The History of Osteopathy in France

In France, just like for the rest of Europe, osteopathy did not experience the same explosive development it had seen in the USA, here osteopathy took its first steps in the context of orthodox medicine, although until the 1950s it was also practiced by numerous categories of other operators such as, for istance, bonesetters, masseurs, chiropractors, physiotherapists and kinesiotherapists. The association to other kinds of alternative medicines was later also a clever expedient for survival.

The Société Française d’Ostéopathie – Robert Lavezzari and Robert Maigne

In 1913 a volume signed by Dr Moutin and Dr Mann was published in France. Somehow the book resembled Barber’s works: a brief introductory guide on osteopathy, aimed at all health professionals but also at the general public, with images and descriptions of some manipulative techniques (Moutin and Mann 1913).

Nevertheless, the origins of French osteopathy date back to the work of Dr. Robert Lavezzari (1886-1977), who graduated in 1913 from the medical faculty of the University of Montpellier with a thesis on hysteria (Lavezzari 1913).

After fighting in the First World War he returned to Nice, his hometown, where he came across a fascinating article signed by the American osteopath Florence Gair, who had been very close to Andrew Taylor Sill. As Booth recalls, she was a wealthy girl from Brooklyn, New York, who had been involved in a riding accident in 1891, which had left her disabled. Having subsequently recovered through osteopathy, she had enrolled in Kirksville school in 1907 and completed her studies for the sole purpose of being of service to mankind. In 1911 she had opened a clinic in her hometown for destitute children, especially those suffering from paralysis. In 1917 she enlarged her clinic thanks to her father who supported her financially (Booth 1924: 725ff).

So it was that, around 1918, Robert Lavezzari began to practice osteopathy, mainly applying the techniques of mobilization of the cervical vertebrae. In 1932, Lavezzati started the first course in osteopathy at the Dispensaire Hahnemann in Paris, the city where he settled in 1936. He published various articles, held various conferences and even wrote a book entitled Une nouvelle méthode clinique et thérapeutique: l’osteopathie (A new clinical and therapeutic method: osteopathy),  published in 1949.

In 1951, together with other colleagues, he established the Société Française d’Ostéopathie, which could be joined by medical graduates who applied osteopathic manipulative techniques. He presided over the society until 1977, nonetheless the society still exists to this day (Cardin 2004: 36;

Another doctor interested in manual therapy was the French rheumatologist Robert Maigne (1923-2012) who in the 1950s studied at the British School of Osteopathy in London for a year, having the well-known osteopath Myron Beal as his teacher.

Robert Maigne introduced Manipulative Techniques as a new topic into the curriculum of French medical universities and created the concept of minor intervertebral pain disorder, which, in his opinion,  produced palpable changes in the soft tissues of the corresponding metamere (tenomyalgia cell syndrome). He was the author of many articles and books. In 1959 he established the French Society of Orthopedic Manual Medicine and Medical Osteopathy (Société Française de Médecine Manuelle Orthopédique et Ostéopathie Médicale, SOFMMOM) and in 1968 he was one of the founders of the International Federation of Manual Medicine (Fédération Internationale de Médecine Manuelle, FIMM), the international association of medical graduates applying manipulative techniques in their medical practice.

Overall, this line of thought integrated osteopathy into orthodox medicine, interpreting it as a rehabilitation therapy and a set of precise and codified maneuvers, ignoring its philosophical aspects and functional techniques. The representatives of this line of thought considered manipulation an exclusively medical technique and fought against those who practiced manual medicine without having a medical degree. 

After the war, French osteopathy spread among many non-medical practitioners. Initially it was two physiotherapists, Paul Geny and his friend Jacques Potter, who founded the Osteopathic Research Society (Société de Recherches Ostéopathique). Paul Geny had known osteopathy thanks to the teachings of an English osteopath, Tom Dummer. From 1951 the courses, structured as seminars, began. Many of the participants later became lecturers at the French School of Osteopathy (École Française d’Ostéopathie, EFO), founded in 1956.

In March of the same year, a trade association called the Union of Masseurs-Osteopaths of France and of the French Union (Syndicat des Masseurs-Ostéopathes de France et de l’Union Française, SMOFUF) was also established. In 1960 the Union of the Masseurs (Syndicat des Masseurs) merged with an association that brought together the practitioners of osteopathic massage, taking the name of Union of French Osteopaths (Syndicat des Ostéopathes de France).

