Osteopathic Manipulative Therapy

[geauxtohell]

I am curious if anyone here has had experience as a patient with osteopathic manipulative therapy (OMT) and what their impressions were about it.

I know what the data says, but I am curious as to people's personal experiences if they are willing to share them.

 

[xotoxi]

I am a DO, so I am trained to do it.

But, just like with any medical field, I learned it in medical school, but never felt comfortable with it or felt like I could do it successfully, therefore I never pursued it or attempted to perfect it.

Many of my colleagues are very successful with it and it is a very good adjunctive treatment modality for musculoskeletal issues.

Did you have any specific questions about it that I can answer?

 

[geauxtohell]

I am a DO, so I am trained to do it.

But, just like with any medical field, I learned it in medical school, but never felt comfortable with it or felt like I could do it successfully, therefore I never pursued it or attempted to perfect it.

Many of my colleagues are very successful with it and it is a very good adjunctive treatment modality for musculoskeletal issues.

Did you have any specific questions about it that I can answer?

Not really. I was just curious as to the what people's personal reflections were on the matter. I know that many practicing DO's, per the AOA, don't utilize OMT past medical school. At the same time, I know many patients that swear by it and the hospital I am at right now (Probably 70/30 MDs to DOs) has an OMT clinic and that it can be an effective modality to treat that phantom menace "chronic lower back" pain.

I just read "A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain" by Andersson et al in the New England Journal of Medicine and was interested in their findings (specifically that OMT can drastically reduce the need for physical therapy, which to me suggests that it could be a good augmentation for people who need PT. I also read the rebuttals and found their points interesting too.

As far as OMT is concerned, I think the jury is always going to be out. It's hard enough to quantify pain on the 10 point scale, which makes studies in pain management extremely hard, so I think it's always going to boil down to a patient's preference, just as some people are comfortable with chiropractry and others are not.

So no hidden bias or agenda, just curious.

 

[xotoxi]

I am a DO, so I am trained to do it.

But, just like with any medical field, I learned it in medical school, but never felt comfortable with it or felt like I could do it successfully, therefore I never pursued it or attempted to perfect it.

Many of my colleagues are very successful with it and it is a very good adjunctive treatment modality for musculoskeletal issues.

Did you have any specific questions about it that I can answer?

Not really. I was just curious as to the what people's personal reflections were on the matter. I know that many practicing DO's, per the AOA, don't utilize OMT past medical school. At the same time, I know many patients that swear by it and the hospital I am at right now (Probably 70/30 MDs to DOs) has an OMT clinic and that it can be an effective modality to treat that phantom menace "chronic lower back" pain.

I just read "A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain" by Andersson et al in the New England Journal of Medicine and was interested in their findings (specifically that OMT can drastically reduce the need for physical therapy, which to me suggests that it could be a good augmentation for people who need PT. I also read the rebuttals and found their points interesting too.

As far as OMT is concerned, I think the jury is always going to be out. It's hard enough to quantify pain on the 10 point scale, which makes studies in pain management extremely hard, so I think it's always going to boil down to a patient's preference, just as some people are comfortable with chiropractry and others are not.

So no hidden bias or agenda, just curious.

I personally feel that physical medicine in most lower back pain syndromes is the treatment of choice...with the other treatments being narcotic pain medications, injections, and/or surgery.

I routinely refer patient's for PT, probably 3-5 times a day, because I believe that the treatments that they perform will correct the vast majority of spinal musculoskeletal diagnoses most of the time without any further treatments or workup.

I also have a lot of patients who go to chiropractors. While I don't favor them over PT, I do think they play a role. My biggest hangup on chiro is that they tend to treat the bones and joints, and not treat the muscles and soft tissue (which is where the problem usually is). In osteopathic training, we learned to treat the soft tissue first and then treat the bones and joints if needed (and it is not always needed if you correctly fix the soft tissues). I think that random repositioning of the vertebrae leads to a misalignment of the vertebrae which requires repositioning of the vertebrae which leads to a misalignment of the vertebrae which requires...I think you know where I am going.

 

[geauxtohell]

I am a DO, so I am trained to do it.

But, just like with any medical field, I learned it in medical school, but never felt comfortable with it or felt like I could do it successfully, therefore I never pursued it or attempted to perfect it.

