MoonDragon's Alternative Health Information
Touch & Movement Therapies
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The holistic approach to diagnosis and treatment originated in the United States in the late 19th century. Practitioners use touch and manipulation of the musculoskeletal system to restore or improve mobility and balance, and thereby enhance well-being. Techniques range from gentle massage to high-velocity mobilization of the joints. Now established alongside conventional medicine in North America, and practiced throughout Europe and Australia, osteopathy is one of the most respected and widely used complementary therapies, particularly for pain in the back and joints.
Osteopaths detect problems by examining the patient's muscles, joints and tissues, and by sensing changes in muscle tone or skin temperature in response to touch.
MAIN USES OF OSTEOPATHY
Back & neck pain. Joint pain, such as arthritis. Sciatica. Sports injuries & repetitive strain injuries. Headaches. Insomnia, depression. Menstrual pain. Digestive disorders. Asthma.
Dr. Andrew Taylor Still, who developed osteopathy, considered that all disease was related to the body's musculoskeletal framework.
HISTORY OF OSTEOPATHY
Osteopathy, from the Greek osteon (bone) and pathos (disease), was developed by Dr. Andrew Taylor Still of Virginia, who was an army doctor in the Civil War. Prompted by the tragic deaths of his wife and three of his children from meningitis, in 1972 he devised osteopathy to stimulate the body's self-healing powers.
In 1892 Dr. Still founded the American School of Osteopathy. Despite initial opposition from the conventional medical establishment, the therapy proved popular, receiving a major boost during the flu epidemic of 1919, when the mortality rate for patients in osteopathic hospitals was far below that in conventional hospitals. In 1917 on of Still's pupils, Dr. John Martin Littlejohn, founded the British School of Osteopathy in London.
In the US, osteopaths have been licensed as conventional practitioners since 1972. In the UK, osteopathy gained official recognition with the passing of the Osteopathy Act in 1993. Osteopathy is popular in Japan, Australasia, North America and Europe.
KEY PRINCIPLES OF OSTEOPATHY
The organs of the body are supported and protected by the musculoskeletal system. If this system of joints and muscles is correctly aligned and working well, the tissues of the body, including the brain and nerves, will be healthy, and the circulatory, lymphatic, and digestive systems will function properly. Osteopaths aim to improve the mobility of the joints and soft tissues using various manual techniques.
An osteopath will be as concerned about why there is a fault in the musculoskeletal framework as with the physical problem itself, and will look for the reasons behind the problem. For this holistic approach, lifestyle and mental and emotional health are seen as important factors influencing physiological health.
THE THEORY OF OSTEOPATHY
Physical or emotional stress, injury, or poor posture can affect the musculoskeletal system. They can cause pain or impair nerve function locally or elsewhere in the body, and affect the vital organs and respiratory, circulatory, and nervous systems. Osteopathy aims to ease muscle tension and restore bone and joint function to strengthen the body systems and restore the body's ability to heal itself. While chiropractors often concentrate on manipulation of misaligned joints, osteopaths may focus on "soft tissue" treatment to relax muscles and bring back joint mobility.
MoonDragon's Alternative Health Therapy: Touch & Movement - Chiropractic
THE MUSCULOSKELETAL SYSTEM
Osteopaths believe that this mechanical system, comprising the bones, joints, muscles, ligaments, and connective tissue, is not merely scaffolding for the rest of the body, but plays a vital part in maintaining health. Any disturbance of this system can cause pain and strain, and affect other body systems. (See The Theory of Chiropractic)
Frontal Lobe of the cortex governs ideas and expectations. Hypothalamus controls automatic body processes, including muscle tension and blood supply to muscles. Thalamus influences the emotions. Hippocampus is involved in memory storage. Cerebellum is linked to posture and muscle tone. Brain stem regulates the release of endorphins. A spinal segment includes all the tissues supplied by the nerves of a particular section of the spinal cord. If the spinal joint is affected by injury or strain, it stiffens up and makes the whole segment vulnerable to irritation. The muscle supplied by the spinal joint can be affected by pain and tension spreading out from the joint; if pain and tension persists, it puts strain on other areas as the body tries to adapt. The nerves supplying the muscle can be affected by pain from injury to a muscle; the spinal joints relating to those nerves consequently stiffen. HOW THE BODY REGISTERS & RESPONDS TO PAIN
Muscle, bone, and joint pain registers in the cortex of the brain, but other areas of the brain influence how the mind perceives and adapts to this pain.
