Related methods: an overview

Musculoskeletal medicine, orthomanipulation, manual therapy, chiropractic, osteopathy ... and they all say that they will relieve you of your symptoms. So many different systems and claims give confusion. Where do you have to go with your complaints? In this article I try to create some overview.



Many methods are related to each other by divisions in the past or by 'taking over' techniques and ideas from each other. They are all about the same musculoskeletal system. The hands of the examinator/therapist play an important role. Osteopathy and chiropractic are at the basis of most modern movements. These are methods that were already in use in the United States before 1900. Presumably these methods on their turn had their roots in traveling bone crackers. Negative experiences with the doctor's guild also gave a drive for the development of something else. It was a time when doctors had few effective treatment methods: natural science medicine was still under development. Effective medications did not exist. Experiments with various poisons. Not infrequently with deadly results.


Osteopathy and chiropractic

Both methods originally had manipulations of joints as the basis. The one manipulated something more robust than the other. The idea was that dislocations of vertebral joints hinder the life energy and/or nerves in their functioning. The so-called hardliners continued to embrace this idea to this day. Another part of the osteopaths and chiropractors (mixers) went more to the general medical side. Manipulations still remained in the foreground, but also working with regular medicines was allowed. In the meantime these groups are allowed to call themselves Doctor of Osteopathy (DO) and Doctor in Chiropractic (DC) after 3 to 4 years of training in the United States. It is a title that is comparable in the USA to the medical title Medical Doctor (MD). Outside the US, the recognition of these professions is very variable. In the Netherlands, they are liberal professions and fall under alternative or complementary medicine.


Manual therapy

Manual therapies have been practiced for centuries by people in various forms: from hitting with rolling pins to stretching to kicking with the feet. Many of the current manual therapies stem from osteopathy and chiropractic when these methods came to Europe after World War II. The techniques were changed according to their own insight, further developed and/or provided with the same theories or very different by critical pioneers. The most practiced method in the Netherlands is the manual therapy based on arthrokinematic theory, also known as the Eindhoven method. The training is in Amersfoort and trains physiotherapists in an extra 3-year course. In arthrokinematics, the knowledge of movement of joint surfaces on each other is seen as the basis of the quality of movement and in the treatment of disorders.


Manual medicine

Manual medicine was originally manual therapy method Eindhoven practiced by physiotherapists, but now by doctors. Manual medicine, however, wants to be more than a treatment technique. It is a so-called open method: every relevant development of insights, examination and treatment of the musculoskeletal system can be included if there is a sufficient degree of plausibility, logic and scientific substantiation. This may mean that some ideas are abandoned to make room for others. The arthrokinematic principle is still in use. (Click for more information on manual medicine and the manual doctor).



One of the pioneers who turned away from manual therapy and medicine was physician Sickesz. The movement function of joints made room for position function: alignement. In a joint, the matching bone parts need to stand on each other according to certain standards. Basically straight and symmetrical. This system was developed experimentally and the original principles still apply. The position of the pelvic girdle is seen as a basis and the position of vertebrae in the vertebral column is a good second. For the extremities (arms and legs) there is also room, but less in the foreground. The system is characterized by 'regularities': how deviations react to each other within the musculoskeletal system and how the treatment and sequence of actions should take place. (Click for more information about orthomanipulation and the orthomanual doctor).


Orthomanual medicine

How different manual medicine and orthomanipulation are: both groups of doctors have united in 2006 under the heading Orthomanual Medicine. In terms of content, nothing changed in the methods.


Musculoskeletal medicine

Later, in 2017, the name Orthomanual Medicine changed to Musculoskeletal Medicine. In terms of content, nothing changed in the original orthomanipulation. However, the realization from manual medicine arose that musculoskeletal complaints require a much broader approach than just these two methods and the specific approaches of the joints. Connection was sought internationally. The name musculoskeletal medicine has been used there for a long time to indicate the (mainly non-surgical) approach to musculoskeletal complaints. This involves a combination of knowledge and skills from orthopedics, neurology, sports medicine and rehabilitation medicine among other things. It is also about knowledge of pharmaceutical pain relief including injections, exercise therapies, reading of scans and ultrasounds, the ability to assess scientific literature and even more. (Click for more information on musculoskeletal medicine and the musculoskeletal doctor).