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An osteopathy consultation

Créé le : Tuesday 28 March 2006 by Patrick Chêne

Dernière modificaton le : Wednesday 16 March 2011

Your animal is going to undergo an osteopathy consultation. If it is the first time, you will probably have some questions about the procedure. Indeed, the way to make a diagnosis, a treatment and to assess a prognosis differs completely from that of general medicine. I am therefore going to attempt to give you a concise and simple explanation concerning:

what we are trying to find, how we find it, why the lesions are so important, how we fix osteopathic dysfunctions, what happens next.

A - What we’re trying to find

Namely, osteopathic lesions (or dysfunctions), that is to say a loss of mobility of one element compared to another, and which is maintained through superficial albeit deep contractures.

The nervous system can be divided as follows:

the voluntary or reflexive nervous system, which we use to grab an object, for instance

the autonomic nervous system (NAV) which determines the movement of our organs (heart, intestines) along with the muscle tone, which is what we’re interested in.

Thus, this tone stands up as a signal enabling to assess the NAV activity; it is also a keyboard permitting us to modify the NAV action upon the muscles and organs by means of reflex points, among other things.

In conclusion, we are dealing with a nervous system which is called autonomic, but which may be modified so as to have the body react in different ways.

We shall distinguish between the lesion as a standard medical term referring to the effect on the organ integrity, and the osteopathic lesion, where the problem at stake is functional (the structures are intact but there is a dysfunction).

For instance:

permanent and unusual contractures causing pain a dislocated disc is a good illustration, since it corresponds to a contracture in the deep paravertebral muscles causing a restriction in the mobility of this disc (which, anatomically speaking is in no way dislocated)

hyper or hypo-activity of an organ: for instance, in the case of a bitch failing to be in heat at the usual time; the ovary is intact, but it does not “function” properly.

The osteopathic lesion is solely a functional one. The osteopathic techniques may relieve an affection properly only in this case. If the integrity of the issue has been affected, they may only act as a support, and other techniques might be required.

Therefore, it will always be wise to wonder whether osteopathy is the only treatment required

I will endeavour, in each case, to give you my opinion, in order to try and help you make a decision

However, during my trips, I don’t have enough material nor time available to give a classical medical diagnosis. Therefore, if in doubt, I encourage you to get in touch with your usual vet, so as to rule out classical pathologies, either before or after I treat the animal.

B - How to trace an osteopathic lesion:

The osteopathic diagnosis requires:

Traditional touch: with proper experience, it can trace quite number of contractures. It is used in search of fascias modification and of contractures surrounding the discs in lesions, by means of different techniques (palpation/rolling; assessing the mobility of a structure). But owing to the superimposition and the ill-defined extent of the reacting zones, these methods require a great experience in order to prevent being mislead.

Proprioceptive touch: which enable to feel the Primary respiratory movement (PRM), which is a typical osteopathic notion and the foundation of proprioceptive examination. This movement is initiated by the brain, which glial cells contract around 15 times per minute, thus triggering the cerebrospinal fluid into a wave which trough various mechanisms which I am not going to detail here, can be felt throughout the body. Measured on the human skull, this wave has an amplitude of 15 microns. As a result, it cannot be seen, nor felt through casual touch. Only long practice enables us to sense its normality or abnormality. What must be remembered is that there is a disruption in the PRM every where there is an osteopathic dysfunction. A great part of the consultation will consist in seeking these zones of little mobility (called in restriction).

C - why are the lesions so important?

When you come across a locomotor symptom or a vertebral pain, the relation between the contracture and the pain is obvious, just as it is obvious that the act of removing the contracture will have a relieving effect.

What is less obvious, in view of our occidental concept of our body, is that these contractures are dependent on a sympathetic ganglion, which controls other muscular areas, as well as organs or part of some organs. These can therefore signal the dysfunction of an organ, all the while perhaps causing discomfort.

Last but not least, when we distangle these contractures, we help to regulate the functioning of the related organ.

A typical example would be that of the little dog who suffers, through hypermotility, from chronic gastritis: a single manipulation will stop its vomiting.

D - How can osteopathic lesions be fixed?

