Osteopath: who he is and what he does. Law and professional requirements in Italy

Osteopath: who he is and what he does. Law and professional requirements in Italy

Let’s explore in depth the figure of the osteopath with the new legislative advances, the aims and the character of the profession. Who can call themselves an osteopath? What are the areas of action of this professional figure?


What does the osteopath do and what does osteopathy cure? How is this professional figure formed and what laws regulate his profession? 

In Italy there are about 12,000 osteopaths and, in recent years, more and more people have chosen to turn to these professionals and who, in general, opt for allopathic therapies. But who is the osteopath? 

The osteopath is a health worker who has a diploma in osteopathy (or “osteopathic medicine”) which is considered by the WHO as an alternative or complementary therapy based on the contact of the hands on the patient’s body for both diagnosis and treatment of various ailments. The osteopath evaluates the patient in a holistic sense since the human body is conceived by osteopathy as a unity of body, mind and spirit.

Maybe redundant? The holistic approach of osteopathy is based on the concept thatthe body is a dynamic functional unit whose parts are interconnected and capable of self-regulation and self-healing.

The osteopath uses a variety of manual techniques to help physiological functions that have been altered by damage to anatomical components such as bones, joints, myofascial structures and associated vascular and nerve networks . 

What the osteopath does

Recently the register of osteopaths of Italy (ROI) has drawn up a first document in which the main and fundamental indications of the profession are collected. Here in summary: ” The osteopath must know how to perform an osteopathic evaluation, which starts from clinical reasoning, based on osteopathic principles and models. The evaluation of the patient begins with the acquisition of all useful information about his clinical history, reports doctors and those in charge, to decide if there is an indication for osteopathic treatment. The medical history and information relating to the state of health must be recorded in the Osteopathic Record .

After having made this first careful evaluation, the osteopath must come to oneosteopathic diagnosis based on static and dynamic postural analysis , through active and passive tests, using perceptual palpation, detecting functional alterations related to allostatic overload (i.e. excessive or insufficient activation of the mechanisms of adaptation and stabilization of the organism to external stimuli) o the possible presence of somatic dysfunctions (ie alterations of the mechanisms that allow the maintenance of the state of health following stressful “insults”).

The treatment is then plannedand performs it with the selected manipulative techniques. Finally, the osteopath records the treatments performed in the osteopathic file and evaluates the results of the treatment, with osteopathic tests and clinical findings, sharing with the patient its possible continuation. “

Osteopathy treats reversible functional lesions . In other words, it does not it is indicated, for example, in case of fracture, tumor or to treat serious diseases that endanger the person’s life. 


This professional can open his own clinic and collaborate with other health professionals, in particular from other specialized fields of conventional medicine.

The areas of intervention concern the supporting structure of the organism and the connections between this and specific functions: orthopedics, otolaryngology, odonto-stomatology, pediatrics, ophthalmology, geriatrics, urology, gastro-enterolology, cardiology, endocrinology, gynecology.

Become an osteopath  

To become an osteopath in Italy you need a five-year training course – if full-time – or six years – if part-time.

The curriculum includes basic medical sciences such as anatomy, pathology, physiology, biomechanics, biochemistry, biophysics, embryology, histology, neurology and others, in addition to purely osteopathic subjects.

Training in Italy is not university-based but private, in schools not yet officially recognized.


Osteopathy in Italy: Lorenzin law

With the Lorenzin law 3/2018,  the new health professions of osteopath and chiropractor have been established but the “regulation” process has not yet been completed: this professional profile is being examined by CSS (Superior Council of Health), Ministry and Conference State-Regions and only later will the decree for the degree course arrive.

Various implementing measures are still awaited : the agreement for the identification of the professional qualification, the area of ​​activity, the criteria for evaluating professional experience and for the recognition of equivalent qualifications, two opinions of the Superior Health Council and the subsequent Miur-Health decree for the establishment of degree courses and the related didactic system.

L’agreement in the State Regions, start of the process, should have been ratified by May 2018 and the professional profile of osteopaths has not yet been defined.

The process of regulating osteopathy as a health profession, in implementation of the law, is therefore delayed. This is detrimental to professionals and patients who use it.

Waiting for a reference health legislationthe category of osteopaths remains in a situation of uncertainty, worsened during the health emergency from the COVID-19 pandemic. Even in the weeks of lockdown for operators in the sector it was impossible to receive exact information on their activities, unlike other health professional categories already formally regulated.

The maxi-Order of Health Technicians and Medical Health Professions

Osteopaths, like chiropractors, could therefore fall within the maxi-Order TSRM and PSTRP (Health technicians, medical radiology and technical health professions, rehabilitation and prevention) chaired by Alessandro Beux who declared, as reported  here :

” The Superior Health Council has dismissed its opinion on the professional profile of the Osteopath. Now the proposal for an agreement is expected to arrive at the State-Regions Conference “

The definition of the professional profile would close the first phase of the process, allowing to work on the didactic organization of the Degree Courses in Osteopathy: the professional profile will tell what the osteopath does, the didactic organization will indicate the courses that, in the three years, students will have to follow to acquire the necessary skills to do so “ .

Osteopathy in the world

In the United States, where she was born, osteopathy entered public health in 1991 and, by law, is practiced by doctors. It then spread more and more to the rest of the world.
The legislation on osteopathy in Europe has spread unevenly with substantial differences from country to country.

It is already fully recognized as a health profession in ten countries: Great Britain, France, Finland, South Africa, Australia, New Zealand, South Africa, Switzerland, Portugal, and Iceland.

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