In 1960 Paul Geny made the French School of Osteopathy (École Française d’Ostéopathie, EFO) independent of the school of kinesiotherapy, after having shared the same premises with it,  and moved to another location. The courses took place from November to May and included seven seminars held from Friday to Monday. Among the teachers there were several British osteopaths and chiropractors, such as John Wernham, Parnell Bradbury and Denis Brookes. Hygiene and Naturopathy were taught by Tom Dummer.

Following a ministerial decree of 1962, which had banned non-medical practitioners from practicing osteopathy in France, in 1965 the EFO was transferred to London at the BCNO, the British College of Naturopathy and Osteopathy, where his sixteen pupils had to go to continue their studies.

After a few years, given the demand coming also from countries other than France, the school was renamed École Européenne d’Ostéopathie, and then in 1971 it was transferred to Maidstone, Kent, under the direction of Tom Dummer – the well-known osteopath who was an advocate for the Specific Adjusting Technique, SAT. In 1974 it also took on the name of the European School of Osteopathy, ESO, the institute still exists to this day.

A further development of French osteopathy occurred when the osteopaths René Quéguiner, Francis Peyralade and Bernard Barillon, all trained at Paul Geny’s school, continued their studies under the guidance of Denis Brookes, a passionate advocate of osteopathy in the cranial field. On November 30, 1964, Denis Brookes succeeded in organizing the first seminar on this subject, which was held by a group of American osteopaths who had been direct students of Sutherland, their names were Harold I. Magoun, Viola Frymann and Thomas Schooley.

When the Americans realized that three of the participants in the seminar – the young French osteopaths – did not have a medical degree, they were very disappointed. However, in the end they decided to have the students undergo a small test: first they were blindfolded and then they had to recognize a skull bone exclusively by palpation. The three passed the test and after studying for another five years they were authorized to teach cranial osteopathy in France. In 1978 René Quéguiner and Francis Peyralade founded the Society for studies, research and teaching of osteopathic techniques (Société d’études, de recherche e d’enseignement des technique ostéopathiques, SERETO).

From a political point of view, at that time manual therapies could be devided  into 2 opposing groups in France.

On one side there were those who claimed that these disciplines belonged exclusively to the medical field, initially represented by the National Union of Orthotherapists of France and of the French Union (Syndicat National des Médecins Orthothérapeutes de France et de l’Union Française, SNMOFUF), founded in 1953 by Robert Maigne and some of his colleagues. From 1958 the SNMOFUF changed its name to National Union of Osteopathic Physicians of France (Syndicat National des Médecins Ostéothrérapeutes de France, SNMOF) and from 2002 it was called Union of Manual Medicine Osteopath of France (Syndicat de Médecine Manuelle Ostéopathe de France, SMMOF).

On the other side there were several associations of non-medical practitioners, including:

  • The French Association for the Defense of Osteopathy (Association Française de Défense de l’Ostéopathie (AFDO), founded in 1973 to bring together all the osteopaths graduated from the ESO in Maidstone, which since 1995 had taken the name of French Syndicate of Osteopaths (Syndicat Français des Ostéopathes, SFDO).
  • The International Osteopathic Association (Association Ostéopathique Internationale, AOI), founded in 1963 to connect and bring together all qualified osteopaths under a single banner to promote and defend osteopathy, its practice and its future. The AOI also engaged in the fight for the official recognition of the osteopathic science. In 1973 the AOI changed its name to International Institute of Etiopathy (Institut International d’Etiopathie, IIE). The use of the word ‘Etiopathie’ (etiopathy) was a choice of the founder of the AOI, Christian Trédaniel, as he believed that the word ‘osteopathy’ was limited in defining a science that was not only concerned with bone care. But behind this change there were mostly political reasons; in fact, the French medical association, given the success obtained by osteopathy among physiotherapists, put pressure on the authorities so that osteopaths without a medical degree would not be authorized to teach osteopathy. There were indeed no prescriptions for teaching etiopathy.
  • The National Institute of the College of Osteopathy (Institut National du Collège d’Ostéopathie, INCO), which in 1974 set itself the goal of bringing together specialized osteopaths, in particular for the research of the best sciences and techniques in a naturopathic and ecological context.