An osteopath will use soft tissue manipulation and mobilization of the vertebrae around the tense areas of the spine to relax the muscles at the local source of the pain. He will also seek to ease tension in other muscles whose nerves pass through the irritated area of the spine, and examine underlying factors, such as poor posture or anxiety, that cause or perpetuate tension either locally or elsewhere in the body.
THE PAIN-TENSION CYCLE
The various factors that contribute to pain can form a vicious cycle. Pain signals (caused by strain or injury or by the buildup of chemical waste products, such as lactic acid) pass from a muscle or joint to the spinal segment that supplies its nerves. This segment then sends back reflex nerve impulses to the muscle that tense the muscle even more. The spinal segment also becomes more open to irritation, and may become more sensitive in the long term and therefore prone to further problems.
EVIDENCE & RESEARCH
There has been a considerable amount of research into osteopathy in the US, though not to a consistently high standard. Much evidence is anecdotal and most osteopaths accept that more clinically controlled trials need to be carried out. Research studies are under way in the UK, including Department of Health pilot projects to test the possibility of health care providers referring National Health Service (NHS) patients to osteopaths and chiropractors. In 1994, the Clinical Standards Advisory Group recommended that manipulation should be available for NHS patients with acute back pain, and that conventional health care practitioners should work more closely with osteopaths, chiropractors, and physiotherapists.
Two studies, published in the US and UK in 1988 and 1990 respectively, showed that osteopathic manipulation could improve recovery time for lower back pain patients. During the 1940s, an American physiologist used electrical measurements to confirm osteopaths' claims of increased activity in muscles.
CONVENTIONAL MEDICAL OPINION
With official recognition as doctors for over two decades, American osteopaths are part of the medical mainstream, and osteopathy is increasingly being integrated into the practice of medicine worldwide. Although perhaps a third of conventional health care practitioners in the UK refer patients to osteopaths, some are still reluctant to do so, especially when the patient's problem is not musculoskeletal. The establishment of the UK General Council of Osteopaths in 1996 should build a basis for strong cooperation with the medical profession.
CONSULTING A PRACTITIONER
At the first consultation the practitioner will ask how your symptoms began and what activities make them worse. He will ask about your medical history, especially any past injuries, about any medication you are taking, including homeopathic and herbal remedies, and about your lifestyle, work, and emotional health.
Be prepared to undress to your underwear, so that the practitioner can see as much of your body framework as possible. You may be offered a gown if you feel uncomfortable. In order to assess the way you hold yourself and how the joints are functioning, you may be asked to stand, sit, and lie down on a treatment table. The practitioner will probably examine your muscles for stresses and strains and will ask you to bend in various ways while feeling your spine.
Standard medical tests are carried out, and arrangements are made for x-rays or blood tests where necessary.
Diagnostic procedures include conventional medical tests as well as a full examination of the body's structure.
- Blood pressure is measured.(1)
- Reflexes are often tested with a reflex hammer. (2)
- Posture is examined for asymmetry. (3)
This assessment enables the practitioner to make a diagnosis, and decide whether osteopathy can help or whether you should be referred to another specialist.
QUESTIONS FOR YOUR OSTEOPATH
How long does a treatment session last?
The first consultation is roughly 30 to 60 minutes; subsequent sessions last 20 to 30 minutes.
How many sessions will I need?
One visit may be enough, but 3 to 6 sessions are average, depending on your state of health and the problem. More sessions are often needed in old age and for longer-term problems. Some patients have regular sessions as a preventive measure.
Will it be uncomfortable?
Manipulation is not usually painful, but this will depend on the problem.
Will there be any aftereffects?
Some stiffness is common for a day or two following treatment, and strenuous activity should also be avoided during this period.
Any osteopathic treatment will be tailored to your individual needs and adapted as treatment progresses. It may consist simply of soft tissue treatment, using cradling and light pressure, or it may involve vigorous manipulation of the joints, necessitating some rather unusual positions. Discomfort caused by muscle spasm can disappear after one session, but most patients need a course of treatment.
The main osteopathic procedures range from gentle manipulation of the joints, taking the limbs through their full range of movement, to an abrupt high-velocity thrust that, although painless, can cause the joint to "click" disconcertingly. Other techniques include positioning you so that tension from area of strain or injury is spontaneously released, "muscle energy techniques," in which you release muscle tension by working against resistance provided by the practitioner, and visceral manipulation, in which the practitioner uses 'touch and pressure to pinpoint and relieve problems in the internal organs.
