Tuesday, December 27, 2005


Source: www.indianaholistichealth.net/glossary.htm

This is a very gentle form of treatment that can be used on almost any patient. The basis of this technique is the location of tender points, which are painful areas in myofascial structures that do not radiate to other parts of the body.


Considered an INDIRECT method if treatment in which the dysfunctional tissue is positioned at a point of ease, or balance, which is away from the restrictive barrier. It is based upon identifying tender points and positioning the patient so that the tenderness is relieved. Strain/counterstrain was discovered in 1955 by Lawrence H. Jones, D.O. This technique was originally called spontaneous release by positioning and has also been called positional release therapy (frequently by physical therapists).


  1. Locate the significant tender point.
  2. Place the patient in a position of optimal comfort. The goal for pain reduction should be at least 70%.
  3. Maintain the position of comfort for 90 seconds (120 seconds for ribs).
  4. Slowly return the patient to the starting position.
  5. Recheck the tender point.

Principles of the Cranial Techniques

Source: pages.prodigy.net/stn1/Cranial%20Technique.htm

William Garner Sutherland, D.O., was the founder of cranial technique. He first began to theorize movement of the cranial bones in 1899 while a student at the American School of Osteopathy in Kirksville, Missouri. Upon graduation in the class of 1900, he devoted 30 years of research and study on the subject before he began presenting the concept to the osteopathic profession. After many lectures and presentations, he published The Cranial Bowl in 1939. In 1947 the Osteopathic Cranial Association was formed as an affiliate of the Academy of Applied Osteopathy, and the Sutherland Cranial Teaching Foundation was established in 1953.



Primary- Underlying all other physiologic functions.
Respiratory- Concerned with cellular respiration.
Mechanism- Cranial articulations.

The PRM is often described in terms of the rhythm of the cranium, called the cranial rhythmic impulse (CRI). The rate of the CRI is from 6-12 to 10-14 cycles per minute, depending on what source you read. The central focus of this mechanism is the SPHENOBASILAR SYMPHYSIS (SBS). This is also referred to as the sphenobasilar synchondrosis or the sphenobasilar junction.

The components of the primary respiratory mechanism are as follows:

The anatomy of the cranial bones and their design for motion.
The mobility of the dural membranes (reciprocal tension membrane).
The inherent mobility of the brain and spinal cord, a constant rhythm of discharge and recharge of cells accompanied by a change in cell size.
The fluctuation of the cerebral spinal fluid.
The articular mobility of the sacrum between the ilia.


Dr. Sutherland hypothesized that the motion of the cranial bones originated from the sphenoid and that the DRIVING FORCE for the sphenoid came from the rhythmic fluctuation of the CSF, which was harnessed and transferred to the sphenoid through the dural membrane system. Think of the RTM as the guiding and limiting mechanism for the cranial and sacral bones as they are involved in the PRM. The axis around which the membranes move is called the SUTHERLAND FULCRUM in his honor. This fulcrum is the point along which all tension in the dural membranes is focused. It is located where the falx cerebri and the two parts of the tentorium cerebelli meet (in the area of the straight sinus).

Components of the reciprocal tension membrane:
1. Falx cerebri.
2. Falx cerebelli
3. Tentorium cerebelli
4. Spinal dura

Saturday, December 24, 2005

Knee Cap Degeneration and the benefits of Osteopathic Manipulative Treatment

Source: www.joselitodelacruz.com/Knee_pain.htm

Knee Cap Degeneration
(wearing down of the lining under the knee cap)

Frequent falls compressing the knee cap against the underlying bone, causing wear and tear of the cartilage lining.
Shortening of one side of the knee muscles, causing misalignment of the knee cap.
Dropped foot arch causing a twist in the knee and misaligning the knee cap.
Excessive twisting of the hips straining the knee.
Compensatory strain of the knee from lower back injuries or limping from foot problems.

A complete mechanical analysis of the knee and other joints. Balancing ligaments that are strained with local deep friction and ultrasound therapy to reduce inflammation and promote recovery. Muscular stretching to shortened muscles and deep soft tissue release to muscles that have adhesions combined with muscle energy techniques to rebalance muscle co-ordination. Craniosacral treatments to release and improve previously sustained stress and strains.

Where DOs can help: Osteopaths are quite good at analysing knee problems because we take into consideration mechanical problems elsewhere in the body that have direct and indirect connections with the knee. We also work with podiatrists (foot specialists) when further analysis is required for foot related problems

Aims of Osteopathic Diagnosis

Source: www.osteopathic.org/index.cfm?PageID=ost_tenet

The aims of osteopathic diagnosis are two fold:

  1. To identify the site of the source of the symptoms and the nature of the tissue disturbance.
  2. To assess the mechanical structure and function of the body.

It is the second aim that differentiates the osteopathic approach, both in the evaluation of the patient and consequently in treatment. It emphasizes not only of the local tissue damage or disturbance but also the interaction with the rest of the body. This is a two way process; the local dysfunction has an impact on the rest of the body but equally the local response will be affected by factors in other parts. It is our ultimately our purpose to assist the person to cope with and where possible, overcome the problem so long as it is amenable to an osteopathic approach. Osteopathic musculoskeletal evaluation is unique in that palpation is integrated with motion testing. Osteopathy emphasizes the interrelationships between structure (anatomy) and function (physiology).

But the osteopathic profession sees itself as being relevant to a wide range of health problems, and not simply limited to the treatment of musculoskeletal derangements. Osteopathic theory and practice are firmly in line with the concepts of Hippocrates. The patient is considered and treated as a whole. Founded as it was in this tradition, osteopathy is patient orientated rather than disease orientated. It has utilized structural diagnosis and manipulative treatment as part of its philosophy and practice, and therefore as part of total patient care, not confining it to painful conditions of the musculoskeletal systems alone.

According to the AOA, here are the tenets of osteopathic medicine:


Tenets of Osteopathic Medicine

First, do no harm. A thoughtful diagnosis should be made before exposing the patient to any potentially harmful procedure.

Look beyond the disease for the cause. Treatment should center on the cause, with effect addressed only when it benefits the patient in some tangible way.

The practice of medicine should be based on sound medical principles. Only therapies proven clinically beneficial in improving patient outcome should be recommended.

The body is subject to mechanical laws. The science of physics applies to humans. Even a slight alteration in the body’s precision can result in disorders that overcome natural defenses.

The body has the potential to make all substances necessary to insure its health. No medical approach can exceed the efficacy of the body’s natural defense systems if those defenses are functioning properly. Therefore, teaching the patient to care for his own health and to prevent disease is part of a physician’s responsibility.

The nervous system controls, influences, and/or integrates all bodily functions.

Osteopathy embraces all known areas of practice.

Osteopathic Treatment of Neck Problems

Source: www.backandbodycare.com/home/neck/neck.htm

Joint strain/lock

Osteopaths are able to feel and locate locked joints that are causing the pain.

Cause: Sports injuries, keeping the neck turned for too long, sleeping with high/low pillows, turning too quickly.

Treatment: Osteopathic manipulation to release the joints, mobilisation to increase the range of movement. Ultrasound therapy may be used. Balancing the ligaments that hold joints together.

Background: Manipulation of locked joints frees the neck and improves the range.
Clicking of these joints is not the same as when people click their own neck; they are not as specific and tend to click the same joints for years, causing future problems.
With osteopathic treatment and management people click their neck less often, feel more flexibility. They can turn their head further and have less discomfort.
Massage often helps temporarily to release the muscles, but without releasing the locked joint the stiffness soon returns. However, osteopathic deep soft massage can give longer relief because muscles are also stretched and lengthened to allow the joints to move freely. Otherwise residual stiffness can remain for a long time.

Upper Rib Problems
People are often surprised when they are told that the cause of their neck pain or stiffness is due to their ribs.

Cause: Sleeping on one side for too long with wrong pillow height, previous unresolved injury, muscle- or joint-trauma, compression from a spinal curvature.

Treatment: Deep soft tissue release of the muscles in between ribs as well as increasing the gap between rib segments, manipulation of the rib joints in the spine. Balancing the ligaments that hold joints together.

