Posts Categorized: Osteopathic treatment

What are your standards for Cauda Equina Syndrome?

Cauda Equina Syndrome is rare but it is one of the most serious conditions we are likely to come across in clinic and missing or delaying this diagnosis can have life-changing consequences. Question and Safety Net Always screen back pain patients for bowel and bladder and sexual function changes and saddle anasthesia. There is a need to be really clear about what symptoms you are looking for – difficulty going, difficulty stopping, going without realising, knowing when you have stopped. Numbness in a saddle distribution is also a key symptom. Continue Reading »

Skills and conundrums in helping people with pain

Using the biopsychosocial understanding for diagnosis and treatment requires an expansion of manual therapy skills. We have already looked in-depth at the explanation of why biomedical reasoning alone is not justified in explaining pain and treatment methods. This post will consider some of the challenges involved in applying biopsychosocial reasoning in clinic. Osteopathic principles? The challenges and changes in clinical reasoning from our understanding of pain and the lack of correlation between tissue state and treatment is also a challenge to osteopathic principles. There has already been questions regarding Still’s Continue Reading »

Grappling with diagnostic reasoning and treatment

Research has established that health practitioners are unable to rely on tissue based diagnoses and justify the effects of manual therapy on mobility or tissue lengthening. There is a realisation that patients need a psychosocial approach alongside biomedical intervention. This has led to the development of several models for diagnostic reasoning and treatment by manual therapists. I’ll just discuss a few models here. It’s a challenge to osteopaths to really think about their diagnostic reasoning and treatment methods in light of current evidence. It’s something all the manual therapy professions Continue Reading »

Reconceptualising an osteopathic approach to pain, Part 1

Research evidence has eroded the foundations of much of osteopathic and manual therapy clinical reasoning: Inaccuracy of palpation Unreliability of postural, tissue-based diagnosis Ineffectiveness of manual therapy techniques to achieve significant changes in posture, tension and mobility. Many postural and structural diagnostic explanations have been found to be invalid, Biopsychosocial? There is an increasing evidence of the importance of the biopsychosocial model. You may consider this to be nothing new. Osteopathic has always emphasised a holistic approach. However, if you were to consider the diagnostic reasoning, treatment methods and treatment Continue Reading »