What is osteopathy?

By: Philippe Davenet, President of the Monaco Register of Osteopaths (ROM).

These days, who hasn’t consulted an osteopath, at least once? The figures speak for themselves: 30% to 40% of the French population are reported to have consulted an osteopath in 2019! But do we truly understand what osteopathy is and how it is practised in the Principality? What about the differences, conflicts but above all misunderstandings between osteopathy and conventional medical and paramedical practicevarious definitions of osteopathy given by the World Health Organization (WHO), the French Register of Osteopaths (ROF), the Monaco Register of Osteopaths (ROM) and other bodies, sometimes not terribly reliable, frequently diverge. Originally, the “creator” of osteopathy, Dr A.T. Still, intended it to be a holistic form of medicine, but he soon turned away from the art of medicine, which he considered to be “polluting” and “too invasive” for osteopathic philosophy. He created the D.O. (Diplomate in Osteopathy) qualification, to completely distinguish and separate it from the M.D (Doctor of Medicine). According to WHO “Osteopathy relies on manual contact for diagnosis and treatment (...) It lays emphasis on the structural and functional integrity of the body and the body’s intrinsic tendency for self-healing (...) This holistic approach to patient care and healing is based on the concept that the human being is a dynamic functional unit, in which all parts are interrelated.” This view is not wrong, but equally it is not sufficiently precise and is highly restrictive in its reference to manual contact.

The practice of osteopathy in the Principality of Monaco

According to the Monaco Register of Osteopaths (the ROM), osteopathy is “an overall therapeutic approach which seeks to diagnose, primarily through palpation, functional imbalances (which may cause disease) and to ‘correct’ or ‘normalise’ them in order to restore the integrity of the physiological (natural) functions associated with good health: this approach can only be a holistic one.” According to the French Register of Osteopaths (the ROF), “Osteopathy involves gaining a comprehensive understanding of the patient to prevent, diagnose and treat, manually, disorders in the mobility of human tissue that can alter a person’s state of health.” To be more precise, osteopathy can be distinguished from conventional medicine in several ways.

Osteopathy: a complement to medicine

Above all, under no circumstances does an osteopath analyse a disease itself, or treat it, this remains the prerogative of medicine. However, the osteopath should,, drawing on clinical symptoms supplemented by a palpatory, inquisitive and visual osteopathic analysis, look for malfunctions in the patient’s physiology and should ‘normalise’ them, in other words eliminate them to recreate homeostasis in the patient and normal physiological conditions that will enable the patient to heal themselves of their disease. A. T. Still liked to say that “the structure governs function”, but he would also note that “without function, the structure would return to dust”!

The role of the osteopath: to promote homeostasis and self-healing

Don’t assume, however, that osteopaths and doctors always understand one another: many misunderstandings persist, notably around so-called manipulation techniques: In the eyes of too many in the medical world, a manipulation is seen as a more or less forceful passive mobilisation which aims to “return” a bone or other element back to the “correct” place! This view is, of course, completely incorrect and highly pejorative regarding the nature of the relevant act. However it lingers, mostly due to ignorance, but also due to deliberate malice on the part of some opponents. We have been given the opportunity here to set the record straight on these manipulations which, let me be clear, should never be forced or imposed on tissue of any kind. Moreover, the term “manipulation” ought to be replaced by the term “tissue normalisation”. Structural tissue normalisation is a corrective act which uses nothing but speed as a corrective agent, with the aim of reprogramming the tissues. Neither force nor a wide range of correction are ever used. It targets the nervous system which is stimulated in a harmless way, using a specific protocol to enable it to regain full freedom. This act is like a kind of message, a corrective vector sent to the nervous system which will neutralise the malfunction. There are also other techniques, such as functional techniques, in which the tissue’s self-balancing process is used without any specific “manipulation”, but rather solely by positioning tissues in a particular direction and then nudging them towards correction when the tissues are ready! Medicine has its own principles for analysing certain clinical symptoms and in terms of its surgical and pharmaceutical treatment techniques, which are generally interventionist and direct. It has trouble imagining that a gentle, local rebalancing of the physiology could have some kind of overall positive effect! In addition, this misunderstanding combined with the certainty among many that only allopathic doctors have undertaken serious study has driven a wedge between osteopaths and doctors. It is due to these misunderstandings, among other things, that we wanted to establish, with the help of the Prince’s Government, the Monaco Register of Osteopaths (the ROM) which, like its French counterpart, the ROF, provides greater transparency for the profession, highlights its ethics code and brings together the profession to prevent the abuses, excesses and errors that would be inevitable without a guide or reference point. The ROM (which was initially backed by the ROF) has established, within the structure of an association, a quasi professional body, guaranteeing the stability of the profession, and excluding any purely commercial or sham practitioners, by removing non-exclusive practices which create misunderstanding among our patients. This promotes the transparency which is vital to our profession.

Collaboration between osteopaths and doctors in the Principality

The aim of osteopathy is to become part of the healthcare offer available in the Principality, as healthcare professionals working in complete harmony and collaborating fully with the medical and paramedical world, operating privately but also – soon – in hospital settings. Such collaboration between healthcare professionals is vital to meet patient expectations and ensure that they receive good treatment, which is ultimately all that matters. Follow this link to visit ROM, the official website of osteopaths in Monaco. If you would like to see some figures about osteopathy in France, please check the following link: https://oosteo.com/blog/2022/02/etat-des-lieux-de-losteopathie-en-2022/.