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Osteopathy FAQs

Richard A. Feely, D.O., FAAO, FCA, FAAMA

Q. What is Osteopathy?

A. Osteopathy is a complete school of medicine in the United States. It is a separate and distinct medical profession with unlimited practice rights in the field of medicine and surgery. It is a medical art and science with a unifying holistic philosophy of body, mind and spirit.

Q. What is an osteopathic doctor in the USA?

A. In the USA, an osteopathic doctor is a fully licensed and trained physician and surgeon like an MD but with the addition of osteopathic manipulation. Each DO is licensed by each individual state to practice Osteopathic Medicine and Surgery. An English DO to practice in the US would have to take 4 years of Osteopathic Medicine at a US college plus 3 years of residency/internship, then pass a national or state board exam. He would then be able to apply and receive a state license.

Q. What is Osteopathic Manipulation?

A. Osteopathic manipulation is a manual medical procedure that the physician applies to a patient. This manual hands-on technique involves putting joints and tissues through a range of motion, releasing membranous articular strain, muscle spasm and tight joint capsules and ligaments. Osteopathic manipulation alleviates somatic dysfunction.

Q. What is Somatic Dysfunction?

A. Somatic dysfunction is impaired or altered function of related components of the somatic (body framework) system. This includes skeletal, arthrodial, myofascial structures, and their related vascular, lymphatic, and neural elements.

Q. What is the Osteopathic profession like?

A. The osteopathic profession is a group of over 36,000 physicians and surgeons throughout the United States that are involved in unlimited medical practice providing diagnosis and treatment in all standard medical specialties including family practice, internal medicine, neurosurgery, cardiovascular surgery, obstetrics and gynecology, general surgery, cardiology, neurology, internal medicine, etc.

Q. What is Osteopathic Manipulative Medicine?

A. It is a primary care specialty emphasizing in-depth application of the osteopathic philosophy and special proficiency in osteopathic diagnosis and treatment.

Q. What is Osteopathic manipulative treatment?

A. It is a diagnosis followed by therapeutic application of manually guided forces by an osteopathic physician to alleviate somatic dysfunction. This is accomplished by a variety of techniques.

Q. What are some techniques used in Osteopathic manipulative treatment?

A. Some techniques include:

1. Articulatory treatment - low velocity, moderate to high amplitude technique that carries a joint through a full range of motion to increase freedom of movement.

2. Counterstrain - inhibits inappropriate strain reflex by applying mild strain opposite to the reflex.

3. Cranial treatment - diagnosis and treatment using the primary respiratory mechanism.

4. Directed treatment - engages the restrictive barrier and carries the dysfunctional component towards the restricted barrier.

5. Exaggeration treatment - moves the dysfunctional component away from the restricted barrier through and beyond the range of motion.

6. Facilitated positional release - myofascial release treatment involving activating force compression or torsion.

7. Muscle energy treatment - patient moves as directed by the physician against defined resistance.

10. Myofascial treatment - continuous palpatory feedback to achieve release of myofascial tissues.

11. Ligamentous articular strain - myofascial release techniques.

12. Traction treatment - stretching or separating parts along the longitudinal axis.

13. Visceral manipulation - positioning viscera to fascial balance.

Q. What is the Osteopathic philosophy?

A. Osteopathic medicine is a philosophy of healthcare and a distinctive art supported by expanding scientific knowledge. Its philosophy embraces the concept of the unity of the living organism's structure and function. It applies science and art to establish and maintain health, prevent and alleviate disease. Osteopathic concepts emphasize principles like the body's self-regulatory mechanisms, interrelation of structure and function, and rational treatment based on these principles.

Q. What is an Osteopathic structural examination?

A. An examination of the patient by an osteopathic physician with an emphasis on the neuromuscular skeletal system. It includes palpatory diagnosis of somatic dysfunction in the context of total patient care.

Q. What is palpatory diagnosis?

A. It is the process of palpating the patient to evaluate the neuromuscular skeletal and visceral systems.

Q. What is the primary respiratory mechanism?

A. It refers to the interdependent function among five body components: brain and spinal cord motility, cerebral spinal fluid fluctuation, intracranial and intraspinal spinal membrane mobility, articular mobility of cranial bones, and sacral mobility between ilia or pelvic bones.

Q. What is postural decompensation?

A. It's the distribution of body mass away from the ideal when postural homeostatic mechanisms are overwhelmed, resulting in changes like scoliotic, rotational, kyphotic, or lordotic changes.

Q. What is the somato visceral reflex?

A. It's an involuntary nervous system response to sensory input that produces reflex responses in segmentally related visceral structures.

Q. What is a visceral somatic reflex?

A. It's a localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures.

Q. What is the cranial sacral mechanism?

A. It refers to the connection between the occiput and sacrum by the spinal dura mater as described by William G. Sutherland D.O.

Q. What is spinal facilitation?

A. It's the maintenance of a pool of neurons, motor neurons, or preganglionic sympathetic neurons in a state of partial or subthreshold excitation in the spinal cord, requiring less afferent or presynaptic stimulation to trigger impulse discharge.

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