Frequently Asked Questions about Osteopathy
What is Osteopathy?
In the United States, an Osteopathic Physician is a full fledged medical doctor trained in all aspects of medicine, surgery, and obstetrics. Our profession was founded on the philosophy that the human body has the innate ability to heal itself.(See “The Osteopathic Concept.”). The structure and function of the body are so intimately related that one directly affects the other. The goal of an osteopathic physician is to optimize the healing ability of each patient through understanding this structure-function relationship. If the body’s structure is impaired the function is sub-optimal. If the structural abnormalities overwhelm the bodies ability to compensate dis-ease sets in.
Osteopathic physicians are trained in the basic sciences of anatomy, physiology, biochemistry, pharmacology, etc. and clinical medical/surgical specialties like orthopedics, internal medicine, pediatrics, family practice, cardiology, ob/gyn, neurosurgery etc. This is equivalent to M.D. training. There are lots of D.O.’s in this area. Another part of our training is in Osteopathic Manipulative Medicine i.e. “osteopathic manipulation”. From the first day of anatomy class Osteopaths are educated in the interrelationship of structure (anatomy) and function (physiology/biomechanics).Through this understanding, hands-on techniques are used to influence motion in various parts of the body. We were made to move!
Many may think of Chiropractic when I say, “manipulation”. Osteopathic philosophy was founded in the same “era” as chiropractic. In the mid to late 1800’s, Andrew Taylor Still, the founder of Osteopathy was an active medical doctor at that time and developed its philosophy. He founded the first Osteopathic Medical School in 1892 in Kirksville, MO called the American School of Osteopathy. There has been approxiamately 110 years of growth in the United States. Some early students traveled to England and Europe and started schools of Osteopathy overseas and in Canada. Today, there are about 16+ colleges of Osteopathic Medicine in the United States. Osteopaths trained in the United States have equivalent standards, medical school-residency training, practice rights and privilegesand lisensure as M.D.’s as well as formal training in manipulation. That translates into diagnosing medical problems, writing prescriptions for medication, managing sick people in the hospital/office based care and using all we know to optimize health, and diagnose disease.
Andrew Taylor Still the founder of Osteopathic medicine theorized that the body needed adequate circulation of blood, nervous system input/flow, and lymphatic drainage to maintain it self. A basic difference between chiropractic philosophy is their founder Dr. Palmer felt the nerve was supreme and every thing else was secondary.There is some historical writing to suggest that Dr.Still and Dr. Palmer both MD’s in the early 1900’s knew each other and lived in the Kansas territory at the same time. Needless to say they were contempories but, started different schools of thought.
Osteopathic doctors practice equivalently to medical doctors. We prescribe medication, go to hospitals, recommend/perform appropriate surgery, diagnose illnesses, order tests just like other doctors of medicine. What is unique is the concept of Somatic Dysfunction. All Osteopaths are trained in this concept. By graduation from medical school, they have met a specific level of proficiency in manual medicine i.e. manipulation The big difference is whether the individual Docs keep up by practicing manipulation routinely along with the other ways of being a doctor. Some Osteopaths do not practice manipulation at all yet provide excellent medical care through use of the many other facets of medical practice including surgery. Some Osteopaths provide a little manipulation and others incorporate it into each visit if appropriate. Some are so specialized that manipulation is the cornerstone of their practice.
What is the Osteopathic Concept?
Osteopathic medicine is a philosophy of health care and a distinctive art, supported by expanding scientific knowledge; its philosophy embraces the concept of the unity of the living organism’s structure (anatomy) and function (physiology). Its art is the application of the philosophy in the practice of medicine and surgery in all its branches and specialties. Its science includes the behavioral, chemical, physical, spiritual, and biological knowledge related to the establishment and maintenance of health as wall as the prevention and alleviation of disease. Osteopathic concepts emphasize the following principles:
1. The human person is a unit in which structure, function, mind and spirit are mutually and reciprocally interdependent.
2. The body, through a complex equilibrium system, tends to be self-regulatory and self-healing in the face o disease processes.