Background: Individual ribs can be injured and cause discomfort during breathing and neck movements. Upper rib problems tend to be painful on either side of the neck, between the shoulder blades and a few inches away from the spine. The pain is not sharp but often nagging and persistent. The discomfort can be quite deep, non-specific, and can vary.
People often ignore these symptoms until other overlapping problems become prominent.
Osteopaths examine other areas looking for structures that can contribute to the problem. This approach is different from orthopaedic surgeons or physiotherapists.
Osteopathic evaluation for neck complaints includes the examination of other structures like shoulders, mid back and rib cage. The examination can highlight long-standing upper rib pain that has intermittently caused discomfort for many years.
However, it is only after the detailed examination that patients realize the extent of their pain and the memory of the forgotten discomfort that they have come to accept.
The initial osteopathic treatment can relieve the current muscle and joint stiffness, but treating the underlying rib problems will provide long-term relief.

There is a misconception that taking the “curve” out of the spine will relieve pain and discomfort. People with a straight spine also get back pain!

Cause: For some, the curvature runs in the family as a hereditary problem, for others poor posture and bad habits in the long term can promote a curvature. Long or short leg syndrome is a common cause.

Treatment: X-rays are often recommended to assess the curve in detail. Soft tissue stretching and joint/spinal manipulation are needed to allow the body to compensate better for the curvature. Craniosacral techniques to release the internal stress and strains of the body.

Background: Osteopathic principles guide osteopaths to improve mobility, flexibility and function of the body and not just the spine, allowing the body to cope better under any circumstance - this includes scoliosis.
Scoliosis is not a disease but a description of the curvature of the spine. No person is 100% symmetrical and everyone is dominant on one side (the majority are right hand dominant). And so everyone has some form of curvature, which varies within a given range.
Patients with neck pain/stiffness resulting from a curvature in the mid back can get pain relief by osteopathic manipulation and mobilization of the soft tissues (muscles, ligaments, tendons) and joints.
The aim is to release any restriction around the mid back and neck to give the body a chance to compensate better for the curvature.
These treatments result in reducing both the constant daily stiffness and the frequency of clicking their own neck and an improved posture.

Trapped Nerves
Tingling and numbness in the hand and fingers constitute compression of spinal nerves at the lower part of the neck.

Cause: Compression and damage to discs (spondylosis), shortened and very tight muscles in the front and side of the neck can compress the nerves and blood vessels of the arm

Treatment: Patients can get relief from osteopathic manipulation - not simply applying traction to the neck, which is the standard hospital treatment, but by local and general treatment to the upper girdle (shoulder and head/neck) and lower girdle (pelvis and hips). Craniosacral techniques to release tension in the upper girdle and resolve previous trauma.

Background: Osteopathic manipulation can reduce the amount of hand symptoms for a person suffering from spondylosis.
There is no cure for this condition but rather a better treatment regime. They will always be prone to recurring symptoms, which is why exercise and posture correction are prescribed.
Treatment reduces the compression of the nerves, and osteopathic examination identifies factors that contribute to the nerve irritation.
These can be from poor posture, bad sleeping habits, lack of exercise or unresolved joint problems.

Osteopathic treatment can help prepare the structures around the neck prior to surgery. This will help to improve the recovery rate.

Disc operations in the neck are un-common but for those who have undergone this procedure, osteopathic treatment can often provide relief from neck stiffness, nerve compression, joint degeneration and muscle tightness.

First Aid to Neck problems

Use ice compress as soon as possible for 10 minutes to reduce inflammation. Take a break for 10 minutes and repeat 3x. This can be done every 2-3 hours for the first 1-2 days.

Take some anti-inflammatory tablets to control pain and reduce inflammation. Take care if you have sensitive stomach lining or ulcers.

If the pain is severe, make an appointment with the osteopath

If the pain persists after two days, see the osteopath. Take note that your body takes longer to recover if you delay your treatment.

If in doubt, call the osteopath for advice.

Find a DO near you today!

Osteopathic Manipulative Treatment-Some common questions by patients

Source: www.healthywomen.org/content. cfm?L1=3&L2=102&L3=6.0000

My doctor of osteopathic medicine (DO) didn't perform osteopathic manipulative treatment (OMT) on me. Why?

DOs will select the best therapy or other modalities that are necessary for the treatment of the patient as a whole. Not all conditions or each visit will require OMT. Remember, DOs are indistinguishable from medical doctors (MD) and thus utilize the standards of treatment, but are afforded an extra modality of OMT when appropriate.

I had a few sessions of osteopathic manipulative treatment (OMT) and I don't feel any better.

Manipulation takes time as well as your participation in maintaining your treatment by making postural changes and other life style changes in order for your condition to improve. Talk to your DO about other approaches to maintaining your treatment.

How does osteopathic medicine differ from chiropractics?

The most obvious distinction is that chiropractors are not the legal equivalents of MDs—they can't prescribe medication or perform surgery. Although both DOs and chiropractors practice manipulation and share a philosophy that good health is tied to the body's structure, chiropractors focus almost exclusively on realigning the bones and joints. DOs also practice traditional medicine and can treat a range of conditions with an array of tools.

A friend of mine had craniosacral therapy. Is that the same thing as cranial osteopathic medicine?

No. Cranial sacral osteopathic medicine is practiced by trained DOs (and some MDs); it involves gentle pressure to your head in a directed manner to obtain desired results. Craniosacral therapy is usually practiced by physical therapists, massage therapists or other alternative health professionals who never attended medical school. It may have its benefits, but it has its limitations in that it is not the complete treatment of the cranial sacral regions of the body. Be sure to talk to your health care professional before pursuing it.

Friday, December 23, 2005

Curing Headaches and Migraine

Source: www.indiangyan.com/books/therapybooks/ Osteopathy/Headaches_Migraine.shtml

A headache is a common problem today. Who does not get a headache? An executive, a philosopher, a scientist, a business magnate, a clerk, a housewife, a student - everybody, at sometime or other, is afflicted by a headache! It has no professional or age barriers.
Women suffer more than men. The reason may well be pre-menstrual migraines during puberty. These get worse as the years roll by, and are cured only by menopause. Contraceptives are known to cause headaches in some women and cure them in others. Headaches may become less frequent in pregnancy. In fact, a headache is not a killing disease, but its attack is so intense that all the nerves in the skull start throbbing due to great pressure.
A lot of research has been done to find out the cause of headaches.

What is a headache? Is it an allergic disease caused by something we eat or breathe? Has it any relation to our posture, incorrect way of sitting, standing or working? Is it a product of tension in our day-to-day life, a way to relieve frustration? Or is it due to some mechanical problem in the neck or head itself?

In the 5th century, it was thought that a headache was due to a severe chill, exposure to sunlight, or even fatigue. In the 11th century, it was thought that it occurred after having cold things in our food. According to Tissort (1784), vomiting often concluded an attack. He also suggested that a reflex irritation of the gastric nerves resulted in an attack of migraine. Living (1873) said that a headache was related to asthma and a convulsive state. Rilay (1932) suggested that it occurred when noxious vapor entered the cerebral blood vessels. According to another opinion, it occurred due to eye strain. A few researchers concluded that it was due to adhesions of the cerebral membranes and formation of excessive cerebro-spinal fluid. Disorders of the ovaries and thyroid were also thought to cause migraines. Emotional problems were also attributed to headaches - for instance, a difficult father-and-son relationship in business, tough competition, a tense situation in the family, a hard struggle to get oneself established .... Apart from this, certain foods were found to cause headaches: chocolate, cheese, fruits, alcohol, fatty fried foods, tea, coffee, sea food, pork and many more.


The long series of researches in this direction have shown that the human race has suffered a lot from headaches and though thousands of remedies have been prescribed, they have only succeeded in providing temporary relief Many migraine clinics and foundations have spent millions of rupees to find a remedy which will bring permanent relief These efforts are akin to ploughing in the sand! How long have we to live with such strong medications which produce side-effects in other systems of our body? After using a particular medicine for a long time, it loses its effectiveness anyway.

Sometimes, while suffering from a headache, a striking idea, solution or news gets rid of the headache and the patient becomes normal again. During a battle, General Ulysses S. Grant was seized with an attack of migraine. The limping general received the good news that his enemy was ready to surrender. Ulysses sprang to his feet at this glad news, and his headache vanished miraculously.

