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
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
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
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
- stress-related problems (such as tension headaches, muscle
- strains and sprains (especially of the neck and back)
- shoulder pain
- painful menstruation
- injuries (such as whiplash)
- scoliosis (side to side curvature of the spine)
- infantile colic
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
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.
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