Pitfalls and challenges involved in the process of perception and interpretation of palpatory findings

Palpation is the cornerstone of osteopathic diagnosis and treatment and the major building block of clinical decision making within osteopathy. It depends not only on the interpretation of palpatory sensations, but the perception process itself can be affected by many factors that mostly act on the subconscious of the palpating individual. Palpation is a complex process and influenced by previous experiences, the type of information to collect as well as the context in which it takes place. Hence, the various influences that shape the perception and interpretation of palpatory findings may create challenges when treating a patient.Amongst other factors, such as the previously described multisensory integration of both vision and haptic information, diagnostic palpation can be experienced and interpreted based on additional influences, such as habitual and context-related influences, as well as cultural and social imprinting. This article reviews and explores these factors as potential pitfalls with regards to the osteopathic palpatory approach and in light of the available osteopathic research evidence. Other literature from the field of neuroscience and psychology, where relevant, has also been explored. Awareness of these challenges and pitfalls may result in more adequate palpation procedures and enhance competence in palpation practice.