[Comparative analysis between orthopaedic manual therapy and osteopathy : focus on the Belgian situation]

Orthopaedic manual therapy (OMT) and osteopathy have been coexisting since a long time in Belgium to manage musculoskeletal disorders (MSDs). There are millions of consultations per year in these both disciplines. Both of them offer good clinical outcomes as well as patient satisfaction with care, good cost-effectiveness, as well as minor side effects. Nevertheless, a major misunderstanding remains in Belgium concerning these both professions. A narrative review by Belgian experts in osteopathy and/or in OMT has been undertake. In Belgium, both professions present several major differences concerning the primary first care access, the recognition as health care profession, tailored reimbursement systems, types and organization of education, the use of rehabilitation and motor control, the integration of evidence based practice concept, the reasons/indications of consultation, the degree of confidence within the therapeutic touch concept. In the meantime, several similarities also exist including the integration of the bio-psycho-social model, the evaluation of the neuromusculoskeletal system and the treatment of MSDs using sometimes identical manual techniques, as well as the use of therapeutic education of the patient and specific clinical reasoning. This analysis may help health professionals, students and patients to better understand the convergences and divergences between these both disciplines of musculoskeletal care in Belgium.