Osteopathy is based on the belief that most diseases are related to problems
in the musculoskeletal system and that structure and function of the body are
The musculoskeletal system is comprised of the muscles, bones, and soft-tissues
like cartilage, tendons, and ligaments. All of these structures are interconnected
and form the body's framework. Nerves originating in the spinal cord create
an important network throughout the body and are highly connected to the musculoskeletal
Doctors of osteopathy (D.O.s) receive the same basic training as medical doctors
(M.D.s). D.O.s also learn manipulation therapies (hands-on adjustments of muscles,
bones, and ligaments), using these in addition to more conventional medical
treatments. Most D.O.s are primary care practitioners, specializing in family
medicine, internal medicine, obstetrics/gynecology, or pediatrics. A few can
be found in other medical specialties as well. D.O.s have full practice rights
in all 50 states.
Although osteopathic manipulations were originally intended and used to treat
all forms of disease, now they are mainly considered useful for musculoskeletal
How does osteopathy work?
Long nerves connect the spine to various organs in the body. According to
Andrew Taylor Still, the founder of osteopathy, when problems arise in the
spine the nerves send abnormal signals to the body's organs. Still called these
spinal problems "osteopathic lesions" ("osteo" for bone and "pathic" for diseased),
and devised osteopathic manipulation techniques (OMTs) to treat them. Such
lesions are detected by the osteopathic doctor from abnormal texture of the
skin and other soft tissues of the body as well as from restricted range of
motion in the joints.
OMTs range from light pressure on the soft tissues to high-velocity thrusts
on the joints. These treatments, he believed, would return the nerves to their
normal function and allow the blood to flow freely throughout the circulatory
system. Mr. Still theorized that with structure restored, the body's own natural
healing powers are then able to restore the entire body to full health.
What happens during a visit to
A visit to a D.O. is much like a visit to your family doctor. The D.O. will
ask you questions about your medical history, physical condition, and lifestyle.
However, because D.O.s have particular expertise in musculoskeletal systems
(namely, bones, joints, and soft tissues like ligaments and tendons), the physical
exam of that bodily system will likely be more extensive.
During the physical, the D.O. will assess your posture, spine, and balance;
check your joints, muscles, tendons, and ligaments; and may use their hands
to manipulate your back, legs, or arms. Variations in your skin temperature
and sweat gland activity will also be measured. If needed, the D.O. will order
x-rays and laboratory tests.
When the results are in, the D.O. will make a diagnosis and establish a treatment
plan for you that may even include prescriptions for medications.
For problems involving the bones, muscles, tendons, tissues, or spine, many
(but not all) D.O.s use OMTs. There are two categories of OMT procedures: direct
and indirect. In direct OMT, "problem" or "tight" tissues are moved (by the
D.O., the person being treated, or both) toward the areas of tightness or restricted
movement. In indirect OMT, the D.O. pushes the "tight" tissues away from the
area of restricted movement, in the opposite direction of the muscle's resistance.
The D.O. holds the tissues in this position until the tight muscle relaxes.
What illnesses and conditions respond
well to osteopathy?
OMTs can be applied to a variety of health problems, both musculoskeletal
and non-musculoskeletal. According to the US Department of Health and Human
Services, OMTs are most effective for back and neck pain. In fact, if you have
back pain, you may be able to reduce the amount of pain medication you are
taking if you receive OMT as part of your therapy.
Examples of other conditions for which OMT may be helpful include:
- Stress-related problems (such as tension headaches, muscle spasm)
- Strains and sprains (especially of the neck and back)
- Shoulder pain
- High blood pressure
- Injuries (such as whiplash or carpal tunnel syndrome)
- Sinus congestion
Who should not be treated with
You should avoid osteopathic manipulation if you have a broken bone or dislocation,
bone cancer, a bone or joint infection, damaged ligaments, rheumatoid arthritis
of the neck, or osteoporosis. Osteopathic manipulation is also not recommended
for people who recently underwent joint surgery or for people taking an anticoagulant
(blood thinning) medication.
Are there risks associated with
Shortly after an OMT treatment you might feel an increase in pain, slight
headache, or fatigue. These symptoms are temporary, and generally disappear
within a day. More serious adverse events of stroke and spinal injury have
been reported following manipulation of the neck; this complication is extremely
How can I find a qualified practitioner?
To locate a licensed D.O. in your area that has been trained in one of the
19 medical schools and 200 teaching hospitals approved by the American Osteopathic
Association (AOA), visit the AOA's web site at www.osteopathic.org.
For additional information or referrals, visit the American Academy of Osteopathy
web site at www.academyofosteopathy.org, or the American College of Osteopathic
Family Physicians web site at www.acofp.org.
Review Date: 4/6/2007
Reviewed By: Benjamin D. Roye, M.D., M.P.H., Orthopaedic Surgery, The Mount Sinai Hospital, New York, NY. Review provided by VeriMed Healthcare Network.
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