The practice of osteopathy outside of orthodox medicine continued to spread, and from the early 1980s voluntary organizations, similar to professional associations, such as the Register of Osteopaths of France (Registre des Ostéopathes de France, ROF) and the Federation of Osteopaths of France (Fédération des Osteopathes de France, FOF) came into the picture. The ROF was a register founded in 1981 which brought together those practitioners who would openly call themselves osteopaths as they would not practice the discipline secretly, pretending to be either kinesiotherapists or physiotherapists or something else; in fact, its mission was precisely to promote the practice of osteopathy as an independent profession. The FOF, on the other hand, was nothing more than an evolution of the FFO (Fédération Française d’Ostéopathie) – an association founded in 1976 in Montpellier, with the aim of bringing together the organizations that defended osteopathy and manual therapies, namely the National College of Osteopathy  (Collège Nationale d’Ostéopathie, CNO) and the French College of Osteopathy  (Collège Français d’Ostéopathie, CFO).

What is more, by this time, osteopathy had won the favor of the public. For example, in 1983 in Grenoble, the parents of some disabled children worked side by side with a number of osteopaths in order to found the Disabled Children Association-Osteopathic Hope (Association Enfants Handicapés-espoir Ostéopathique, EHEO). This facility offered osteopathic care on a voluntary basis to severely disabled children who would probably not have had any access to such services because of their high costs.

On October 8, 1986, Prof R. Villey (who at that time was President of the National Order of Doctors) received the representatives of the FOF and AFDO in audience. Prof Villey concluded the meeting by promising that he would not take any measures that would violate the French law in place against any deception perpetrated by unreliable individuals, the so-called charlatans.

In the same year, tax measures were also introduced to the detriment of osteopaths, in fact, starting from 1986 all osteopaths were obliged to pay VAT. Such a decision reinforced the refusal by the French authorities to recognize osteopathy as a health profession; in fact, professions based on personal care in France were exempt from paying VAT, and still are. But this was only one of the blows inflicted on the profession by the French institutions. The worst was yet to come, and it would not take very long.

Starting in 1988, all osteopaths without a medical degree found themselves facing a difficult time, known as the “dark years” (“années noires“). The problems of these years showed especially in the increase in the number of trials for illegal practice of medicine to which many osteopaths were subjected, also associated to an aggravation of the sentences inflicted. The peculiarity of these events was that they did not concern single osteopaths in their individuality but rather entire groups of them, for instance, all the osteopaths of the same town could be subjected to persecution and finally condemned.

Since the early 1990s, there was a proliferation of schools offering osteopathic training to students who only possessed the high school diploma and no opportunity to gain experience in a formal health-care setting.

In 1999, the French Secretary of State for Health and Social Action entrusted Guy Nicolas with the task of carrying out a research on osteopathic and chiropractic practices, with the intention of defining the minimum requirements for the practice of osteopathy. The report came out the following year. In the same year, the osteopathic doctors belonging to the SNMOF launched a campaign aimed at dissolving the ROF which represented the majority of osteopathic doctors without medical degrees. Despite taking the ROF to court nothing really happened and the ROF overcame the blow.

We have reported below some of the most important events that led to the recognition of osteopathy in France.

The date of March 4, 2002 marked a turning point in the history of French osteopathy thanks to the approval of the Kouchner law by the National Assembly (Loi n° 2002-303, article 75). The title of osteopath was finally recognized and continuing education became mandatory. In other words, the title could only be used by those who owned a Diploma issued by a training institution recognised by the Ministry of Health. Furthermore, the High Authority of Health (Haute Autorité de Santé, HAS) was commissioned to produce a guideline manual called Good Practice Recommendations (Recommandations de Bonnes Pratiques, RBP). Despite all of this, a situation of uncertainty persisted until 2007, as the Kouchner law did not specify the type of training required, nor the scope of action of the osteopathic practice – not to mention the lack of precision regarding the definition of the status of exclusive osteopaths. Osteopathy had therefore definitively entered legality without however benefiting from a clear regulation.

On the other hand, on August 6, 2002, a new law (Loi n. 2002-1062) sanctioned the amnesty for the crime of illegal practice of medicine linked to the practice of osteopathy.

A further step towards the credibility of osteopathy was taken on March 25, 2007, through the Decree n. 435, about the acts and conditions for the practice of osteopathy (Décret n°2007-435). The decree defined the conditions required for the practice of osteopathy and the acts that were prohibited in it or had limited-access conditions. This date was also a decisive step for the teaching of osteopathy, with the introduction of a training reference system, and with the definition, among the other things, of the procedure to follow in order to request one’s qualification after the completion of the minimum training required.

