Known as the “back pain therapist”, the osteopath can treat much more than musculoskeletal pain. It may also act on disorders of the cardiovascular, digestive, genitourinary, neurological, otolaryngological and pulmonary systems. A wide field of action which makes the practice of osteopathy a truly interesting option whether for acute or chronic pain.

Osteopathy is a so-called “alternative” therapy. Osteopaths after observing your posture, use a fine palpation to detect tensions or imbalances that cause pain or discomfort, then do manipulations to restore balance. According to them, osteopathy is a global therapy with its own modes of “diagnosis” and treatment. It would treat a wide variety of ailments.

For osteopathy, the body is made up of different parts that are linked together. Thus physical or psychological affections can have resonances everywhere in the body. Bad postures, history of trauma, stress, etc., do not disturb a single system (musculoskeletal, digestive, neurological, vascular, hormonal, etc.), but the whole organism. To cure each problem, it is therefore necessary to restore harmony in the musculoskeletal system and in each of the other systems.

In the language of osteopaths, this harmony is often translated by the terms mobility and motility, motility designating all the movements specific to an organ or a system. A healthy body would be endowed with excellent motility, not only in its joints, but in all the tissues of the body: bones, muscles, nerves, ligaments, tendons, fascia, fluids, etc.

One of the distinctive characteristics of osteopathy is also to take into account the entire structure of the body and all its movements, whether they are large and powerful or whether they are barely fluctuations. noticeable.

Fundamentals of osteopathy

There are 3:

• The whole: the human body is a functional unit made up of different parts. Ailment in one part of the body influences others. This is why the osteopath sometimes manipulates areas far from your first pain (on the diaphragm to relieve the back for example).
• Structure governs function, that is, the various bodily functions interact with the structure of the musculoskeletal system.
• The third and fourth principles relate more to the preventive aspect of osteopathy: homeostasis. The body would have the capacity to self-regulate and therefore to be able to find a dynamic which would ward off pain. “To be in good health is to fall ill and recover from it”, said Canguilhem (XNUMXth century doctor and philosopher). Associated with a good arterial vascularization preventing all congestion, the body would have all the cards to cure itself or at least to limit the affections.

The osteopath is not only interested in a painful symptom, but considers the patient as a whole to be evaluated as a whole. He must precisely discover the origin of the tensions and blockages that restrict the mobility of the various tissues. Osteopaths are therefore trained at length to acquire a deep knowledge of bodily structures (bones, joints, organs, viscera, muscles, etc.). They have a great sense of observation, as well as an extreme finesse of touch allowing them to detect slight blockages or particularly subtle movements. Although the term osteopathy, from the Greek prefix “osteo” meaning “bone”, may suggest that the osteopath is only interested in bones, this discipline also concerns muscles, viscera, aponeuroses …

Is osteopathy regulated?

Osteopathy was conceptualized in the United States in 1873 by Andrew Taylor Still (former Methodist physician). Arrived in Europe in 1917, it was recognized by Great Britain in 1993. Belgium followed suit in 1999.

In France, it was first developed through doctors and physiotherapists during the 2002th century, who then exercised it exclusively. At the end of legal conflicts and debates, the title of osteopath was recognized in 2007. The decrees governing his practice were promulgated in March 6. Since then, it has continued to develop and is today exercised by 023 osteopaths.

Osteopathy in treatment

Osteopathy is first recognized for its ability to relieve ailments and disorders of the musculoskeletal system, of which back pain takes a large part. According to research conducted among 3 American osteopaths, more than half of their treatments are related to it.

These are both acute problems such as sprains, sports injuries; or chronic such as herniated discs, low back pain, joint pain, perinatal pain, scoliosis and tendonitis. Plantar fascist, Lenoir’s spine, musculoskeletal disorders (MSDs) caused by work postures (prolonged computer work for example), and carpal tunnel syndrome are also treated by osteopaths.

According to practitioners, the approach would also be able to intervene on several other systems, which would also allow it to relieve or treat the following conditions:

• Circulatory disorders of the lower limbs, hemorrhoids, venous congestion, palpitations, etc.
• Flatulence, constipation, gastric acidity, hepatobiliary disorders, etc.
• Gynecological pain and dysfunction, cystitis, functional sterility, enuresis, etc.
• Asthma, otitis media (manipulation would drain the middle ear), rhinitis, sinusitis, dizziness, migraines, ringing, etc.
• -Accompaniment of depressive states, stress, anxiety, certain sleep disorders, etc.

Osteopathy in prevention

In recent years, the approach has increasingly focused on prevention, especially during pregnancy. Osteopathy could treat some functional problems in pregnancy, such as joint pain, lower back pain, and digestion problems. In order to facilitate the progress of childbirth, the osteopath can also check the mobility of the pelvis and the spinal axis of the pregnant woman. A cohort study published in 2003 argued that osteopathic treatment could thus reduce complications related to childbirth.

Still in the context of prevention, it is also recommended that newborns see the osteopath in order to carry out an examination in the weeks following their birth. This will correct trauma caused by childbirth, which could influence the mobility of the joints of the bones of the skull and cause subsequent functional disorders.

A wide field of action

Although scientific research has not yet been able to prove everything, osteopathy has a wide range of interventions. Additionally, systematic reviews, meta-analyzes and even sometimes clinical trials often assess the effects of osteopathy and chiropractic together, referred to as spinal manipulation. Evidence related to each of these approaches is therefore regularly confused.

Contribute to the relief of back pain, especially low back pain

Numerous articles, including a few systematic reviews, have been published regarding the relief of back pain, especially low back pain, using osteopathy. A systematic review coupled with a meta-analysis of randomized clinical trials concluded that this approach reduced pain more effectively than placebo treatment. In addition, it reports on several studies in which osteopathy has been shown to be more effective than conventional treatments.

In addition, it seems that this effect would be beneficial in the short as well as in the medium term (the effects having lasted beyond 3 months). Finally, this reduction in pain would be comparable to that obtained with certain non-steroidal anti-inflammatory drugs (NSAIDs), without the side effects associated with the latter. Osteopathy could therefore constitute a solid alternative solution to drugs for people with acute back pain, and possibly for chronic pain.

Ease the pain

A few studies report the positive effects of osteopathy in relieving acute or chronic pain. For example, the results of a randomized clinical trial, carried out on 58 patients suffering from neck pain for less than 3 weeks, reveal that this approach could be as effective as an analgesic recognized to treat acute musculoskeletal pain. .

Another example, a clinical study evaluated chronic neck pain in 41 patients. A decrease in pain intensity was observed in the osteopathic group, compared to the placebo group, after 10 weeks of treatment. The authors stress that these changes had a positive effect on the quality of life of the participants.

Contribute to the reduction of certain symptoms related to asthma

According to some studies, osteopathy may have beneficial effects in the treatment of asthma. The results of a randomized clinical trial in 140 children aged 5 to 17 years suggest that, compared to a sham procedure, osteopathic treatment resulted in a greater improvement in peak expiratory flow (the maximum rate at which l (air may be exhaled from the lungs during a forced exhalation). However, the lack of rigorous studies does not allow, for the moment, to conclude on the effectiveness of osteopathy or any other manual therapy in the treatment of asthma.

Regain mobility following surgical interventions

Surgical scars can sometimes create adhesions causing pain that the osteopath would be able to relieve.

Patients operated on for breast cancer (by lumpectomy or mastectomy) regain mobility in the shoulder after osteopathic manipulations.

Relieve the cephalic and ENT sphere

Osteopathy seems to be able to relieve certain headaches due to blockages in the neck and stiffness of the aponeurosis of the skull. These disorders would prevent a good vascularization causing these affections. Results would also seem to be present in certain cases of dizziness and tinnitus (apart from tumoral and organic damage).

The intestinal sphere

It seems that osteopathy can also act in the event of functional disorders of the intestine such as for example in the event of irritable bowel syndrome, constipation, bloating …

The pelvic sphere

Some benign gynecological conditions such as painful periods may also be relieved.

Update: in no case does osteopathy claim and cannot cure degenerative diseases (cancer, AIDS, multiple sclerosis, etc.), genetic diseases (cystic fibrosis, congenital myopathy, etc.) or infectious diseases ( tuberculosis, tetanus, etc.).

The osteopath

He can be an osteopath DO exclusively, or from a medical training. He must have studied in a school whose training is recognized by the Ministry of Health. The first quality of an osteopath must be listening. He must be attentive to your pain, and adapt to your condition. His palpation should be fine and gentle.

