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More Information and Research on Osteopathy & Cranial Osteopathy

© 2019 City Osteopaths
ACC Data:
According to the ACC National Service Report of June 2016, for the conditions of lumbar (low back) sprain, neck sprain, sacroiliac sprain and shoulder and upper arm sprain, Osteopaths were more likely to require 0-5 treatments compared to physiotherapists who were more likely to require 6-10 treatments for these conditions. Also, under Osteopathic treatment 96-99% of injured patients were returned to independence, compared to 60-65% for those patients receiving a mix of clinical services.

​What is Osteopathy?

Osteopathy is a system of manual medicine that looks at the relationship between the body's physical structure and its impact on physiological processes.

Manual medicine refers to the use of the hands both in the examination and diagnosis of mechanical imbalances within or between physical structures, and also in the correction of these imbalances.

Physical structure refers not just to the musculoskeletal system (although this is very important), but to all tissues that make up the human organism.

Physiological processes include the nourishing and transporting functions of blood and fluids, the guiding functions of the nervous system, direct metabolic functions of the cells themselves, and biochemical activity.

The body's inherent capacity for health, homeostasis and self-repair can be impeded by imperfect structure and motion of any part of it. Osteopathic treatments involve a gentle, effective hands-on treatment following whole body Osteopathic diagnosis.

Each of our osteopaths have studied for four or five years full-time (40 hours per week) at University. The course of study to become an osteopath includes Anatomy, Spinal Anatomy, Human Dissection, Embryology, Physiology, Pathology, Neurology, Physics, Chemistry, Biochemistry,  Histology, Orthopaedics, Orthopaedic, Neurological and Physical examination, Differential Diagnosis, Paediatrics, Geriatrics, Obstetrics and Clinical Osteopathy.

Osteopaths must be registered with the Osteopathic Council of New Zealand (OCNZ) which is the governmental registration body for osteopaths set up under the Health Practitioners Competency Act in 2004. New Zealand Osteopaths are registered ACC treatment providers.

In the United States, Osteopaths are medical doctors and there are Osteopathic hospitals, however the model chosen for New Zealand and Australia is Registered Osteopaths as primary healthcare physicians who use their hands rather than drugs to assist the body back to optimal health. 

What is Health?

The word "Health" is an English noun referring to the overall soundness or condition of an organism. Osteopaths also like to think of health as being a verb; that is, the action of striving to optimise the condition of the organism.

Many of us have heard of this concept before, under the name "homeostasis", meaning "stay the same." For the osteopath, this word contains entirely the wrong connotations - there is nothing "static" about it. Maintaining a state of health is a constant dynamic battle to overcome the never-ending stream of insult and injury that characterises life. Health is about bouncing back. Health is not just that which protects us from bacteria and virii, but also that which maintains our blood pH, heals the cut on our finger, and maintains our positional sense to remain upright in Wellington's notorious wind.

Health is, to the osteopath, not a state of being without disease, but an optimum ability to withstand and self-right from insult or injury.

I haven't heard of Osteopathy before - is it new?

No. Osteopathy has existed in its modern form for around 150 years, but this incarnation is best understood as just the latest chapter in manual medicine, which has probably existed for much longer than human civilisation - since the time when primitive man first instinctively rubbed an ache. The oldest confirmed written record is possibly that of the Tomb of Ankh-Mahor in Egypt, a VIth Dynasty Pharoah who died in 2340BC. Since that time, manual medicine has sprouted forth all over the globe and persisted for one simple reason - it works.

Modern Osteopathy was founded by Dr Andrew Taylor Still, an American physician, in the mid-1870s after he became dissatisfied with orthodox medicine.

Dr Still observed that patients who were ill often had irregularities in the alignment of their spines and he became certain that many illnesses arise when part of the body's structure is misaligned or not moving properly. He reasoned that adequate function of the body's physiological systems depends on unimpeded blood and nerve supply. He was able to alleviate or cure his patient's illnesses by manipulating joints and soft tissue.

His simple techniques were effective (true to the history of manual medicine), but more importantly his philosophy paved the way for further advances guided by a new understanding of health and disease. He said "My aim is to make the osteopath a philosopher, and place him on the rock of reason." The last 140 years has seen osteopathic practice spread throughout the globe and incorporate the latest advances of science, experience and observation while remaining true to its philosophical underpinnings, namely: The body is a unit. The body has self-healing and self-regulatory functions. Structure and function are reciprocally interrelated. The goal of the osteopath should be to find health; anyone can find disease.

Nowadays full-time University training, followed by rigorous clinical examinations are required to become an osteopath. In New Zealand all osteopaths have to complete ongoing postgraduate education to obtain an Annual Practicing Certificate.  All osteopaths should display their Annual Practicing Certificate and have Reg. Osteopath after their name.

What is Cranial Osteopathy?

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Many of our osteopaths practice Cranial Osteopathy, which is a specialised diagnostic and treatment approach following on from the discoveries of American Osteopath Dr William Garner Sutherland in 1898, who observed that the various bones of the cranium (skull) fitted together in a way that permitted (small) motion.

