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Pilot study: Osteopathic healthcare in the diagnosis and treatment of emotional disorders
Abstract
Associations between the musculoskeletal system and emotional experience have been studied with regards to various components including posture, facial expressions, breathing mechanics and organ dysfunction. Research suggests that changes in these components may be a result of, or even contribute towards, emotional experiences. This phenomenon underlies osteopathic philosophy, yet with regards to structural osteopathy, there is little research in which it is demonstrated. This study investigated the relationship between the emotion of happiness and somatic flexibility. 48 participants were asked to complete the Oxford Happiness Questionnaire to determine levels of happiness. Results ranged from 95 points to 160 points, the maximum score possible being 174, with a mean of 125.5. Three stretches - the prone back extension, the left straight leg raise and the right straight leg raise, were performed to assess flexibility. Five combinations of the above stretches were assessed against levels of happiness. Results demonstrated a significant difference (p < 0.05) between straight leg raise flexibility and back extension flexibility in those who demonstrated higher levels of happiness, compared to those with lower levels. The findings of the other four combinations were non-significant. full text
Differential diagnosis
As a manual therapist it is necessary to be able to distinguish between referred pain and local pain. This enables one to diagnose correctly, and hence treat appropriately. This article considers the differences between a patient who may present with osteoarthritis in his right knee, and one who may present with nerve root irritation at the level of L3. Both of these scenarios could cause knee pain, however, the latter would be due to nerve referral rather than local tissue damage. full text
Complications of cervical spine manipulation
There is much information regarding complications of spinal manipulation, particularly rotary thrusts to the upper cervical segments, during which the vertebral arteries are stretched and can be torn, or a small clot, dislodged. However, the exact risk factor is unknown and figures could lie anywhere between one incident per forty thousand manipulations to one in ten million, with effects from temporary dizziness and nausea to permanent neurological deficit and even death. full text
The importance of the musculoskeleal system
DiGiovanna (1997) describes the musculoskeletal system (M-S system) as a mirror of both health and disease which is connected to all bodily systems through the nervous system. Kern (2001) explains how the body forms itself around who we are inside - our fears, beliefs, emotions and so on. It is well known that the mind and body are intimately interrelated and therefore that a healthy M-S system is essential for our function. However, to truly appreciate its importance many things have to be considered.
According to Smith et al (1995) the M-S system comprises the bony skeleton of the body and the hundreds of muscles attached to it. It is our framework. Due to the huge amount of beliefs, philosophies and religions, human function is not as easily defined, however, most would agree that primarily our function is to survive, individually and as a species, and secondly, to experience life while attaining a level of peace. As "peace" depends on so many factors it will be discussed here in terms of the five domains of holism (otherwise known as the Diagnostic Logos) - the physical, psychological, sociological, spiritual and cognitive. These domains will be explored after the first section, which deals with our primary function. full text
Clinical diagnosis of serious disease
According to many, the osteopath’s primary function is to spot "red flag" signs, which are signs in a patient’s medical history that are associated with a high risk of underlying serious disease. This is one factor which differentiates osteopaths from other manual therapists, and is the main reason for which osteopathic studies are lengthy and of such depth. The following study discusses a case in which a patient, Mrs Y, had been experiencing symptoms that rose concerns, and as such was referred to her general practitioner for investigations. full text
Case study 1: Predisposing factors
Osteopathy is defined not by the techniques it uses to ward off disease, but by several principles that have their base in holism. An understanding of these principles is necessary for the practice of osteopathy, and their relevance to specific cases should be reflected upon, to deepen one’s understanding of them. This study examines the principle of the relationship between structure and function, in connection to a specific patient. full text
Case study 2: Osteopathy for neurological disorders
Neurology, according to the British Medical Association (1995), is the branch of medicine concerned with the causes, progress, diagnosis and treatment of conditions that affect the nervous system. In its array are conditions such as parkinsonism, multiple sclerosis, cerebral palsy, polyneuropathy and mononeuritis multiplex. This essay will discuss the portion of neurology concerned with radiculopathy, or nerve root irritation, and relate it to a particular patient's case.
The patient, Mr A, will first be described along with his medical history, presenting complaint, and relevant psychosocial and environmental factors. This will be followed by several differential diagnoses and the reasons for which they were proposed. Details of the physical osteopathic examination will follow, and the acquired working hypothesis, with an explanation of its implications for osteopathic treatment and patient management will be discussed. full text
Case study 3: Osteopathy for psychological conditions
Dohrenwend and Dohrenwend (1974) describe how events such as moving house or starting a new job are associated with subsequent ill-health. Kern (2001) explains how the body forms itself around who we are inside - our fears, beliefs, emotions and so on. It is well known in holistic medicine that aside from the physical aspects of health, the psychological, sociological, cognitive and spiritual domains must be considered by the manual therapist in order to treat effectively. These five domains are referred to as Diagnostic Logos.
This essay aims to discuss how two of the above domains, namely the psychological and sociological, have, according to a clinician, a higher bearing on a particular patient's case. The patient, Mrs J, will first be described along with relevant information. This will be followed by a description of one psychological concept, and how it can illuminate her case and influence its practical management. A discussion of one sociological concept will follow and also be related to Mrs J and her practical management. full text
Case study 4: Osteopathy for rheumatological conditions
Rheumatology, according to Smith (1995), is the branch of medicine concerned with the causes, progress, diagnosis and treatment of conditions that affect the joints, muscles and connective tissue. In its myriad are diseases such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, systemic lupus erythematosus, arteritis and polymyalgia rheumatica (Currey, 1980). This essay will discuss the portion of rheumatology concerned with facet degeneration and spondylosis in relation to a particular patient's case.
The patient, Mrs A, will first be described along with her medical history, presenting complaint, and relevant psychosocial and environmental factors. This will be followed by several differential diagnoses and the reasons for which they were proposed. Details of the physical osteopathic examination will follow, and the acquired working hypothesis, with an explanation of its implications for osteopathic treatment and patient management will be discussed. full text
Case study 5: Pain
Pain, according to Merskey (1979), is an unpleasant sensory and emotional experience with associated actual or potential tissue damage. The Cartesian model, which was developed by Descartes (1664), described pain as a signal of tissue damage, however, it is now agreed that the nature of pain is more complex and that pain may be perceived even when no tissue damage is occurring (Melzack and Dennis, 1978 and Loeser, 1980).
This essay, after having explored the subject by reviewing the neurophysiological and psychosocial pain models, will discuss the impact of pain upon human function using two real case histories as examples. full text
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