Many victims change their environment, take to the Himalayas, Tibet or Somaliland, go from the highest altitude to the lowest, from the wettest to the driest, experiencing a new climate, food and cultural changes but the migraine remains, because they carry their personal environment with them.

Headache of Cervical Origin

Frequently, a chronic headache resistant to treatment is due to a disorder of the cervical spine, which may be cured by manipulation. Certain mechanical changes in the cervical spine may cause an intermittent or a continuous headache. These changes respond well to manipulation. The pain can spring from the neck. Some people do not believe in the possibility that pain can radiate from the neck to the head.

An experiment was carried out by Kellgreen. A concentrated saline solution was injected in the area where the cervical spine first joins with the head, producing tenderness and headache in the forehead region. This proved a connection between the neck and the forehead.
Important changes have been found in the cervical spine in cases of headaches. These relate to disturbances in the lumen of the vertebral artery which passes through the transverse process of the cervical vertebrae and supplies blood to the brain.

Sometimes the therapeutic effect of cervical manipulation helps us to confirm whether a particular headache is of cervical origin.

Sometimes a headache is produced by the head being kept in a certain position; keeping it in the opposite direction relieves the headache. Sometimes manual traction at the neck relieves the headache. These are indications that headaches may be of cervical origin, and manipulation succeeds.

Embryological, the head and the first and second cervical vertebrae are formed by the first and second cervical segment.

As they originate from the same segments they ought to have some relationship between them. So any abnormality at the level of the first and second cervical vertebrae can give rise to pain in any part of the head, the temple and the forehead. As it happens elsewhere, local pain at the level of the cervical vertebrae may be completely absent and the patient may complain only of a headache.

This type of headache may come on while waking up in the morning. It may be felt in the back of the head or the front of the head, or may be only in the forehead. This begins to ease after some hours and is much better by mid-day. The patient is free from headache till the next morning. As the years pass by, the headache may tend to last longer during the day. It responds well to manipulative treatment.

Dr Bicker's staff is of the opinion that headache is due to stretching or tension in the muscles, vessels or the outermost sheath of the spinal chord. If it is due to these mechanical reasons, the pain starts in the upper neck muscles, and spreads to the upper back and head. Instead of being limited in this area, it spreads to the entire head. It may be associated with stiffness and pain in the upper neck. It occurs off and on. The -headache seems to spread from the neck to the head rather than from the head to the neck.

There can be other causes of headaches too. Keeping that in mind, a detailed history of the patient can help in pinpointing the cause of the headache.

At times differentiation is difficult. But distinction is important, as headaches arising from the neck can most easily and lastingly be relieved'. So it is a great pity when the right diagnosis is not made and the right treatment is not administered. Am old man is often told that his headache is due to high blood pressure. In fact, it may be completely unconnected and it may be due to upper cervical osteoarthritis. Cervical manipulation can relieve pain on the lateral side of the face. This pain often has rhythmically and may be associated with a running nose or watering of the eyes. It may radiate to the upper jaw or even the lower jaw. The patient is often referred to a dental surgeon or oral surgeon.

Osteopathic examination may show tenderness over the side of the second and third cervical vertebra on the same side, and if the X-ray picture is clear, manipulation will be successful in many cases and the pain will subside.

Other Possible Causes of Headaches
• Eye strain due to defective eyesight
• Sinusitis
• Toothache
• Digestive disturbances
• Neurological problems, e.g., an intra-cranial tumour
• Allergy
• Cardiovascular diseases
• Psychogenic (mental) frustration

Upper cervical pain may be caused by:
An intra-cranial tumour of the posterior fossa (portion) of the skull.
A disease of the upper cervical spine such as tuberculosis,

Headaches occurring at intervals on the right or left side of the head, are associated with nausea and vomiting. There may be a feeling of seeing non-existent objects in front of the eyes before the onset of the headache. Such headaches usually start before the age of 30.

Many such patients respond to manipulation. In some cases Migraine may occur at the back of the head. In such cases manipulation will relieve the headache to a considerable degree.

Migraine of Cervical Origin.
Spondylosis and osteo-arthritic changes in the cervical spine can cause an inflammatory reaction. This causes a spasm in the vertebral artery and its branches, resulting in a headache with the following characteristics:
1. It is mostly localized in the forehead and may be associated with nausea and severe vomiting. The headache always occurs on the same side. Manipulation elicits a good response.
2. Sometimes the headache is localized at the back of the eyeball and the initial symptoms pertain to visual abnormalities.

Case Histories

A girl, eleven years old, had a severe headache for five days. She underwent laboratory tests of blood, urine, and stool. X-rays were also taken. Every finding was normal and the cause could not be detected. In spite of all possible medication she did not show any improvement. She was thought to be a case fit for a psychiatrist. But her father brought the child to me and narrated the following history: she complained of upper back pain when she went to school with a heavy bag strapped across her shoulders. This pain continued till late evening. She became irritable and would not listen to her parents.

The history of irritability and failure of drugs proved that her ailment was not physical but mental. She was treated manipulatively three times and her headache completely disappeared. She was taught to walk straight instead of going about with a forward stoop. She showed complete recovery.

A 29-year-old lady with three children had been getting headaches off and on since her college days. She also suffered from severe pain in the neck and both shoulders. The headache would occur twice or thrice a month during the day, lasting each time for 10-20 minutes. It would become less during the menstruation cycles. After she got married, the headaches went on increasing in frequency and intensity, and for two years she got headaches every day and had to resort to pain killers. The headaches were accompanied by tension in the neck and were more intense at the back of the head and in the frontal area, in her eyeballs and behind them.
Her condition was diagnosed as migraine. She was given manipulative treatment for her cervical spine and upper dorsal spine. Gradually the headaches started getting less frequent and less intense. She rarely used a pain killer. In 10 weeks the headaches completely subsided.

A 36-year-old engineer employed in the Railways had been suffering from headaches since his school days. They used to occur at fortnightly intervals and later, almost every week. The pain was very severe, starting from the back of the head and then spreading all over the head. He also felt pain in the upper back. His veins became prominent in the temples during the attack, and throbbed. He suffered from nausea and vomiting and would turn away from food or drink. All this would last for twenty-four hours, sometimes even for two to three days. Occasionally, when there was no severe headache, there would be a feeling of general uneasiness. He would prefer to remain in the dark and not be disturbed. He also preferred to lie down till recovery. He was given glasses as his sight was found to be weak, but this did not help. He consulted many doctors and took treatment, but to no avail.

He came to me with his complaint. I examined him thoroughly and found him to have a round upper back. X-rays of the cervical and dorsal spine were taken, but they did not reveal any abnormality; other pathological tests too were all normal.

Manipulative treatment was started. He felt no improvement after the first session. He was called again after a week and manipulative treatment of the cervical and dorsal spine was repeated. He felt some improvement. After a few weeks, his headache became less severe and less frequent. In three months he felt completely recovered, but he continued to come once a month for three months. He has since been advised to come twice a year for maintenance treatment. He has had no attacks ever since.

A young girl aged 21 years suffered from headaches for eight years. At first, she used to have a headache once a month or once a fortnight. During the last three years, the headaches became more frequent and she started having headaches almost every day. The ache was in the entire head, though more severe in the forehead. She did not get nausea or vomiting. Due to the severity of the headaches, she had to discontinue her studies. She was examined by a few doctors but nothing seemed to help her.

She was then referred to me for manipulative treatment. After being treated for three weeks, she felt much better. By the end of six weeks, she was completely cured and the headaches never returned. She has resumed her studies happily.

A good website for more information:

Wednesday, December 21, 2005

Osteopathic Manipulative Treatment(OMT): Muscle Energy Technique (MET)

Source: www.healthy.net/scr/article.asp?ID=1650

Muscle Energy Technique (MET) is a further method of applying direct action to a restricted area. With MET, however, it is the patient's own forces which produce the manipulative effort. By placing a joint in a precise position, and calling on the patient to use a muscular effort in a particular direction, against a distinctly executed counter-force from the practitioner, it is frequently possible to achieve dramatic improvements in joint mobility. The skill in such a manouevre is in creating a balance of forces which can operate precisely on the restriction. In general terms MET involves placing the joint in question at the limit of its possible motion, in the direction in which it is most restricted. This position is maintained (not exaggerated) by pressure from the practitioner and, in a controlled manner, the patient then attempts to move the joint, by sustained effort, against the practitioner's counterforce. No movement should take place during repeated short or long efforts of this type. After each such effort the joint should be reassessed, and if the range of movement has increased then the joint should be taken to this new limit before the next attempt. This method is virtually painless, and is suitable for self-use in many areas of the body (fingers or elbow, for example).

