Discovering Osteopathy
by Peta Sneddon & Paolo Cosechi

Osteopathy is a distinctive and complete system of health care, based on broad principles that “offer a way of thinking and acting in relation to questions of health and disease” (Dr. I. M. Korr). The procedures it uses in diagnosis and treatment promote healthy functioning in a person by correcting mechanical imbalances within and between the structures of the body. By structures we mean the muscles, bones, ligaments, organs, and fascia. The fascia is a very thin layer of tissue that is found under the skin. Correcting the mechanical imbalances in the structures is done by restoring, maintaining, and improving the harmonious working of the nervous and musculoskeletal systems.

The name osteopathy (given to the therapy by Dr. Still) comes from the Greek osteon (bone) and pathos (to suffer), so it literally means suffering of the bone. The name has created some confusion, leading people to think that an osteopath treats only conditions of the bones. However, Dr. Still chose the name because he recognized the importance of a properly functioning musculoskeletal system for the total well-being of the individual.

Human Anatomy
The greatest interest of practitioners of osteopathy is the study of human anatomy and physiology. Following in Dr. Still’s footsteps, they know how important it is to have a thorough understanding of the correct position and function of each bone and other structures in the body. This is essential in order to find out about the normal and healthy working of the human body. Those working in osteopathy look at the causes of disease and suffering, originating in the abnormal working relationship that can exist within and between structures.

Dr. Still thought of the musculoskeletal system as the primary machinery of life and saw how disruptions in this delicate machine may lead to illness. For the osteopath, therefore, the physical integrity of the whole body is seen as one of the most important factors in health and disease. Rather than bone specialists, osteopaths are in fact masters in the biomechanics of the human machine.

Osteopathy and Medicine
Osteopathy and orthodox medicine have many things in common: they both use the scientific knowledge of anatomy and physiology, as well as clinical methods of investigation. In this respect, they have a similar language. The greatest differences, however, lie in the way patients are evaluated and in the approach to treatment.

As a general rule, the orthodox medical approach focuses on the end product of the problem — that is, on the illness. Treatment aims to redress the balance by giving drugs or carrying out surgery.

Osteopaths focus on tracing the changes in function that have occurred over a period of time. This is in order to try to understand the chain of events that have altered the relationship between structure and function, resulting in the present complaint.

A typical example might be a six-year-old boy who, while playing, falls very hard on his bottom. He cries bitterly and complains of pain over his sacrum for a week or so. A kiss and “rub it better” console him. During a sudden growth spurt as a teenager, the same boy complains of low back ache. By the age of eighteen, he has his first attack of sciatica, which is helped by anti-inflammatory and muscle relaxant medicine. He gives up his favorite sport, rowing, because it seems to aggravate the problem.

In his late twenties, married with a young child and a stressful job, he begins to have an irritable colon and attacks of cystitis. He takes antibiotics and changes his diet. At the age of forty, he has a major attack of low back pain and sciatica and is in bed for two weeks. At this point, hoping to avoid surgery, he visits an osteopath.

Homeostasis and the Systems Theory
The belief in the self-healing capacity of the body is very ancient, and in our Western medical tradition it can be traced back to Hippocrates. Dr. Still reaffirmed this belief at a time when it was particularly needed, and before the discovery of the law of homeostasis.

Homeostasis is the process by which every living thing makes continual adjustments to keep itself in a stable condition and function to the best of its ability. It is a self-regulating activity, with pre-set limits. For example, in the blood there must be a precise quantity of dissolved oxygen within maximum and minimum levels in order for all the body tissues to work. The body is constantly readjusting to maintain this balance.

The in-built homeostatic mechanism comes into play to restore balance where it has been disrupted and it is the result of the biological cognitive (the ability of a system to modify itself in order to stay alive) process. This occurs in every cell in the body, involving a kind of memory that is not limited to our brain and conscious thought. In this sense, the whole of our physical structure is but a bank of memories.

The Living System
Modern biology and cognitive science (the study of how we know what we know) can give us a better insight into some of Dr. Still’s theories and beliefs. Every living thing, from a single cell to the earth itself, can be seen as a living system. To see how the principles of osteopathy are rooted in our physiological make up, we can take the example of one individual cell.

When in the presence of an irritant, the cell changes its wall to protect itself, and stabilizes its internal network of communications. The result is that the life within the cell is kept in balance, through its self-adjusting, “thinking” responses. The ability to do this is found in each cell throughout the body. A cell, like any other living system, is considered to be both closed and open. It is closed because it always refers to its internal organization in its exchanges with the world around it. It is able to construct its own inner environment and is self-generating. A cell is an open system, because it is able to modify its structure in response to the stimuli it receives from outside. A living system is therefore open, because it is influenced by and responds to its outside environment. This leads us on to another important aspect of a living organism, which is the tendency to self-improvement.

Systems theory shows the depth of the structure-function relationship that is found in each and every cell of the body. This is not limited to the cell, but involves the functioning of the whole of the physical body, as well as giving us an insight into the way we relate both to ourselves and to the external world. By affirming the existence of a “total body memory” and our inherent capacity for balance and self-improvement, we can understand how the self-healing power of the body is often helped by the minimum of therapeutic intervention. Clearly, this theory also supports and justifies and holistic approach to health.

