Osteopathic Manipulation for Low Back Pain

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What is a DO?
A DO is a doctor of osteopathic medicine. Osteopathic medicine represents one of two distinct schools of medicine in the United States. The education process for a DO consists of four years of an undergraduate degree, four years of medical school and at least three years of residency training.

What is osteopathic medicine?
Osteopathic medicine focuses on the total person, with an appreciation for the interrelationship of the various systems of the body to maintain health, and to prevent illness and disease. Here are a few additional facts about osteopathic medicine:

• Osteopathic medicine was founded by Andrew Taylor Still in 1874.
• The first osteopathic medical school was opened in 1892 in Kirksville, Missouri.
• Sixty-four percent of DOs are primary care physicians.
• Osteopathic medicine is the fastest growing medical field in the United States.

How is a DO different from an MD?
In addition to conventional medical training, a DO also receives "hands on" training in osteopathic diagnosis and manipulative treatment. This acts as an extra tool to treat patient ailments.

What is osteopathic manipulation (OMT)?
OMT is a whole system of evaluation and treatment designed to achieve and maintain health by restoring normal function to the body. Manipulation means the therapeutic application of manual pressure or force. OMT is different from what a chiropractor would do. Chiropractors focus exclusively on the realignment of joints. DOs believe structural problems in the spinal column can affect the nerves that radiate out to the various organs, thus causing disease.

Some DOs still use OMT to treat all forms of disease. However, the majority of DOs use manipulation to treat musculoskeletal disorders such as:

• Low back pain
• Neck pain
• Sports injuries
• Repetitive stress injuries
• Some types of headaches

The New England Journal of Medicine's Nov. 4, 1999 issue concluded that patients with chronic low back pain can be treated effectively with manipulation.

What should I expect from a visit to a DO?
The doctor will perform a complete history and physical, and order any X-rays or other diagnostic tests that may be necessary to help diagnose your condition. Once your problem is diagnosed, the doctor will develop a plan of treatment.

The first exam will take approximately 30 to 60 minutes. Follow-up appointments will last from 15 to 30 minutes.

What types of OMT are used?
There are several different techniques of OMT, including:

• Soft tissue technique--This approach applies pressure to the muscle area around the spine. It consists of rhythmic stretching, deep pressure and traction.

• Muscle energy technique--With this technique, the patient is directed to use his or her muscles from a precise position and in a specific direction against a counterforce applied by the doctor.

• Thrust technique--This approach uses high velocity forces to restore motion to a joint to reduce or eliminate the signs of tissue changes, asymmetry, restricted movement and tenderness. This is the "cracking" technique of manipulation.

• Counterstrain technique--During this approach, the patient is moved away from a position where motion is restricted to one of greater comfort. This technique is good for an acute injury.

Who should avoid OMT?
While OMT is beneficial for many common musculoskeletal problems, such as low back pain, patients with some conditions should avoid this therapy. These include patients with:

• Bone cancer
• Bone or joint infection
• Osteoporosis
• Spinal fusion

What are the side effects of OMT?
There are no side effects of OMT other than possible soreness for one to two days after manipulation. Of course, the degree of potential soreness depends on the approach used by your physician.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

Updated on: 12/10/09