Curing Elbow Pain through Osteopathic Manipulative Treatment(OMT)

Source: www.healthlibrary.com/reading/cure/chap13.html

A patient may complain that he cannot pour a cup of tea for himself He experiences difficulty in closing his fist tightly, or while grabbing and lifting heavy things from the ground with his hands. He has pain on the lateral aspect of the elbow at a prominent point called the lateral condyl of the humerus or arm bone. The pain travels along the back of the forearm and may go as far as the wrist or the back of the hand as far as the ring finger of the hand. It may be severe enough to go to the external aspect of the arm up to the shoulder, but this is less common. Sometimes, there is a constant ache, which gets worse at night, disturbing the sleep. The patient may wake up with stiffness of the elbow.

Tennis Elbow

Pain at the elbow joint is commonly seen among tennis players. That is why this condition is commonly called tennis elbow. Those who do not play tennis may also suffer from elbow pain.
The pain starts due to a strain where the wrist has to be extended again and again as is done while playing tennis or while using the hammer. The patient does not feel any pain even after a slight injury to the elbow joint is sustained during these movements. Later on, certain movements at the wrist joint or elbow start hurting and a fortnight later, a tennis player cannot hit backstrokes at all.

It is not the tear of the tendon which causes the pain. The pain is due to the formation of a painful scar which results from multiple injuries. During the game or due to the active use of the elbow and wrist, the healing process which is accelerated by rest and avoidance of movement, remains incomplete. The strain on the extension ligaments is caused during the extension or backward bending at the wrist joint. The pain is peculiar; occasionally it comes on suddenly and the grip of the hand becomes powerless momentarily. The patient may even drop light objects that he is holding on the ground.

Getting a tennis elbow is frequent between the ages of forty to sixty years, the years when cervical spondylosis is also common. A view is often expressed that elbow pain has some relation with the neck. Sometimes this is true. Pain in the elbow joint can arise from the neck without any injury at the elbow. All cases of elbow pain should be examined for a neck lesion too. Generally tenderness can be located at the level of the fifth, sixth and seventh cervical vertebrae. Marked tenderness is noted in the lower part of the neck on the side of the elbow involved. So if the pain in the elbow joint is due to the neck, manipulation of the latter will result in a spectacular recovery. A distinction must be made between elbow pain due to the cervical spine and pain due to a tennis elbow. Sometimes an elbow pain is due to both a cervical lesion and periarthritis of the elbow. These two causes can be easily distinguished. In a true tennis elbow, the extension of the wrist joint is painful. During this test the elbow must be fully stretched. In a true tennis elbow, the side bending of the wrist towards the thumb side is also painful. Sometimes muscles on the lateral aspect of the forearm feel tender on deep palpation; these muscles help in extension at the wrist joint.


A tennis elbow recovers on its own without any treatment in about a year, if a person is under sixty years. However it takes longer when the person is over sixty.

Ordinarily it is treated by local hydrocortisone injections. These injections inhibit spontaneous recovery. It is not uncommon for patients to remain well after an injection for a few months and then feel the need for further injections month after month. If left untreated however, there is a possibility that the patient may recover completely in twelve months on It’s own.

Manipulation is found to be effective for a tennis elbow. The elbow is fixed and deep friction is applied on the epicondyl for five to ten minutes before manipulation, This softens the scar tissue which becomes easier to break by manipulation. Manipulation is repeated once or twice a week for four to six weeks. Such sessions are enough to relieve the pain completely. Manipulation is done in hypertension. One may hear the cracking sound during manipulation and relief is felt immediately following the manipulation.

Manipulation shortens the time required for recovery, and once the condition is cured, it does not recur.

Case Histories

A fifty-two-year old man with a good build, employed as a supervisor in building construction, had pain in the elbow for two months. He used to drive a motor cycle for an average of 100 km daily. But the pain made him incapable of driving., He even had a lot of difficulty in lifting and moving the telephone. He had stiffness in the elbow in the mornings, and was not able to sleep well due to the pain. He had had a similar pain earlier on and it had subsided with local injection of hydrocortisone.
X-rays and laboratory tests were conducted after the problem was diagnosed as a tennis elbow. He felt relief after the first manipulative treatment. The pain decreased gradually and subsided six weeks later. He was advised to use his arm as little as possible during the treatment. He never complained of pain for two years following the treatment.

A forty-one-year old housewife with five children had pain in the right elbow for five years. The pain had begun following a fall where she had supported herself by the hand. There was a slight swelling over the elbow. She experienced more pain if she used her hand more during work. Sometimes she felt pain in the forearm and upper arm upto the shoulder and neck.
She came to me with the above-mentioned complaint. There was a slight swelling over her left elbow. The X-ray showed no abnormality and the laboratory tests were normal.

Manipulation of the left elbow was started, along with manipulation of the cervical spine. She felt better following the first treatment. By the third week she was comfortable. The pain became more localized, and there was no pain in the neck and shoulder. The pain in the elbow subsided gradually and in ten weeks she was free of it.

AOA to Promote Preventive Health Issues

Source: AOA Daily Reports

The American Osteopathic Association (AOA) has received a free, 115 square foot window space in Rockefeller Plaza, steps from the NBC Today Show, through Executive Health Exams International (EHE). EHE is a preventive healthcare organization that provides the window space free of charge to a different organization each month to promote preventive health care issues. In January, the AOA will use the space to promote preventive health issues related to obesity, smoking and depression. The display will be available January 3-31st 2006. Rockefeller Center Management estimates the number of people that pass through the Plaza each day as 250,000, providing the AOA with a great opportunity to promote D.O.s/osteopathic medicine.

Tuesday, December 20, 2005

CranioSacral Therapy vs. Cranial Osteopathy: Differences Divide

Source: www.massagetoday.com/archives/2002/10/14.html

CranioSacral Therapy, which I developed in the 1970s, is compared frequently to cranial osteopathy, developed by Dr. William Sutherland. Although Dr. Sutherland's discovery regarding the flexibility of skull sutures led to the early research behind CranioSacral Therapy - and both approaches affect the cranium, sacrum and coccyx - the similarities end there.

What was to become cranial osteopathy began as the idea of an osteopathic student in Kirksville, Missouri, in the early 1900s. Dr. William Sutherland saw that the bones of the skull were designed to allow for movement in relationship to one another. It was a radical idea that flew in the face of American and British anatomy textbooks, which taught that skull bones fuse together before adulthood.

To test his theory, Dr. Sutherland filled a skull with dry beans and added water. This caused the skull bones to move along the suture lines, and ultimately to disarticulate. He also performed makeshift experiments on himself with helmet-like devices that imposed variable controlled and sustained pressures on different parts of his head. His wife recorded personality changes, head pain and coordination problems he displayed in response to different pressure applications.
Based on his experiments, Dr. Sutherland developed a system of examination and treatment for the bones of the skull that became known as cranial osteopathy. Because so little was known about how it worked - and patient results seemed miraculous at times - Sutherland's system acquired an esoteric reputation.

Conversely, the origin of CranioSacral Therapy can be traced to the accidental discovery of the craniosacral system during a seemingly routine surgery in 1970. At the time, I had a unique view of the dura mater, the outer layer of the meningeal membrane in the neck. Ordinarily compromised as part of surgical procedure, the dura mater was deliberately left intact during this surgery to prevent any risk of meningeal infection.

My task as a surgical assistant was to hold the dura mater still while the surgeon scraped a calcium plaque off its surface. No matter how I tried, I was unable to do it. The membrane continued to move rhythmically at a rate of about 10 cycles per minute. Neither my colleagues nor any medical text I consulted could explanation this phenomenon.