The practitioner may recommend exercises and relaxation techniques to follow at home or work.
CHECKING PELVIC ALIGNMENT
The practitioner uses his hands to examine the alignment of the two pelvic bones (the ilia) with the sacrum (the base of the spine) and to check whether one side is higher than the other.
CHECKING PELVIC ALIGNMENT
The practitioner places his hands on the pelvic bones to check their alignment.
CHECKING LEG LENGTH
The lengths of the patient's legs are compared. Any discrepancy may indicate a curve in the spine or asymmetry in the pelvis, or show that one leg is structurally shorter than the other.
STRAIGHT LEG RAISE
Raising the leg stretches the sciatic nerve and shows the mobility of the lumbar (lower) vertebrae. Pain suggests a disorder in the lumbar spine, usually a disk or joint problem.
TREATING THE LOWER SPINE
Lower (or lumbar) back pain is a common problem, and one for which osteopathy is often used. Sitting habitually in a slouched position, lifting heavy objects incorrectly, and sports or other injuries all frequently cause lower back pain. The practitioner examines the spine to identify areas of stiffness. He uses soft tissue treatment to relax the area and then may perform precise manipulations, which may be accompanied by a "click" as joints are restored to their full range of movement.
With the patient's leg raised and bent to flex and rotate the lumbar vertebrae in the lower back, the practitioner uses his fingers to feel the range of movement of a vertebra and, if necessary, stretch the lumbar spine with a precise movement.
The practitioner repeats this exercise on each lumbar vertebra. As he moves up the spine to examine the next vertebra, he moves the leg to bend and rotate the spine and uses his fingers to monitor the resulting movement of the vertebra. The practitioner uses his body weight and momentum to rotate the patient's vertebrae rhythmically.
THE SIDE ROLL
The patient lies on one side with her spine gently rotated to allow the practitioner to target each lumbar vertebra precisely. He examines each vertebra with his fingers to detect and correct any restriction in its range of movement.
Pulling the patient's elbows up to "open" her spine, the practitioner uses his body to deliver a high-velocity thrust to a specific area.
UPPER BACK & NECK TREATMENT
Sprains, stiffness, and injuries such as whiplash or the locking of the vertebra in the neck can be treated with osteopathic manipulation, shown below, or by soft tissue treatment. This uses light massage and rhythmic stretching techniques designed to improve joint mobility by decreasing muscle tension and improving blood supply to the tissue.
CORRECTING THE UPPER SPINE
The patient sits across the couch, while the practitioner uses his left thumb to mobilize vertebrae in the upper (dorsal) spine to restore the full range of movement to the joints.
CORRECTING THE NECK (SUPINE)
For this correction the patient lies face up while the practitioner focuses on the neck (cervical) vertebrae, using the base of his index finger as a lever.
CORRECTING THE NECK (PRONE)
Less commonly, the patient may lie on her front as the practitioner corrects the cervical vertebrae in the neck, using the tip or base of his index finger.
THE CERVICODORSAL LIFT
With the patient's hands behind her neck, interlocked with his, the practitioner gently uses his body to stretch and realign her upper spine (cervico dorsal spine).
ACUTE BACK PAIN - A PATIENT'S EXPERIENCE
David, 45, works as a chef. He consulted an osteopath while suffering from acute back pain: "I felt a twinge in my back after moving a table and the next day, when I bent over, I collapsed in excruciating agony. I hobbled around to Tom, the osteopath, who was one of our regular customers. He asked me loads of questions, examined me this way and that, and explained that it was a pinched nerve, the culmination of years of minor strains. Tom twisted and turned me to straighten the nerve, and made clicks in my neck, but afterward the pain did ease slightly. He gave me exercises to practice and I went back twice during the following week. Each time my back improved. Now it is fine and I have not had a problem since."
Gentle exercise that stretches muscles without strain or active movement can help to realign the spine and major joints. With regular stretching, you can relieve spasms, add to joint mobility and improve overall posture and flexibility, thus reinforcing the work of the chiropractor or osteopath. Yoga is ideal; it stretches the muscles in a balanced way, lengthens the spine and lessens stress.
TIPS FOR BACK PAIN
Back pain afflicts most of us at one time or another. Keep the following in mind to avoid back injuries and keep you away from the chiropractor's or osteopath's office.
