|Importance of Osteopathy in Portugal|
The importance of Osteopathy in Portugal
By : Prof.Dr. M.A.Borges de Sousa
The Success achieved in the 20th Century was the increase oh human life benefiting from medical, social, economical, political and cultural factors, favouring the social well-being and a better quality of life contributing, also, for a demographic change, with an expected increase of the average live cycle oh human being.
In the present Century the long-life expectation is of, in average, 70 to 80 years old being an essential contributing factor for the economical and social development of modern societies. Therefore, one of the most important challenges that faces the 21st Century society is, the combination based on the independence of the elderly with their active participation within the society. This new aging paradigm, considering the elderly as active participants in the society, offers the base for a new promotion of health and a better quality of the life.
Although, what is seen within the actual society, is the reneging of the life experience of the elderly depreciating their productive capacity that could be of great importance for the social organization and equilibrium of the society. This is phenomenon is present in the Portuguese Society, we just need to observe the elderly sitting in benches in public parks, inactive in front of television sets or, yet, living in old age homes.
In demographic terms Portugal, between 1960 and 2001, suffered 36% reduction in young population and an increase of 140% in the elderly population, as per a statistical study done by I.N.E.
Portugal, with a considerable elderly index , will have the necessity to alter the health policy favouring the prevention and consequently the maintenance of the Pubic Health.
It is important not to confuse aging with illnesses that may occur in the old age, as it stated by Prof.Dr. L.R.Stigler Marczyk: “The distinction is extremely important not to commit the mistake of attributing to aging all types of modification found in the elderly, obstructing the diagnostic of pathologies that are curable and, on the other extreme, confuse normal alterations of the development as pathologies leading to unnecessary exams and treatments”.
The president if Portuguese Society of Rheumatology and member of the European Commission for the Bone and Articulations Decade, Aroso Dias, assures that about 20% of the Portuguese society suffers from Osteoarthritis, mostly women, and adds: “there is sufficient data to say that rheumatic illnesses are extremely in capacitating.” Speaking of incapacity we are talking about anticipated pensions that imply additional costs to the State`s budget.
As per specialists, musculoskeletal disorders are chronic conditions that have most negative impact in the quality of life of the individual, are, also, the primary cause for the consumption of healthcare and incapacity in individuals with higher long-life cycle. These affect daily about 80% of the patients that go to external consultation services.
Portugal will have to search for other forms of effective treatment for these pathologies as José Pereira, Rheumatologist at the Coimbra University Hospital: “Since the aging of the population contributes for the development of more chronic illnesses there is a need for more efficient treatment”, this being, offering to the elderly the possibility to recur to other therapies, in order to propose to the aging population a better well-being, through therapies that are applied to the degenerated musculoskeletal mechanism which are less aggressive.
In this context, Osteopathy can offer an added value, as its objective in the population is to implement the prevention and slow the degeneration musculoskeletal diseases of mechanical origin, to give joint mobility and to eliminate joint pain. It is noted that the osteopathic techniques do not have side effects, are quite effective and more economics. They are important for the postural equilibrium and to minimize painful syndromes of the human body.
The interest for the Non-Conventional Therapies is testified worldwide, even being supported by the W.H.O. that has 24 centres dedicated to these therapies (24 Collaborating Centres for Traditional Medicine – WHOM nº.2 March-April 1996).
The analysis of the efficiency and utility of the costs introduces a concept of value, not only the effect of the treatment but, also, from the patients point of view, the anxiety reduction for the results, that as consequence of a greater disposition from the patient for a better quality of life, as it has been confirmed by Grossman and associates in their investigation. “ The Demand for Health: a Theorical and Empirical Investigation, Edt.NBER, New York, 1992.”
The lumbar pains , for example, cost the N.H.S. huge sums of money.
The Meadle & associates study revealed a saving of 8 millions sterling pounds for the N.H.S. in UK by utilizing osteopathic manipulations and food diets to patients with lumbar pains.
In another study done by Stanno& associates, the computerized results of payments were analysed by Insurance Companies to medical doctors in the United States. For treatment of lumbar pain for a one year period (about 400.000 cases). If was confirmed that patients with lumbar pain treated by conventional means, cost, in average, more than US$ 1.000,00 per patient than those treated by manipulations.
The Richardson report on a study about “Health Services Research and Evaluation Unit” of the Lewisham Hospital N.H.S. Trust States: “There is evidence on the efficiency of osteopathic treatments in back pain and headaches, as demonstrated by consistent results, as evaluated by different researchers as:
Long and Mercef (1995) University of Leeds, that presented 5 studies on the evidence of the efficiency of osteopathic manipulations.
Brunaski (1984), concluded that the osteopathic manipulations were more efficient than the normal medical treatment.
Koes(1991), in a controlled study one group of 309 patients with lumbar pain and 5 with cervical pain, achieved a positive result assuring that manipulation therapy revealed to be more efficient than other treatments.
Anderson and colleagues (1992), achieved more efficient results with manipulation than, when compared with other treatments.
Meadle (1990), studied 741 patients with lumbar pain during 24 months with a maximum of 10 treatments per patient. The results which show that the manipulative treatment was more efficient.
Wells MRand Colleagues in a study on” standard Osteopathic Manipulative treatment acutely improves gait performance in patients with Parkinson´s disease” achieved positive results (Published in the Journal American Osteopathic Association, 1999February, 99 (2): 92-8).
The British Medical Journal of 9th July 1994, refers that osteopathic manipulative treatment are used:
Belgium 19% of the population, Denmark 23%, France 7%, Sweden 48%, United Kingdom 36% and United Stated 30%.
These and other studies carried out by officials Institutions from European Community and USA, have demonstrated not only the positive results in the regarding Osteopathy, as a cost reduction in the use of this therapy for specific musculoskeletal disorders.
In Portugal the Medical Council in its magazine in publishing in the Out/Nov/December 22 of 2002, an article about the “Projects of Regulation on the Exercise of Non-Conventional Medicines” states the following:
“ The Medical Science accepts some therapies as good, that are practised by non physicians as it is the case….. or manipulative techniques that are practiced by Osteopaths.”
The perspective for the future of healthcare in Portugal, go through to comply with Act nº.45/2003 of 22/8 that Regulates the Non-Conventional Therapies where Osteopathy is integrated.
This matter becomes more complex when faced with other components that constitue the National Healthcare . Price and Quality –although Osteopathy is a very economical therapy method due to recurring to simple tests as means of diagnosis, non use of consumables and uses as treatment the hands as a working instrument.
Studies were shown that Osteopathy, although not being the solution to all diseases, it is an important therapy for musculoskeletal problems with a very significant effects, benefiting the general population and the elderly in particular, as a heath maintenance factor and well-being in order to maintain the dignity and to contribute for an active aging, with autonomy and independence.