The Self-Healing Mechanism
Osteopaths believe that health, and not disease, is the natural heritage of man. The human body has inside itself — within certain limits — the capacity for self-repair and correction. It can create its own remedies, provided that good circulation is maintained, a balanced diet is eaten, a positive attitude is held and — as far as possible — you live in a pollution-free environment.

The self-healing mechanism is the backbone and sustainer of the principles and application of osteopathy. Osteopaths believe that disease primarily comes from within the individual, and so they concentrate on the person who is suffering rather than on the microorganisms that are thought to cause disease. There are, however, some stages of disease where the changes it has brought about have gone beyond the point of return. In these cases, osteopathy can help the person to function to the best of his ability, given the circumstances. Where necessary, an osteopath will refer a patient for further specialist examination and treatment.

Holistic Healing thru Osteopathy

The Principles of Osteopathy
Three of the main principles of osteopathy are:

1. Structure and function are interdependent 
2. “The rule of the artery is supreme” 
3. The unity of the human being

Structure and Function are Interdependent
Life is a dynamic process in which change is the only constant and so its main characteristic is motion. Motion — or movement — within a healthy, balanced body (or any other living thing) is fluid and rhythmical. Free movement between the body structures is essential for the health of an individual. When it is disrupted the function is in some way disturbed. Disrupted movement is the altered state that comes about before disease emerges.

When we use the term structure, we mean the muscles, bones ligaments, organs, and fascia. By the term function, we mean the way in which all the different parts of the body work within themselves and in relation to each other. The relationship between structure and function applied in a therapeutic context is probably the greatest contribution made by Andrew Still to medicine. A very good example of this relationship is the young, growing brain. The amount of varied activity that stimulates the brain to work also influences the rate and quality of the growth of the brain tissue itself.

The structure of the circulatory system is the heart, blood vessels, their valves, and the blood. If the blood vessel walls get thicker and harder — which may be caused by an imbalance in the contents of the blood — then problems may develop in the circulation.

The osteopath looks for free movement between the joints. In the spine, for example, she looks for flexibility and mobility, as without these the blood and nerve supply to the surrounding and related tissues and organs will be poor. In treatment, the osteopath aims to have a positive effect on the body’s function, even though she works directly on the structure.

The Rule of the Artery Is Supreme
This expression means that, for good health, good circulation of all body fluids is essential. Poor circulation is likely to mean that the cells will be starved of what they need to survive, and will eventually die. All the tissues in the body are made up of different kinds of cells, which get their nutrients from the fluid in which they live. The body fluid consists of the blood, lymph, which drains and cleans the tissues, and the spinal fluid that supports, nourishes and drains the central nervous system. In order for the nutrients to be easily absorbed and for waste products to be got rid of, three conditions need to be fulfilled:

• the fluid must be present in sufficient quantity
• the rhythmic movement of the cells must be constant 
• the body fluids must circulate freely

The circulatory system carries the hormones produced by the endocrine system and is controlled by the nervous system. The two systems that form a communication between all the systems of the body are the nervous and circulatory systems. In his writing, Dr. Still often emphasized the importance of one particular system — the musculoskeletal system, the lymphatic system, the fascia, etc. The reason for this was probably his intuition that in each individual case, one system was the most important factor in creating the disease. At the same time, he always maintained his vision of the unity of the whole body.

The Unity of the Human Being
 According to the Western Christian tradition, the human being consists of a threefold unit: body, mind, and spirit. This view was adopted by many of the first osteopaths and it is still held by many practitioners today. The relationship between the mind and the body is now taken into consideration by most physicians and health-care professionals. The effect of emotions such as fear, laughter, or sadness on the body, for example, is immediately apparent.

This unity of the body, and its self-healing capacity, is also evident in the neurological, endocrine, and immune systems. In the past decade, researchers have discovered that chemical substances (a variety of hormones and neurological transmitters) produced by the body are recognized by, and communicate with, these three systems. This process is a means by which the body sets in motion its healing mechanism.

For example, an inflammation in the tissues results in the release of substances that increase circulation and temperature, and cause increased sensitivity or even pain by irritating the nerve endings. This information travels in the spinal cord, and some of it goes to the brain, where it stimulates the release of hormones into the blood. It also brings to our conscious awareness the local problem. Once in circulation around the body, these hormones will affect different organs and interact with the immune system. In this way, the whole body is woken up and works as a complete unit to bring things back to normal.

The nervous and circulatory systems not only integrate the normal functions of the body but, if disturbed, can inhibit the body’s natural powers of self-healing. The body’s musculoskeletal system reflects, and may aggravate, the condition of these systems and so influence a person’s state of health. When an osteopath thinks of the interconnectedness of the body he has in his mind all of these systems.

Osteopathy and the Holistic Approach
A holistic approach to health means that every part of the body is seen within the context of the whole; that whole is more than the sum of the parts. As all the organs and systems of the body are interconnected, we cannot treat one part without influencing and changing the whole. This may mean that the cause of a problem may be far from where the symptoms are found.