Once the implementing decrees were published, the ROF welcomed them favorably. In the French osteopathic community, such a stance aroused confusion and misunderstanding since its contents had taken little account of the requests formulated by the osteopaths themselves. The ROF, on the other hand, considered this development vital for the future of  osteopathy as the absence of legislation had been increasingly compromising its practice, given also that millions of French people were already resorting to osteopathy. Following this logic, starting from 2007, the ROF turned to the Council of State with regard to the implementation of the decrees by the Ministry of Health.

On 30 April 2007, the National Recognition Commission (Commission nationale des agréments) was set up in order to approve the training  institutions that were authorized to train osteopaths at that time. The teaching of biological and osteopathic subjects had to respect a basis of 2660 hours and, in order to obtain accreditation, each school had to respect a rigorous list of criteria. However, between 2007 and 2009, the Ministry of Health issued the certificate of recognition to various institutes, bypassing the decisions of the Commission itself.

As a consequence, in 2009, the law Hospital-Patient-Health-Territory (Loi Hôpital-Patient-Santé-Territoire) was issued, aimed at improving education and strengthening control over the training providers. Furthermore, the diploma in osteopathy could be obtained since 2007 by completing a 3-year course of study, the so-called Bac+3 (equivalent to a university degree). The qualification required to access one of these private schools was the high school diploma.

This raised some concerns, especially due to the suppression of the obligation to consult a doctor for the practice of any cervical manipulations. What is more, the list of required courses was relatively short. Thus students who failed entrance exams into medicine or physiotherapy often flocked to private osteopathic schools. To this must be added the fact that the osteopathic profession began to be very fashionable, probably due to its high lucrative potential. In short, osteopathy was certainly becoming more and more attractive, but at what price? After all, the ethics of teaching largely depended on the integrity of the directors of the schools, since, for some of them, osteopathy had become a real business.

In 2009, the situation of osteopathy – and chiropractic – became particularly problematic due to three factors. First of all, there was a strong heterogeneity in the way these disciplines were accessed while the way of exercising them was identical. The heterogeneity of education was attributed to a sort of laxity. And finally, the cost of training in private institutions remained considerably high, despite not having an appropriate scientific basis, which at the time was believed to steer students towards uncertain outlets. For this reason, some schools tried to fight in the name of the quality of teaching. This initiative also allowed many of them to obtain the Erasmus charter.

Osteopathy continued its ascent towards recognition with the decree of July 12, 2012 (Arrêté 12 juillet 2012) – modified in 2014 – which ruled the integration of the osteopathic profession in the ADELI, a national register listing accredited health professionals, collecting their details and other pieces of information such as their place of practice, their diplomas, languages spoken etc. The number assigned by the ADELI to each professional was then written on their health professional card (Carte de Professionnel de Santé, CPS). Let us now take a quick leap into the present: in 2022, ADELI became obsolete; within the EPARS project, osteopaths will be incorporated during 2023 in the Shared List of Healthcare Professionals (Répertoire Partagé des Professionnels de Santé, Shared List of Healthcare Professionals, RPPS) corresponding to a unique and permanent number.

With that said, we can go back to our time travel.

The representatives of the exclusive osteopaths and the Directorate-General for Health (Direction Générale de l’Offre de Soins, DGOS) organized a meeting on April 15, 2013, with the aim of reviewing the training system and organizing a work program divided into three phases: the drafting of a frame of reference for the activities and skills of osteopaths; the elaboration of a frame of reference for the training of osteopaths; a change in the recognition criteria for training institutions.

With the obligation of a professional civil liability (Responsabilité Civile Professionnelle, RCP), obtained through the law n. 2014-201 of  February 24, 2014 (Loi n. 2014-201) the government helped to anchor osteopaths more firmly within the French healthcare landscape. From January 1st 2015, every practitioner authorized to use the title of osteopath became liable for compensation for any damage caused to others during the practice. Basically, osteopaths had to be able to demonstrate that their liability was covered under the conditions established by law.

Following the proliferation of osteopathic schools in France, the government and representatives of the profession believed that the quality of training was in danger. Indeed, this posed a risk to health in general. Therefore they jointly outlined a new legal framework. It was with the decree of 12 December 2014 (Arrêté du 12 décembre 2014)  that the harmonization of osteopathic training was finally established, establishing, among other things, that the diploma would be issued no longer after 3 years of study but rather after 5.

