Each month there are more than 100,000 new medical research articles published. If you read, and could understand, 10 articles per day, and you didn't stop for weekends or holidays, then in about 30 years time, you would be getting close to reading the current month's articles. Nobody can keep up. Text books are out of date before they are published; university lectures are often out of date before they are delivered. We all need a way to simplify all of this information, so that we can do something with it to help our patients.

The simplification process most-often used in mainstream medicine is called 'reductionism'; breaking a complex problem down into simpler parts. This often means treating a problem in one 'system' or 'tissue' as though the problem and its causes all lie within that tissue or that system. It involves breaking treatment down into specialties; and these are getting narrower. Specialists often have an area of particular interest which is narrower than their overall specialist area, so that they can keep up. GPs have a particular challenge, because they are expected to know something about everything. Their training often copes with this by focussing on conditions seen in hospitals, and by working on defined conditions and the treatment of choice for those.

Reductionism is a helpful approach; and medicine wouldn't be as advanced as it is without it. It does have some major limitations, though; particularly if you have a complex, multi-system problem, which doesn't fit easily with standard approaches; or if you have a problem that doesn't seem to be responding; or if you are just interested in maximising your overall health. As an osteopath, while I use reductionism, I rely more on other approaches for simplifying the complexity that is human health.

Osteopaths make four assumptions about health:

1) Bodies are generally amazingly good at fixing themselves. If this isn't happening, we want to understand why not. Our approach is more about facilitating your own health, than about giving you a cure. This means I don't lock you in for a fixed number of treatments, nor for permanent maintenance. Some people do like to come regularly, but that is their choice. Some people only need one treatment to have something resolved which was stopping their health from moving forward. It depends on you as an individual; and I try to make decisions about how much treatment my patients need with them, not for them.

Everyone involved in human health has a massive challenge; keeping up with the research. It's physically impossible to do it. I know I can't.

2) If parts of your body are stuck, not moving well, or not communicating well with one another, we tend to assume that this can get in the way of your body's ability to repair itself. If blood restriciton is limited, if lymph cannot drain well, if nerve supply is inhibited, if muscles are over tight, if joints aren't free, if organs don't glide well against each other, etc, then things are going to be more difficult for your system to get back on track. And so I have a lot of different techniques in my toolkit, to help your body to move and communicate with itself more freely.

3) A problem in one part of the body is likely to affect another part. I think about connections, rather than just seeing issues in isolation. If you have a sinus infection, I will be interested, among other things, in whether your clavicals are stuck down and restricting the flow of lymph. If you have neck pain I will be interested in whether your diaphragm is tight and is pulling down on the connective tissues that attach all the way to your neck.

4) We are all different. There are similarities and patterns in health and disease, but in the end, your life to this point has been different from everyone else's. Your body became the way it is through its own journey; and getting back to the health you want will be your own process. So I will focus on you as an individual.

This means, among other things that the treatment process is quite exploratory. I will probably reach a "medical" diagnosis of your condition quite quickly, but that is just the start. I will do a range of testing, and, as I start to treat you, I will learn more about how your system responds and what else it needs. For complex cases, this can be like peeling away the layers of an onion. Diagnosis can become an ongoing process of treating, then checking the response.


John Smartt, Osteopath
Bachelor of Applied Science (Osteopathy) Master of Osteopathy (UWS)

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We say 'disease' when we should say 'effect'; for disease is the effect of a change in different parts of the physical body. Disease in an abnormal body is just as natural as is health when all parts are in place.”

AT Still, the "discoverer" of osteopathy,