The role of touch in osteopathic practice: A narrative review and integrative hypothesis

International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review

“…Rather than a disease, it is regarded as a factor that contributes to and maintains patient symptoms [ 7 ]. In recent years, osteopathic researchers have referred to SD as a neurologically active area, region or a generalised body pattern to be used by osteopaths to deliver the effects of touch and other hands-off procedures to improve the patient’s agency [ 24 ]. Nevertheless, there is still a trend to use the term “osteopathic lesion” inside the osteopathic community, illustrating the adoption and misappropriation of a biomedical word and the potential nocebo effect on symptoms [ 33 ].…”

“…With respect to the time frame, the duration and frequency of osteopathic treatments were consistent with the data summarized in the osteopathic guidelines [ 8 ] and in a recent systematic review [ 56 ]. The differences in duration between 15 min to 1 h could be related to the different focus of the osteopathic intervention administered in the studies included in this review, i.e., a complex person-centred osteopathic intervention requires assessing regions of interest in the osteopathic patient dyadic relationship [ 24 ]. The shared decision-making process, which is based on verbal and non-verbal communication (i.e., on proximity and touch) usually takes a considerable amount of time [ 51 ].…”

“…Since OMT techniques can have different effects on neurophysiological activities [ 18 , 19 , 20 ] their choice during treatment is a clinical judgment of the practitioner. OMT person-centred interventions should focus on somatic dysfunctions (SD) [ 21 , 22 , 23 ] detected in shared decision-making [ 24 ]. SD can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions that can be remote from the symptomatic area [ 25 ].…”

Osteopathy and Mental Health: An Embodied, Predictive, and Interoceptive Framework

“…While some propose a neuro–fasciagenic perspective to somatic dysfunction ( Tozzi, 2015a , b ), others emphasized the relation between palpatory findings and allostatic load ( Lunghi et al, 2020 ) or movement variability ( Bergna et al, 2020 ). Apart from ongoing work on the conceptual basis of the somatic dysfunction framework, more recently, special attention has been given to the effects of touch in general ( Manzotti et al, 2020 ; Baroni et al, 2021 ) and the underlying neurological mechanisms of osteopathic care ( D’Alessandro et al, 2016 ; Pelletier et al, 2018 ; Gyer et al, 2019 ).…”

“…Research demonstrates that the cognitive status of the osteopath (focusing attention on touch vs. audition) influences the subject’s functional connectivity patterns involving brain correlates that process the interoceptive and attentional value of touch (the insula, posterior cingulate cortex, and right inferior–frontal gyrus) ( Cerritelli et al, 2017a ). Furthermore, recent reviews of neuroimaging studies demonstrate functional convergence for mindfulness and touch at the interoceptive cortex—this provides a rationale for investigating the combination of top-down mindfulness–informed and bottom-up touch-based approaches in the treatment of body-mind disorders that involve interoceptive deficits ( Casals-Gutiérrez and Abbey, 2020 ; Baroni et al, 2021 ), including chronic pain ( Di Lernia et al, 2016b ) and depression ( Smith et al, 2021 ). In general, it has been shown that implementing an audio-guided mindfulness-based practice for patients in the waiting room before receiving osteopathic manipulative treatment enhances treatment satisfaction and the patient’s feeling of safety and mindful connection to their own bodies ( Hanley et al, 2021 ).…”