What is the difference between Chiropractic, Osteopathy and Physiotherapy? Part 2 – Philosophy
Last week I discussed the history and evolution of Chiropractic, Osteopathy and Physiotherapy as part of my 3 part blog series. This week I will be expanding into the philosophy of these practices and how they differentiate.
When University education was limited in the 1890’s, DD Palmer was not considered a particularly educated man. Instead, he was an established reader interested in the scientific and philosophical writings of his time.
His knowledge gained from reading and experience with his early cases where he applied his Chiropractic method caused him to believe that the spine and health were related through the nervous system. He assumed that a misalignment of the spine, a subluxation, would create pressure on a nerve. Once the subluxation was reduced with a specific manual manipulation, which he termed as an adjustment, the pressure on the nerve would be removed. Once the function of the nerve was returned to normal, the body’s innate intelligence would perform the healing. His notion of the innate intelligence that existed in the body was an inter-connected fragment of the universal intelligence, or energy field that existed throughout the universe. This was his explanation as to why his adjustments seemed to have a positive effect on many conditions seemingly unrelated to the spine. This explanation is still relevant today as we see results with conditions such as irritable bowel, asthma and hypoglycaemia.
While the founder or Osteopathy, Andrew Taylor Still was educated as a physician and surgeon, there is evidence that he and D.D Palmer met at each others houses and probably considered each other as intellectual equals, enjoying each others company. They would have had a shared interest in scientific topics of the day such as anatomy and physiology and treatment of the human condition, but probably argued on Palmer’s philosophy. Any points of disagreement would have involved A.T Still as a straight scientist in contrast with D.D Palmer who had a sound scientific knowledge blended with his spiritual notion of everything in the universe being connected by meta-physical means. Palmer’s textbook from 1910, The Science, Art and Philosophy of Chiropractic has recently attracted the attention of cellular biologists such as Bruce Lipton who are attempting to explain through quantum physics that the cell is not merely a biochemical machine but is connected to a universal energy field.
A commonly proposed philosophical distinction between Chiropractic and Osteopathy has been that while D.D Palmer’s focus was solely on the nervous system, Still’s was on the blood and vascular system. This might be partially true, but the current explanation of Osteopathy in Wikipedia is “the therapeutic application of manually guided forces to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction”. Additional elements to the vascular system are mentioned in the alteration of related components including bones, joint, muscle structures and “their related vascular, lymphatic and neural elements”.
Because Physiotherapy developed within western medicine, it is likely to have shared its more mechanistic view rather than any philosophy similar to that of Chiropractic (or even Osteopathy). This system sees the body as an imperfect machine, which requires an external element such as a drug or a surgical addition or subtraction to make the machine work better. While traditional Chiropractic philosophy is based on vitalism and holism seeing the body as a perfect machine and once all of its elements are working properly the machine has the ability to heal and regulate itself.
Holism relates to the body being a sum of its parts and if one part is not working, than other distant parts might be affected. An example of this might be a patient with knee pain, where the physiotherapist would evaluate and treat the knee. A Chiropractor or anyone else working in a Holistic manner would consider other structures such as the low back or the pelvis and their possible involvement in the knee problem.
Regardless of the philosophical core of any individual Chiropractic, Osteopathic or Physiotherapy practitioner, as trained and registered primary care health practitioners, all are capable of recognising when a patient is outside of their own scope of practice and would willingly refer the patient for emergency medical care or any care that is required outside of their own professional ability.
Next week I will discuss the different methods between the three techniques, so stay tuned!