In September 2015, there were 26 accredited training institutions registered in France. This number increased until 2021, year in which the Ministry of Health monitored more closely their compliance with the training criteria established.

On September 1st 2021, the sentence was pronounced: out of 31 osteopathic schools, 9 lost their accreditation due to the “total degradation of the quality of their curriculum”, some suffered a reduction in their enrolment capacity while others were kept under close supervision by the Ministry of Health. Therefore, the beginning of the 2021 academic year registered 8907 students against the 11345 of the previous year. Despite everything, the excluded schools did not give up and asked for a renewal of their certificate which they managed to obtain on September 22, 2021, in a provisional form and limited to the 2021-2022 academic year.

In 2002, it was estimated that there were 4,000 osteopaths in France, for a total of 4 million consultations per year (against around 20 million in 2010). By the end of 2008, the number of osteopaths had more than doubled to 9,808. From 2007 the profession experienced a demographic boom from 2007 which could be explained by the opening of many training institutions, which released to the market a number of osteopath ranging from 2,500 to 3,500 every year. Nevertheless, between 2012 and 2014, there was a significant drop in enrolments due to the regulation of the training system (qualitative criteria, limited annual number of students admitted in each school).

Moreover, as the time went by, an exclusive practice of the profession became more and more common. In 2010, only 43% of osteopaths practiced osteopathy exclusively, but two years later this trend reversed and reached 53%. In 2016, we found 26,222 osteopaths including 14,953 exclusives, that is 57% of them. In December 2017, there were 29,612 osteopaths of which approximately 60% were exclusive according to the ADELI. In January 2022, the percentage of exclusive osteopaths went up to 63%.

Such a boom showed as well in the growing spreading of osteopathy amongst te population and on the easy access to the treatments offered. Here are some clear data: in 2010 there was 1 osteopath out of every 5,566 inhabitants (with 11,608 osteopaths in total) while in December 2021 there was 1 osteopath out of every 1829 inhabitants (with 36,861 osteopaths in total), marking an increase in the osteopathic profession of the 218%. These figures correspond to annual averages calculated throughout the whole territory in the country.

Therefore, in terms of density, France takes the first place in Europe; in fact if we compare the data of Belgium, for example, we will notice a substantial difference; 1 osteopath for every 4,600 inhabitants in 2022. But France’s primacy goes beyond the borders of the old continent to surpass, in terms of density, the osteopathic population of the United States of America,  osteopathy’s native country, which counted 40,000 osteopaths in the same year.

The growing demand for osteopathic treatments was therefore answered by a dazzling increase of osteopaths in the country. Even though the majority of them practiced in the big cities, osteopathy still reached the whole territory, with a stronger concentration in the souther regions (Auvergne-Rhône-Alpes, Occitanie, Provence-Alpes-Côte d’Azur , Nouvelle-Aquitaine). On the other hand, the rural, peri-urban regions north of the Loire region were sanitary deserts, which represented a godsend opportunity for young practitioners.

Starting from 2009, the boom of the profession was accompanied by its progressive feminization. See below the progressive increase of the percentage of women in the profession:

  • 38% in 2014
  • 43% in 2017
  • 45% in December 2021

According to the French Department of Research, Studies, Evaluation and Statistics (Direction de la Recherche, des Études, de l’Évaluation et des Statistiques, DREES) men accounted for 55% of osteopaths in 2021 versus 62% in 2014. Thus, osteopathy was moving towards parity between genders, with a positive trend for female practitioners.

There was also a certain dynamism within the profession, whose population remained particularly young. In 2021, the age group between 25 and 35 represented 34% of osteopaths while those between 35 and 45 represented 30%. Thus, more than one in three osteopaths were under the age of 35 and more than two out of three were under the age of 45.

An increase in the number of substitute osteopaths began to color the osteopathic landscape. In 2012 there were 980 substitutes out of 17,835 osteopaths. Four years later, there were 1,854 out of 26,222 osteopaths.

On the other hand, the number of members of the Regional Health Agency (Agence Régionale de Santé, ARS) – skyrocketed:

  • 70 memberships in 2002
  • 8.971 memberships in 2008
  • 2.116 memberships in 2021

The year 2008 showed a neat increase aa a direct consequence of the 2002 law and the registration of diplomas obtained before. Since 2010, the annual average of ARS registration had settled at around 2,000 units.