3. Adequate function of the body systems depends upon the unimpeded circulatory mechanisms, nerve impulse, and neurotrophic influences.
4. A rational treatment regimen is based on the philosophy and these principles.
What Is Somatic Dysfunction?
Somatic Dysfunction is altered anatomy that represents altered function. Somatic Dysfunction is diagnosed by palpating the body for TART :
Tissue texture changes, Asymmetry of motion, Restricted range of motion, and Tenderness. These findings imply impaired or altered function in the body. If the structure or function of our body’s defense mechanisms is overwhelmed, the body may not be able to defend itself optimally, which can lead to “dis-ease”. By treating these areas, we know we are optimizing the body’s ability to protect and heal by maintaining optimal blood flow, nervous system input and lymphatic drainage.
What causes or effects somatic dysfunction?
Physical posture, trauma-major or minor, repetitive overload syndromes, infections, emotional, mental stressors, allergies, viral/bacterial illnesses, inadequate nutrition,
I.E. Life! Many diseases have somatic dysfunction related to them.
How does our emotional state influence Somatic Dysfunction?
We are physical, emotional, mental, spiritual beings that are highly integrated such that our mental or emotional state impacts our physical body and visa versa. How many of you accept that stomach ulcers can be caused by worrying? How about the pain in your neck that comes from thinking about that problem you need to solve, or the weight of the world that is on your shoulders by the decisions you have to make and how you feel overwhelmed with responsibility. Get the picture? The point is that our physical body is so intimately related to our emotional, mental, spiritual states that somatic dysfunction can be present before significant physical problems or disease occur. It is a two way street. Our body is made to move in a variety of ways that promotes good health. This not only means exercise, but I mean the heart must pump, the lungs must breath, the blood must circulate, muscle must contract, the nervous system must perceive and stimulate. All work in concert, gross motion and subtle motion, for us to FUNCTION in the world.
What is Manipulation?
The goal of manipulation is directed at treating what osteopaths call “somatic dysfunction”. (See Somatic Dysfunction)
The goal of manipulation is to treat this somatic dysfunction. A basic example of this is when we get a cold or bronchitis. We get stuffy, headachy, neck pain, runny nose, want to cough but can not cough cause everything hurts. By mobilizing the ribs, the neck and lower back the body can do what it needs to, cough up and out, flush and heal itself of the viruses or bacteria. There are a variety of techniques to mobilize the structures of the body.
I really want to dispel the myth about manipulation- it does not have to HURT! What many people have experienced from chiropractic and osteopathic alike is what is called “high velocity-low amplitude” thrust techniques delivered to the neck or back. (also known as, “ HVLA”.) The wind up and “thrust through the painful barrier”. This type of technique is NOT the only type of manipulation technique. In my experience when the forces are localized very specifically very little force has to be applied to mobilize the barrier. HVLA is effective when used appropriately, but it is not the only type of techniques. There are many others that can be used effectively.
What are the types of manipulation?
General categories: Osteopathy in the Cranial Field, high velocity-low amplitude, myofascial release, counterstrain, ligamentous articular release, facilitated positional releases, lymphatic pump drainage techniques, visceral releases, Chapman’s Reflexes.
There are a least 6 different basic types of manipulation techniques Osteopaths are trained in. These include High velocity low amplitude, muscle energy, counterstrain, facilitated positional release, craniosacral, myofascial release.
Just know there is a variety of techniques and they do not need to hurt you. There are also other techniques that chiropractors and osteopaths use that I have not mentioned like the activator or percussion/vibration techniques. These are beyond the scope of this talk but they are useful and predominately not invasive.
What is post manipulation soreness?
The body’s response to the new freedom of motion and position. Other areas need to adjust to this restoration of motion, freedom or symmetry. This soreness can last 24 to 72 hours if that. You can feel really sore, yet it is one of those good pains increased muscle spasm can occur and if out right pain occurs ice is often your best friend and talk to your doctor to see if something needs to be looked over. Our bodies compensate so well that sometimes a large stress or injury do not seem to cause a lot of grief. Yet another seemly minor insult can be the last straw on the camels back that breaks it.