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The
greatest discovery of any generation is that human
beings can alter their lives by altering the attitudes
of their minds.
- Albert Schweitzer
Osteopathy is
a form of physical medicine that helps restore the structural balance
of the musculoskeletal system. Combining joint manipulation, physical
therapy and postural re-education, osteopathy is effective in treating
spinal and joint difficulties, arthritis, digestive disorder, menstrual
problems and chronic pain.
Uses
Born over a
century ago from the belief that displaced bones, nerves and muscles
are at the root of most ailments, osteopathy has long since merged
into the medical mainstream. Most practitioners still use osteopathic
manipulative treatment to correct harmful 'obstructions' in at least
a few selected patients, but they also stand ready to provide all
other forms of medical care. The majority of osteopathic physicians
(DOs) enter family practice, and you can use them the same way you
would use any other family physician. Although originally used to
treat virtually all forms of disease, osteopathic manipulation per
se is now considered useful primarily for musculoskeletal disorders
such as back and neck pain, joint pain, sciatica, sport injuries,
repetitive stress injuries and some types of headache.
Procedure
of Treatment
A visit to a
DO is much like one to a Doctor of Medicine (MD). The doctor will
begin by asking you for your complete medical history. Since DOs
pride themselves on their 'holistic' approach to patients, he may
also spend some time discussing your physical condition and lifestyle.
You will then be asked to undress for a complete physical examination.
An osteopathic physical covers all the concerns addressed in a standard
medical exam. However, because of osteopathy's emphasis on the musculoskeletal
system, it typically includes a slightly more intensive structural
exam. During this portion of the physical, the DO will assess your
posture, spine and balance, use his hands to palpate your back,
legs and arms, and check your joints, muscle tendons and ligaments.
If you need laboratory tests, X-rays or other diagnostic procedures,
the DO will order them, just as an MD would. As with any other physician,
the tests may be conducted in the doctor's office or at an outside
lab or hospital. When the results of the tests are in, the DO will
make a diagnosis, then establish a treatment plan. He will write
prescriptions for medicines you may need, or refer you to an osteopathic
or other specialist, if required. For most disorders, the treatment
offered by an osteopathic physician is essentially the same as what
you would receive from an MD, including prescription medicines and
surgery as needed. However, for problems involving bones, muscles,
tendons, tissues, and the spinal column, many DOs employ osteopathic
manipulative treatment (OMT). This form of therapy ranges from light
pressure on the soft tissues to high-velocity thrusts on the joints.
In its most typical form, it calls for little more than gentle manipulation
of the joints and spine. To many people, manipulative treatment
seems like a specialized type of massage. Others erroneously compare
it with chiropractic adjustment, which focuses exclusively on realignment
of joints. Although a few DOs (roughly 6 per cent) still use manipulative
treatment on a majority of their patients, most undertake it only
a quarter of the time-or less. Younger DOs tend to use it least
of all.
Treatment Time: Osteopathic physicians claim to spend more time
with each patient than their MD counterparts. However, there are
no firm statistics to support this assertion. For practical purposes,
you can expect a visit to be as long as one to a medical doctor-30
to 60 minutes the first time, 20 to 30 minutes thereafter.
Treatment Frequency: As in other forms of care, there is
no set frequency for treatment by an osteopathic physician. If you
are receiving manipulative treatment, however, you may require three
to six sessions in all.
Benefits
Osteopathic
medicine began as an outgrowth of conventional U.S. medicine in
the late 1800s, a period when the causes of disease were still unknown
and most treatment consisted of crude surgery or the use of drugs
to control obvious symptoms. Disenchanted with the persistent failure
of these techniques, Civil War physician Andrew Taylor Still devised
a kinder, gentler, approach based on his belief that all disease
was related to disorders in the muscles and joints. Still was convinced
that structural problems in the spinal column can affect the nerves
that radiate out to the various organs, and that this is the true
cause of disease. He called these problems 'osteopathic lessons'
('osteo' for bone and 'pathic' for diseased), and devised osteopathic
manipulations to treat them. These treatments, he believed, could
break up obstructions in the circulatory system, allowing the blood
to flow freely and the nerves to resume their normal function. With
proper balance restored, the body could then exert its own natural
healing powers. In 1892, Still founded the American School of Osteopathy
to teach these percepts. From these beginnings, osteopathic medicine
diverged from the predominant form of medical practice for several
decades, relying less on surgery or drugs and more on manipulation,
nutrition and lifestyle. Then, as scientists learned more about
the genuine causes of disease, Still's original theories were gradually
downplayed, ultimately to be abandoned by many DOs. In the 1940s,
osteopathy began edging back into the mainstream, and by 1972 osteopathic
physicians were licensed to practice alongside their MD brethren.
Today, osteopathy is definitely on the rise. The number of DOs has
increased 50 per cent in the last decade alone. By the year 2000,
the U.S. will have 45,000 DOs in practice. Osteopathic physicians,
like other physicians, must earn a four-year undergraduate degree
emphasizing the scinces, take the medical college admissions test
(MCAT) for admission to medical school, undergo four years of medical
education, and complete required residency training. Specialization
in a specific area of practice, such as internal medicine, surgery,
pediatrics, radiology or pathology, may require from two to six
years of additional training. Both DOs and MDs must pass state licensing
exams. Both can be found in licensed hospitals, and both are eligible
for membership in the American Medical Association. DOs, however,
undergo a completely separate course of training in the 19 medical
schools and 200 teaching hospitals approved by the American Osteopathic
Association (AOA). In addition to conventional medical training,
they receive instruction in 'hands-on' osteopathic diagnosis and
osteopathic manipulative treatment. Most DOs ultimately enter primary
care practice, specializing in the areas of family medicine, internal
medicine, obstetrics/gynaecology and pediatrics. However, a few
can be found in every other medical specialty as well.
Who Should
Avoid This Therapy?
Any problem
that would prompt you to consult an MD can also be taken to a DO.
You should avoid osteopathic manipulation, however, if you have
bone cancer, a bone or joint infection, or the brittle bone disease
osteoporosis. It is also best to forego manipulation if you have
had spinal fusion or suffer from a prolapsed disk.
Side-effects
DOs offer the
full range of standard medical treatments, and side effects depend
entirely on the approach the doctor selects. Osteopathic manipulative
treatment itself has no potential side-effects other than temporary
soreness for a day or two after therapy.
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