To return briefly to the number of consultations, we can deduce a growing curve from the increase in coverage by private health insurance companies, increasingly more open to taking on the costs of osteopathic services.

To understand the role played by osteopathy in French society up to this day, it is essential to observe its sociological and economic aspect.

In 2010, as many as 42% of the population had already consulted an osteopath, however this percentage continued to grow, reaching 67% in 2016. Indeed, it would not be wrong to say that osteopathy was considered rather positively by the French. The survey carried out by the Institute for opinion and marketing studies in France and abroad  (Institut d’études opinion et marketing en France et à l’international, Ifop) for the Osteopathes de France in 2016 showed that more than 1 in 10 French citizens had a “good” opinion of osteopathy while 3 out of 10 had a “very good” one. Furthermore, in this same survey, 9 out of 10 French citizens recognized the efficiency of osteopathy.

A study conducted in 2019 by the Cabinet Asterès Studies & Consulting  (Cabinet Asterès Études & Conseils) and requested by the ROF and CBP Assurances (CBP Assurances) illustrated the economic impact of osteopathy in France. This study selected only two problems treated with osteopathy (low back pain and neck pain), focusing on the more robust and conservative works related to osteopathy.

The study showed that 6% of patients, who in addition to following a so-called “classic” therapy were also treated by an osteopath, obtained a higher recovery rate.This led to a global economic gain. Through the study, the data obtained underlined the fact that the total economic gain  amounted to 67 million euros per year; including 29 million euros in savings for health insurance, the National Health Insurance Fund (Caisse Nationale d’Assurance Maladie, CNAM), 51 million euros in earnings for companies and 13 million euros in additional costs for patients and their supplementary insurance.

By deduction, the impact of osteopathy in France in 2009 could be rated as positive.

The French osteopathic landscape is made up of a variety of different actors, some of which have the task of ensuring its smooth functioning.

  • The Regional Health Agencies (Agences Régionales de Santé. ARS).  In each region there is an agency with the role of monitoring health security to better respond to the needs of the local population and improve the efficiency of the system. There are 19 of them in total throughout the whole French territory.
  • The Ministry of Solidarity and Health (Ministère des Solidarités et de la Santé) develops and implements government policies in the fields of social affairs, solidarity and social cohesion, public health including the organization of the health system.
  • The High Authority of Health (Haute Autorité de Santé, HAS),  responsible for the evaluation of medicines, devices and reimbursement documents; for the development of guidelines; and for the improvement of the quality of hospitals, clinics, city doctors and social and medical-social centres.
  • The Ministry of Sport (Ministère des Sports). This public administration defines the objectives regarding the national sport policy. It establishes the legal framework and must ensure that the general interest is respected.
  • The Ministry of Agriculture and Nutrition (Ministère de l’agriculture et de l’alimentation), responsible for strengthening food independence.

Furthermore, there is a distinction between exclusive and non-exclusive osteopaths that reflects in the creation of separate organizations.

Let us start with Exclusive osteopaths.

