- Cranial Osteopathy
- Cranial-sacral Therapy
- Doctor of Osteopathic Medicine (D.O.)
- Muscle Energy Technique
- Jones Counterstrain
- Myofascial Release
- Osteopathic Manipulation
- Osteopathic Medicine
Principle Proposed Uses
Osteopathic medicine originated as a 19th century alternative medical approach emphasizing the physical manipulation of the neuromusculoskeletal system. Today, doctors of osteopathic medicine study and practice the same types of medical and surgical techniques as their conventional MD colleagues with the addition of osteopathic manipulative treatment (OMT).
History of Osteopathic Manipulative Treatment
Osteopathic medicine was founded in 1874 by Andrew Taylor Still, a US physician. Physicians educated in this method were called doctors of osteopathy. Subsequently, however, schools of osteopathic medicine incorporated much of the same curriculum taught in conventional medical schools, while uniquely preserving training in OMT. Today, these physicians are now called doctors of osteopathic medicine (DO). The osteopathic medicine license is legally equivalent to that of MD. Like MDs, DOs complete 4 years of medical education followed by 3-8 years of graduate medical education.
Forms of Osteopathic Manipulative Treatment
Osteopathic medicine and chiropractic techniques overlap, but they are not identical. As a general rule, chiropractors focus most of their attention on the spine, while osteopathic physicians devote their efforts throughout the musculoskeletal system, including soft tissues and joints outside the spine.
There are several specific osteopathic techniques in wide use. Some of the more popular include:
- High velocity, low amplitude (HVLA) technique
- Muscle energy technique
- Strain-counterstrain technique
- Myofascial release technique
- Osteopathy in the cranial field
High Velocity/Low Amplitude Technique (HVLA)
HVLA is used to release restrictions in the movement by applying a rapid, therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint. It is also known as "thrust technique."
Muscle Energy Technique
In muscle energy technique, the patient voluntarily moves a body part from a precisely controlled position against a defined resistance by the osteopathic physician. The purpose is to progressively improve mobility of a joint.
Strain-counterstrain Technique (Jones Counterstrain)
Strain-counterstrain technique (Jones counterstrain) involves finding tender points and then passively manipulating associated joints until the tenderness decreases. Like muscle-energy work, strain-counterstrain progressively increases range of motion and, it is hoped, decreases muscle spasm and pain.
Myofascial release focuses on the fascial tissues that surround muscles. The practitioner palpates the fascial tissues, looking for a subtle sensation that indicates the tissues are ready to "unwind," and then helps the tissue to follow a pattern of spontaneous movement. This process is repeated over several sessions until a full release is achieved.
Osteopathy in the Cranial Field
What Is Osteopathic Manipulative Treatment Used For?
At the discretion of the DO, OMT is used as a key component of the management plan in conjunction with medications, surgery, education, and lifestyle counseling. OMT is primarily used to treat musculoskeletal pain conditions, such as back pain , shoulder pain , arthritis , and tension headaches . Some advocates of OMT believe that it has numerous other benefits, including:
What Is the Scientific Evidence for Osteopathic Manipulative Treatment?
There is little evidence as yet that OMT is helpful for the treatment of any medical condition. There are several possible reasons for this, but one is fundamental: Even with the best of intentions, it is difficult to properly ascertain the effectiveness of a hands-on therapy like OMT.
Only one form of study can truly prove that a treatment is effective—the double-blind, placebo-controlled trial . (For more information on why such studies are so crucial, see Why Does This Database Rely on Double-blind Studies? ) However, it isn’t possible to fit OMT into a study design of this type. What could researchers use as a placebo OMT? And how could they make sure that both participants and practitioners would be kept in the dark regarding who is receiving real OMT and who is receiving fake OMT? The fact is, they can’t.
Because of these problems, all studies of OMT fall short of optimum design. Many have compared OMT against no treatment. However, studies of that type cannot provide reliable evidence about the efficacy of a treatment: If a benefit is seen, there is no way to determine whether it was a result of OMT specifically or just attention generally. (Attention alone will almost always produce some reported benefit.)
More meaningful trials used fake osteopathy for the control group. Such studies are single-blind because the practitioner is aware of applying phony treatment. However, this design can introduce potential bias in the form of subtle unconscious communication between practitioner and patient.
Still other studies have simply involved giving people OMT and seeing if they improve. These trials are particularly meaningless; it has long since been proven that both participants and examining physicians will think, at least, that they observe improvement in people given a treatment, whether or not the treatment does anything on its own; such studies are not reported here.
Given these caveats, the following is a summary of what science knows about the effects of OMT.
Possible Effects of Osteopathic Manipulative Treatment
Most studies of OMT have involved its potential use for various pain conditions.
Finding a Qualified Practitioner of Osteopathic Manipulative Treatment
At the current rate of growth, it is estimated that more than 100,000 DOs will be in active medical practice by the year 2020. Many DOs who use OMT have been certified by the American Osteopathic Board of Neuromusculoskeletal Medicine. Osteopathic family physicians are the highest utilizers of OMT. People can find a DO by searching online at sites like the American Osteopathic Association or the American Academy of Osteopathy .
Be aware that some health practitioners may use the terms osteopathy or osteopath but are not licensed osteopathic physicians. Some areas outside of the United States also have osteopath training that does not include MD training. Look for the terms Osteopathic Physician or DO and ask your doctor or practitioner about their training before beginning treatments.
- Reviewer: EBSCO CAM Review Board
- Review Date: 08/2013 -
- Update Date: 10/00/2013 -