Osteopathy in Canada: What You Should Know

If someone recommends osteopathy, you might leave the conversation with a few questions.

What exactly does an Osteopathic Manual Practitioner do? Is osteopathy regulated? Is it covered by insurance? How is it different from physiotherapy or other forms of manual care? And how do you know whether the person you're seeing has appropriate training?

Those are especially good questions in Canada, where the word osteopathy can mean different things depending on where you are. Here's what's worth knowing.

First, what does “osteopathy” mean in Canada?

This is where some of the confusion starts.

In the United States, Doctors of Osteopathic Medicine (DOs) are licensed physicians. They attend medical school and can diagnose illness, prescribe medication, perform surgery and practise across medical specialties.

That is not the type of osteopathy I practise.

I practise osteopathic manual care — a hands-on approach to healthcare that considers relationships between the body's structure, movement and function.

In Ontario, osteopathic manual practice is not currently a regulated health profession in the same way that medicine, physiotherapy, chiropractic or massage therapy are.

Because the profession isn't provincially regulated, education can vary between practitioners. Looking at someone's training, credentials and professional association is therefore an important part of choosing your care.

What training should I look for?

This is one area where it's worth looking beyond the letters after someone's name.

I completed my osteopathic education at the Canadian Academy of Osteopathy, earning my M.OMSc — Master in Practice Diploma of Osteopathic Manipulative Sciences.

The CAO curriculum comprises more than 4,200 hours of education and more than 1,500 hours of hands-on training, including 1,000 hours of supervised clinical experience. Osteopathy Canada (OSTCAN) requires new professional members to complete a minimum of four years and 4,200 hours of osteopathic education, including at least 1,000 hours of supervised clinical practice and training. OSTCAN states that its education requirements meet the Type 1 standard outlined in the World Health Organization's Benchmarks for Training in Osteopathy.

4,200+ hours of osteopathic education · 1,500+ hours of hands-on training · 1,000 hours of supervised clinical experience

My training included extensive study of anatomy, physiology, biomechanics, osteopathic principles, assessment, clinical reasoning and hands-on treatment.

And learning doesn't stop at graduation. I continue to pursue professional education, including additional study in pediatric osteopathic care.

What are the OOA and OSTCAN — and why do they matter?

OSTCAN is a national organization representing osteopathic manual practitioners and provincial associations across Canada. In Ontario, its provincial association is the Ontario Osteopathic Association (OOA).

In an unregulated profession, these organizations provide an additional layer of professional accountability. Membership requirements include education standards and other professional obligations.

For a client, association membership is one more useful piece of information when deciding who you trust with your care.

Is osteopathic treatment covered by insurance?

Many extended health-benefit plans provide coverage for osteopathic manual treatment, but coverage depends on your individual plan and the practitioner your insurer recognizes.

Your plan may specify an annual maximum, an amount per visit, referral requirements or particular practitioner credentials or professional associations.

Before your first appointment, checking your benefits policy or contacting your insurer directly is the simplest way to confirm your coverage.

So where does osteopathy fit in healthcare?

I don't think of osteopathy as competing with medicine, physiotherapy or other healthcare professions. We bring different expertise and different lenses to the same human body.

Medicine plays an essential role in investigating symptoms, diagnosing and managing illness and disease. Physiotherapy may be particularly valuable when someone needs progressive rehabilitation, strengthening or a targeted exercise program following injury or surgery.

Osteopathic manual practice brings a hands-on, structural and whole-body perspective. If you come to me because your lower back hurts, I'm interested in your lower back. But I'm not interested only in your lower back. I want to understand how the rest of your body might be participating in the pattern.

The painful place isn't always the whole story

Bodies are remarkably good at adapting.

An old ankle injury may change how you walk for a while. Your hip and pelvis adapt. Your trunk responds. Or perhaps there wasn't an injury at all: you sit for eight hours a day, carry a toddler on one hip, work overhead, run long distances or sleep in the same position every night.

Your body continually finds ways to keep you functioning. Sometimes those adaptations work beautifully. Sometimes, eventually, something starts to complain.

That's why osteopathic assessment looks at relationships. Muscles, joints and fascia don't function as independent pieces. Nerves and blood vessels travel through and around those same tissues. Forces created in one region have to be absorbed and transferred elsewhere.

Instead of asking only, “Where does it hurt?” we're also interested in, “How is this body organizing itself — and what might be influencing this pattern?”

Movement matters for more than movement

A joint moving well isn't simply about becoming more flexible.

Our tissues also depend on the physiological environment around them. Blood supplies oxygen and nutrients required for normal cellular activity and transports metabolic by-products. Nerves travel through and around muscles, connective tissues and joints. Muscles and joints continually exchange sensory information with the nervous system.

Structure, movement, circulation and neurological function don't exist independently of one another.

This doesn't mean a restricted joint is necessarily “cutting off” its blood supply, or that manual treatment can cure disease by increasing circulation. The idea is more grounded: the physical environment surrounding our tissues matters.

Osteopathic treatment aims to reduce unnecessary mechanical restriction where appropriate and create better conditions for comfortable, efficient movement and function.

Assessment. Treatment. Reassessment.

One of the things that makes osteopathic care distinctive is that assessment doesn't simply happen at the beginning of your appointment.

The body is dynamic, so treatment is responsive. I assess how your body is moving and where I find relative ease or restriction. I treat. Then I reassess. What changed? What didn't? Where does that information lead us next?

Treatment unfolds from what we're finding rather than following a predetermined recipe. That's why two people can arrive with the same complaint and receive very different treatments.

Their symptoms may sound the same. Their bodies may be telling very different stories.

We're not trying to create a perfect body

Perfect symmetry isn't the goal. Neither is forcing your body into some theoretical ideal posture.

I'm more interested in options: more freedom where movement has become restricted, better distribution of forces across joints and tissues, less need for one region to continually compensate for another, and more comfortable, coordinated movement.

The goal is to reduce unnecessary barriers so your body has greater capacity to move, adapt and function.

And sometimes osteopathy isn't what you need

This is an important part of good care.

There are times when symptoms warrant medical investigation. There are times when progressive strengthening or rehabilitation with a physiotherapist may better support someone's needs. And there are situations where several healthcare professionals working together makes the most sense.

Referral isn't a failure of osteopathic treatment. It's part of good healthcare.

I don't see my role as being the person who “fixes” your body. I bring my understanding of anatomy, structure and movement. You bring your experience of living in your body. From there, we work together.

Because ultimately, osteopathy isn't simply about treating the place that hurts. It's about understanding the body experiencing it.