Still curious about what I had seen, I enrolled two years later in a seminar that explained Dr. Sutherland's ideas and taught some of his evaluation and treatment techniques. Coupling my scientific background with tactile sensitivity, I surmised that the rhythmical motion I had seen during surgery could have been caused by a hydraulic-type system functioning inside a membranous sac encased within the skull and canal of the spinal column. After further study and research, I refined Dr. Sutherland's techniques and successfully incorporated them into my private medical practice.

In 1975, I was invited by Michigan State University to lead the world's first task force to study and verify the mobility of cranial sutures and bones. For the next five years, I led a team of anatomists, physiologists, biophysicists and bioengineers, and together we researched the basics and potential for performing therapy on the craniosacral system.

Through an extensive series of studies and experiments, we demonstrated how the craniosacral system could be used to assess and improve numerous health problems involving the brain and spinal cord. Yet this was a very different approach than that used in cranial osteopathy. Here we were focusing not on the bones of the skull, but on the membranes and cerebrospinal fluid surrounding the brain and spinal cord.

We verified that the craniosacral system does indeed operate like a semi-closed hydraulic system. Pressures build as the amount of cerebrospinal fluid increases in the system, forcing the fluid to move up and down the spinal cord. When the fluid moves, the membranes containing it also move, normally at a rate of 6-12 cycles per minute.

CranioSacral Therapy practitioners are trained to gently monitor this rhythm to detect and release imbalances and restrictions in the membranes that could potentially cause sensory, motor or neurological dysfunctions. As such, CranioSacral Therapy is never intended to cure disease, but simply to facilitate the body's ability to self-correct. It offers a comprehensive, whole-body structural and functional evaluation protocol.
Even today, the focus of cranial osteopathy remains on manipulating the sutures of the skull.

With CranioSacral Therapy, the bones of the skull are involved in that they serve as "handles" for the practitioner to use to access and affect the membrane system that attaches to those bones.

Another major difference between the two approaches is in the quality of touch. In general, the manipulations used in cranial osteopathy are often heavy and directive. Practitioners of

CranioSacral Therapy usually use a light touch, scientifically measured to be between 5 and 10 grams. That's about the weight of a U.S. nickel resting in the palm of your hand. This gentle quality often belies the effectiveness of the therapy. Most patients report feeling nothing more than subtle sensations during a typical session.

Yes, CranioSacral Therapy and cranial osteopathy are quite different. Yet they remain linked in history by two osteopaths who trusted their observations and continued undaunted in their quests to prove their theories.
John Upledger, DO, OMM Palm Beach Gardens, Florida

Life, Stress and Health-where OMT can help

Source: www.massagetoday.com/archives/2002/09/14.html

Stress is a primary contributing factor in a myriad of diseases processes, yet the biggest factor is actually the way in which our bodies deal with stress. Perhaps our high-tech society has evolved more rapidly than our bodies' ability to respond effectively.

Stress responses began to be seriously recognized as causing disease processes during the '40s and '50s. Hans Selye, MD, was the pioneer in this area. He did most of his work at the University of Montreal before dying at age 75 in 1982. Today, through clinical and laboratory work, we have come to know many of the mechanisms by which stress stimulates internal responses that damage organs, tissues, psyches and the like. What's more, the stress itself does not have to be within your conscious awareness.

Let's say you've finally found a job that is perfect in every way except one: the air conditioner in the office makes a strange kind of hum that sets your teeth on edge. You tell yourself you can get used to it. You have a great job and you aren't going to let a silly thing like noise screw it up. So you push the sound into your subliminal perception so you don't consciously hear it anymore.

The problem is, the vibrational frequency that irritates/stimulates something in you can still affect your body. You may be having a great time, but you seem to catch every germ that flies into your space. After a while, your temper becomes more active.

Are all these "colds" making you irritable and cross? Perhaps. But let's look at this from a stress/response point of view. First, the vibrational frequency of the irritating sound you removed from your consciousness is still getting into your body. Why should your body be so sensitive to a given sound frequency that it produces a stress response? For whatever reason, the vibration in question is a stressor to you.

Perhaps certain tissues in your body resonate with this particular vibration. On the other hand, maybe this is the same vibrational frequency that occurred when you were in an operating room getting your tonsils out. The sound came from the hospital air conditioner at the same time you were afraid the anesthesia might kill you. Although you had suppressed the memory of the fear that occurred during your tonsillectomy, it became linked with the vibrational frequency nonconsciously, as did your bodily responses.

And how does your body respond to the fear stressor being initiated now at your new place of employment? By producing adrenalin, which saves your life. Adrenalin diverts blood flow from organs to muscles, because you may need your muscles to survive. It also increases your heart rate and blood pressure, which gives you a greater ability to physically confront danger.

At the same time adrenalin is emitted, your internal alarm system goes on ready alert. The reticular alarm system connects with your adrenal glands and sympathetic nervous system. When the alarm system senses danger, both systems activate to prepare you for a life-saving battle. The sympathetic nervous system is also a division of your autonomic nervous system. It has the ability to shut down internal systems and organs not necessary for "fight or flight," such as your digestive system and related organs: kidneys, bladder, bowel elimination system and immune system.

Consider now that the air conditioner at your new job sets off the internal alarm system that remembers the danger of the operating room and your tonsillectomy. It activates your adrenal glands and sympathetic nervous system so you become uptight and irritable. At the same time, your sympathetic nervous system reduces immune system activity, so you lose some of your ability to resist passing germs.

Dr. Selye also showed that increased adrenalin can cause a weakening of the heart muscle and ulcers in the stomach. The adrenal glands, which enlarge to help keep up with the increased demand, eventually devitalize and lose their ability to produce satisfactory amounts of adrenalin. Once this occurs, your stress response is compromised. You can no longer fight off the effects of stressors, and ultimately collapse into illness.

Many of us think of stressors as things we can see, feel or perceive, but as I've illustrated, your body responds just as significantly to stressors of which you may not be aware. It's also not unusual for our bodies to sound the alarm in preparation for an acute crisis that never comes.

Why? Because in our world we are surrounded by chronic stressors. Many have to do with vibrational frequencies: sounds, lights, colors, aromas, magnetic fields, electrical fields, barometric pressure changes and so on. Others include molecules that are toxic or stressful to our biochemistries. They can be in food, drink, the air, our clothing, and any number of other places.

You can turn off or move away from many of these environmental variables. Yet there is another area of stress that is less tangible and somewhat more fun to hypothesize about. These are the stressors that come from consciousness fields and intentions that are either foreign or neutral to us, or perhaps downright unfriendly. We encounter these "energy fields" in our daily lives.

Haven't you found yourself naturally drawn to someone from across the room? Or perhaps you've seen others who repulse you, scare you, or give you a feeling of distrust. Call it intuition, fantasy, imagination, or something else, but more and more proof is coming from the scientific world that energy fields exist both through and around living systems. And evidence mounts that these energy fields have characteristics that correlate to anger, danger, fear, guilt, love, compassion, empathy, and other emotions. It is not a big jump to presume each of us has internal sensors that tell us about the nature of an energy field moving into our own.

What can we do to avoid the destructive effects of stress? First, avoid stressors you can identify. There are also ways to disempower stress factors so your system responds more reasonably and recovers more quickly. I always recommend regular meditation and centering to avoid long-term responses. Exercise is another great way to use up the adrenalin produced and not used when, for instance, a car cuts you off on the interstate. Years ago I put up a punching bag in my basement. Whenever I got home from work, I would go into the basement, beat on the bag and feel better.

I'm sure at the time the bag saved me from an ulcer. These days, I'm convinced the most effective methods of stress-response control fall under the umbrella of CranioSacral Therapy, including Energy Cyst Release, SomatoEmotional Release, and Therapeutic Imagery and Dialogue. CranioSacral Therapy has been shown to reduce sympathetic nervous system activity and irritability, indicating a decrease in adrenalin production. This is the immediate symptomatic effect.

Going a step further, we can release old tissue memories of things that occurred during childhood (or earlier) that continue to cause over-responses. We use Energy Cyst Release to discharge foreign energies that were injected into the body by injuries, infections and emotional crises. These energy cysts, which keep stress-response systems on ready alert, can be released so alarm systems can relax. Using SomatoEmotional Release, we can disempower previous experiences, such as abuse, rape and near-death traumas, so the hyper-responsiveness is calmed down. And using Therapeutic Imagery and Dialogue, we can dialogue with the reticular alarm system and negotiate a reduced level of activity.

