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  » Alternative Medicine  »  Osteopathy

What is osteopathy?

Osteopathy is based on the belief that all diseases are related to problems in the musculoskeletal system. The musculoskeletal system is comprised of the nerves, muscles, and bones—all of which are interconnected and form the body's structure.

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. In 1892, Still founded the American School of Osteopathy—a school that taught manual manipulation, nutrition, and lifestyle modifications rather than surgery and drug therapies.

Today, doctors of osteopathy (D.O.s) receive the same basic training as medical doctors (M.D.s), but D.O.s use manipulation therapies (hands-on adjustments of muscles, bones, and ligaments) 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 about 44,000 osteopathic physicians practicing in the United States today, and 100 million people visit D.O.s each year. Although osteopathy was originally used to treat all forms of disease, it is now mainly considered useful for musculoskeletal conditions.

How does it 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. Still theorized that problems arise in the spine and as a result the nerves send "danger 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. 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. You can expect your first visit to last 30 to 60 minutes and subsequent visits 20 to 30 minutes. The D.O. will ask you questions about your medical history, physical condition, and lifestyle. However, because a D.O.'s emphasis is on the musculoskeletal system, the physical exam 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. 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 include prescriptions for medications.

For problems involving the bones, muscles, tendons, tissues, or spine, many D.O.s (but not all) 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?

According to the American Osteopathic Association, OMTs are most effective for back and neck pain, allergies, asthma, chronic fatigue, heartburn, high blood pressure, migraines, pediatric middle ear infections, repetitive stress injuries, headaches, and premenstrual syndrome (PMS).

Are there conditions that should not be treated with osteopathy?

You should avoid osteopathic manipulation if you have bone cancer, a bone or joint infection, or osteoporosis. Osteopathic manipulation is also not recommended for people with serious back injuries.

Is there anything I should watch out for?

Be sure not to confuse cranial osteopathy with craniosacral therapy. Cranial osteopathy is an OMT practiced by D.O.s. It is an indirect technique by which D.O.s gently adjust membranes and ligaments in a person's head.

Craniosacral therapy, on the other hand, is a version of cranial osteopathy that is not practiced by D.O.s. The therapists who practice this technique do not have medical school training and cannot diagnose and treat disease like D.O.s. Most of these therapists are bodyworkers, massage therapists, or physical therapists who have learned craniosacral therapy through a series of short courses.

How can I find a qualified practitioner?

To locate a 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 312-280-5800 or visit their Web site at http://www.aoa-net.org/.

How much does a treatment cost?

A visit to an osteopathic physician will cost about the same as a visit to your family doctor. The first visit can range from $200 to $300 and follow-up visits may cost from $125 to $150.

How many treatments will I need?

Like most other forms of medical care, the number of treatments needed depends upon the illness being treated. Most people seeking OMT for common conditions like back and neck pain will require 3 to 6 sessions.

Will my medical insurance cover osteopathy treatments?

Because most D.O.s are primary care family doctors, insurance companies tend to cover osteopathy. Check with your insurancG company to see what your policy offers.

Supporting Research

American Osteopathic Association. What is a doctor of osteopathic medicine (D.O.)? Accessed July 27, 2000 at http://www.aoa-net.org/Consumers/consumers.htm

Andersson GB, Lucente T, Davis AM, Kappler RE, Lipton JA, Leurgans S. A comparison of osteopathic spinal manipulation with standard care for patients with low back pain. N Engl J Med. 1999;341(19):1426-1431.

Kappler R, Ramey KA, Heinking KP. Osteopathic Medicine. In: Novey DW, ed. Clinician's Complete Reference to Complementary and Alternative Medicine. St. Louis, Mo: Mosby; 2000:325-337.

Lesho EP. An overview of osteopathic medicine. Arch Fam Med. 1999;8(6):477-484.

Rayan GM. Carpal tunnel syndrome between two centuries. J Okla State Med Assoc. 1999;92(10):493-503.

Sucher BM. Palpatory diagnosis and manipulative management of carpal tunnel syndrome. J Am Osteopath Assoc. 1994;94(8):647-663.

Sucher BM, Hinrichs RN. Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament. J Am Osteopath Assoc. 1998;98(12):679-686.

Szabo RM. Carpal tunnel syndrome as a repetitive motion disorder. Clin Orthop. 1998;351:78-89.

Vickers A, Zollman C. The manipulative therapies: osteopathy and chiropractic. BMJ. 1999;319(7218):1176-1179.

Wagner GN. Osteopathy. In: Micozzi MS, ed. Fundamentals of Complementary and Alternative Medicine. New York, NY: Churchill Livingstone; 1996:79-89.

Integrative Medicine Companion. Newton, Mass: Integrative Medicine Communications; 2000:40-41.