  • ROF (mentioned above)
  • The Academy of Osteopathy (Académie d’osteopathie), founded on January 26, 1997, on the initiative of more than 60 osteopaths as a non-profit association, according to the 1901 law, with the help of various trade associations of the time. It defines itself as a place of exchange and reflection on the tradition, philosophy, research and art of osteopathy. Still active today thanks to the volunteer work of many osteopaths who share the same willingness to best serve osteopathy.
  • In addition, there are the Trade Unions that present themselves as spokespersons for the osteopathic profession in front of the government authorities:
    • The Osteopaths of France, formerly UFOF (Ostéopathes de France, ODF, formerly UFOF), established in 1987
    • The French Union of Osteopaths (Syndicat Français des Ostéopathes, SFDO ), established in 1973
    • The National Chamber of Osteopaths (Chambre Nationale des Ostéopathes, CNO), established in 2004 
  • There are also humanitarian associations including:
    • Corp’Ostéo which was created by two Parisian osteopaths in September 2013. The 1901 law association offers osteopathic treatments to the poorest citizens or those in difficulty in terms of health. It brings together people in conditions of poverty, precariousness but also people with disabilities or who live on the margins of society. Location: Paris.
    • The Osteopathic Dispensary for Infants and Children or the Osteopathy Wednesdays (Dispensaire Ostéopathique du nourrisson et de l’enfant ou les mercredis de l’ostéopathie, DONE). Created in March 1998, the association is managed by the osteopaths of Grenoble. It offers voluntary osteopathic consultations for infants and children with disabilities or with financial difficulty. Location: Grenoble and its surroundings.
    • Emerging Countries Humans & Osteopaths (Emerging Countries Humans & Osteopaths, ECHOSTEO):  a non-profit law 1901 association, which has been operating since 2014 thanks to volunteer osteopaths and osteopathic students. Founders Julie Nicolas and Samuel Hagiakan shared the same ambition: to cross geographical and social borders to improve health in developing countries by introducing osteopathy.
  • Judicial experts are professionals who collaborate occasionally with judges. They are consulted to bring their knowledge independently through a report in which they are required to answer only the questions asked. The Board of Exclusive Osteopathic Judicial Experts (Collège des Experts Judiciaires Ostéopathes Exclusifs, CEJOE) is a law 1901 association established in 2012. It became the Company of Exclusive Osteopathic Judicial Experts (Compagnie des Experts Judiciaires Ostéopathes Exclusifs, CEJOE) after the general assembly of  October 21, 2017.

For non-exclusive osteopaths the actors are different, even if there are some who perform the same function as exclusive osteopaths including the trade unions and the judicial experts.

  • The Order of Physicians/Physiotherapists (Ordre des médecins/kinésithérapeutes): a private-law body born in 2004, charged with a public service mission by the Public Health Code. Globally, it operates by helping, both financially and logistically, those operators, or their families, who find themselves in a difficult situation following accidents of life or natural disasters. In short, the Departmental Council of the Order of Doctors (Consiglio dipartimentale dell’ordine dei medici) represents a close interlocutor made available to each operator.
  • The National Academy of Medicine (Académie Nationale de Médecine, ANM) became the heir of the Royal Academy of Surgery (Académie Royale de Chirurgie, 1731) and of the Royal Society of Medicine (Société Royale de Médecine, 1778) on the initiative of Baron Portal. In 1820, the foundation of the National Academy of Medicine was proclaimed by Louis XVIII. Today, it answers questions posed by the government in the area of public health. The peculiarity of this istitution is that it is entitled to a certain degree of freedom with regard to the publication of opinions or statements, despite being intended for a large circulation. In fact, government authorities might request its opinion, but the ANM can also act on its own initiative on health issues, in particular issues of public health and medical ethics. Furthermore, it is dedicated to the improvement of medical and pharmaceutical sciences and their application.
  • The Trade Unions for non-exclusive osteopaths:
    • The French Federation of Rehabilitation Massage Therapists (Fédération Française des masseurs-kinésithérapeutes rééducateurs, FFMKR) since 1963;
    • The National Union of Rehabilitative Masseur-Kinesiotherapists (Syndicat National des Masseurs-kinésithérapeutes rééducateurs, SNMKR ) since 1977.
  • For Osteopathic Physicians:
    • The Osteopaths of France (Les Ostéos de France) since 1998
  • As an example of judicial experts, we can mention the National Company of Judicial Experts in Osteopathic Medicine  (Compagnie nationale des Experts Judiciaires en Médecine Ostéopathique, CNEJMO) which is an association law 1901, created in 2011.

However, the list of actors does not nd here but goes quite beyond that. We can go on with a non-exhaustive list to give a preview of the wide range available in the French osteopathic scene.