Yes, I am biased about the best methods for maintaining an appropriate stress response. I have seen remarkable success using these techniques. It is time we learn to work with stress (and our responses to stress) to avoid disease. This seems a more effective method of enhancing health than the "patch 'em up after the fact" approach that still dominates.

John Upledger, DO, OMM
Palm Beach Gardens, Florida

Osteopathic Docs as Mainstream as M.D.s

Source: www.hon.ch/News/HSN/509181.html

These physicians combine hands-on body manipulation with traditional medicine
By Janice Billingsley

What does it mean when your doctor has a D.O. after her name instead of an M.D.? Is she a "real" doctor?

The answer is an unqualified yes. A doctor of osteopathy has the same four-year medical school training as a medical doctor -- although at different medical schools -- as well as a year of internship and a year of residency.

While the basics are the same, there are subtle differences in the ways the two groups of physicians practice medicine.

"When people ask me, I use the analogy of the Democrats and the Republicans. They are both writing laws, but are coming at them with different philosophies," says Dr. Tyler Cymet, a doctor of osteopathy and a professor at Johns Hopkins Medical School in Baltimore. "M.D.s and D.O.s are both in the business of healing, but they have different philosophies and a different orientation."

Adds Dr. J. Edward Hill, chairman of the American Medical Association: "The position of the American Medical Association is that M.D.s and D.O.s are perfectly comparable. There are no significant differences between the two. We are very supportive of each other, and it's been a good arrangement."

D.O.s, Cymet says, are trained in a "whole person" idea, so they focus on personal history in addition to medical history when diagnosing an illness. They also receive extra training in the musculoskeletal system, the way the body's nerves, tissues, muscles and bones are interconnected, with the idea of understanding how an injury or illness in one part of your body affects other parts. The training includes osteopathic manipulative treatment (OMT), which is a therapeutic application of force to help patients maintain a full range of motion.

"Sixty percent of D.O.s are primary-care specialists," Cymet says. "We are not just looking at the disease. We try to develop a relationship with the patient, understanding the social aspects of their lives as well as the biomechanical problems they may have."

He adds, "Our philosophy is to use the body to heal itself, to use medical knowledge to free up motion to allow the person to be active, to help a person stay healthier."

Cymet says a typical initial visit with a patient takes an hour. First, there is a physical examination, and then he spends time getting to know the patient.

"I ask him how he spends his day, what time he wakes up, what he eats for breakfast…," he says. "Then I ask about the problem, whether it is new or old, and how it has changed his life. The discussion itself can be therapeutic to the patient."

The treatment can be a standard medical treatment, such as a drug prescription, or can include manipulative treatment to help the patient with his pain or range of motion. Because of time constraints, however, Cymet says he often has to have the patient return for osteopathic manipulative treatment.

Though an OMT sounds like standard chiropractic treatment, Cymet says it's more than that.
"We have more medical training," he says. "We know more about the organs and soft tissues than chiropractors, and are much better prepared to know if there is a problem with a prostate or gall bladder or other organs."

Dr. Patrick Alguire, the director of education and career development at the American College of Physicians in Philadelphia, used to teach a training program in internal medicine at Michigan State University, which has both a D.O. and M.D. program. He agrees the training for both specialties is very similar.

"Many of the courses were the same, and there was no difference in the baseline knowledge or skills with patients," he says, except that the D.O.s took courses in manipulative medicine.
Alguire, an M.D., adds he continues to see little difference in the ways the two groups practice medicine.

"Holistic care is not unique to D.O.s," he says. "Starting about 20 or 30 years ago, there has been a push toward generalization, to developing specialized training tracks for primary-care physicians."

There are far more M.D.s than D.O.s, says Cymet, but the ranks of D.O.s are growing.
According to the American Osteopathic Association, there were more than 56,000 osteopathic doctors in 2005, the latest year with available figures.

"The number of schools has increased, from six in the 1980s to 23 schools now, and there are two-and-a-half applicants for every spot," Cymet says.

What To Do
For an explanation of osteopathic manipulative treatment, you can visit the American Osteopathic Association . And the American Cancer Society has an informative explanation of doctors of osteopathy.
SOURCES: Tyler Cymet, D.O., assistant professor, internal medicine, Johns Hopkins School of Medicine, and section head, family medicine, Sinai Hospital, Baltimore, Md.; Patrick Alguire, M.D., director, education and career development, American College of Physicians, Philadelphia; J. Edward Hill, M.D., chairman, American Medical Association, Chicago

Monday, December 19, 2005

Family Health® Added!!

I have added the Family Health® radio feed to the blog sidebar.


Something about this wonderful service:

Since first airing in 1981, Family Health® has grown to encompass a network of 225 radio stations and reaches 11 million listeners daily in the United States. In addition, the series is heard worldwide on the U.S. Armed Forces Radio Network. Radio stations receive the programs monthly, free of charge, on a compact disc.

The host of Family Health® is Harold C. Thompson III, D.O., an assistant professor in the Department of Family Medicine at the Ohio University College of Osteopathic Medicine. Dr. Thompson, is a graduate of the Chicago College of Osteopathic Medicine, and previously practiced as a family physician in Nelsonville, Ohio. He also has served as the director of OU-COM's Center of Excellence in Multicultural Medicine.

The series is a service of the College of Osteopathic Medicine and the Center For Public Media at Ohio University. Utilizing the Center's facilities, the programs are recorded, edited, and mastered by producer Don Bilski. Carl J. Denbow, Ph.D., OU-COM director of communication, is the project director for the series.

Production and distribution are funded in part with support from the American Osteopathic Association, the American College of Osteopathic Family Physicians, the Brentwood Foundation, the Ohio Osteopathic Foundation, the American College of Osteopathic Surgeons, and The Ohio Chapter of American College of Osteopathic Family Physicians.

Quality of life in referred patients presenting to a specialty clinic for osteopathic manipulative treatment.

Source: Journal of the American Osteopathic Association. 102(3):151-5, 2002 Mar.

Previous research has found that patients of osteopathic physicians tend to report poorer general health perceptions than persons in the general population or than patients of allopathic physicians. Quality of life and level of healthcare satisfaction in patients referred to a specialty clinic for osteopathic manipulative treatment (OMT) at a college of osteopathic medicine were measured in 1997. Data from the Medical Outcomes Study 36-Item Short Form (SF-36) were used to compute standardized scores in the following eight health scales: physical functioning, role limitations because of physical problems, bodily pain, general health perceptions, vitality, social functioning, role limitations because of emotional problems, and mental health. There were 185 patients who returned the survey (mean response rate, 90%), including 22 new and 163 established patients. Patients reported poorer health than the general population on all eight scales (P < .001). Patients frequently reported poorer quality of life than referents with hypertension, congestive heart failure, type 2 diabetes mellitus, recent acute myocardial infarction, or clinical depression. More than 97% of established patients were satisfied or very satisfied with the healthcare received at the clinic. This study suggests that referred patients presenting to osteopathic physicians for OMT may have poorer quality of life than is generally recognized when relying only on traditional diagnostic approaches. Early detection and treatment of musculoskeletal conditions may be important factors in preventing chronicity and its impact on quality of life.

Sunday, December 18, 2005

Osteopathic Medicine: A Reformation in Progress

Source: Book description taken from Amazon.com Review

by R. Michael Gallagher (Editor), Frederick J. Humphrey, Marc S. Micozzi (Editor)

Book Description

Osteopathic medicine is a holistic method of health care that focuses on manipulative treatments to maintain the harmonious balance of the body's interactions. Osteopathic Medicine: A Reformation in Progress offers a broad-based introduction to the basic tenets of osteopathic medicine, from the roots of osteopathic reformation to its present and future role in primary care medicine. It addresses the problems that the osteopathic profession has faced and continues to face, and offers concrete and proactive recommendations for the future. Both osteopathic practitioners and physicians who practice mainstream medicine can benefit from the theories and practices presented in this intriguing text.

Osteopathic Medicine: A Reformation in Progress
is a long overdue reference for those seeking accurate information about the history and development of the ostoepathic medical profession. It concisely reviews the historical foundations and evolution of osteopathic medicine from a frontier-based medical sect to a full-fledged social movement in American health care.

