Somatic dysfunction: An osteopathic conundrum

Somatic dysfunction is considered a central concept for the theory and practice of osteopathy, but its relevance to the modern profession is questionable due to its unclear pathophysiology and poor reliability of detection. This article will explore the factors that may produce clinical signs attributed to somatic dysfunction and discuss the plausibility of the concept. A conceptual model is presented for the clinical diagnostic cues attributed to intervertebral somatic dysfunction, where signs of dysfunction arise from tissue and neurological factors related by a cycle of tissue injury and nociceptive-driven functional changes. Finally, the relevance of the concept of somatic dysfunction to the modern osteopathic profession is discussed and recommendations for the osteopathic profession are made.