The elegant ‘Vulcan’ salutation ‘Live long and prosper’ has wended its way into the vernacular of the present day. A more fitting exhortation for the new year, there is not, so from all of us at Dunedin Osteopathic Clinic for 2009, live long and prosper!

On this note though, recent and further evidence (King CR, Knutson KL, Rathouz PJ, et al. Short sleep duration and incident coronary artery calcification. JAMA. 2008;300:2859-2866) again offers evidential confirmation of what we always knew instinctively, namely that a good night’s sleep is a necessary pre-requisite for health. Sustained poor quality sleep or insufficient sleep is a certain way to diminish the chances for good health.

The chief reason that people seek help from us, in our experience at Dunedin Osteopathic Clinic, is because they are in pain. Usually this pain is musculo-skeletal in nature, though sometimes it is not, which is a fact that highlights the importance of a sound clinical examination and diagnostic process. ‘Focused Osteopathic Care’ is precisely that and at Dunedin Osteopathic Clinic we strive to establish underlying cause and a reasoned, evidence based approach to manual osteopathic treatment.

One obvious benefit that occurs with a reduction of pain or enhancement of comfort, or simply the relief engendered through a better understanding of a health problem, is an improvement in sleep. And with this also comes a reinforcement of the natural processes of recovery. With regard to the previously mentioned study by King, Knutson, Rathouz and colleagues, they theorize a number of possible explanations for the observed decrease in risk of calcification of the coronary arteries seen with more sleep. But one additional explanation they do not directly mention is a well described physiological phenomena that occurs during sleep, namely that of decreased sympathetic drive of the cardiac circulation resulting in improved coronary circulation, as the coronary arteries become less constricted.

Osteopathic research literature has long identified the role of sympathicotonia (heightened sympathetic drive or tonus) as a potential mechanism in the disease process and a state which is both created and sustained by somatic dysfunction – impaired functioning of the body framework and its related structures. Somatic dysfunction (and any concomitant pain) is ultimately what an osteopath seeks to modify with the uniquely distinctive manual expertise and treatment approach. But now we can see a potential range of additional benefits that apart from less pain and an enhanced ease of motion (the stated and immediate reason for initially seeing an osteopath), also include the likelihood of better sleep and the associated longevity promoting effects of better coronary blood flow.

So osteopathic treatment can be suggested to have immediate (pain reducing effects) as well as longer term and far reaching effects (reduced sympathicotonia and better coronary circulation). Consulting an osteopath may be a good point from which to live long and prosper!

Preventing back pain during pregnancy is a key task for osteopathic clinicians. Sometimes referred to as ‘pregnancy related peripartum pelvic pain’ (PRPP) in which both low back and pelvic pain feature, the condition arises for a variety of reasons related to pregnancy, possibly associated with changes in posture, activity, weight and centre of mass. In addition, questions arise concerning the effects of hormonal changes during pregnancy and the consequences of such changes on joints and ligaments around joints, and whether such changes cause PRPP. A recent study in Taiwanese women (Tzeng & Su 2008) suggest that as much as 50% of women suffer from low back pain in pregnancy, a figure that finds agreement with other earlier studies, which means this is a troublesomely large problem.

Key advice to sufferers is to maintain comfortable activity, preferably aquatic based and seek treatment. Comfort is the pre-eminent aim whist maintaining activity. An important addition to this advice is that standarised osteopathic treatment appears to be an effective non-medication intervention, both in terms of acute back pain in pregnancy as well as in postpartum back pain after pregnancy. These findings were recently published in the International Journal of Osteopathic Medicine as abstracts from the 7th International Conference on Advances in Osteopathic Medicine Research, held in Bradenton, Florida USA in September 2008. Serial osteopathic manipulative treatment was reported to relieve pain and enhance function immediately, and have a beneficial effect that persisted over weeks, when followed up by researchers.

So, hands-on, focused osteopathic care at Dunedin Osteopathic Clinic is a which way in which osteopathic treatment helps patients, in this case by controlling, relieving and managing difficult symptoms without medication and where possible, actually preventing back pain during pregnancy.