Osteopathy. Who more and who less knows what osteopathy is. But do you know that osteopathy has its own diagnostic method? Do you know that they have their own techniques, tests, tests to diagnose dysfunction and be able to treat it? Interested in knowing what Osteopathic diagnosis is? I invite you to continue reading.

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Diagnosis

It comes from the Greek diagnostics whose prefix Dia means "through", and gnosis, "knowledge" or "fit to know".

In medicine, diagnosis is the process by which the nature of a disease is identified through tests and observation of its signs or symptoms. That is, it is the procedure by which disease, syndrome, or the state of Health is identified in a patient, something fundamental to determine the treatment that the patient will receive and what his prognosis will be.

Osteopathic diagnosis

It all started in 1874, when the creator of Osteopathy, Andrew Taylor Still proposed a different model of diagnosis and treatment, in which the musculoskeletal system played a central role.
Before applying any osteopathic treatment, it is imperative to come to a correct diagnosis. Without a diagnosis, it is impossible to determine the right treatment.

In osteopathy, the goal of diagnosis is threefold:

  • Is the disorder amenable to osteopathic treatment? The first step when a patient consults the osteopath is to rule out the existence of some condition that belongs to the field of conventional medicine (for example, cancer or a fracture). In this case, the patient will need to be referred to the doctor.
  • Once it is clear that the disorder can be treated with osteopathy, the tissue responsible for the pain or the symptom that the patient is attending must be located, as well as other structures that must also be analyzed to reach a correct diagnosis.
  • Based on the diagnosis, the most appropriate techniques for that particular patient will be determined.
Regardless of the reason for consulting the patient (which most often will be a pain), the diagnostic process requires a few concrete steps:

  • Interrogation (anamnesis)

The patient counts, in his own words, what happens to him. At this point, the appropriate questions are heard and raised to bring to light everything that helps determine the cause of the disorder and the factors that may influence the choice of treatment. It is a structured dialogue and, as such, should contain all the necessary information.

In this interrogation, some of the topics to be treated are main symptoms, background, lifestyle, family history, skin, respiratory system, head, urogenital region, digestive system, cardiovascular, locomotor system, and nervous system.

Pain is the main reason why people turn to the osteopath. A thorough interrogation to characterize the pain will give many clues to come to an accurate diagnosis. And the characteristics and symptoms associated with pain can guide its cause and on the structure that causes it. It can be bone, disc, ligament, tendon muscle pain, neurological, arthrosis, visceral, inflammatory pain, or other suspicious signs such as fever.

  • Inspection

The inspection begins from the moment the patient enters through the door: How does he walk? How does it move? How are you feeling? It's about looking at the tion he takes, how he shakes your hand, the Vitality (tiredness, decay...), the mood (desire to talk...), and everything that helps you understand what happens to him.

The inspection is carried out still (static inspection) and in motion (dynamic inspection). Attention should be paid to the skin: spots, bruises, scars, thickenings, lumps, varicose veins, etc. and observe the body as a whole, and then in detail, part by part.

  • Static inspection

The patient is observed from all perspectives: anterior (attention is paid to asymmetries in different zones), posterior (if there is any alteration or asymmetry in The Shape of the body), and sideways (alterations of the line of gravity and the increase or correction of the physiological curves of the spine are observed).

  • Dynamic inspection:

The overall movements of the trunk, as well as those of the different regions of the column, in all directions, are observed. The same with the limbs. Restricted movements and their amplitude are noted, and those that produce pain. An easy and visual way to do this is by using the Maigne star, in which each movement is indicated with an arrow.

  • Palpation

It is undoubtedly the most important tool available to the osteopath. In addition to diagnosing, it serves to determine the effectiveness of treatment. You can (and should) train it through continuous practice.

  • Static palpation:

Areas, where alterations have been found through interrogation and prior observation, have to be palpated. It can be done before or after dynamic palpation (palpation tests). You have to look for signs of somatic dysfunction. To do this, three structures must be palpated: the skin (dermatomal), muscles (myotomy), and sclerotome.

  • Dynamic palpation (palpation tests):

They serve to detect hypomobilities, fixations (that is, somatic dysfunctions). They are mobility tests of the different anatomical parts, which are used to detect structures with reduced mobility and determine the appropriate technique for that particular dysfunction.

By palpation, three characteristics are evaluated:
  1. The amplitude of motion.
  2. Pain.
  3. The type of final sensation or end-feel (a type of resistance perceived by the therapist at the end of passive movement of a joint). It serves to determine what is the structure that limits movement (muscle, ligaments and capsule, bone, or edema) and, depending on what it is, decide which technique to apply.
It is also possible to detect hypermobility, although it is difficult to appreciate by palpation. A feeling of greater elasticity of the joint complex and greater amplitude of movement can be noted, with a rapid increase in tension and hardness as the end of the amplitude of movement approaches.

Palpatory tests can be of various types. The most used are the following:

  • Global mobility Test or screening test: they allow to quickly analyze the general mobility of an area, and then analyze with specific tests the areas of hypomobility that have been detected. They are nonspecific tests since they tell us where the restriction is, but not how it is.
  • Analytical or segmental mobility tests: the objective is to study each of the main mobility parameters of the Joint being examined. These tests are specific since they tell us the limited movements; that is, they allow us to know the type of somatic dysfunction

Other scans and tests

  • Neurological examination:

Neurological examination is sometimes necessary to rule out certain pathologies, especially when the pain is neurological (by compression of a root or nerve). It should be examined: the skin (dermatomal), muscles (myotomy),, and osteotendinous reflexes. Neurological examination is done by comparing each side, to detect asymmetries.

  • Orthopedic tests:

Orthopedic tests are tests that help differential diagnosis. There are many different; Only those should be performed that, depending on the suspicion that is held by previous tests, help to confirm or rule it out.

  • Radiological tests:

Radiological tests serve to rule out pathologies that contradict manipulations: fractures, degenerative disorders, bone tumors (primary or metastases). They must be done when these conditions are suspected.

On the other hand, they sometimes help to come to a correct Osteopathic diagnosis.

X-rays can be static and dynamic; they are used to assess instabilities, asymmetries, signs of hypomobility, etc. other radiological techniques are computed axial tomography (CT) and nuclear magnetic resonance (NMR).

  • Analytical tests:

Also, certain analytical tests (such as globular sedimentation rate and C-reactive protein) are useful to rule out inflammatory, infectious and other pathologies, which are contraindicated Osteopathic therapy.

  • Study of the skull and viscera:

Osteopathic diagnosis can not leave aside the study of the skull and viscera. Both the cranial vault and the organs have mobility and their decrease will cause dysfunctions, which can be diagnosed and treated.

Cranial and visceral Osteopathic diagnosis requires the same steps as structural: anamnesis, inspection, palpation, mobility test, neurological study, radiological examination, and other complementary tests with their peculiarities.

And so is Osteopathic diagnosis, a method of identifying dysfunctions and their origin to be able to treat them with osteopathic techniques, but also to know how to identify cases in which Osteopathic therapy is contraindicated.

What did you think? Interesting? Have you discovered anything you didn't know about osteopathy?