The criteria on which a manipulative prescription is based and the choice of technique to be used are governed by the diagnosis or pre-treatment assessment. In conventional medicine, diagnosis relates to the discovery of disease and this leads automatically to a choice of treatment methods. The approach to treatment will vary slightly according to the knowledge, philosophy and system of the practitioner, but will usually fit in with established guidelines. Diagnosis in osteopathy is similar, in that it relates to the discovery of disease in much the same way as orthodox medicine, but then should lead the practitioner along a choice of several different paths. The first path is the choice whether to treat or not, and as to whether the case is suitable for osteopathic intervention. For a case to be suitable there must be some evidence of mechanical dysfunction present that can be changed or improved by physical treatment. If it is not suitable, possibly due to the presence of serious disease that would be better attended by another discipline, the practitioner must have enough knowledge about the condition to be able to refer the patient to a suitable authority. This would avoid wasting the patient’s time and money on fruitless physical treatment. He must understand the contra-indications to treatment, and have enough knowledge of pathology to be able to make a reasoned judgement as to possible dangers. His knowledge and competence to decline to treat must be sufficient to avoid being negligent, yet must be tempered by a sense of realism. He must decide whether there are any possible benefits from his therapy.
KeywordsDisc Degeneration Discal Irritability Orthodox Medicine Present Syndrome Facet Syndrome
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