Osteopathic manipulations

Manipulative therapies (chiropractic and osteopathy) are amongst the most prevalent of complementary treatments. Spinal manipulation is carried out by chiropractors, osteopaths, physiotherapists, and other healthcare professionals to treat back and neck pain as well as other (predominantly musculoskeletal) disorders. 

In the early 1900 s, osteopathic medicine increasingly incorporated the practices of allopathic medicine, while retaining the whole-person approach and manipulation techniques. In 1950, a court decision in Missouri recognized the basic equivalency of an osteopathic doctor (D.O.) and medical doctor (M.D.) and their right to practice and perform surgery in a... 

For osteopaths, treating a disorder involves not only returning a person s body to its normal alignment and functioning but also determining what caused the disorder. In the case of a joint injury, especially if a recent fall or mild blow to an area is the likely cause, osteopaths may treat the patient with manipulation. 

Some controversy exists in regards to the efficacy of manipulation however, it provides rehef to millions of patients. Backs and necks are most commonly manipulated. Sometimes one manipulation or a short series is enough, but some parients require multiple treatments. Others fail to respond, and osteopaths must seek another form of treatment. Once... 

Cranial Osteopathy. Some, but not all, practitioners believe that the skull bones can also be manipulated. Cranial osteopathy is a theory based on the premise that the bones of the skull permit small increments of movement. This application, which became popular for treating babies and children, is said to be based on a rhythm that can be felt by practitioners whose sense of touch is highly developed. Some osteopaths believe that improving the cranial rhythmic movement helps increase the flow of the cerebral spinal fluid that surrounds the brain and spinal cord. This increase in flow can then raise metabolic outflow and nutrition inflow. 

Craniosacral Therapy. Craniosacral therapy (CST) is a hands-on approach to monitoring and mobilizing what osteopaths refer to as the craniosacral rhythm. In this therapy, the spine and the cranial junctions of the skull as well as soft tissue are gently manipulated to improve the flow of cerebrospinal fluid in the... 

Visceral Osteopathy. Osteopaths who propose the application of visceral osteopathy state that the internal organs and bodily structures (such as the digestive tract and respiratory system) and the body s motion are interconnected. For optimal health, connections among the organs and structures need to remain balanced and stable, despite the body s endless motion. Visceral osteopaths believe that manipulating the musculoskeletal system benefits the internal organs and vice versa. The effectiveness of visceral osteopathy remains controversial even within the osteopathic profession. 

A 1999 study shovdng that osteopathic manipulation was effective in treating lower back pain at a lower cost and with fewer side effects than medication alone appeared in T ie New England Journal of Medicine. 

Former Associate Professor Stanley Schiowitz Department of Osteopathic Manipulative Medicine New York College of Osteopathic Medicine New York Institute of Teohnology Old Westbury, New York Deoeased... 

The 4 years in osteopathic medical school are spent in the study of basic and clinical sciences, much as in nonosteopathic medical schools, but with an added focus on osteopathic principles and concepts and intensive study of osteopathic manipulative medicine. The third and fourth years allow rotations into clinic, office, and hospital settings with introductions to inner city, suburban, and raral types of practice. 

The uniqueness of osteopathic medicine lies in the application of osteopathic philosoplty and concepts. Osteopathic medical practitioners follow accepted methods of physical and surgical diagnosis and treatment they are also trained to expertly evaluate the neuromusculoskeletal system and seek to achieve normal body mechanics through the use of manual manipulative medicine. Osteopathic physicians recognize the body s ability to regulate itself and mount its own defenses against most pathologic conditions. 

Another important principle in osteopathic medicine is that stracture and function are intimately interrelated. An abnormality in the stracture of any body part can lead to abnormal function, whether ejq)ressed locally or distantly from the deranged structure. To correct the mechanical disorders, the osteopathic physician undertakes therapeutic osteopathic manipulation. This... 

The Osteopathic profession has changed even as it has grown. It has achieved recognition as a significant part of the American health care system. It is now carefully defining its special contributions to medicine and is tmdertaldng various kinds of research to prove the effectiveness of its manipulative techniques. With these and similar steps toward full realization of the potential of Osteopathic medicine, the profession is seeming its position in the modem medical ch-mate. 

Osteopathic medicine is not merely a combination of traditional Western medicine and osteopathic manipulations. Rather, the principles and philosophy of osteopathic medicine apply not only to manipulative treatment but also to complete health care of the individual. This includes surgery, obstetrics, emergency medicine, internal medicine, pediatrics, geriatrics, and any other areas of care traditionally associated with conventional Western medicine. In fact, osteopathic principles and philosophy permeate all aspects of health maintenance and disease prevention and treatment. 

Osteopathic manipulative treatment was not mentioned in these precepts of osteo-pathic philosophy. When Still first announced his philosophy in 1874, he did not mention manipulation, and it was approximately 5 years later that he began using manipulation as a tool for diagnosis and treatment. Manipulation is not the only aspect of osteopathic philosophy, nor is it necessarily the most impoitanL However, with recognition of the importance of the somatic conponent of disease, the value of manipulation will be correspondingly better appreciated. 

In essence, osteopathy is based on the concepts of stractnre and function. At its simplest interpretation, stracture is anaton and fimction is physiology. An understanding of plysiology and neurophysiology in particular is essential to un-deistanding the mechanisnis of somatic dysfunction and the logical apphcation of osteopathic manipulation. Some basic terminology needs to be clarified ... 

The changes created by osteopathic manipulative treatment are mediated at a local level but have the potential to be far-reaching and interactive. Proper control of muscle function depends on local excitation in conjunction with continuous feedback from the brain about muscle status. 

PRACTICAL APPLICATIONS OF NEUROPHYSIOLOGY IN OSTEOPATHIC MANIPULATIVE TREATMENT... 

York Science Publishing, 1985. Korr IM. Somatic dysfunction. Osteopathic manipulative... 

Greenman PE. Models and mechanisms of osteopathic manipulative medicine. Osteopath Med News 1987 IV 11-14, 20. 

Lawrence Jones, an osteopathic family practitioner in Oregon, developed the counterstrain techmcpie. In 1955, he chanced on its discoveiy during the treatment of a patient with severe psoas spasm who had not responded to previous chiropractic or conventional osteopathic manipulation. After positioning the patient into a position of comfort, he left him on the table for a time and, when the man arose, he was pain-free. Dr. Jones spent many years perfecting the technique before introducing it to the profession. 

Still AT. The Philosophy and Mechanical Principles of Osteopathy. Kansas City, MO Hudson Kimberly Publishing Co., 1902 (Reprint Kirksville, MO Osteopathic Enterprise). Van Buskirk RL. A manipulative technique of Andrew Taylor Still. 7 Am Osteopath Assoe 1996 96 597-602. 

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