Osteopathy
Overview
What is osteopathy?
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 inseparable. The musculoskeletal system is comprised 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 viewed to be
the ineffective and hazardous nature of remedies at that time. He
believed that the doctor's role in combating disease was to restore
proper musculoskeletal function to the body. Despite mainstream
opposition, 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.
In 1896, Vermont became the first state to license DOs and the
American Osteopathic Association was formed in 1901 to regulate the
profession. Even with these important milestones, those in conventional
medicine continued to disapprove of osteopathy until 1962 when DOs had
full practice rights in all 50 states. By 1973, the California Medical
Association invited DOs to join and become voting members.
Today, doctors of osteopathy (D.O.s) receive the same basic training
as medical doctors (M.D.s), and D.O.s also learn manipulation therapies
(hands-on adjustments of muscles, bones, and ligaments) and use 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.
According to the American Osteopathic Association, there are well
over 40,000 osteopathic physicians practicing in the United States today
(that's 5% of all physicians in the country), and 100 million people
visit D.O.s each year. Although osteopathic manipulations were
originally intended and used to treat all forms of disease, now they are
mainly mainly considered useful for musculoskeletal conditions.
How does osteopathy work?
Long nerves connect the spine to various organs in the body. Andrew
Taylor Still believed that every disease or illness began with
structural problems in the spine. According to Still, 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. With structure restored,
the body's own natural healing powers would then be able to restore the
entire body to full health.
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, 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 be more extensive than one with your family doctor. During
the physical, the D.O. will assess your posture, spine, and balance;
check your joints, muscles, tendons, and ligaments; and may use his or
her 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 current day (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. He or she 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. One study showed that patients with pancreatitis were able
to go home from the hospital sooner when they had OMT.
In one small study, people with Parkinson's disease were able to walk
better after only one session of OMT. Another study looked at 38
patients who had knee surgery. Those who had OMT were able to walk up
stairs 20% earlier than those who did not have OMT.
A study of 100 people with high blood pressure treated only with OMT
showed that OMT produced significant reductions in blood pressure.
Studies show that OMT eases breathing, drains the sinuses and
relieves the symptoms, duration, and recurrence of the common cold.
Osteopathy may also be an effective way to treat carpal tunnel
syndrome. More studies are needed to confirm this.
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
- osteoarthritis
- headaches
- painful menstruation
- injuries (such as whiplash)
- scoliosis (side to side curvature of the spine)
- infantile colic
- insomnia
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 also not recommended for people who recently
underwent joint surgery nor for people taking an anticoagulant (blood
thinning) medication.
Are there risks associated with osteopathy?
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 rare.
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), call the AOA at 800-621-1773 or
visit their Web site at
http://www.aoa-net.org . For additional information or referrals,
contact the American Academy of Osteopathy at 317-879-1881 or on the web
at
www.aao.medguide.net or the American College of Osteopathic Family
Physicians at 800-323-0794 or www.acofb.org.
Supporting Research
American Osteopathic Association. What is a doctor of osteopathic
medicine (D.O.)? Accessed July 27, 2002 at
http://www.aoa-net.org/Consumers/whatdo01.htm
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A comparison of osteopathic spinal manipulation with standard care for
patients with low back pain. N Engl J Med.
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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. Altern Ther
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Sucher BM. Palpatory diagnosis and manipulative management of carpal
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