In 2001, I wrote an article entitled "Osteopathic treatment by injection: A comparison of osteopathic manipulative treatment and neural therapy". The piece was published in the American Academy of Osteopathy Journal and directed at the osteopathic profession. It's subject matter addressed primarily the theoretical bases of both disciplines which have a number of similarities. A main point of the article was that somatic dysfunction is a form of interference field.
This month I plan to return to this subject but rather than discuss theory, examine practical aspects of detecting interference fields using osteopathic as well as other more established techniques. Some of this is covered in Chapter 4 of my book Neural therapy: Applied neurophysiology and other topics, but I would like to extend these ideas with experiences that I have accumulated over recent years.
The most distinctive characteristic of osteopathy linking it to neural therapy is the principle that somatic dysfunction anywhere in the body can be the cause of a symptom anywhere else in the body. For example a "shear" of a sacroiliac joint may be the primary causative factor in a chronic headache. Or a cranial lesion (e.g. compression of a tempero-parietal suture) may be the key to understanding low back instability. To be sure, symptoms are more common in the segment where the somatic dysfunction is found, just as interference fields generally provoke symptoms nearby, but the principle still holds. With an unexplained symptom, the whole body must be searched ‐ in the case of osteopathy for mechanical disturbances, in neural therapy for the usual kinds of interference fields, e.g. scars, teeth, organs, etc.
That somatic dysfunction is a form of interference field can be demonstrated in two ways: by autonomic response testing and by response to treatment. Touching a level of the spine corresponding to a vertebral somatic dysfunction will cause weakening in an indicator muscle. Quaddles of subcutaneous dilute procaine or administration of a Tenscam will treat somatic dysfunction as effectively as will manipulation.
However there are exceptions. Some somatic dysfunction extends over too large an area to be detected by autonomic response testing. This occurs with restriction of a group of muscles, as with the respiratory diaphragm or the pelvic floor diaphragm. These cannot be detected by autonomic response testing, but if untreated still block regulation and make autonomic response testing difficult.
Some osteopaths routinely treat the "diaphragms" before more specific treatment. There are several of them, including the thoracic outlet, the cranial base, and the tentorium cerebellum. Others only treat them if indicated. Indications that they need treatment include an inordinate degree of local restriction of craniosacral (primary respiratory) movement, or the presence of "arcing" in a diaphragm.
Arcing is a phenomenon described by the late John Upledger DO in his book Craniosacral therapy. It is a subtle pulsation at about 1 Hz emanating from a specific locus - often a site of previous injury. The arc refers to the shape of the wave, which is circular and like the spherical waves in a pool of water indicate where the fish jumped or the stone was dropped.
Upledger described arcing in mechanical terms, as a pulsation that could be felt in the tissues. However with practice it can also be felt "off the body" or even seen by the "mind's eye". This might be an intimidating concept for those not trained in manual therapies or for those unfamiliar with energetics, but it does not have to be. Dosch's Manual of neural therapy according to Huneke describes how the old neural therapy masters had an intuitive sense of where to find interference fields.
I believe that this intuitive sense is available to everyone. It is a matter of listening to one's own intuition or even gazing at the patient's body. One should not be ashamed to "guess". A guess in an educated, empathetic and sensitive person will often lead to the right solution.
How do we treat arcing? The osteopathic method is to place one's hands lightly on opposite sides of the patient's body - usually above and below, with the patient supine. The hands should be passive and in "listening" mode. The tissues will very subtly begin to move ("unwind") and the hands should simply follow. The movements may reproduce the strains that occurred with the initial injury, or may move in one direction and then another. At a certain point, usually within a few minutes, the tissues will "go still"; the patient may feel a generalized relaxation and the treatment is over. For those physicians trained in cranial osteopathy (or craniosacral therapy), the craniosacral rhythm will first stop and then increase in amplitude and be more relaxed. Alternatively, autonomic response testing will often indicate "open" or unblocked autonomic regulation.
For those disinclined to try manual therapy, quaddles with dilute procaine over the affected region or administration of the Tenscam device may provide a satisfactory response. However I find manual treatment more satisfactory, if only because I can feel the patient's response.
I believe all neural therapists can benefit from learning some osteopathy and osteopaths will find that they can offer more to their patients by learning neural therapy. Both systems are intimately connected to autonomic nervous system function and are more philosophically similar than is commonly realized.
Robert F. Kidd, MD, CM