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Osteopathic Manipulative Treatment

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

In an era marked by medical advances, from state-of-the-art surgery to the newest prescription medication, what unique tool will osteopathic physicians use? Their hands.

Osteopathic physicians (D.O.s) provide you with all the best that medicine has to offer. They can specialize in any recognized area of medicine, from pediatrics to neurosurgery. However, their knowledge and use of the latest medical technology is complemented by their application of a hands-on treatment tool known as osteopathic manipulative treatment, or OMT.

Using OMT, D.O.s bring an added dimension to healthcare, in the form of a non-invasive treatment. D.O.s use OMT to diagnose, treat and even prevent illness or injury. When appropriate it can be used in conjunction with, or in place of, medication or surgery.

Unique Philosophy

D.O.s are widely recognized for their incorporation of manipulative medicine into their spectrum of care. OMT is just one element of the unique philosophy of osteopathic medicine.

The Big Picture

By taking the whole person approach to care, D.O.s don't just focus on the disease or injury. They look for the underlying causes of disease instead of simply treating the symptoms. Not only do they consider your physical condition, but also they take other factors into account like home, work and family life when making a diagnosis.

Patient, Heal Thyself

D.O.s recognize that the body is inherently capable of healing itself, though it must constantly fight physical, emotional and nutritional “stressors” to maintain a state of wellness. D.O.s believe in educating you about good health and prevention of disease.

The Musculoskeletal System

D.O.s place particular emphasis on the musculoskeletal system, which comprises two-thirds of the body's mass. D.O.s believe that all of the body's systems, including the musculoskeletal system, work together and that disturbances in one system may impact function elsewhere in the body. This understanding of body structure and function provides the foundation for the osteopathic approach to medicine.

The ABC's of OMT and How It Can Work for You

OMT is predicated upon your D.O.'s knowledge of medicine. Once your D.O. has ruled out mechanical causes for your illness or injury (through blood and urine testing, X-rays, etc.), and based upon physical and mechanical findings, your D.O. may decide to utilize OMT. While it is commonly associated with physical ailments such as low back pain, this modality can also be used to relieve the discomfort or musculoskeletal abnormality associated with a number of disorders, including: asthma, sinus disorder, carpal tunnel, migraines and menstrual pain.

The osteopathic approach to treating many diseases includes medication and/or surgical intervention, plus OMT. OMT can relieve muscle pain associated with a disease and can hasten your recovery from illness by promoting blood flow through tissues.


Your structural exam will begin with an assessment of your posture, spine and balance. Your D.O. will then use his fingers to palpate your back and extremities. Your D.O. will then use his fingers to palpate your back and extremities. He will also check your joints for restriction and/or pain during motion as well as check your muscles, tendons and ligaments where tenderness can signal a problem. Through extensive osteopathic training in manipulative medicine, D.O.s can detect changes in tissue, however small, that signal injury or impairment.

Once the structural exam is complete, your D.O. will integrate this information with your medical history and a complete physical exam. After that point, a treatment plan can be established.


Using a variety of OMT techniques, your D.O. will apply manual forces to your body's affected areas to treat structural abnormalities and will then apply specific corrective forces to relieve joint restrictions and misalignments. Based upon the severity of your problem, you may require more than one treatment.

Case 1

Mary visited her D.O. complaining of a sharp pain in her side. The physician asked a series of questions about her pain: its intensity, onset and duration. They also discussed her medical history. The physician then ordered a series of tests to determine whether the pain was caused by disease (i.e. gallbladder or appendix). Tests revealed that it was not. Since the patient indicated that she worked in an office with a “surround style” desk, the D.O. considered that Mary might be suffering from postural/mechanical strain. Based upon his examination, interview with the patient and negative test results, the physician decided to employ OMT to relieve motion restrictions and muscle strain caused by improper sitting and movement. He also recommended changes in the set-up of her workstation to alleviate further pain.

Case 2

Michael's symptoms included cough, congestion, fever and headache. Suspecting chronic sinusitis, his D.O. conducted an exam and ordered appropriate tests. When results confirmed the diagnosis, the physician prescribed an antibiotic to treat the infection. She also employed a variety of OMT techniques to promote sinus drainage and relieve pain related to the infection. Michael's congestion was markedly reduced after just one OMT session. Upon completion of his antibiotic therapy two weeks later, his infection was eliminated.

Who Can Benefit

People of all ages and backgrounds have found relief from pain and dysfunction as well as improved mobility through OMT. D.O.s incorporate this modality into their treatment plans for top athletes and performance artists, workers with on-the-job injuries and thousands of people, just like you.

Proof Positive

A study published in the November 4, 1999 issue of the New England Journal of Medicine confirms what D.O.s have known for years' that OMT works. In this case, researchers examined the effectiveness of OMT for treating low back pain.

Patients were divided into two groups' one treated with standard options like hot/cold packs, physical therapy and anti-inflammatory medication while the other group received OMT and standard care. After a twelve-week period, patients in both groups showed improvement. However, researchers learned that the patients receiving OMT required less medication and physical therapy, resulting in less side effects and lower health care costs.

Another study released on OMT revealed its effectiveness in reducing pain after a hysterectomy. Researchers measured the amount of morphine to treat patients' pain as well as their perception of their pain levels. Upon the study's completion, it was determined that administering OMT significantly reduced patients' needs for pain medication.

By incorporating OMT into their practice of complete medicine, D.O.s are providing the most comprehensive care available today.


The earliest medical writings from centuries past describe the efficacy of manual medicine. In 1874, osteopathic medicine's founder, Dr. A.T. Still, recognized the power of hands-on care and incorporated it into his philosophy of medicine. Dr. Still identified the musculoskeletal system as a key element of health; he recognized the body's self-healing capacity; he emphasized prevention, exercise and keeping fit; and he identified palpation and human touch as vital and less intrusive elements of diagnosis and treatment. As the impressive growth of osteopathic medicine demonstrates, Dr. Still's founding tenets have withstood the test of time and scientific scrutiny.


D.O.s complete four years of medical training at one of the nation's fully accredited colleges of osteopathic medicine. The osteopathic curriculum is intensive and broad-based. It includes comprehensive training in the musculoskeletal system and the use of OMT. Manipulation combined with the osteopathic principles of holistic care, prevention and primary care makes osteopathic medicine unique.

Upon graduation from medical school, D.O.s complete a one-year rotating internship through all the areas of primary care. Afterwards, they may complete a residency in any of more than 120 specialty and subspecialty areas of medicine. However, sixty-four percent of all D.O.s remain in primary care practices.

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