A patient who has had a whiplash injury in a car accident, for example, may complain of pain in the leg. Tension in the lower back may be causing this pain, but as the primary problem is located in the neck, until this is resolved there is little chance that the symptoms will clear. The osteopath will therefore take great care in treating the neck, as well as the leg and back. This approach will release the stress in the nervous system and help the body to recover as a whole.

Practicing Osteopathy
Dr. Andrew Still said: “Find it, fix it, and leave it alone.” These words sum up how the principles of osteopathy may be applied to treatment. As the path to cure lies inside the patient’s body, treatment is directed toward removing some of the obstacles that are stopping the healing process from taking place spontaneously. Overtreatment is a mistake — the osteopath must respect each patient’s own rhythms and the pace at which each person functions and so can heal. The practitioner needs to offer the space and time for the individual to carry out their own self-healing.

By acknowledging the uniqueness of each individual, in every treatment session there is a key point for the mind and body which, if properly corrected, will in time bring about a broad and deep change in that person’s situation. In order to find the key point, the osteopath must be, as much as possible, in tune with the patient.

What is Healing?
Dr. Still emphasized in all his books the importance of mind-matter-motion. He identified “mind” with man’s spiritual being, which can maintain the body in good health only by tuning in to nature’s “mind”. Behind this, for Still, lay the will of God, the Mind of all minds. Motion was central to Still’s thinking because he saw in it the very expression of life.

With this as a starting point, we can say that health is a dynamic process characterized by every aspect of a human being — the thinking, social, physical, and spiritual components that go to make up the whole person. A deep healing cannot take place without the combination of all of these parts in our lives.

The way in which the body and mind are linked in the process of healing may be as follows. Within ourselves, we have a series of built-in, automatic reflexes ranging from physiological homeostatic mechanisms, to those that regulate our behavior patterns. These mechanisms can become locked in a circle of self-repetition that may eventually lead to disease. An example of this may be a person who has been under a great deal of stress; because of this, he develops an increasing level of anxiety and starts to eat compulsively. This in turn may in time lead to diabetes. So a conditioned pattern of behavior becomes locked in a vicious, self-repeating circle.

Another example could be an elderly woman who breaks her hip. Consequently, she is bedridden for several weeks, becomes depressed, loses interest in food, and eventually dies prematurely.

On the other hand, we also have a natural tendency toward self-improvement, which means that we can function more efficiently both psychologically and physically. Psychologically, this tendency is characterized by the conscious effort we make toward an increasing self-awareness that can break down unbalanced, conditioned behavior and be our source of continual growth.

Healing spans an extremely wide range, from getting rid of a common cold, to achieving a well-balanced personality. It is, of course, not necessary to go through a deep inner change in order to cure a cold. On the other hand, to heal from serious illness such as cancer may require — along with the appropriate medication — a total transformation and an awakening. Healing goes hand in hand with a feeling of well-being and the return to a joyous personality.

Treatment and Healing
Healing does not always coincide with treatment. Whether the treatment takes the form of manual manipulation, surgery, drugs, or counseling, healing will not always follow and may come about months or years after clinical treatment. One definition of healing may therefore be that a person is functioning to the best of her potential and is therefore healthy. An example of this is a child who, after a fracture, has one leg slightly shorter than the other. He suffers from low back pain and has a limp; he may also have problems with his digestion and difficulty in sleeping. Osteopathic treatment may help with the back pain, digestive and sleeping problems, but the length of the child’s leg may be irreparable. So we could say that he is healing when he is back to functioning as well as he can, given that circumstance.

Osteopathy and Other Therapies
Chiropractic and osteopathy both had their origins in the U.S. toward the end of the nineteenth century. Dr. Daniel Palmer, the founder of chiropractic, is believed to have spent some time studying with Dr. Still. Following that study, Dr. Palmer moved to another state and started his own personal healing discipline. Chiropractic means manual treatment — it is formed by two Greek words, chiro, meaning hands, and praktikos, meaning done by.

There are similarities and differences between the two therapies. Palmer first stressed the role of the nervous system and of the spinal column in health and disease, seeing nerve compression as the basis for all problems. Chiropractors are more likely to use X-rays when diagnosing a patient’s problem. They also concentrate on manipulation of the spine, directly adjusting it with rapid movements.

Physiotherapy. The differences between osteopathy and physiotherapy are mainly found in their underlying philosophies. They do not use drugs, but manual treatment, exercises, and electrotherapies. In the past, physiotherapists did not make diagnoses, but worked with a patient after the doctor’s diagnosis.

Physiotherapists are experts in their field and they work in collaboration with osteopaths in various cases. Over the past hundred years of its life, the profession has changed greatly and it is interesting to see how the attitude and approach of physiotherapists has come to appreciate other methods of treatment. They maintain that they are moving toward a more holistic approach to health and patient management.

Authors: Peta Sneddon and Paolo Cosechi are registered osteopaths who share a private practice in Chianti, Italy.

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