The word “treatment” has specific meaning, but its connotation can be ambiguous relative to the practice of Osteopathic Medicine. The ‘dictionary‘ definition is: “the manner in which someone behaves toward or deals with someone or something.”
Getting treated osteopathically suggests that the patient is ready to be involved in a process that pays attention to the patient’s state of being; whether that be in health or as a result of injury or illness. Implicit to osteopathic treatment is its assistance in diagnosis of a health.
With treatment, the patient is often lying “passively” on the treatment table, where they are being evaluated by the osteopathic physician. A “non-passive” exchange of ‘positional’ information is expressed by the patient and interpreted by the osteopathic physician. This information transfers between the physician and patient by interactive palpation and by the physician’s study of the patients static and functional anatomy. Tactile examination of the patient’s body habitus, structure, and anatomy is accessed relative to inherent motion. Consequent states of relaxation or awareness are affected by or can induce that motion. The motion induced by the physician can add to the narrative when indicated. The detection of subtle motion within the body is key to osteopathic training.
Motion within the body is multi-variant: blood, lymphatic, cerebrospinal fluid, glymphatic pulsations or lack therein, respiratory patterns and its impact on conscious or unconscious control of the musculoskeletal system, patterns of posture unreleased in the supine position affected by pain or guarding from internal sensations, even suggestions from the study of embryology may suggest relationships important to treatment as a process.
Experience of sensation as an ‘internal surveillance’ in the patient may be detected by their vagus nerve and ascending spinal tracts. The patient surveys organ and autonomic function and takes note of specific environmental cues from internal sources or as a reaction to the environment from central nervous system overrides.
Most patients have not practiced or trained themselves to re-experience the environment on an internal level (direct sensory experience) or to express their physiology as it relates to the environment that they occupy. Eastern and yogic traditions are more familiar with this internal ‘bio-terrain’ training/sensing and children frequently have the ability to access internal sensation but rarely have a vocabulary with which to communicate its subtile experience.
Osteopathic treatment begins with a discovery, or a decision, or a capability to learn how to interpret healthy, maladapted or reflexed patterns of being. Our psycho-neurology allows us to relax, trust, or deepen our exploration of internal experience in specific environments that facilitate the body’s parasympathetic response (tendency to feed and breathe). The osteopathic treatment facilitates diagnosis in a parasympathetic state for accuracy in accessing tissue injury.
This experience of the self in the context of a treatment is an afferent neural pattern, as it brings sensations that appear from the external environment to the inside as a physiologic response. It allows less ‘fear’ in the interpretation of the body environment and assists the osteopathic physician in their diagnosis by localizing “complaints” within the primacy of injury as experienced by palpated anatomy through lens of the patient’s internal experience. It is the observer being observed that facilitates in the advancement of diagnosis towards treatment of therapeutic recovery.
The specificity of addressing temperament and background may encourage patient facilitation or allow an understanding why physiologic responses can be opposite to what is an anticipated treatment response. For example, is it easier to meditate/relax in a church or on the subway? If a patient has had a prior stressful event that overwhelms nervous system activity and is associated with a church, the result can be a physiologic paradox, and church may be more stressful than the subway. Adaptation is patient specific and re-learning access points allow for non-paradoxical patterns to emerge. Non-paradoxical patterns may assist in restoring health to the mind/body connection. Palpating tissue and diagnosing it through linkage, limits and absence of physiologic imprint can help the physician address when constraint to the tissue response is present and assist in dis-engagement.
