The official, and I think slightly trite answer, is that we don’t treat conditions we treat patients. One of the tenets of osteopathy is that we regard the body as a whole, aiming to restore overall function, rather than, for example just working on one muscle or joint. That doesn’t help you if you are looking for a therapist for a particular problem. You want to know if that therapist is likely to be able to improve your symptoms, so I’ll try to give some guidance on what I consider to be within the remit of how I practice osteopathy.
The first thing to say is that as a structural osteopath I work mainly with muscles and other soft tissues and with joints, so problems affecting muscles and joints directly are usually appropriate for treatment. How much and how quickly they will respond to treatment depends on the nature and severity of the problem, so, for example severe osteoarthritis isn’t going to be reversed but treatment may prevent further deterioration and may decrease pain or increase mobility whereas a more acute problem may be fully resolved in one or two treatments
Compression and inflammation caused by dysfunctional joints or muscles may also affect nerves, generating pain or altered sensation, sciatica or certain types of headache are good examples of these. I believe that osteopathy certainly has a role to play in treating these conditions.
What is interesting is when you start to think about what other structures inflammation or compression may affect. If you ever injure your ribs or upper back, notice the effect it has on your breathing, if it affects your breathing it affects the oxygenation of your blood, affecting everything from your energy levels to your ability to think.
The blood supply, not so much the high pressure arterial supply but venous return and lymphatic drainage, is affected firstly by compressive forces surrounding vessels but also because your body contains a number of pumps which rely on musculoskeletal integrity to maxmimise their potential. A good example of this is the calf pump; when you walk the alternate squeezing and releasing of your calf muscles, coupled with the valves in your veins, helps pump the blood back up to your heart. Any musculoskeletal problem which changes the action of these muscles will reduce the efficiency of that pump.
Being able to breathe correctly causes a slight massaging of the abdominal contents, which appears to be beneficial to their health, there’s a paper here http://link.springer.com/article/10.1016/S1091-255X(01)00009-9#page-1 about the benefits of post-operative abdominal massage. Given that posture can affect the space available within the abdomen and it would seem reasonable to suggest that abdominal crowding may lead to discomfort or dysfunction, the opening out of posture may lead to improved function and a reduction of symptoms from abdominal organs.
Last but not least, the reduction in pain and increase in mobility has the potential to have an enormous impact on mental health.
So, do I claim to be able to treat everything? Not at all! My remit is musculoskeletal complaints and if you have symptoms which I identify as outside my remit I will refer appropriately, but you may find that my treatment of your musculoskeletal symptoms has additional benefits, because, after all I am treating the person not the condition.
First of all let's establish what osteoarthritis is. It's a process which is initiated when the wear and tear on an area of articular cartilage (that's the smooth material covering the surfaces of most of your mobile joints) exceeds the ability of the body to repair that wear and tear. The breakdown of the cartilage alters how forces are transmitted through the joint and results in inflammation and damage and remodelling of the bones around the joint. It is the inflammation and bony remodelling that can cause pain and restrict motion. We don't fully understand what initiates this process but below is a diagram from Arthritis Research UK showing the major known risk factors
So what can osteopathy do to help? Well, I can't change your gender, age or genetic factors, or indeed the history of what has happened to your joints, and losing weight is up to you; however I can work within the confines of these factors to help your body dissipate forces through the joint in the most even way possible, so the wear across the whole joint is even, working to reduce the chance of osteoarthritis. This is a natural part of what osteopaths do, looking at the body as a whole and working to reduce undue strain and restriction. For those who already have osteoarthritis, reducing and redistributing forces through the area can help to prevent further deterioration and may allow some symptom relief. For these patients I will also work to ensure that the joint remains as mobile as possible; reducing inappropriate muscle guarding. Maintaining joint movement is essential as movement and in particular compression and release of the articular cartilage stimulates the production and flow throughout the joint of synovial fluid , which helps to lubricate, provide nutrition and initiate repair.
Damian is the principal osteopath at Vauxhall Village Osteopathy and Oval Osteopathy