Many of my colleagues are very successful with it and it is a very good adjunctive treatment modality for musculoskeletal issues.

Did you have any specific questions about it that I can answer?

Not really. I was just curious as to the what people's personal reflections were on the matter. I know that many practicing DO's, per the AOA, don't utilize OMT past medical school. At the same time, I know many patients that swear by it and the hospital I am at right now (Probably 70/30 MDs to DOs) has an OMT clinic and that it can be an effective modality to treat that phantom menace "chronic lower back" pain.

I just read "A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain" by Andersson et al in the New England Journal of Medicine and was interested in their findings (specifically that OMT can drastically reduce the need for physical therapy, which to me suggests that it could be a good augmentation for people who need PT. I also read the rebuttals and found their points interesting too.

As far as OMT is concerned, I think the jury is always going to be out. It's hard enough to quantify pain on the 10 point scale, which makes studies in pain management extremely hard, so I think it's always going to boil down to a patient's preference, just as some people are comfortable with chiropractry and others are not.

So no hidden bias or agenda, just curious.

I personally feel that physical medicine in most lower back pain syndromes is the treatment of choice...with the other treatments being narcotic pain medications, injections, and/or surgery.

I routinely refer patient's for PT, probably 3-5 times a day, because I believe that the treatments that they perform will correct the vast majority of spinal musculoskeletal diagnoses most of the time without any further treatments or workup.

I also have a lot of patients who go to chiropractors. While I don't favor them over PT, I do think they play a role. My biggest hangup on chiro is that they tend to treat the bones and joints, and not treat the muscles and soft tissue (which is where the problem usually is). In osteopathic training, we learned to treat the soft tissue first and then treat the bones and joints if needed (and it is not always needed if you correctly fix the soft tissues). I think that random repositioning of the vertebrae leads to a misalignment of the vertebrae which requires repositioning of the vertebrae which leads to a misalignment of the vertebrae which requires...I think you know where I am going.

Absolutely. I am not down on chiropractry, but I am weary of some of their procedures, specifically high velocity torsion around the cervical vertebrae. I believe there is an alarmingly high rate of mortality with that.

With the fact that 80% of back pain resolves spontaneously, I can't say that the allopathic approach of Rx'ing an anti-inflammatory+an analgesic+a muscle relaxer is completely misguided, but even if we accept that we are just managing pain in the hopes that they fall in that 80%, that leaves 20% of patients who are not being adequately treated. I saw one of them in clinic last week. He had basically been given narcotics for a couple of years (was turned down by neurosurgery two years ago, and I believe he had some cervical stenosis and lumbar disk bulges). Last week he had lost function in his right arm, was sick of the pain, and understandably pissed off at the inability of the staff to make him right.

I think patients like that would benefit from PT. That's what I recommended to the attending and we re-referred him to neurosurgery to see if they could anything for him.

Back pain is just tough. It seems like the people who have it never resolve the issue, so I am dubious as to the 80% figure unto itself.

 

[geauxtohell]

A side question for you, Doc:

Doxycycline is used as a prophylaxis against malaria. I had to take it every day in A'stan for that indication and if you got malaria, you could be charged with malingering.

Any clue how a tetracycline antibiotic would do a damn thing to a eukaryote?

 

[xotoxi]

A side question for you, Doc:

Doxycycline is used as a prophylaxis against malaria. I had to take it every day in A'stan for that indication and if you got malaria, you could be charged with malingering.

Any clue how a tetracycline antibiotic would do a damn thing to a eukaryote?

I have to admit that I had to go to Wikipedia to start my search on this question...but I followed links to a legitimate source.

I think this explains it: Tetracyclines specifically target the apicoplast o...[Antimicrob Agents Chemother. 2006] - PubMed Result

 

[Fatality]

I am curious if anyone here has had experience as a patient with osteopathic manipulative therapy (OMT) and what their impressions were about it.

I know what the data says, but I am curious as to people's personal experiences if they are willing to share them.

i went to an osteopath one time, he cracked my spin from the base of my skull to the tip of my tail bone it felt like. scared the shit out of me. i have not and will never go back to a bone cracker, im rather fond of the ability to walk.

 

[Terry]

my 30 year old son two years ago was sent to chiropractor's, neurologist, PT, and other speciality doc's because my son had extreme pain in his left calf muscle. Each doctor said it was a disc, deep vein thromboses, and others. He followed all of doctor's orders, with no relief. They drugged him up but he didn't want to take drugs but was in serious pain for so long he couldn't handle pain any more.

