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OSTEOPATHIC PRINCIPLES IN MANAGING BACK PAIN
These are an integral part of the overall evaluation and management of every patient.
The body is a unit. As the osteopath approaches the diagnosis of the patient’s condition, the unity of the body should be kept in mind. It is never good practice to isolate the focus of the examination to a single body part, even though the symptom may seem related to only one area. A clear example is lower back pain. Pain in the lower back may be predisposed to or maintained by flat feet, dysfunction of the knee or hip, sacro-iliac joint dysfunction, pelvic imbalance, muscle imbalances anywhere in the body, or restrictions of the upper back, essentially postural imbalance that has caused compensation from the feet to the head. The osteopath must consider all facets of interrelatedness of the body.
Structure and function are interrelated. The osteopath must recognise that an abnormal structure is likely to result in abnormal functioning of that body part. Likewise, longstanding abnormal function will eventually affect the structure involved by creating a compensatory position or motion pattern, changes in the structure itself, or stresses on the structure that will result in a breakdown of tissue. A treatment plan must focus on improving the structure and function of the patient to the nearest normal possible for that patient, even when those restrictions found do not seem to be related to the problem at hand. The musculoskeletal system is the osteopath’s route to the treatment of many conditions both of that system and other systems connected to it by the nervous and circulatory systems.
The body is self-regulating and self-healing. The osteopath will use the body’s ability to repair and maintain itself. It is then the role of the osteopath to know when and where to intervene to assist the body in its healing process. Osteopathic considerations in doing so include: (1) Maintaining good circulation to involved body parts. (2) Treating all restrictions that interfere with motion of any body part or mobility of the patient in general. (3) Removing any sources of pain or discomfort that are treatable manually. (4) Preventing dysfunction of spinal segments that may send inappropriate feedback to involved structures through the nervous system.