Osteopathy

Overview

What is osteopathy?

Osteopathy, or osteopathic medicine, 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 related. The musculoskeletal system is made of the nerves, muscles, and bones -- all of which are interconnected and form the body's structure.

What is the history of osteopathy?

Osteopathy was founded in 1874 by Andrew Taylor Still. Still was a Missouri physician who had become frustrated with what he saw as the ineffective nature of remedies at that time. He believed that the doctor's role in fighting disease was to restore the body’s proper musculoskeletal function. Still founded the American School of Osteopathy in Missouri in 1892. The school taught manual manipulation, nutrition, and lifestyle modifications rather than surgery and drug therapies.

The American Osteopathic Association was formed in 1901 to regulate the profession. In 1962, doctors of osteopathy (D.O.s) were recognized for full practice rights in all 50 states (provided they obtain a license in any given state). By 1973, the California Medical Association invited D.O.s to join and become voting members.

Today, D.O.s get the same basic training as medical doctors (M.D.s), but they also learn manipulation (hands on adjustments of muscles, bones, and ligaments) and use this along with more conventional medical treatments. Most D.O.s are primary care practitioners, specializing in family medicine, internal medicine, obstetrics/gynecology, or pediatrics.

D.O.s practice in all specialties of medicine ranging from emergency medicine and cardiovascular surgery to psychiatry and geriatrics. D.O.s trained in various specialty areas take a whole patient (holistic) approach.

According to the American Osteopathic Association, more than 64,000 osteopathic physicians practice in the United States today. Although osteopathic manipulations were once used to treat all forms of disease, now they are considered useful mostly for musculoskeletal conditions (such as back pain).

How does osteopathy work?

Andrew Taylor Still believed that every disease or illness began with structural problems in the spine. Long nerves connect the spine to various organs in the body. According to Still, when there is a problem with 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 created osteopathic manipulation techniques (OMTs) to treat them. These treatments, he believed, would return the nerves to their normal function and allow the blood to flow freely throughout the circulatory system. With structure restored, the body's own natural healing powers would be able to restore full health.

Osteopathy also pioneered the techniques that have become known as craniosacral therapy, which is now practiced in different disciplines. Craniosacral therapy is the gentle manipulation of the bones of the skull to restore balance to the whole body.

What happens during a visit to the osteopath?

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, the physical exam of your bones, joints, muscles, ligaments, and tendons will be more extensive than with your family doctor. During the physical, the D.O. will look at your posture, spine, and balance; check your joints, muscles, tendons, and ligaments; and may use his hands to manipulate your back, legs, or arms. He may also measure changes in your skin temperature and sweat gland activity. 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 set up a treatment plan for you that may include prescription medications.

For problems involving the bones, muscles, tendons, tissues, or spine, many 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. In indirect OMT, the D.O. pushes the "tight" tissues away, 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?

Most osteopathic doctors use many of the medical and surgical treatments used by medical doctors. OMTs are used to treat a variety of health problems, both musculoskeletal and non musculoskeletal. The best scientific evidence shows that OMTs are most effective for back and neck pain. In fact, you may be able to reduce the amount of pain medication you are taking for back pain if you receive OMTs as part of your therapy.

Some preliminary evidence also shows that OMTs may be helpful for:

  • Low back pain
  • Ankle injuries
  • Asthma
  • Fibromyalgia
  • Tennis elbow
  • Neck pain
  • Chronic obstructive pulmonary disease (COPD)
  • Recovery after surgery
  • Menstrual pain
  • Depression
  • Irritable bowel syndrome (IBS)

Are there conditions that should not be treated with osteopathy?

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 not recommended for people who recently underwent joint surgery or for people taking an anticoagulant (blood thinning) medication, such as aspirin or warfarin (Coumadin).

Are there risks associated with osteopathy?

Shortly after an OMT treatment you might feel an increase in pain, slight headache, or fatigue. These side effects are temporary, and generally disappear within 4 - 24 hours. More seriously, stroke and spinal injury have been reported following manipulation of the neck. This complication is extremely rare.

