The Principles of Osteopathy

Updated on April 14, 2020
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Niall is a Master of Osteopathy working from private clinics in Yorkshire. He provides strength & conditioning and anatomy learning online.

Principles of Osteopathy
Principles of Osteopathy | Source

The Four Principles of Osteopathy

Osteopaths in the UK are trained to a high level at University and are on the NHS's list of "allied healthcare professionals". Osteopaths asses, diagnose and treat musculoskeletal conditions in a way that works with the patient's own body, as opposed to prescribing drugs and performing surgery like conventional medicine. Physical therapy methods such as stretching, massage, joint manipulation and exercise prescription are utilised to create an effective way of caring for patients.

Osteopathy originates back in 1874 by physician Andrew Taylor Still, the son of an American doctor. As the profession grew and gained a large following, it developed four key principles that allowed Osteopaths to both define themselves to others by reciting the principles as well as ensuring the stay true to original beliefs and medical motives. These principles along with an example and description of their meanings are discussed below.

Andrew Taylor Still is the founder of Osteopathy. Here he is observing a human femur.
Andrew Taylor Still is the founder of Osteopathy. Here he is observing a human femur.

1. Structure and Function Are Reciprocally Interrelated

This principle refers to the theory that the body is designed in a way that allows it to perform the millions of functions we require from it. These functions are carried out using the structures of the body that are designated to that particular function. This relates to Osteopathy, as it is believed that if a structure is no longer working correctly it cannot perform it's function optimally. The "reciprocally interrelated" part of the principle, is present due to the fact that this can also be reversed. If humans perform a function in a way that the structure hasn't evolved to perform, then the structure will be less efficient at performing the function.

An example of this principle and the way it works reciprocally can be seen with the knee joint. This joint is mainly used to flex and extend the leg. It has developed as a method to allow us to run, swim, sit in a squat position, pick things up and jump. When humans perform these movements regularly and safely, the health of the knee is maintained, the structure remains working optimally and the function continues. However, in today's society, an increase in sitting at desks, a sedentary lifestyle and obesity, means that the function that the knee is used to (flexion and extension) is altered. The knee is exposed to long periods of remaining in the same position and when loaded, its often with bodyweight well outside the weight it's designed to move efficiently. This is when the structure becomes altered over time, developing into conditions such as osteoarthritis, meniscal tears and muscular imbalances (as seen with chondromalacia patellae). Once the structure of the knee is altered in this way, it often performs the function in a suboptimal way.

Other fantastic examples of structure and function governing one another are; the development of opposable thumbs in order to grasp tools, and intervertebral spinal discs to withstand the forces of gravity when humans began to stand in an upright position.

Opposable thumbs are a great example of structure and function.
Opposable thumbs are a great example of structure and function.

2. The Body Contains It's Own Medicine Chest (And Is Capable of Healing Itself)

This principal is one of Osteopathy's most magical statements. It highlights a knowledge of the body's ability to heal and repair itself when injured or infected and did so before the idea of "immunology" was fully understood or described. The meaning behind this principle personifies alternative medicine. It encourages practitioners to assist the body's immune system or facilitate the recovery of musculoskeletal injuries rather than attempt to cover them up with painkillers, anti-inflammatories, steroids or surgery, etc.

Osteopaths aim to assist patients immune systems through methods such as; lymphatic drainage, stress reduction including cervical massage, articulation and exercise prescription such as yoga. Musculoskeletal rehabilitation is assisted through joint articulation, manipulation, soft tissue work, stretching and injury or sports specific exercise prescription. A study by Wiscowki. S, et al (2014), found that Osteopathic lymphatic drainage techniques successfully mobilised blood dendritic cells around the body thus improving the body's immune response.

White blood cells of the immune system engulf bacteria.
White blood cells of the immune system engulf bacteria.

3. The Rule of the Artery Is Supreme

This is an interesting principle, as it aims to highlight the importance of blood flow. It refers to the fact that if an area of the body is flush with oxygenated blood and the nutrients blood brings with it, then it will often heal quickly and thrive without disease. When blood flow is interrupted through trauma or diseases such as diabetes, the area of the body becomes inefficient, or in extreme cases, dies.

It's been debated amongst various healthcare practitioners such as chiropractors and physiotherapist, that maybe the principle should be altered to state "The rule of the nerve" is supreme. This is due to the fact that manual therapists like Osteopaths, treat musculoskeletal patients as a majority. They're able to manipulate and articulate joints, positively effect the sympathetic and parasympathetic nervous system and provide exercises to floss nerves within their neural sheath. Nerves really are the leader when it comes to the bodies ability to function, and whether a patient will feel pain, radiating sensations, numbness, weakness, headaches etc. It's also usually dictated by the nerve more often than the circulatory system. This can be observed in patients suffering from spinal radiculopathy or carpal tunnel syndrome.

Artery, Vein and Capillary Cross Section
Artery, Vein and Capillary Cross Section

4. The Body Is a Unit

The body is a unit, is the easiest principle to understand. The human body works like a complex machine, continually changing and adapting, whilst allowing its bodily systems to work together to perform functions. The body consists of individual systems such as the respiratory system of the lungs and respiratory tract. This system intakes oxygen and expires carbon dioxide, it then filtrates fresh oxygen into the bloodstream of the circulatory system, which then distributes the oxygen quickly to the musculoskeletal system which is then able to assist the original function of breathing, and provide locomotion to the rest of the body.

In a rehabilitation sense, it also highlights the fact that the body is holistic and should be approached as a whole. Patients attending a clinic with knee or hip pain, often find that the underlying cause is related to the foot or low back. Alternatively, the body can act a unit even further. Patients with minor congenital scoliosis, previously broken ankles or arms, often feel very little pain in the long term. This is due to the body's process of compensation. Looking out for itself and sharing the load, work and positioning to take the pressure off a weakened structure. Osteopaths, in particular, look hard to find these holistic links and compensations,

Even with a double lower limb amputation, the human body still adapts well enough to compete at the Paralympics.
Even with a double lower limb amputation, the human body still adapts well enough to compete at the Paralympics.


Walkowski, S. et al, (2014). Osteopathic Manipulative Treatment Induces Enhanced Intracellular Immune Response. The Journal of the American Osteopathic Association. 114 (-), 813-814.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


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