Positive Health Online

When I trained as an Osteopath the course was integrated with Naturopathy, at what was then The British College of Naturopathy & Osteopathy. This institution has now modified its name to The British School of Osteopathic Medicine, however, I am told it still has a Naturopathic content to its courses.

My perspective is that Osteopathy provides the structural (biomechanical) element of Naturopathy, which as a comprehensive health care system embraces Biochemical, Psychosocial,  and Biomechanical elements, so that all aspects of the person can be considered. Permeating these areas, in Naturopathic thinking, lies a vitalistic appreciation of an energy, or spiritual, dimension.

The core of Naturopathic thinking is that whatever the health problem, causes are evaluated, and efforts are made to encourage self-regulating homeostatic functions. This, in practice, requires that two major factors be considered – ways of reducing adaptive demands (poor diet, poor posture, poor patterns of use, lack of exercise, exposure to toxicity etc, etc.) that are interacting with inherent tendencies and characteristics, while simultaneously enhancing those functions (digestive, eliminative, immune, circulatory etc, etc.) that cope with adaptive demands.

In North America and Australia, Naturopathic education includes ‘physical medicine’ as a major feature (partially based on Osteopathic, Chiropractic, Physiotherapy, Hydrotherapy and Massage Methods). In the USA and Canada, the ability to provide manual/ physical therapy is part of the licensing requirement for NDs (Naturopathic Doctors) – who in almost half the states and several provinces, practise as first line Physicians.

One of my concerns over the past few years, when I have lectured to NDs in these countries, has been the relative decline in interest of the manual/physical side of their health care provision.

This has happened as the Naturopathic profession’s focus on Botanical, Homeopathic, Chinese Medicine and Nutrition has increased; some see North American Naturopathy tilting towards a  ‘Green Allopathy’.

This is not universal – with many NDs practising excellent ‘bodywork’, as well as offering a broad and integrated model of Naturopathic care.

My concerns regarding the decline in interest in the Biomechanical/Physical side of Naturopathy was confirmed by a recent study/survey of the profession that indicated that fewer than 50% of patients attending NDs in Canada received any physical medicine care – even though strong evidence exists of potential benefit being available from such treatment.[1]

In order to help NDs reconnect with the structural side of health care, a number of North American and Australian practitioners, and I decided to put together a textbook of Naturopathic Physical Medicine that would provide the rationale and the evidence that such approaches are indeed fundamental to comprehensive health care – with every bit as much weight as nutritional and psychological considerations. For the past 15 months or so I have been editing and part-writing this book. (It will be published towards the end of this year or early 2008 by Elsevier).

A major part of this absorbing process has been the need to explore, in depth, the evidence that exists for physical medicine’s potential benefits – other than the obvious ones involving low back, neck and shoulder dysfunction and pain.

What has emerged is that there exist numerous studies where, for example, Osteopathic Manipulative Treatment (OMT) has been shown to have a positive impact on the length of hospital stay for patients. Clark and McCombs[2] have described a selection of basic manual approaches, including positional release, muscle energy, myofascial release and other soft-tissue manipulation techniques, as well – when indicated – as high velocity thrust (‘adjustment’) techniques, that effectively support respiration, circulation (venous and lymphatic), ventilation, and perfusion, in hospitalized patients, in order to augment recovery following surgery and/or a disease.

Studies by Stiles,[3]  Radjieski,[4] Cantieri,[5] Noll et al,[6],[7] Sleszynski, Kelso8 and others – all demonstrate that recovery time from various conditions (pneumonia for example) and situations (post-operative for example), can be reduced, and length of stay in hospital minimized, when combinations of manual modalities are used in patient care.

It is my intention, over the coming issues of Positive Health, in which this column appears, to discuss a number of these integrated treatment approaches – and to tell you more about Naturopathic physical medicine.

References

1.    Verhoef M et al.  The Scope of Naturopathic Medicine in Canada: An Emerging Profession.  Social Science & Medicine. 63(2): 409-417. 2006.
2.    Clark R and McCombs T. Post Operative Osteopathic Manipulative Protocol for Delivery by Students in an Allopathic Environment. American Academy of Osteopathy Journal. 16(20):19-21. 2006.
3.    Stiles E. Somatic Dysfunction in Hospital Practice. Osteopathic Annals. 7(1): 35-38. 1979.
4.    Radjieski J,  Lumley M and Cantieri M. Effect of Osteopathic Manipulative Treatment on Length of Stay for Pancreatitis: a Randomized Pilot Study. Journal American Osteopathic Association. 98:(5). 264-272. 1998.
5.    Cantieri M. Inpatient Osteopathic Manipulative Treatment; Impact on Length of Stay. American Academy of Osteopathy Journal. (4): 25-29. 1997.
6.    Noll D, Shores J, Bryman P et al. Adjunctive Osteopathic Manipulative Treatment in the Elderly Hospitalized with Pneumonia: A Pilot Study. Journal American Osteopathic Association. 99(3): 143-152. 1999.
7.    Noll D, Shores J, Gamber R et al. Benefits of Osteopathic Manipulative Treatments for Hospitalized Elderly Patients with Pneumonia. Journal American Osteopathic Association. 100(12): 776-782. 2000.
8.    Sleszynski S and Kelso A. Comparison of Thoracic Manipulation with Incentive Spirometry in Preventing Postoperative Atelectasis. Journal American Osteopathic Association. (8): 834-838. 1993.