In a well-written and engaging style, the authors provide the reader with a critical appraisal of where the osteopathic medical profession has been, its past achievements and current challenges, as well as a clear course for its future development. It also explores the dimensions of osteopathic medical education and practice that distinguish DOs from their MD counterparts. The authors review the philosophical foundations that drive the unique osteopathic approach to patient care as well as a critical appraisal of efforts to incorporate osteopathic principles and practice into the broader infrastructure and science of total health care management. This is book is highly recommended reading for all pre-medical students considering a career in osteopathic medicine, current osteopathic medical students and residents, as well as practicing physicians, and interested lay people. This book will also be of particular interest to medical educators and public health policy-makers who work to further refine and develop a health care system that is compassionate, accessible, evidence-based, integrative, and technologically advanced.

For all those who still quite do not understand what D.O.s contribute to the American healthcare system, this book is a perfect pick to read!

Here is an article from JAOA:

This insightful, user-friendly manual approaches the story of osteopathic medicine from past, present, and future perspectives. Osteopathic medical educators recount the history and purpose of osteopathic medicine in a book designed for physicians, student physicians, and interested nonphysicians.

Gerald G. Osborn, MD, MPhil, succinctly presents the complex history of osteopathic medicine, making it clear that this form of healthcare is a uniquely American phenomenon. Starting from humble beginnings, the osteopathic medical profession expanded its curriculum beyond that of the musculoskeletal system, yet purposely maintained a central theme that recognizes the importance of this system for the maintenance of health. Organizational cohesiveness, political and legal savvy, and certainly some good fortune allowed osteopathic medicine to not only survive, but to also develop a strong position in modern healthcare.

In chapter 2, John M. Jones, DO, focuses on osteopathic medicine as we know it today, exploring the osteopathic medical philosophy and how it has evolved. Later in the chapter, the osteopathic profession's "second great osteopathic philosopher," Irvin M. Korr, PhD, builds on the initial teachings of osteopathic medicine's founder, Andrew Taylor Still, MD, DO. The author reviews osteopathic principles and practice and uses case presentations to clarify these concepts.

Next, Barbara Ross-Lee, DO, describes how classic osteopathic medical care evolved into a healthcare delivery profession with a primary care emphasis. As allopathic medicine pursued specialty and subspecialty care, osteopathic medicine maintained its focus and strength in primary care medicine.

Felix J. Rogers, DO, explains in another chapter how, despite this primary care focus, specialty and subspecialty care evolved within the osteopathic medical profession. The evolution of these areas of specialization accelerated the profession's prestige and increased its acceptance by patients. Osteopathic physicians chose to maintain the basic practices of osteopathic medicine, however, and implemented osteopathic medical tenets, which were later expanded.

Douglas L. Wood, DO, discusses the progressiveness of the osteopathic medical education process, the growth of which was necessary to support the growth that was occurring in the profession. Dr Wood's explanation helps readers to understand how the basic tenets of osteopathic medicine were maintained as the profession matured and was integrated into the healthcare environment.

The final chapter focuses on the future of osteopathic medicine. Here, the editors, R. Michael Gallagher, DO; Frederick J. Humphrey II, DO; and Marc S. Micozzi, MD, PhD, speculate how the osteopathic medical profession may change over time, noting in particular the ways in which patient care and medical education need to change so that osteopathic medicine remains separate from allopathic medicine as a healthcare system.

I recommend this book for experienced osteopathic physicians as well as osteopathic physicians-in-training and individuals who are interested in understanding the osteopathic medical profession.

I have now read this book twice and, with each reading, have learned a great deal. I have a greater appreciation for the foundation of hard work that was required to develop this professional opportunity that allows osteopathic physicians to provide patients with a distinct and effective mode of therapy.

Saturday, December 17, 2005

How Osteopathic Manipulative Treatment can help a patient in treating slipped disc?

What is a disc?

The spine is made up of the vertebrae (the bones making up the spine), which have cartilage discs between them.

The discs consist of a circle of connective tissue with a central gel-like core. This makes the spine flexible and at the same time acts as a protective buffer.

In the centre of this column of vertebrae and discs is the spinal canal, which contains the spinal cord stretching from the brain-stem down to the first or second lumbar vertebra. It continues as a bundle of nerve fibres called the cauda equina stretching down towards the sacrum, which is the extension of the spine. Between each vertebra, the spinal cord has nerve root connections to other parts of the body.

The spine is divided into three parts:

neck (cervical vertebrae)

chest (thoracic vertebrae)

the lower back (lumbar vertebrae).

Source: www.netdoctor.co.uk/diseases/facts/slippeddisc.htm

What is a slipped disc?

A slipped disc is when the soft part of the disc bulges through the circle of connective tissue. This prolapse may push on the spinal cord or on the nerve roots. However, it is worth noting that 20 per cent of the population have slipped discs without experiencing any noticeable symptoms.

The term 'slipped disc' does not really describe the process properly - the disc does not actually slip out of place, but bulges out towards the spinal cord.

What is the cause of a slipped disc?

A slipped disc occurs due to the breaking down of the circle of connective tissue with advancing age. This causes a weakness allowing the soft part to swell.

Slipped discs most often affect the lower back and are relatively rare in the chest part of the spine.

It is possible that hard physical labour can increase the likelihood of a slipped disc. They are also occasionally seen following trauma such as an injury from a fall or a road traffic accident.

At what age can a slipped disc occur?

A slipped disc in the lower back is most often seen between the ages of 30 and 50. In the cervical vertebrae around the neck, slipped discs are most often seen between the ages of 40 and 60.

What are the symptoms of a slipped disc?

A slipped disc can be symptom free. If it causes pain, it is primarily due to the pressure on the nerve roots, the spinal cord or the cauda equina.

Symptoms of nerve root pressure

Paralysis of single muscles, possibly with pain radiating to the arms or legs. There may also be a disturbance of feeling in the limbs.

Symptoms of pressure on the spinal cord

Disturbance of feeling, muscle spasms or paralysis in the part of the body below the spinal cord pressure. For example, pressure on the spinal cord in the chest area will cause spasms in the legs but not in the arms.

Pressure on the spinal cord may cause problems with control of the bladder.

Symptoms of pressure on the cauda equina

The symptoms can include loss of control of the bladder function, disturbance of feeling in the rectum and the inside of the thighs and paralysis of both legs. These are serious symptoms and anyone developing them should contact a doctor immediately. (They are so-called 'red flag' symptoms.)

How does the doctor make a diagnosis?

It is possible to make a diagnosis from the patient's history and the doctor's physical examination.

In many cases it is possible to determine which disc is affected. This can be confirmed either by a CT scan, MRI scan or a myelography - an injection into the spinal cord canal.

The doctor will decide which examination is necessary.

An ordinary X-ray of the spine is usually taken as well, but is much less use diagnostically than a scan or myelogram.

It is important to make a correct diagnosis because several other diseases have similar symptoms. Any 'red flag' symptoms must be acted upon without delay.

How is a slipped disc treated?

It is generally agreed that a slipped disc should be treated conservatively, with surgery being considered only when other approaches to treatment have failed.

The treatment will typically mean a brief period of bed-rest with appropriate painkillers. Physiotherapy or chiropractic treatment should also be explored.

Whether to have an operation or not, is a decision for a specialist.

When there are symptoms of pressure on the spinal cord or on the cauda equina, an operation should be performed as soon as possible.

Cases involving serious or increasing paralysis should be treated as an emergency and admitted to hospital for assessment immediately.

When there are changes in the symptoms, a doctor should be consulted. Significant changes in bladder habits or control, increasing paralysis of the limbs or muscle spasticity should always receive immediate medical assessment. .

How can osteopathy help?

Osteopathic treatment will decrease the recovery time enabling the patient to get back on their feet quicker. The osteopath will reduce the muscle spasm, which causes much of the pain and reduce the pressure on the nerve. The treatment also reduces the chance of scar tissue forming at the disc thereby reducing the chances of recurrent injury.The osteopath will not just treat the area of pain but also surrounding areas to reduce the pressure on the injured disc.

What can the patient do at home?