One doctor finally thought what it could be even though it never showed up on MRI with contrast. This doctor decided to do surgery to look...and yep...my son had 3 holes in a vein. He clamped off the vein and my son has been fine since. The doctor said that this usually happens in people over 60 not a 30 year old. That is why they didn't diagnose it.

I'm wondering how many people out there with chronic pain might have a hole in a vein also.

 

[geauxtohell]

my 30 year old son two years ago was sent to chiropractor's, neurologist, PT, and other speciality doc's because my son had extreme pain in his left calf muscle. Each doctor said it was a disc, deep vein thromboses, and others. He followed all of doctor's orders, with no relief. They drugged him up but he didn't want to take drugs but was in serious pain for so long he couldn't handle pain any more.

One doctor finally thought what it could be even though it never showed up on MRI with contrast. This doctor decided to do surgery to look...and yep...my son had 3 holes in a vein. He clamped off the vein and my son has been fine since. The doctor said that this usually happens in people over 60 not a 30 year old. That is why they didn't diagnose it.

I'm wondering how many people out there with chronic pain might have a hole in a vein also.

That's interesting. Thanks. I am glad you were willing to get a 2nd, 3rd, and 4th opinion.

 

[geauxtohell]

I am curious if anyone here has had experience as a patient with osteopathic manipulative therapy (OMT) and what their impressions were about it.

I know what the data says, but I am curious as to people's personal experiences if they are willing to share them.

i went to an osteopath one time, he cracked my spin from the base of my skull to the tip of my tail bone it felt like. scared the shit out of me. i have not and will never go back to a bone cracker, im rather fond of the ability to walk.

Was it a D.O. or a chiropractor?

Did OMT help with your issues, even if it frightened you?

 

[Fatality]

I am curious if anyone here has had experience as a patient with osteopathic manipulative therapy (OMT) and what their impressions were about it.

I know what the data says, but I am curious as to people's personal experiences if they are willing to share them.

i went to an osteopath one time, he cracked my spin from the base of my skull to the tip of my tail bone it felt like. scared the shit out of me. i have not and will never go back to a bone cracker, im rather fond of the ability to walk.

Was it a D.O. or a chiropractor?

Did OMT help with your issues, even if it frightened you?

it was a D.O

no it didnt do crap but make me think i would never walk again

i went to a PT sports medicine guy instead, no bone cracking there.

 

[xotoxi]

my 30 year old son two years ago was sent to chiropractor's, neurologist, PT, and other speciality doc's because my son had extreme pain in his left calf muscle. Each doctor said it was a disc, deep vein thromboses, and others. He followed all of doctor's orders, with no relief. They drugged him up but he didn't want to take drugs but was in serious pain for so long he couldn't handle pain any more.

One doctor finally thought what it could be even though it never showed up on MRI with contrast. This doctor decided to do surgery to look...and yep...my son had 3 holes in a vein. He clamped off the vein and my son has been fine since. The doctor said that this usually happens in people over 60 not a 30 year old. That is why they didn't diagnose it.

I'm wondering how many people out there with chronic pain might have a hole in a vein also.

What do you mean by a hole in a vein? I'm not sure I understand.

Was it varicose veins due to incompetant valves?

 

[anne12]

Hello Friends...........

Osteopathic medicine provides all of the benefits of modern medicine including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury. It also offers the added benefit of hands-on diagnosis and treatment through a system of therapy known as osteopathic

Thanks

 

[geauxtohell]

Hello Friends...........

Osteopathic medicine provides all of the benefits of modern medicine including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury. It also offers the added benefit of hands-on diagnosis and treatment through a system of therapy known as osteopathic

Thanks

No one is taking anything away from the D.O. degree which is equivalent to the M.D. degree, just curious about one particular modality that is unique to the degree.

Also, all physicians utilize "hands-on diagnosis", that's not inherent to any degree. It's pretty hard to do a physical exam without putting your hands on someone. It is slightly annoying when people make it seem like that is some sort of unique facet to medicine.

*Edit* I see you are in the U.K. Are you referring to Osteopaths in England or the United States? In the U.S. Osteopaths absolutely have full practice rights, but I was under the impression that was not the case in England.