Abstract
Back pain is a common problem in general practice, and is of enormous economic importance. A recent report urges general practitioners (GPs) to refer early for manual therapies, such as osteopathy. The key concept to understanding osteopathic principles is somatic dysfunction. This is a disorder of function, rather than pathology, of the musculoskeletal and related systems. Its characteristic features are asymmetry of anatomical landmarks, asymmetry of joint movement, tissue texture changes, and tenderness. The scientific basis of the tissue texture changes and tenderness can be explained in terms of the 'facilitated segment', but the cause of movement asymmetry remains elusive. Randomized controlled trials provide some support for the use of osteopathic treatment in acute low back pain. It is proposed that somatic dysfunction is the new paradigm for non-specific back pain.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson E., Anderson P. General practitioners and alternative medicine. J R Coll Gen Pract. 1987 Feb;37(295):52–55. [PMC free article] [PubMed] [Google Scholar]
- Jayson M. I. Mechanisms underlying chronic back pain. BMJ. 1994 Sep 17;309(6956):681–682. doi: 10.1136/bmj.309.6956.681. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KORR I. M., WRIGHT H. M., THOMAS P. E. Effects of experimental myofascial insults on cutaneous patterns of sympathetic activity in man. Acta Neuroveg (Wien) 1962;23:329–355. doi: 10.1007/BF01239851. [DOI] [PubMed] [Google Scholar]
- Kidd B. L., Cruwys S., Mapp P. I., Blake D. R. Role of the sympathetic nervous system in chronic joint pain and inflammation. Ann Rheum Dis. 1992 Nov;51(11):1188–1191. doi: 10.1136/ard.51.11.1188. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Korr I. M. Proprioceptors and somatic dysfunction. J Am Osteopath Assoc. 1975 Mar;74(7):638–650. [PubMed] [Google Scholar]
- Slosberg M. Spinal learning: central modulation of pain processing and long-term alteration of interneuronal excitability as a result of nociceptive peripheral input. J Manipulative Physiol Ther. 1990 Jul-Aug;13(6):326–336. [PubMed] [Google Scholar]
- Wharton R., Lewith G. Complementary medicine and the general practitioner. Br Med J (Clin Res Ed) 1986 Jun 7;292(6534):1498–1500. doi: 10.1136/bmj.292.6534.1498. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Woolf C. J. Recent advances in the pathophysiology of acute pain. Br J Anaesth. 1989 Aug;63(2):139–146. doi: 10.1093/bja/63.2.139. [DOI] [PubMed] [Google Scholar]