Subsequent study found that not only was motion present within the skull, but that slow rhythmic motions (independent of breathing and heart-rate) also existed elsewhere in the body. Nowadays "Cranial Osteopathy" is practiced all over the body, but the name remains, in homage to Sutherland's original discovery. This motion has known many names over the 100-odd years since, including Cranial Rhythmic Impulse, Inherent Motility, and the Involuntary Mechanism, although today it is most commonly referred to as the Primary Respiratory Mechanism (PRM).

The PRM consists of very slow motion. The slowest regularly observed rhythm has a cycle of approximately 100 seconds. Motion present includes Traube-Hering-Mayer (THM) vasomotor waves and independent metabolic motion. Cranial osteopaths diagnose and treat various characteristics of the motion observed using a finely-tuned sense of touch. Not all osteopaths are trained in Cranial Osteopathy and it takes many years to become skilled. This treatment approach is gentle and very appropriate for babies, children as well as adults.

Research evidence for cranial bone mobility:
http://www.icnr.com/articles/radiographic-evidence-of-cranial-bone-mobility.html
​
Research on cranial rhythmic impulse and the Traube-Hering-Mayer oscillation:
http://jaoa.org/article.aspx?articleid=2092406 
Research on measuring intracranial wave form pulsatility:
http://www.ncbi.nlm.nih.gov/pubmed/9779147

What is the Biodynamic Model?

American Osteopath Dr James Jealous successfully combined Dr Sutherland's "Cranial Osteopathy" with German embryologist Dr Erich Blechschmidt's "Biokinetics and Biodynamics of Human Differentiation" to form an approach to osteopathy that he called "Biodynamics of Osteopathy in the Cranial Field."

Where traditional Cranial Osteopathy had concerned itself with tissue lesions preventing full expression of the motion of the PRM, the Biodynamic Model was interested in the movement itself. Blechschmidt's work had established a correlation between subtle movements and metabolic fields in the developing human embryo, and Jealous began to investigate the effect of these movements on metabolic activity in adults. Jealous found that not only were developmental movements of the embryo and primary respiration (PRM) in the developed human one and the same, but that there appeared to be a correlation between primary respiration and the potency of self-repair (health) itself.

Thus a cranial osteopath working biodynamically is not concerned with tissue lesions, but with the direct apprehension and optimisation of the faculties of self-repair and self-correction.

An Osteopath working with the Biodynamic Model seeks first and foremost to understand Health as a verb.
​

Osteopathy in the treatment of Infants and Children and Adults

Birth
A baby's passage through the birth canal is a difficult process and nature ensures that the bones of the skull are pliable enough to overlap to enable this to happen. Sometimes the bones do not return to their normal positions after delivery. This can happen if the labour is unusually long or short, if there is a large baby passing through a small pelvis, if a baby has a large head or if intervention is necessary for example a forceps delivery or ventouse extraction. A Caesarian birth may involve trauma to the baby who is stuck in the mother's pelvis. Alternatively, problems can occur in utero if there is insufficient amniotic fluid.
When to Seek Treatment for infants
A baby will often communicate there is a problem by being unsettled, irritable or wakeful. Symptoms in a newborn baby to be aware of are:
  • colic
  • excessive wind
  • continuous crying
  • difficulty feeding or a preference to feed from one breast
  • sticky eyes
  • sleeping difficulties
  • stiffness of the neck muscles
  • favouring the head to one side 
  • a misshapen head
  • tongue tie or jaw restriction

Osteopathy can be useful in treating a wide range of symptoms and conditions in children and adults. Our treatments are based on clinical experience, expert opinion and informed by evidence where available. People come to see us for the following researched conditions: (Please note this page is still being completed and is continually updated)
​
  • ear infections and glue ear The tissues of the upper back, ribs and neck which attach to the underside of the cranium can pull on the membranes surrounding the temporal bone (which the ear sits in) and affect the eustachian tube drainage from the middle ear into the back of the nose. Freeing up the temporal bone  assists in easing acute ear infections in children or adults. We also work with the more chronic situation of glue ear to assist drainage, and help avoid grommet surgery if at all possible. Research in Australia has shown that antibiotics are no longer recommended as treatment for recurrent ear infections for children.  (Research:http://www.ncbi.nlm.nih.gov/pubmed/12963590 and http://www.ncbi.nlm.nih.gov/pubmed/24917631)

  • back and neck pain Our Osteopaths are highly trained and experienced to help people everyday in this area. We take a thorough look at why you may be getting neck or back pain, we ask many questions and assess your whole body structure and how it functions. We aim to get results quickly to get you out of pain, to save you time and reduce suffering. We also look at developing a plan with you so we can help prevent it re-occurring. Our aim is always for you to remain pain free and for you NOT to need to see us again!  (Research: http://www.ncbi.nlm.nih.gov/pubmed?term=Licciardone%20JC,%20Minotti%20DE,%20Gatchel%20RJ,%20Kearns%20CM,%20Singh%20KP.%20Osteopathic%20manual%20treatment%20and%20ultrasound%20therapy%20for%20chronic%20low%20back%20pain:%20a%20randomized%20controlled%20trial.%20Ann%20Fam%20Med%202013;11:122%E2%80%9329.) Also see the ACC data summary for number of treatments at the top of this page.

