The confluence of concepts that were accepted and genuflect toward were these. Pain is perceived by the brain, signals from the peripheral nervous system are given pain status by the brain – before that they are just signals. The brain screens out 90% of all signaling from the peripheral nerves. Sensations from the periphery can be inhibited or up regulated by the nervous system at the nerve root or in nine separate sections of the brain. If a signal from the periphery can be up-regulated so can it down regulated. The regions of the brain involved in this process are; posterior cingulate, amygdala, insula, supplementary motor, prefrontal, anterior cingulata, somatosensory and posterior parietal. I will go into the specific roles of these sections of the brain in my next post.
Each of these regions governs differing behaviour and thought processes – if we increase those behaviours and thoughts – those apart from pain – we can down regulate pain.
In neuroplasticity, as in somatoplasticity, we know three things. Repetition builds super pathways (practice makes perfect). Change is unbelievably rapid if it is emotionally embraced – imagine how felt about a partner just before they betrayed you, and then just after you caught them betraying you – so sudden and so complete? Yes. Thirdly and I would propose most importantly, although there are a 100 billion neurological connections in our brains that number is a set and full, so when a part of our brain starts to think something new – it has to discards another possible connection. If you factor these things together you stumble upon the chance of sudden transformation. Lightening transformations.
Think about it – what we think about we think about more, we can change what we think/believe in seconds and every new thought makes some other thought redundant. Such a powerful force – for positive or negative outcomes.
These are the realisations inherent in this year’s national conference. That is the confluence of study over the last 60 years. I can never recollect a time when our science has so clearly and explicitly stated that ‘with our thoughts we make the world’. Nor has the effect of our determination to be positive or negative been so clearly marked and generally accepted.
I am regularly asked what is the difference between an osteopath and a chiropractor; or a physiotherapist and an osteopath. The usual scripted answer is philosophy; and osteopaths do have an axiomatic set of principles that guide their work. However, thats not what really sets osteopaths apart. Chiropractors, physiotherapists and osteopaths all have five years of university training, each is taught the same clinical assessment skill, special orthopaedic assessments, neurological assessments, and simple active, passive and active resisted range of motion assessments. What differentiates an osteopath as a manual therapist can be summed up in two words; palpatory assessment – they focus of their examine is by touch.
This is not to say that chiropractors, physiotherapists don’t touch people or use this sense to assess but osteopaths from their very first class are taught to focus on their palpatory assessment. Osteopaths are taught to assess TART; texture, asymmetry, range of motion and tenderness in a very palpatory way. Texture and tenderness are obviously about touch sensation but osteopaths are interested in how the range of motion feels; its end feel, the quality of the movement in their hands and the feeling of symmetry in the tissues under their hands. Over many years of practice the hands of the osteopath become palposcopes capable of perceiving the integrity of bones and ligaments, the quality of the vascular perfusion of tissues, the neurological integrity as well as the tonicity of muscles and tendons. Studies indicate that after 20 years of practice something extraordinary seems to happen to osteopaths – their bookings and earns suddenly increase substantially (Orrock, PJ 2009, ‘Profile of members of the Australian Osteopathic Association: part 1 – the practitioners’, International Journal of Osteopathic Medicine, vol. 12, no. 1, pp. 14-24.). What is the driver behind this profound change hasn’t been thoroughly teased out but palpatory knowledge must be high on the list of causes.
The same is true of treatment as well as assessment, chiropractors, adjustment trained physiotherapists and osteopaths are all trained to stretching, massage, adjust and perform muscle energy techniques and they all have access to and prescribe exercise regimes – what differentiates the professions is the focus. What is important? Cavitating joints? The exact degree of movement a joint ? Or how it feels to move for both the practitioner and the patient. For the experienced and well regarded osteopath the answer is the last of these. It is their aim above all to assist their patient to find pain free movement as a basis for their recuperation and prolonged quality of life.