Abstract
Recent evidence has undermined much of the biomechanical based reasoning of osteopathy. This has led to considerable discussion of the future of the distinctiveness of osteopathy and proposals for new models of osteopathic approaches. Current research on pain processes, aetiology and clinical effectiveness supports a biopsychosocial perspective in clinical reasoning for musculoskeletal pain. New clinical reasoning models proposed by osteopaths Fryer and Lederman are considered alongside models from other professions. Process based models are based on a biopsychosocial approach and involve changes to diagnostic reasoning and treatment rationale. Evidence shows the need for multidimension, multimodal approaches in treatment of musculoskeletal pain. These models may provide a means of applying evidence to practice and a rationale for hands-on manual therapy. Adoption of new models of osteopathic care require change to practice incorporating education and more active approaches alongside hands-on care. Consideration is given to how osteopaths need to adapt and the future of osteopathy in musculoskeletal medicine.
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