  • sinus pain Very small but important motion is required in the bones of the face, in particular the frontal and maxillary bones, in order for the sinuses to keep draining well. Our patients report immediate relief from the pain and pressure of sinus congestion, with our gentle osteopathic treatment.    (Research: http://www.ncbi.nlm.nih.gov/pubmed/22036532)

  • headaches There are many kinds of headaches and causes, we usually see people with headaches which are caused by strain in  their neck or upper back or from the membranes in the head which have lots of nerves in them. We are trained to assess 'red flag' type headaches and refer for further assessment including scanning if appropriate. (Research: http://www.ncbi.nlm.nih.gov/pubmed/1156265)

  • pregnancy back pain In pregnancy the growing uterus requires postural changes to maintain balance. Also the hormone relaxin softens ligaments and can result in pelvic or back pain. We find that past injury such as a fall onto the bottom, even many years before, can show up as a problem in pregnancy. We can treat with the pregnant woman lying comfortably on her side or seated, to restore balance and improve functional reserve to tissues. Our patients find this to be very helpful in reducing their discomfort. We are also able to restore the optimal balance to the pelvis and related muscles to allow for the best natural birth possible.(Research: http://www.ajog.org/article/S0002-9378(09)00843-6/abstract?cc=y=)

  • carpal tunnel (Research: http://www.osteopathic.org/inside-aoa/news-and-publications/media-center/2015-news-releases/Pages/3-2-pilot-project-finds-potential-in-osteopathic-manipulative-treatment-for-carpal-tunnel-syndrome.aspx)

  • Preparation for labour We recommend pregnant women come into the practice around 35 weeks pregnant for a pre birth assessment of their pelvis and uterus balance. We find this helps improve the birth process and results in fewer interventions.  (Research: http://jaoa.org/article.aspx?articleid=2092759 )

  • Pre-term infants (Research: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127370 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648440/)

  • Growing pains (Research:  http://www.osteopathic-research.com/paper_pdf/KramerBirgit.pdf  We find one to three gentle treatments usually sorts this for children)

  • Hyperactivity (Research: http://jaoa.org/article.aspx?articleid=2094741Hyperactivity is often multifactorial so diet and environment also need to be looked at in the appointment. We find that treatment directed towards calming the autonomic, in particular the sympathetic nervous system helps with calming, digesting and sleeping better)

  • Speech problems (may be caused by tongue, jaw or breathing problems so we really need to make an assessment to be more specific )

  • Asthma Osteopaths can't stop the initial allergic reaction of bronchial spasm and increased mucous production,  but we can help reduce the autonomic nervous system response to the allergen, also help improve the rib cage mobility and ease the accessory muscles of respiration which can get so tight and sore with the effort of breathing. (Research:  http://www.ncbi.nlm.nih.gov/pubmed/24778002 and  http://www.ncbi.nlm.nih.gov/pubmed/15710659)

  • Dental problems and orthodontics  We see children of any age and also adults when they are undergoing orthodontic work. (For example to ease pain in the head, neck, jaw or face associated with braces)

  • Jaw or TMJ pain or clicking This can occur after an injury such as a blow to the side of the head or to the jaw directly. We have also seen problems after a long dental surgery session or if the bite is 'off'. It can be very painful and distressing to have pain in this area and be unable to eat or exercise without pain. We find that our gentle techniques are very effective at restoring better jaw function quickly following acute injury.  (Research: http://www.sciencedirect.com/science/article/pii/S1360859209001156 and http://www.ncbi.nlm.nih.gov/pubmed/18380529 )

  • Fibromyalgia  We use gentle myofascial release techniques including  the osteopathic technique Counter-strain to 're-set' the central nervous system when there are trigger points causing pain in the tissues. (Research: http://www.ncbi.nlm.nih.gov/pubmed/21673013 )

  • Post surgery  To reduce your recovery time (Research: http://www.ncbi.nlm.nih.gov/pubmed/10979164 )
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Cranial whole body diagnosis requires an acutely trained sense of touch coupled with a fine discrimination as to the dysfunctions present in need of correction, and this can only be learned by years of study and training under skilled instruction. 

Cranial treatment is extremely gentle, is suitable for infants, children and adults of any age, and involves no pain for the patient.
Research evidence on safety of Cranial Osteopathy: http://jaoa.org/article.aspx?articleid=2093194

An Australian Registered Osteopath, John Smartt, has written a very useful, well researched and referenced document about Osteopathy, that you can download here

​
We would like to see more high quality scientific research for many problems common to Babies and Children. These problems include colic, flat head (plagiocephaly), glue ear, sleeping problems and irritability. Our clinic would be happy to participate in any such trials.
© 2019 City Osteopaths
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