Orthopedics

Orthopedic diseases often affect older patients and cause serious discomfort and reductions in mobility. The treatment involves physiotherapeutic procedures with the aim of reducing discomfort and increasing mobility as well as symptomatic treatment for pain relief. The bone system, the joint system, the connective tissue system, the muscle system and the tendon system do not stop at their mechanical functions, but are seized by a differentiated influence of the constitutional entities. The physical organization is not stable and fixed, but subject to constant transformation processes in the sense of an osteoclastic bone resorption and an osteoblastic bone formation as well as reconstruction processes in the bradytrophic tissues. The biological plasticity indicates the influence of the life organization. These life processes, which are undoubtedly weaker in comparison to tachytrophic tissues yet are still present, are modulated by movement. Therefore, the soul-being, i.e. the astral body, influences the development of the musculoskeletal system.

In their form, the bones are manifestations of the I-organization; like the other form-bearing tissues, they shape the individual human form. The intentional influence of the I (ego) that is active in movement leads to changes in bone tissue: for example, active, volitional movement that is carried out against a resistance causes an increase in bone density; by contrast immobility leads to a reduction of bone substance. The I-organization thus shapes the individual form of the body and is active in the movement of its limbs. Bone health is a manifestation of the physiological influence of all constitutional entities of a human being. Conversely, their limitation leads to the diseases of the skeletal system and of the joint organization.

Changes in the influence of the constitutional entities lead to the corresponding therapeutic measures. For example, osteoporosis, which mostly affects slim patients with a delicate physique shaped by the neurosensory system, is associated with a pathological loosening of the constitutional entities. An increased activity of the latter in the system of limbs (e.g. through movement) can, in turn, have a positive effect on the condition. Medicines can also amplify this influence. However, osteoporosis is more than a structural bone disease. Like other painful diseases of the musculoskeletal systems, it is often accompanied by depression. Some patients experience themselves as being mentally “thin skinned” and sensitive. Eurythmy and art therapy can be a blessing in this context and induce a more intensive activity of the constitutional entities in the skeletal system. Finally, individuality and biography need to be considered. This is because beyond decreased bone density and the physical manifestation in the increasing hyperkyphosis and the reduced anabolic life processes of the bone tissue, osteoporosis also has a mental and spiritual dimension: when postmenopausal osteoporosis manifests itself, this often coincides with a chapter in the life of the patient having been completed. Key aims in life must be adjusted and a reorientation has to occur. In this context, conversation therapy with a focus on the biography plays a key role in the treatment as it helps patients to recognize new aims in life and in realizing these aims biographically. The physical appearance of osteoporosis illustrates the threat to uprightness that is manifested in the kyphosis process of the thoracic spine as a physical expression of the influence of the I (ego). Medicinal therapy, physiotherapy, rhythmic massage, eurhythmy and art therapies in combination with conversation therapy can strengthen an incarnating I-influence with an emphasis on the body.

The treatment of disc problems can also be significantly enriched by an understanding of the influence of the constitutional entities. An acute disc prolapse requires a temporally differentiated approach: initially, a satisfactory pain relief can often be achieved through targeted physiotherapy and rhythmic massage. For more severe symptoms, classical analgesics are administered for symptomatic pain management. The other therapeutic measures are chosen and customized based on the frequently degenerative underlying disease that involves sclerosis processes. The aim is to support the life organization in order to support the free and non-solidifying intervening astral organization as well as the physical, mental and spiritual-biographic promotion of uprightness.

Similarly, in the treatment of joint diseases, essential therapeutic measures can also be derived from the differentiated influence of the constitutional entities corresponding to the threefolded nature of the human organism. Arthroses are a manifestation of sclerosis processes in the joint organization, i.e. a disease activity that is dominated by the neurosensory system. These are opposed by inflammatory processes that initially have a salutogenetic orientation. However, the latter often transition into chronic, destructive forms of inflammation that no longer have any salutogenetic orientation. The external applications from anthroposophic physiotherapy (Arnica compresses, inunctions with Stannum etc.) in combination with a medicinal therapy (Mandragora, Stannum, mistletoe therapy etc.) have time and again led to astonishing improvements of joint discomfort and mobility. This also applies to rheumatoid arthritis that commonly manifests itself early, i.e. between the age of 30 and 50. Its treatment appears particularly impressive if it is combined with dietetics as part of a multimodal treatment concept. Especially for the rheumatologic systemic diseases, the biographical context is of crucial importance. Rudolf Steiner described the biographical significance of “childhood misery” very early; today, this topic is usually discussed in the context of childhood trauma and “early toxic stress”.

For anthroposophic orthopedics, prevention with the aim of ensuring joint and bone health is thus not only a question of a healthy way of life with physiological levels of exercise and a healthy diet, but reaches back to the time of soul-spiritual development during childhood and aims to help develop new biographical perspectives.