Understanding specific, contextual and non-specific effects in osteopathy

Abstract Osteopathic care has been a part of the healthcare landscape for many years, and whilst diverse in its practice, in many world regions it has a predominant focus on musculoskeletal care. Despite the extensive history of osteopathy, the paradigms, principles and modes of effect that occur within its delivery lack consensus. Of the proposed modes of effect, many are based on specific and local phenomena that lack robust evidence supporting their proposed mechanisms. Recent research has promoted a shift away from exclusively explaining clinical outcomes through specific effects but rather, conceptualising these outcomes through the interplay of specific, non-specific and contextual effects. An improved understanding of this interplay is critical for osteopathy and, indeed, all other professions involved in musculoskeletal care. Reconceptualising the effects involved in clinical interventions will contribute to improved health outcomes through the facilitation of person-centred care and the adoption of the biopsychosocial model of healthcare.