflicts, the benefits of the treatment experienced by the patients were the reason for the recognition and acceptance of this practice, which is constantly evolving thanks to the contribution of the various osteopaths in history and to the continuous updating based on new scientific evidence. Due to the lack of papers and research regarding osteopathic philosophy it wasn’t simple and clear to identify the basic principles underlying this profession, as intended by Still, nevertheless, the main universities and institutions agreed in the choice of common points and founding principles of osteopathic therapy.
First, one of the main features is represented by the holistic overview of the person, meaning that the evaluation is not limited to the physical issue or symptoms reported but includes a general understanding of the person, also investigating the lifestyle, habits, history, environment and psycho-emotional sphere. This complete and global research is intended to have an idea of the integrity of all the systems, the energetic capacity and inner balance. The person is indeed considered as a complex unity of body, mind and spirit.
Another important aspect is to focus on body’s intrinsic self-regulation and self-healing mechanisms, that allow the body to recover itself and to maintain health, good practitioners should always keep in mind that they are not healing the body, but they are removing the obstacles that prevent body self-healing capacity. This goal of osteopathic practitioners to look for health instead of focusing on symptoms and illness represents one of the main reasons of conflict with conventional medicine, preventing, for many years, the inclusion of this profession into the health care system.
A further principle is the relation between structure and function which are considered to influence each other and to be interrelated at any level in the body, this implies that any change of the structure impact the function and vice versa. With all these principles in mind the osteopathic doctor should provide a rational treatment, find the primary cause of the disorder, fix it and let the body recover itself.
It is possible to summarize these concepts into four main principles:
- The human being represents a dynamic functional unit, whose state of health is influenced by body, mind and spirit.
- The body is capable of self-regulation, self-healing, and health maintenance.
- Structure and function are reciprocally interrelated at any level.
- Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.
Behind these principles lies the peculiarity of osteopathy as well as the difference from other manual therapies, especially physiotherapy, one of the most frequent questions asked by patient is indeed which is the difference between them. Basically, the difference is represented by the method and the aids used, while physiotherapist provide a treatment to recover a part of the body that lost its function and suffers following either trauma, surgery or a pathology, using manual technique or even electromedical devices and suggesting exercises, osteopath do not treat only the suffering part but they search for the primary cause keeping a general look on the body and treating it by using manual techniques and no devices. Moreover, a further peculiarity of osteopathy it must be identified with perceptive palpation, the touch.
Osteopathic doctors heavily rely on palpation for both structural evaluation and treatment, despite the poor evidence in support of palpation reliability. From the very beginning of his training journey, an osteopathy student learns how to connect with people's bodies and how to feel changes in density, consistency, mobility, all this supported from a deep knowledge of anatomy and physiology. Finally, osteopathic manipulative treatment (OMT) is person centered, every treatment must be planned considering what caused the current situation, body capacity, patient’s expectation to set a proper therapeutic goal, not only during the first visit but every following treatment.
Nowadays osteopathic medicine can be defined as an alternative and complementary therapy that relies on manual contact for diagnosis and treatment, it respects the relationship between body, mind and spirit both in health and disease conditions while the emphasis is placed on the structural and functional integrity of the organism and on its intrinsic tendency to self-healing. Osteopaths use a wide range of manual techniques, aimed at improving physiological function and supporting homeostasis that has been altered by a somatic dysfunction, for example impairment or alteration of the somatic system; skeletal, arthrodial and myofascial structures; and the related vascular, lymphatic and neural elements. Structural diagnosis and OMT are essential components of osteopathy and was developed as a tool to facilitate the physiological self-regulation and self-healing mechanisms present in the body by acting on areas of tissue tension (strain), stress or dysfunction that may hinder the physiological neural, vascular and biochemical mechanisms.
In pursuance of his core principles, to meet therapeutic goals and finally assist people’s recovery the osteopathic doctor get help from a careful observation of body alignment, balance, mobility quality and antigravity response.
In conclusion, osteopathic medicine is a relatively young profession that has faced a great grow making itself known first in America and subsequently in Europe, albeit with differences and not without internal friction, however it has continued to gain fame both thanks to the results obtained in improving the condition of patients and thanks to his holistic and overall vision of the person. Ultimately, the future goal is to spread throughout the world by integrating into the health system by collaborating with other therapeutic figures in order to improve the health of people.
