The practice of medicine and of osteopathy is an art, or skill in the application of definite rules and procedures. Such rules may, or may not, be based upon the accurate and logical interpretation of facts. If an art is based upon the logical interpretation of facts, which are understood and demonstratable, then the application of the word 'science' to the procedures is appropriate. Osteopathy is clearly an art. The clinical and practical value of osteopathic procedures is well established, but thus far there is insufficient research evidence or controlled clinical trials to produce incontravertible proof as to the validity of the theories which underlie it. This in no way invalidates the osteopathic approach.
Even if osteopathic principles cannot be scientifically proved, they do at least broaden the physician's view, and help him to look at the whole picture of the patient and his environment, which is where the skill of the physician needs to be applied, rather than simply attacking symptoms. Much research has been done, which confirms and validates osteopathic principles, and this will be discussed in the chapter on research. The aim of this chapter is to set out the basic beliefs which underlie the practice of osteopathy.
The Basic Premises
The basic premises include:
- That the human body is an integrated unit in which structure and function are reciprocally and mutually interdependent.
- That through complex mechanisms and systems the human body is self regulating and self healing in the face of challenges and diseases (this is known as homeostasis).
- That optimum function of the body systems is dependent upon the unimpeded flow of blood and nerve impulses.
- That the musculo-skeletal system comprises a major system of the body, and that its importance goes far beyond that of providing a supportive framework.
- That there are components of disease within the structure of the musculo-skeletal system which are not only the manifestations of disease processes, but which are frequently important contributing, or maintaining, factors in disease processes. These may be local to, or distant from, such disease processes and are usually amenable to appropriate treatment
The recognition of the importance, in the overall economy of the body, of the musculo-skeletal system, its proneness to dysfunction, and the repercussions of such changes, and finally the recognition of the ability of therapy to normalize such dysfunction by one or more of a variety of manipulative procedures, represents the essence of osteopathy’s individuality.
The body is functional. Structure is the manifestation of function, for structure that does not allow function is pointless. If structure alters, so will function. In a self-regulating mechanism, such as the human body, adaptation and compensation to such structural changes takes place, but always at the expense of optimum, or perfect, function. Such alterations in function may remain within acceptable limits, and not produce noticeable symptoms, but as will be seen, if these changes occur in vital spinal areas, widespread effects may take place, distant from the area of dysfunction. Structure and function should not be thought of as separate entities, one is inconceivable without the other. The musculo-skeletal system comprises roughly 60 per cent of the structure of the human body, and it expends most of the energy of the body. It has been called the 'primary machinery of life' by Professor Irvin Korr [1], who points out that our personality and our individuality are demonstrated through the musculo-skeletal system. The organs of the body can be seen as secondary, supportive, machinery, which provides energy to meet the demands of the musculoskeletal system. It is more than just a framework which supports and contains the viscera of the body, but is the main dynamic component of the living body.
All healing systems recognize that there resides within the body an inherent capacity for adapting to and recovering from the stress and demands placed upon it. There are many mechanisms operating towards this end. The word homeostasis is often used to describe the complex interplay of systems and processes involved in health maintenance. The hormonal, circulatory, lymphatic, nervous and musculo-skeletal supplied by the nerves skeletal systems, all interact in the maintenance and recovery of health.