Welcome on sofmmoo.org The website of The French Society of Orthopaedic and Osteopathic Manual Medicine

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Welcome to our foreign visitors on www.sofmmoo.com. SOFMMOO means French Society of Orthopaedic and Osteopathic Manual Medicine. We are a scientific society the membership of which is restricted to MDs, but this website may interest any back care provider, although it is not designed for a more general public. Our visitors are coming from French speaking countries for 40%, and from the US for another 40%. Presently (November 2004), we receive 7 to 8OO visitors a day.

What is the SOFMMOO?

The complicated name of our society is a tribute payed to our roots. First, our members are all MDs practising manual medicine. This means that they use manual treatments, beside more classical ones (such as drugs, injections, physiotherapy or surgery) to treat their patients. A manual treatment is comprised of mobilisations, muscle energy technics and thrust manipulations. They use these maneuvers to treat back pain, pain referred from the spine and some forms of pain from peripheric joints, provided the lesion involved is purely "mechanical" (i.e. there is no inflammatory component). These technics are osteopathic in origin, but our approach is different and refers to "Orthopaedic Medicine", a route opened by Cyriax in Britain and by Robert Maigne in France, who founded the SOFMMOO in 1965.

Robert Maigne (born 1923), is a MD who, after specialising in rheumatology, spent one year in London (UK) in 1950, to learn osteopathy. One of his teacher was Myron Beal, a worldwide known osteopath. Back in France, he worked ten years in a private setting and progressively gave up traditional osteopathy before publishing his first book on spinal pain syndromes and their treatments by manipulations. The book was prefaced by Pr de Sèze, a prominent French rheumatologist reknown for his studies on the intervertebral disc, common sciatica and back pain. Manipulations were thus introduced into the medical world at a time where they were regarded by many as a doubtful modality of treatment, and when they were only a handful of manual practitionners.

In the following years, Robert Maigne described what he considered to be the basic painful lesion of the vertebral motion segment, the "Painful Minor Intervertebral Dysfunction" (PMID, or DIM in French), often accompanied by palpable changes in the soft tissues of the corresponding metamere ("cellulomyalgic syndrome"). He also described many vertebral syndromes related to common pain: headache of cervical origin, interscapular pain of cervical origin, costal sprains, and low back pain arising from the thoracolumbar junction, now widely known as the "Maigne's syndrome". Some of his basic papers in English are on this website. He put a strong emphasis on the role of the cutaneous dorsal rami and was the first to ascertain the role of the cervical, thoracic and lumbar facets in common pain, on the basis of anesthetic injections, four years before the publication by Mooney and Robertson. He succeded in establishing a universitary diploma of orthopaedic medicine in 1969, in which a large span of time was devoted to manual techniques. After all, his main achievements was to find out a logical basis for painful spinal syndromes, far from the concepts of "hypomobility" and "holistic medicine" and to have made the spinal manipulations part of the conservative management of the spinal pain patients.

He authored two other medical books, the last one in 1989, translated in English and published in 1996 (Diagnosis and Treatment of Pain of Vertebral Origin, A Manual Medicine Approach. Lippincott, Williams & Wilkins, now out of stock). There is an interview with him in English at Maîtrise Orthopédique.

Who practices Manual Medicine in France?

In France, manual medicine is practised by GPs, rheumatologists and physiatrists. This specialty is taught in the majotity of our medical schools (state owned universities of medicine), as a specific university diploma, in two years. Beside the school of Robert Maigne, there is another medical school, more directed to traditional osteopathy, but without a universitary basis. A figure of 2000 MDs practising manual medicine is widely accepted.

A law passed in 2002 legalizes chiropractic and osteopathy teached in private schools.

The role of the SOFMMOO

The SOFMMOO works as any scientific society in the medical field. We run an annual congress, a journal (the Revue de Médecine Vertébrale) and seminars for post-graduates. We also put forward recommendations of good practice. From 1988 to 2000, we also ran an International Course opened to foreign MDs. The course was run in English and lasted two weeks. It gave us the opportunity to meet doctors from all over the world and to spread our approach of vertebral pain.

The SOFMMOO is a fonding member of the FIMM, the International Federation of Manual Medicine. The SOFMMOO is involved in the different comitees of the FIMM and acts as an active member of this federation.