  • Trade associations: click on the link to consult the list.
  • Students’ Associations:
    • The students of the Higher Institute of Osteopathy Paris (Institut Supérieur d’Ostéopathie Paris, ISO Paris) together set up the Osteopathic Students of the World (Étudiants Ostéopathes du Monde, EOM). The association offers osteopathic consultations in various parts of the world to populations that do not yet benefit from osteopathy. It also has a humanitarian side to it,  consisting in the distribution of clothes, medical and school materials, and more, to the populations of the areas where they operate.
    • The National Federation of Osteopathy Students (Fédération Nationale des Étudiants En Osteopathie, FéDEO), founded in 2013, gathers all osteopathic students living in France. It brings together 10 associations out of 31 osteopathic schools. It has multiple purposes, including the defense of individual and collective rights, the updates on the development of osteopathic education and on the osteopathic world in general, the gathering of several osteopathic student associations, the training of the different actors in the network of the associative world and a collective creation of the future of osteopathy.
    • The E&D is a national association of international solidarity and popular education that supports a network of associations law 1901, whose management is entrusted to young people and/or students. It seeks to weave ties based on the principle of global solidarity.
  • School associations:
    • Since June 2004 the ESO Solidaire has been providing humanitarian aid in Africa. It wants to raise awareness of the preventive health system but also give access to osteopathic care to those who live in health deserts.
  • Patient Association:
    • The Today Health Osteopathy (Aujourd’hui Santé Ostéopathie, ASO) fights to fights to assert the rights of free will in the field of medical care by acting in favor of osteopathy.
  • Associations for people with disability:
    • The Circle of Osteopaths of the Basque Country (Cercle des Ostéopathes du Pays Basque, COPB) is a treatment center that offers osteopathic treatment to children with disability.

  • Booth ER. (1924) History of Osteopathy and Twentieth-Century Medical Practice. Cincinnati, OH: Caxton Press; 1924
  • Brousseau P. Specific Adjusting Technic/SAT Hommage à Thomas George Dummer, DO. ApoStill, Janvier 2000 – n. 5:59-63.
  • Cardin H. Guérison et protection du dos. Carnot, Chatou, Francia 2004 
  • Lavezzari R. Que faut-il entendre par hystérie? Tesi discussa presso la Facoltà di Medicina di Montpelllier, 4 luglio 1913. Montpellier: Firmin et Montane, 1913.
  • Lavezzari R. Une nouvelle méthode clinique et thérapeutique: l’ostéopathiei, 1949.
  • Moutin L., Mann GA. Manuel d’ostéopathie pratique, théorie et procédés Pairs: Librairie Internationale de la Pensée Nouvelle, G.A. Mann éditeur, 1913.
  • Osteopathic International Alliance. The OIA Global Report:  Global Review of Osteopathic Medicine and Osteopathy 2020, 2020.
  • Loi n° 2002-303 Kouchner, relative aux droits des malades et à la qualité du système de santé : article 75; 4 mars 2002, Assemblée Nationale; NOR : MESX0100092L; JORF du 5 mars 2002 Texte n° 1
  • Loi n°2002-1062 portant amnistie : article 3 II ; 6 août 2002, Assemblée nationale; NOR: JUSX0200109L; JORF du 9 août 2002 Texte n° 1
  • Décret n° 2007-435 relatif aux actes et aux conditions d’exercice de l’ostéopathie; 25 mars 2007, Assemblée Nationale; NOR: SANH0721330D; JORF n°73 du 27 mars 2007 Texte n°20
  • Loi n° 2009-879 Hôpital-Patient-Santé-Territoire portant réforme de l’hôpital et relative aux patients, à la santé et aux territoires; 21 juillet 2009, Assemblée Nationale; NOR: SASX0822640L;
  • Arrêté 12 juillet 2012 relatif à la mise en place d’un traitement de données à caractère personnel dénommé ADELI de gestion de l’enregistrement et des listes départementales de certaines professions et usages de titres professionnels; 12 juillet 2012, Assemblée Nationale; NOR: AFSE1128927A,
  • Loi n° 2014-201 portant diverses dispositions d’adaptation au droit de l’Union européenne dans le domaine de la santé; 24 février 2014, Assemblée Nationale; NOR: AFSX1315898L; JORF n°0047 du 25 février 2014 Texte n°4

  • The events that led to the legal recognition:
  • An overview of the demographics of French osteopathy:éopathie-en-france#:~:text=En%202002%2C%20l%27Assemblée%20Nationale,l%27usage%20du%20titre%20ostéopathique
  • The impact of osteopathy in France:
    État des lieux de l’ostéopathie en 2022; 9 Février 2022; Erwan-Oosteoéopathes-de-France-juin-19.pdf
  • The actors of osteopathy:


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The spread of osteopathy outside the United States

The History of Osteopathy in the UK

In the late 19th century osteopathy made its debut in the United Kingdom as well, mainly thanks to the decisive contribution of J.M. Littlejohn, founder of the first osteopathy school in the country. The following years were characterized by turmoil and expansion, marked by the opening of various schools and professional associations, whose relationships were not without antagonisms and disagreements. However, starting from the early 1980s, British osteopaths were able to organize a united front, achieving extraordinary results in a very short time.