Osteopathic medicine: Encyclopedia II - Osteopathic medicine - Techniques of Osteopathic Manual Medicine OMM

Osteopathic medicine - Techniques of Osteopathic Manual Medicine OMM

There are different techniques applied to the musculoskeletal system. These techniques can be applied to:

(1) The joints (using High Velocity Technique, mobilization, etc.)

(2) Their surrounding soft tissues (using functional and soft tissue techniques, etc.)

(3) The muscles

(4) The fascia.

When combined, these forms of treatment allow the therapist to restore the normal contact within the joint and with other structures. This eliminates muscular spasms and tensions in the ligaments thereby restoring complete mobility to the joint.

Osteopaths have at their disposal a wide range of manual techniques including:

High Velocity (Low Amplitude) Thrust (HVT) (usually called an 'adjustment' by Chiropractors or more generally 'joint manipulation') - in which a joint is quickly and skillfully taken by the practitioner beyond its normal range of motion, but within its physiological range, with the intention of normalizing 'joint play.'

Joint Mobilization

Myofascial Release

Muscle Energy Technique (MET)

Trigger (or Myodysneuric) Point Therapy

Therapeutic Massage

Cranial Osteopathy

Visceral Manipulation

Lymphatic Pump/Drainage

These are normally employed together with dietary, postural, and occupational advice, as well as counseling to help patients recover from illness and injury, and to minimize pain and disease. Most osteopaths view manual therapies as a complement to physiotherapy, and the judicious use of invasive therapies (pharmaceuticals and surgery) where necessary.

It is probably OMM's comprehensive and eclectic style that distinguishes it most from that employed by most other manual therapists.

The immediate goal of musculoskeletal manipulation is to restore maximal, pain-free movement of the musculoskeletal system in postural balance.

Osteopathic medicine - Scope of Manual Therapies

There is now a well-established body of scientific literature that makes a strong case for the use of manual therapies in the treatment of many neuromusculoskeletal pain syndromes, such as low back pain and tension headache, alongside exercise and other rehabilitative techniques. In recent years, the mainstream medical profession has begun to accept the use of manual therapies to treat spinal pain of mechanical origin.

More controversial is the use of manual therapies in the treatment of seemingly organic conditions, such as asthma, middle ear infections in children, period pain, and pulmonary infection. While research is beginning to shed some light in this area, exploration of the relationship between the NMS system and organic disease and the scope of manual therapies are in their infancy. Nevertheless, the sum of research and clinical experience to date suggests that osteopathic treatment can be a safe and cost-effective means of managing (or co-managing) certain diseases.

Osteopathic medicine - Cranial Osteopathy

Cranial osteopathy is a contested issue within the profession; it is not known what proportion of osteopaths are practitioners. Most medical insurance companies will not reimburse for 'cranial' treatment because it is not based on orthodox diagnostic criteria.

Cranial osteopaths claim they are trained to feel a very subtle, rhythmic shape change that is present in all physical tissues. This is known as the involuntary mechanism or the cranial rhythm. The movement is said to be very subtle, and it takes practitioners with a very finely developed sense of touch to feel it. This rhythm was first described in the early 1900's by Dr. William G. Sutherland, and its existence is not accepted by the mainstream scientific community. The theory underlying cranial osteopathy is rejected by many osteopaths and most orthodox medical doctors because cranial bones fuse by the end of adolescence. The brain does pulsate, but this is thought to be exclusively related to the cardiovascular system [1]. Several studies have looked at inter-operator reproducibility of diagnostic findings when working with the 'cranial rhythm' and found there to be little agreement [2]

How this mechanism is related to health/disease is not established, neither is the relationship between holding the head and re-establishing health. Many dismiss cranial osteopathy as pseudo-science. Moreover, cranial osteopathy is often marketed as being especially suitable for newborn babies and young children. All in all, this practice appears to be popular with patients and this may be a significant factor for osteopaths embracing it. Cranio-sacral therapy is based on the same principles but the practitioners are not qualified osteopaths. Chiropractors have developed similar techniques known as sacro-occipital therapy (SOT) or craniopathy.

Osteopathic medicine - Visceral Osteopathy

Proponents of visceral osteopathy state that the visceral systems (the internal organs: digestive tract, respiratory system, etc.) rely on the interconnected synchronicity between the motions of all the organs and structures of the body, that at optimal health this harmonious relationship remains stable despite the body's endless varieties of motion. The theory is that both somato-visceral and viscero-somatic connections exist, and manipulation of the somatic system can affect the visceral system.

Visceral Osteopathy is said to relieve imbalances and restrictions in the interconnections between the motions of all the organs and structures of the body. During the 1940's, osteopaths like H.V. Hoover or M.D. Young built on the pioneering work of Andrew Taylor Still D.O., to create this method of detailed assessment and highly specific manipulation. The efficacy and basis of this treatment remains controversial even within the osteopathic profession.

Neither cranial osteopathy nor visceral manipulation are the mainstay of most osteopathic practices.

Adapted from the Wikipedia article "Techniques of Osteopathic Manual Medicine OMM", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki