Sensitization and Interoception as Key Neurological Concepts in Osteopathy and Other Manual Medicines

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Here we propose the “interoceptive paradigm” in which (1) altered (acutely and chronically) interoceptive information lead to (2) neurological “sensitization states” (SS) that express their dysfunction through (3) an altered firing of the autonomic nervous system (ANS), which in turn (4) brings the peripheral tissue to an hypersensitivity state and, thus, creating the ground for a (5) vicious metabolic and neurologic cycle (positive feedback loop) and rapid system failure (Figure 1). The recognition of this paradigm will impact the clinical practice with several advantages/benefits:

• Appropriate clinical interpretation of symptoms with respect to the causal and pathogenetic aspects;

• Pertinent ability to “read” and “elucidate” the clinical history, linking aspects related to organs functions, neurology, and pathophysiological adaptation/compensation;

• Adequate comprehension of roles in the mutual doctor-patient relationship.