 |
 |
 |
 |
 |
 |
| |
Osteopathic MedicineAlthough 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, sports injuries, repetitive stress injuries, and some types of headache. A visit to a DO is much like one to an 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'll 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, muscles 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'd 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 percent) 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 3 to 6 sessions in all. Osteopathic medicine began as an outgrowth of conventional U.S. medicine in the late 1800's, 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 lesions" ("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 precepts. 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 1940's, osteopathy began edging back into the mainstream, and by 1972 osteopathic physicians were licensed to practice in all 50 states, often enjoying full hospital privileges alongside their MD brethren. Today, osteopathy is definitely on the rise. The number of DOs has increased 50 percent 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 sciences, 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/gynecology, and pediatrics. However, a few can be found in every other medical specialty as well. 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's also best to forego manipulation if you've had spinal fusion or suffer from a prolapsed disk. 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. If you are seeking an osteopathic physician as your primary-care provider, begin by looking for a board-certified practitioner. Referrals from other physicians or your local medical association can help point you in the right direction. Arrange an initial appointment to see if you are comfortable with the DO's personality and style of practice. Be wary of any doctor who presents manipulation as a cure-all; most reputable DOs use it only for problems of musculoskeletal origin. And be especially suspicious of a doctor who offers craniosacral therapy, an offshoot of osteopathy that has no proven benefits As you would with any physician, you should discuss your progress with your DO. If a particular treatment isn't working, he can try another approach or provide you with a referral to a specialist. If you're receiving osteopathic manipulative treatment, you'll probably need a number of sessions, although pain due to muscle spasm may vanish after a single treatment. From the majority of DOs, you're likely to get the same care that you'd receive from an MD. As with any physician, however, a second opinion is always in order if you become dissatisfied. |