To lift heavy objects, keep your feet slightly apart, and bend your knees instead of bending at the waist. Straighten your legs slowly. Keep your back straight, and do not twist your torso. Hold the object close to you, no higher than your chest.
Sitting on a ball seat (see below) helps you to adopt a proper sitting position.
Do your best to avoid sitting or standing for long periods of time.
Try not to sleep on your stomach. This position forces the back to sway.
Swimming and walking are excellent vigorous exercises for overall good health and for strengthening the back.
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BONES OF THE CRANIUM
The bones of the cranium are connected by interlocking joints, or sutures. Cranial osteopathy works to manipulate the bones along those joints.
An American osteopath, Dr. William Garner Sutherland, developed cranial osteopathy in the 1930s. At that time, it was believed that the bones of the cranium (the part of the skull around the brain) fused by adulthood and could not be adjusted. According to Dr. Sutherland, however, these bones, which are separate in babies and young children, do retain flexibility. He also believed that the cerebrospinal fluid, which nourishes and protects the membranes encasing the brain, spinal cord, and sacrum, pulses at a rate of about 6 to 15 times per minute. This cranial rhythmic impulse (CRI) is difficult to measure with equipment, but practitioners claim to be able to sense it by touch.
Disturbances in the flow of fluid are said to reflect pressures on the cranial bones or injuries and tension in the body, which can be eased by delicate manipulation of the cranial and spinal bones to restore the CRI and boost blood circulation and drainage of lymph and sinus fluids in the head.
Cranial osteopathy is said to be particularly effective on babies and young children.
Cranial osteopathy may be used for the same conditions as osteopathy, and can be combined with other osteopathic methods. It seems to be particularly successful on young children with colic, middle ear effusion (glue ear), and recurrent infections, and is often used on babies to correct distortions in the cranial bones caused during birth. If these are not eased back into place, or are knocked slightly out of position later in life, it may lead to physical problems.
Other variations focus less on the bones than other parts of the cranial system. The reflex approach aims to relieve stress patterns in the body by stimulating nerve endings in the scalp and between the cranial bones. The sacro-occipital technique, preferred by chiropractors, combines the elements of cranial osteopathy and craniosacral techniques (see below).
A diagnostic and healing approach based on the application of corrective pressure tot he cranium and spine (the craniosacral system), craniosacral therapy grew out of work with cranial osteopathy in the US during the 1970s. It goes further than cranial osteopathy in claiming that the cranial rhythmic impulse (see above) affects every cell in the body.
MAIN USES OF CRANIOSACRAL THERAPY
Headaches. Musculoskeletal pain. Arthritis. Depression. Dyslexia & other learning difficulties. Aftereffects of strokes & meningitis. Aftereffects of stress or injury.
Dr. John Upledger, an osteopath at Michigan State University, developed this approach in the late 1970s. While incorporating some of the techniques practiced in cranial osteopathy, Upledger distinguishes it from osteopathy in being "soft tissue-oriented", "fluid-oriented", and "membrane-oriented" rather than "bone-oriented". The approach is still considered controversial in the UK, though more widely practiced in the US.
CONVENTIONAL MEDICAL OPINION
Many conventional health care providers skeptical of cranial osteopathy are even more cautious about this therapy. Unlike osteopaths or chiropractors, some craniosacral practitioners may not have training in anatomy or physiology, and while the therapy is harmless in itself, conventional practitioners fear craniosacral therapists may fail to recognize serious medical conditions.
CONSULTING A PRACTITIONER
While the bones of the cranium are the focus of cranial osteopathy, CranioSacral therapy focuses on the membranes encasing the brain and spinal cord. Practitioners believe that it is these membranes that generate the cranial rhythmic impulse (CRI) of cerebrospinal fluid, which affects the connective tissues linking all of the organs, bones, and muscles of the body. The aim of treatment is to ensure an even, rhythmic flow of CRI.
You will be asked to lie clothed on a treatment table while the practitioner applies subtle pressure with his hands, usually, but not always, on your head or at the base of your spine (the sacrum). Many people report feeling deeply relaxed during treatment, though some experience a spontaneous "unwinding" of tension, believed to result from the release of physical or emotional trauma in the body. One or two treatments of about an hour may be sufficient, but often more sessions are recommended.
MoonDragon's Alternative Health Therapy: Touch & Movement - CranioSacral Therapy
Do not have osteopathy if you have bone cancer or any bone or joint infection, such as osteomyelitis. Avoid vigorous osteopathic manipulations if you have badly prolapsed disks.
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