Osteopatia em Portugal

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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.


Osteopathic Evaluation

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.