Varied and extremely precise manipulations

The functional manipulations allow the therapist, with the help of the subject, to mobilize the tissues (muscles, joints, fluids, membranes, etc.) and to induce a state of relaxation sufficient to allow the self-correction of a lesion (term to explain a loss of mobility / motility). We could say that these manipulations “accompany” the lesion.

Structural manipulations require applying a certain impulse to a structure, this time to “oppose” the lesion (to regain mobility). Sometimes unpleasant, but not painful, they can cause a cracking sound (no guarantee of success of the manipulation).

The purpose of visceral manipulations is to restore maximum motility to the viscera (intestine, liver, spleen, lung, etc.). These would be linked to certain symptoms of functional disorders.

The cranial manipulations are very subtle and might look like a simple laying on of hands. In reality, these are very light movements that would restore the delicate mobility of the bones of the skull and act on the primary respiratory movement. These manipulations were designed at the beginning of the 1970th century by the American osteopath William G. Sutherland. Inspired by this, Dr. John E. Upledger developed, in the XNUMXs, a specialized technique, craniosacral therapy. This attaches exclusively to the cerebrospinal fluid and the membranes that surround and protect the brain and spinal cord.

Let us also mention the existence of aquatic osteopathy which uses classic manipulations, but practiced in a heated swimming pool. They promote greater relaxation, better receptivity of the body (which is supported by small floats) and facilitate access to emotional memories.

Osteopathy is now also practiced on animals (both farm and domestic animals), a veterinarian may have a specialty in veterinary osteopathy.

Course of a session

Osteopathy is adjusted according to each patient. In order to determine the type of your pain, its location and its frequency, the osteopath takes a history by asking you questions. Then he moves on to an observation in his underwear in order to understand your posture. By mobility / motility tests, it locates the areas of “lesions” and by palpation it determines the tissue quality (heat, hard skin, etc.). Once the origin of the pain has been determined, it moves on to treatment. The treatments will not be the same for a child or an athlete, an anxious person or an accident victim, etc.

An osteopathic session generally lasts 45 to 60 minutes. Depending on the case, the subject remains dressed or in underwear. He can be lying down (back, stomach, side), sitting or standing, sometimes in unusual postures. He may have the impression of being “twisted in all directions” or, on the contrary, hardly feel the slow and small amplitude movements of the practitioner.

On average, a treatment may require several sessions (2 to 3) spaced 1 to 3 weeks apart. Sometimes just one consultation is enough and sometimes more. After the consultation, it is not uncommon to feel stiffness. Depending on your reason, the osteopath sometimes gives exercises to be continued at home.

More and more mutuals reimburse osteopathy consultations (the latter not being covered by Social Security).

Become an osteopath

In France to practice osteopathy you must have the DO (osteopathic diploma), obtained after 5 years of compulsory studies. There are also physiotherapists and doctors trained in osteopathy. There are 31 osteopathy schools (26 in initial training, and 5 in continuous reserved for health professionals). These are governed by decrees of 2014 and the latest approvals issued by the Ministry of Health were published in 2015.

Decrees n ° 2014-1505 of 12 December 2014 relating to training in osteopathy require training in 5 years divided into 4860 hours of training bringing together 7 major areas of education. The fields are diverse and varied (anatomy and physiology, medical semiology, etc.). We must add to this 1500 hours of practice. All schools must practice the same mode of teaching, the DO becoming a quality and supervised diploma.

Contraindications of osteopathy

Although osteopathy has a wide field of action, there are nevertheless contraindications to osteopathic treatment. The following list is not exhaustive.

Total contraindications: before any infectious process, before fever, if there is an inflammatory outbreak, inflammation, before any benign or malignant tumor process, before a neurological disease (such as cauda equina syndrome). example).

Relative contraindications: inguinal or crural hernias, herniated disc, migraine attack, etc.

Osteopathy is becoming more and more habitual for patients. 48% of French people have already had recourse to an osteopath. I advise you to consult at least once a year to prevent possible pain. If you have an intensive sporting activity or if you exercise a physical profession, it may be interesting to come at least twice a year.

The main thing is to see that your osteopath continues to learn throughout his career. Whether he is young or older, it is important that he listens to you and that he has a fine and precise touch. He must be available and patient. There are as many types of osteopaths as there are patients. In order to find your way around better, word of mouth is what works best, if not, check its training and the opinions available on the internet …