This article is presented by William Jarrige and Anouk Sanchez, manual practitioners, and thesis candidates for the osteopathy practitioner program at the Canadian School of Osteopathy–Manual Practice–Vancouver. We are the owners of Revelstoke Osteopathy, the new clinic located at 111 Second Street East in Revelstoke. This is the sixth installment in a 10-part series exploring osteopathy.
After reading in our last article on how osteopathy can help athletes, are you wondering if osteopathy can help you as a non athlete? The answer is yes, of course.
Osteopathy is not a therapy that specializes on rehabilitation of injuries such as physiotherapy, but rather finds the cause of the injuries. We explore how osteopathy help patients who are suffering from chronic pain.
As those who suffer from it know, chronic pain can be very difficult to define. In their first consultation, osteopathic practitioners ask detailed questions to learn your history and daily routines to better understand what could have created a situation resulting in chronic pain issues.
It is very difficult to put all chronic pain in the same category so, as an example, here is an example of the kinds of cases that present at our clinic.
The patient presents with neck pain that started about a year ago with no apparent trigger. The pain came on gradually, and this is why the patient took a long time to consult a therapist. The patient has already seen a doctor and taken some tests, but the results don’t bear out any issues. At this point, the osteopathic practitioner already suspects that the pain is a symptom of an underlying problem. He begins his investigation by taking a thorough history.
During the consultation, several signs will confirm an accumulation of small functional disorders that may be causing the pain.
In our example, the client had a car accident 10 years ago causing whiplash. This current incident can leave adhesions between the dura matter (a sheet of thick connective tissue that wraps the spinal cord) and the cervical vertebrae, which over time cause inflammation in the area. Over time, this restriction becomes a weak point in the body that will wake up at the slightest tension, effort, or new trauma in the body. In our example, the person is an occasional climber, works manually doing construction work and has a substantial abdominal scar from a inguinal hernia surgery that pulled him into a slightly slouched posture. From an osteopathic practitioner’s perspective, this has added four more layers to the old whiplash issue.
“We look at the body in health as meaning perfection and harmony, not in one part, but in the whole.” -A. T. Still MD, DO
For example if a patient suffers from Irritable Bowel Syndrome (IBS), the intestines are continually irritated. Over time, this irritation affects the innervation of the intestines which in turn affects the innervation of the muscles along the vertebrae. The vertebrae find themselves restricted in mobility and the patient’s posture will change causing tension in the cervical area, an area already weakened by the whiplash. The works of the osteopathic practitioner, in this case, will be to stimulate the anti-inflammatory processes of the body by working on the liver and proper fluid circulation by working the diaphragm as well as restoring posture. A naturopath may also prove useful to help with changes in diet and natural supplements that will help decrease the inflammation of the intestines.
We must therefore understand that chronic pain is the accumulation of tensions that awaken points already weakened in the past. Whether your weakness is your lower back, neck, hips or knees, it is important to address chronic pain holistically.
We must also understand the patient’s environment and daily activities. Whether the patient is an arborist, an electrician or a secretary, each profession asks the body to adapt to the demands of the work. It is important for people to find activities or modalities to counter act these long term postures. A physiotherapist or a personal trainer can be helpful in giving exercises to balance and strengthen muscles. The massage therapist can relieve muscle tension accumulated during work time. The osteopathic practitioner can be very effective in restoring postural imbalances that are associated with restrictions caused by multiple systems as, for example, between an organ that is in contact with a muscle that attaches on a bones that is related to a fascial chain.
The most common example is people who work in a sitting position for long periods of time. In this position, the abdomen and the pelvic floor relax, the hips are locked and the pressure in the pelvic cavity increases. This position promotes a congestive fluid state in the lesser pelvis. This can result in different symptoms such as urine retention problems, hemorrhoids, prostate problems, pain in the hips and back.
The osteopathic practitioner will relieve the patient by increasing the movement of fluid in this region. He will ensure that the innervation of the lesser pelvis is optimal by freeing any restrictions of the sacrum and lumbar vertebrae. By working on the bones (iliac, femur and sacrum), the therapist works on the lines of gravity and posture. If there are scars, fascial techniques will soften tissue and relieve pressure in the pelvic or abdominal cavity. Visceral techniques will influence the mobility of organs such as the liver, the small intestines, the bladder, the sigmoid colon, uterus and kidneys, which can all increase the pelvic pressure if they are found in a congestive and low position. Let’s not forget to watch the rest of the body; perhaps an old ankle sprain influences posture or a past head trauma affects the pelvis through the dura matter and the sacrum.
Dealing with chronic pain challenges all doctors and therapists because the cause is often obscure. It often takes time, several treatments with different disciplines to get rid of them, but optimism, curiosity and the desire to learn more about your body functions are qualities that will help you through this. Do not hesitate to contact us if you have any questions, the last article in the series will be devoted to your questions.