First, EVERY lesion has to be treated, not only the one which precipitated the consultation. This may lead, for instance, to treating the back first when it’s the front that is painful! Different types of techniques are available:

Structural techniques: These techniques, which entail the “cracking” of the discs, are the most famous and the most spectacular ones, but require a very co-operative animal, hence the difficulty in using them. Their incautious use is not recommended in some cases (osteoporosis/osseous tumour/slipped disc). In the case of the thoracolumbar joint, (which is very fragile for dogs), this technique is very easy to use. (thrust, Johns et...).

Accupuncture needles: This is not an osteopathic technique, but I deem both osteopathy and acupuncture to be close enough. I observed that a needle set on the pivot ( point d’immobilité maximum) and directed towards arthrodia, in the case of a disc, or on some acupuncture points regarding small bones (tarsus), helps and removes an osteopathic lesion.

Functional or myotensive techniques: the hand perceiving the RPM also acts on it and many bring it to a standstill in extreme position, and thereby may force it into a more normal movement. As opposed to structural methods, these techniques act with and not against the lesion: they are therefore softer techniques. Other ones exist (Upleger V spread etc...).

According to our perceptions and predispostions, each one of us will use totally different techniques for the same case.

Each case has its own treatment, but generally speaking, I will opt for less traumatic techniques, leaving apart the little “crack”, which you may therefore not hear, for 3 main reasons:

Only structural techniques have contraindications, and are liable in some cases to worsen the lesion;

These techniques demand a very co-operative patient, who must not make any awkward movement at the last minute; in the case of pets (dogs, cats and horses), nothing can be less certain.

With horses, the muscular mass that has to be moved is a bit... too powerful and heavy for me:

Even if in some cases, the structural manipulations do have quicker results, the small amount of patience required by other methods may, to my mind, be more rewarding.

E - Results of the consultation:

During the consultation, two stages may be more or less intertwined: the perception of the RPM, and the removal of the perceived lesions. This is generally conveyed by an easily seen muscular relaxation along with a feeling of well being in the animal:

The dog will slump on the table and start yawning

The horse will sigh, or his eyelids will droop and his head will grow heavy

Then follows a period (roughly 3 days) when the NAV reacts in an unpredictable way, specific to each animal:

Either no apparent trouble

Or very clear but ephemeral improvement

Or aggravation (always brief)

Or the appearance of symptoms apparently unrelated to the original pathology (light diarrhoea, limb oedema etc...)

In any case, these reactions of the sympathetic system should be noted, but are in no way cause for alarm. Some care must be given, however, to diseases and disturbances liable to happen independently, such as piroplasmosis... or an animal which becomes wild and destructive once relieved of the pain!

The definite result appears at least 2 weeks after the manipulation. It is only then that we may determine:

The percentage of remission

Behavioural modifications: these are essential, and often precede the remission of the symptom which motivated the consultation in the first place

Modification of the symptoms in their intensity, frequency, and in the way they are tolerated by the animal.

An accurate prognosis is impossible during a first consultation. Indeed the result owes less to what is found than to the reaction of the NAV during this fortnight; this reaction varies significantly according to the animal’s capacity to react, the age of the lesion, and how it has been tolerated.

A very clear-cut result does not necessarily imply the need for another consultation, although this might help remove the last lesions or determine their evolution.

A clear-cut but insufficient results may require one or more other consultation. A negative result may sometimes lead to the questioning of the lesion’s existence according to the classical point of view. This may lead to extra tests at your usual vet. In the case of a negative result, trying again may eventually lead to success.

I would like to draw your attention on one last point: the removal of tensions after a manipulation may bring out a non-osteopathic lesion. This lesion will need to be traced and treated immediately when it appears.

The example of irregular, and often lame horses is typical; very often, there is difficulty finding the seat, because the clinical picture is neither obvious nor simple. Within a few days, the removal of dorsal and upper limb compensations may provoke:

A more acute inflammation of a tendon, highlighting the chronic lesion which has been a problem for months...

The landsing of an abscess, or corn, which so far had remained discreet enough to go unnoticed.

I hope this brief exposé will help you understand the results of the consultation.

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