How can I find a qualified practitioner?

Locate a licensed D.O. in your area who has been trained in one of the medical schools or teaching hospitals approved by the American Osteopathic Association (AOA), at www.osteopathic.org.

For additional information or referrals, see:

References

Brantingham JW, Globe G, Pollard H, Hicks M, Korporaal C, Hoskins W. Manipulative therapy for lower extremity conditions: expansion of literature review. J Manipulative Physiol Ther. 2009 Jan;32(1):53-71. Review.

Earley B, Luce H. An Introduction to Clinical Research in Osteopathic Medicine. Primary Care: Clinics in Office Practice. 2010;37(1).

Eisenhart AW, Gaeta TJ, Yens DP. Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries. J Am Osteopath Assoc. 2003;103(9):417-421.

Gamber RG, Shores JH, Russo DP, et al. Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc. 2002;102(6):321-325.

Guiney PA, Chou R, Vianna A, et al. Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized controlled trial. J Am Osteopath Assoc 2005;105(1):7-12.

Hing WA, Reid DA, Monaghan M. Manipulation of the cervical spine. Man Ther. 2003;Feb, 8(1):2-9.

Hondras MA, Linde K, Jones AP. Manual therapy for asthma. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001002. Review.

Hundscheid HW. Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study. J Gastroenterol Hepatol. 2007;22(9):1394-8.

Huntzingkr A. AAP Publishes recommendations for the diagnosis and management of bronchiolitis. Am Fam Physician. 2007 Jan 15;75(2); 265-244.

Jarski RW, Loniewski EG, Williams J, et al. The effectiveness of osteopathic manipulative treatment as complementary therapy following surgery: a prospective, match-controlled outcome study. AlternTher Health Med. 2000;6(5):77-81.

Licciardone J, Gamber R, Cardarelli K. Patient satisfaction and clinical outcomes associated with osteopathic manipulative treatment. J Am Osteopath Assoc. 2002;102(1):13-20.

Licciardone JC, Stoll St, Cardarelli KM, et al. A randomized controlled trial of osteopathic manipulative treatment following knee or hip arthroplasty. J Am Osteopath Assoc. 2004;104(5):193-202.

Licciardone JC, Brimhall AK, King LN. Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2005 Aug 4;6:43.

Lombardini R, Marchesi S, Collebrusco L, Vaudo G, Pasqualini L, Ciuffetti G, Brozzetti M, Lupattelli G, Mannarino E. The use of osteopathic manipulative treatment as adjuvant therapy in patients with peripheral arterial disease. Man Ther. 2009 Aug;14(4):439-43.

McReynolds TM, Sheridan BJ. Intramuscular ketorolac versus osteopathic manipulative treatment in the management of acute neck pain in the emergency department: a randomized clinical trial. J Am Osteopath Assoc. 2005 Feb;105(2):57-68.

Rakel. Rakel: Integrative Medicine, 2nd ed. Philadelphia, PA: Saunders Elsevier, Inc. 2007.

Spiegel AJ, Capobianco JD, Kruger A, Spinner WD. Osteopathic manipulative medicine in the treatment of hypertension: an alternative, conventional approach.Heart Dis. 2003;5(4):272-278.

Suchowersky O. Practice parameter: neuroprotective strategies and alternative therapies for parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006 Apr 11;66(7): 976-82.

Wahl RA, Aldous MB, Worden KA, Grant KL. Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial. BMC Complement Altern Med. 2008 Oct 2;8:56.

Williams NH, Wilkinson C, Russell I, et al. Randomized osteopathic manipulation study (ROMANS): pragmatic trial for spinal pain in primary care. Fam Pract. 2003;20(6):662-669.

Alternative Names

Osteopathic medicine; Osteopathic manipulative technique (OMT)

Version Info

  • Last Reviewed on 10/13/2011
  • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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This page was last updated: May 7, 2013

         
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