Discussion of these concepts will be found in the chapter dealing with osteopathic theory.
There is a growing awareness of the value to general health of an integrated, mechanically sound, musculo-skeletal system. The scientific rationale for this becomes clearer with research. Clinically, however, osteopaths have long realized the positive effects of manipulative therapy on health. It is necessary to keep in mind two essentially different roles filled by Osteopathic practitioners in their work. One is that of providing limited care to patients with joint pains and strains. The other is the total health-care of patients, with any of the myriad ills of mankind. There is also a further extension of osteopathic care, in areas in which no other form of healing offers much help. This is the more recent application of osteopathic principles and methods to the structures (bones, reciprocal tension membranes, fluid fluctuations etc.) of the skull, especially of infants. As will be described in the chapter on Cranial Osteopathy. These methods, when successfully applied to such problems as cerebral palsy and spasticity of the newborn, can produce results bordering on the miraculous. In its limited application (joint injuries, postural stresses etc.) osteopathy is a most effective system for the treatment of musculo-skeletal derangements.
Confusion exists in both public and medical minds as to the distinction between osteopathic and other forms of physical treatment. Because other systems utilize manipulative methods on their approach to the patient it is often assumed, even by apparently knowledgeable individuals, that there really is not very much difference between osteopathy and, for example, physiotherapy or chiropractic. Nothing could be further from the truth, and a brief examination of some of the other systems with which osteopathy is often confused should help to clarify the differences.
Osteopathy and chiropractic differ in three main areas. These are the philosophical or theoretical aspects, the technique and the training. Osteopathy has a basic philosophical viewpoint from which have developed the specialized diagnostic and therapeutic measures, including osteopathic manipulative technique.
Chiropractic originally placed great emphasis on the idea that spinal joints, when misplaced (subluxated), could impinge upon nerves and thus cause disease elsewhere in the body. Chiropractors tended to focus attention on the spinal and pelvic structures, employing elaborate x-ray procedures in their analysis of subluxations. Treatment tended to be by specific high velocity thrust techniques, often employing a rebound effect from complex, sprung treatment couches.
Over the years chiropractic has tended to take more and more interest in joint dysfunction as related to back and neck pain, rather than in the general treatment of ill health. A survey in Australia, Canada and the U.K. indicated that 90 per cent of patients attending chiropractors do so for treatment of low back and neck pain. Chiropractic techniques have also changed over the years, to the point where many practitioners employ similar functional and leverage techniques to osteopaths. In the same way, many osteopaths have incorporated thrust techniques usually associated with chiropractic.
In the U.S.A. osteopathy has become an accepted (in law) alternative system to orthodox medicine, employing its own unique methods as well as what it considers useful from the orthodox system, in the treatment of all forms of ill health. Chiropractic is more limited in its legal position, its range of application and in its range of methods. It is certainly true to say, though, that in treatment of neck and back conditions the difference between the two systems has become blurred. The training of an osteopath in the U.S.A. takes seven years and a full licence is granted to graduates. A four year training which is undertaken to achieve a chiropractic doctorate leads to a limited licence (no surgery, drug prescription or the right to sign death certificates etc.)