Globally, mental and musculoskeletal disorders present with high prevalence, burden of disease and comorbidity. In order to improve the quality of care for patients with persistent and comorbid mental health conditions, person-centered care approaches that address psychosocial factors are currently being advocated. Multidisciplinary collaboration between mental health specialists and musculoskeletal specialists is critical to the success of person-centered care, supported by a strong therapeutic alliance. This collaborative approach could be found in osteopathy, which is typically used to treat patients with musculoskeletal disorders, but arguably it can also benefit mental health outcomes.
However, research and practice exploring the reputed effect of osteopathy on patients with mental health problems lacks a solid framework. In this hypothesis and theory article, we draw on research into embodied cognition, predictive coding, interoception and osteopathy to propose an embodied, predictive and interoceptive framework that underpins person-centered osteopathic care for people with persistent physical and mental problems comorbid. health problems. Based on the premise that, for example, chronic pain and comorbid depression are underlined by overly accurate predictions or imprecise sensory information, we hypothesize that osteopathic treatment can generate strong interoceptive prediction errors that update the generative model that underpins experience of pain and depression.
Therefore, physical and mental symptoms can be reduced through active and perceptual inference. We discuss how these theoretical perspectives can inform future research on osteopathy and mental health to reduce the burden of comorbid psychological factors in patients with persistent physical symptoms and support multidisciplinary person-centered care in mental health. This hypothesis and theory article introduced an embedded, predictive and interoceptive framework for osteopathy and mental health. Based on research into embodied cognition, predictive coding, interoception and osteopathy, this theoretical framework aims to provide a basis for reasoning and investigating the effect that osteopathy supposedly has on comorbid psychological factors in patients with physical conditions.
osteopaths often treat patients with, for example, chronic pain and comorbid depression, which could be said to be related to false inferences and interoceptive deficits, including interoceptive predictions that are too accurate (e.g. Osteopathic manual therapeutic approaches may aim to provide uncertain and surprising interoceptive information (which is contrary to predicted information) to the body área that is associated with the patient's comorbid physical and mental symptoms to update these maladaptive interoceptive predictions and improve the capacity to handle interoceptive information. In particular, these manual techniques should be complemented with patient management approaches that include reassurance, education, support, advice and exercises to provide a cognitive basis for reviewing the generative model responsible for interoceptive predictions and attenuating interoceptive information and integrating these changes in daily life. In this sense, osteopathic interventions may generate interoceptive prediction errors (mismatch between expected and actual interoceptive information) that are minimized by active and perceptual inference processes.
To this end, osteopathic care plays a crucial role in allostatic regulation and, therefore, in health and well-being, particularly through active interoceptive inference. We have suggested that during osteopathic treatment, first, active inference processes leading to autonomic activity may participate, which resembles the predicted physical and mental symptoms associated with pain and depression, since it is inferred that these are the probable cause of uncertain interoceptive. information. However, as interoceptive entry emerges in a healthcare setting, perceptual inference processes can be used to update prediction and underlying belief in accordance with actual interoceptive information, while improving the ability to service interoceptive information.
Simply put, persistent and noisy interoceptive prediction errors (arguably maintaining symptoms) could supposedly be “replaced” by surprising and accurate (arguably symptom-relieving) interoceptive prediction errors. In this way, osteopathic treatment could reduce the belief and prediction of physical and mental states associated with chronic pain and comorbid depression. Still University, the original osteopathic medical school in the humid hills of Kirksville, Missouri. Models and Theoretical Frameworks for Osteopathic Care: A Critical View and a Call for Updates and Research.
Without it, those who rely on manipulative medicine would suffer, their pain would be more difficult to manage without the expert application of osteopathic techniques. Today, osteopathic manipulative medicine consists of dozens of manual techniques, many of them also employed by massage therapists, chiropractors, and physical therapists. We have proposed that osteopathic treatment can facilitate perceptual inference processes by increasing the weight (accuracy) of interoceptive prediction errors to update the belief that issues maladaptive predictions and thus reduce physical and mental health symptoms sustained through active inference processes. Similarly, the putative effect of osteopathic treatment on brain function can be evaluated in this patient population using neuroimaging techniques with emphasis on interoceptive and emotional brain networks (possibly using dynamic causal models).
Although most programs are allopathic, some pursued special osteopathic recognition, demonstrating their commitment to continuing education on osteopathic principles and manipulative medicine. In summary, osteopathic treatment can influence interoceptive processing, which could be relevant to physical and mental health conditions. Therefore, osteopathic interventions can theoretically reduce interoceptive processing dysfunction, autonomic activity and allostatic load by increasing the accuracy of real interoceptive information (probability), generating prediction errors that update (prior) belief, thus decreasing the lack of coincidence between expected and actual interoceptive states. Although the techniques are gentle, you may feel pain for 24 to 48 hours after visiting your osteopathic doctor.
Diagnosing and treating conditions with these techniques is called Osteopathic Manipulative Medicine (OMM). In patients with pneumonia, for example, osteopathic manipulation can reduce the number of days spent in the hospital. We hypothesize that both interoceptive deficits (too accurate interoceptive predictions and imprecise interoceptive prediction errors) may benefit from the interoceptive input provided within osteopathic treatment to update maladaptive prediction and improve the ability to attend to the interoceptive information. Manual osteopathic treatment for pain severity, functional improvement and return to work in patients with chronic pain.