On onset of an acute back the patient should:

- rest for 1-2 days in the foetal position or lying on one’s back with 2 sofa sized pillows under the calves.
- apply an ice pack to the back for 15 minutes (not the leg) each time, every 2-3 hours for a period of 48-72 hours.
- anti-inflammatory tablets can be taken under the guidance of one’s GP.
- No lifting nor sitting on low chairs or sofas as this stresses the injured disc.

After 24-48 hours manual treatment should be started. Long-term bed rest does not help the healing process.

Osteopathic Manipulative Treatment Techniques: Soft-tissue technique.

Source: www.healthy.net/scr/article.asp?ID=1650

One purpose of osteopathic manipulative therapy (OMT) is to restore physiological motion to areas in which there is restriction or dysfunction. By restoring or improving function in the musculo-skeletal system, it is anticipated that all connected parts will benefit, whether these are other parts of the musculo-skeletal system or areas influenced via nerve or circulatory pathways. OMT is not aimed at specific disease processes but rather at normalizing the musculo-skeletal structures with a view to benefiting overall function and thereby maximizing the body's homeostatic, self-regulating and healing activities.

There are a great variety of osteopathic manipulative methods. It is just as ridiculous to talk of manipulation, as though it is a specific entity, as it is to talk of medicine or surgery in the same terms. Just as the allopathic doctor, or surgeon, has a wide range of choice regarding medication or surgical procedure, so does the osteopathic practitioner have a wide range of choices regarding techniques and methods of manipulation.

Among the aims of manipulation are the restoration to normal of the supporting tissues such as muscle, ligaments, fascia etc. Then there is the normalization of movement and articulation, there is the use of reflex, mechanical, influence on the body as a whole. Techniques can, roughly speaking, be divided into three groups:

Shows a soft tissue stretching technique in which the shoulder girdle muscles are lifted and stretched. It also simultaneously allows articulation of the shoulder joint.

Soft-tissue techniques.

These are varied and involve any method that is directed towards tissue other than bone. Frequently soft-tissue techniques are used diagnostically, as well as therapeutically. Soft-tissue techniques may involve stretching movements across or along the lines of the muscular fibres and deep pressure techniques, as well as stretching and separation of muscle and other soft-tissue fibres, especially where muscles originate or insert into bony structures. Much soft-tissue manipulation involves working on fascia or connective tissues.

These methods usually precede manipulation of the bony structures but can frequently achieve mobilization and normalization of joint structures on their own. This can result from the improvement of rigid or tense tissues, allowing a previously restricted joint to achieve a free range of motion.

A uniquely British contribution to this end was developed by the late Stanley Lief D.O., and it is in the use of this and other soft-tissue methods that attention is usually paid to the reflex areas that might influence the patient's condition. These might range from simple trigger points to more complex reflexes, involving internal function (Chapman's reflexes etc.). With soft-tissue techniques, diagnosis and treatment are often simultaneous. As the practitioner is palpating and assessing the tissue for signs of dysfunction, so is he treating and attempting to normalize what he finds.

Coming January 2006: OMT technique videos online!

Friday, December 16, 2005

Research and Proof of where OMT works for sure.

Source: www.intelihealth.com/IH/ihtIH/ WSIHW000/8513/34968/358839.html?d=dmtContent
Back pain
There is growing scientific evidence that the osteopathic approach may be beneficial for low back pain, especially shortly after pain begins. One trial comparing osteopathy with "standard care" showed that both therapies produced similar results. Another study reported that osteopathy patients use fewer drugs (pain relievers, anti-inflammatory drugs and muscle relaxants) and less physical therapy than do patients receiving standard care. In a controlled trial of osteopathic manipulative treatment (compared with "sham manipulation"), no significant benefits were found. Additional research is needed to clarify these findings.
Ankle injury
Preliminary evidence suggests that osteopathic manipulation in the emergency department may have a beneficial effect in the management of acute ankle injuries. Further research is necessary to confirm these findings.
One study of children with asthma found osteopathic manipulative treatment to be beneficial for improving peak flow rates. Further research is needed to confirm these findings.
Tennis elbow (epicondylitis)
There is early evidence from one randomized controlled trial to support the use of an osteopathic approach for epicondylopathia humeri radialis. Further study is needed before a recommendation can be made.
Knee or hip joint replacement
It remains unclear if osteopathic manipulative treatment is beneficial after knee or hip replacement surgery. Preliminary research suggests osteopathic manipulative treatment may reduce pain, improve ambulation (ability to walk) and increase rehabilitation. However, one randomized controlled trial suggests a lack of benefit in rehabilitation. Further research is needed to clarify this evidence.
There is a growing body of research of osteopathic manipulation for a wide range of conditions. There is promising early evidence in a number of areas, including the treatment of asthma, chronic obstructive pulmonary disease and emphysema, depression, fibromyalgia, menstrual pain, neck pain, pneumonia and thoracic outlet syndrome; postoperative care; and overall quality of life. Additional research is currently under way.

Thursday, December 15, 2005

Anti-inflammatory drug Vioxx: OMT, DOs, Pain, osteoarthritis and why many physicians consider OMT before and after surgery.

Source: www6.lexisnexis.com/publisher/ EndUser?Action=UserDisplayFullDocument&orgId=2499&topicId=100015118

IN THE WAKE of the withdrawal of the popular anti-inflammatory drug Vioxx, patients with arthritis are scrambling to find alternatives. Drug companies are stepping up to pitch any number of painkillers, both prescription and over the counter, to cash in on the $2.5 billion market left by Vioxx. But patients, worried about side effects or who have found pills to be ineffective, are now investigating non-pharmaceutical solutions.

The most extreme remedy is surgery to replace joints no longer able to function. Alternative medicine treatments including osteopathic manipulative treatment and acupuncture are less well established, but recommended by some doctors. Many arthritis patients also respond well to weight loss and exercise.

The Vioxx withdrawal is expected to spark additional interest in hyaluronic acid, an injectable painkiller. Two brands approved by the FDA to lubricate the joints and relieve pain are Hyalgan and Synvisc. The benefits of the injections last six months to a year. Patients receive a series of shots over three to five weeks.

The FDA approval was for treatment of the knee. But John Vecchione, 60, of Fairview, N.J., has osteoarthritis in his ankles, and has gotten relief from exercise and two rounds of shots of Hyalgan. He has stopped taking Celebrex, a similar drug to Vioxx in that it's an anti-inflammatory pain reliever considered to have less risk of damaging the gut than painkillers such as aspirin or ibuprofen.

Before treatment, Mr. Vecchione's wife would sometimes push him in a wheelchair when they went out. But now he rides a stationary bike every day for about 15 minutes. Hyalgan is extracted from rooster combs, and patients who are allergic to feathers or eggs may suffer an allergic reaction.

Doctors of osteopathic medicine (D.O.s) say that osteopathic manipulative treatment (OMT) can be affective for arthritis symptoms. Like medical doctors, D.O.s complete four years of osteopathic medical school plus residency. They may specialize and are board-certified to practice. OMT is a combination of techniques in which a D.O. uses his or her hands to move muscles and joints through stretching, gentle pressure and resistance to remove restrictions and restore normal motion to the joints and muscles.

There has been little large-scale clinical research to demonstrate the effectiveness of osteopathy. Research is now in the works, including some at the University of North Texas in Fort Worth. OMT can cost $75 to $120 on top of office visits, depending on how many areas of the body are treated. Insurance coverage varies by region. Insurance carriers in states where there are large populations of D.O.s, such as Pennsylvania and Michigan, tend to offer better coverage. In many areas, D.O.s ask that patients pay upfront and seek reimbursement.

William Morris, associate professor at the University of New England College of Osteopathic Medicine in Biddeford, Maine, said a D.O. looks for asymmetries in the musculoskeletal system that might cause overuse or tension.

Ruth Aldridge, 66, of Arlington, Texas, has had rheumatoid arthritis since she was 17. She now gets OMT along with physical therapy, exercise, weights, electrical stimulation, and two powerful prescription drugs, methotrexate and Remicade. Ms. Aldridge said for the first time in her life, she is lifting weights and building muscle, and is able to drive for as long as three hours.

Patients who are chronically debilitated by pain or who lose the ability to do certain physical activities can consider joint-replacement surgery. Knees and hips are the most commonly replaced joints for both types of arthritis. Metal or plastic prostheses for some or all of the joints are either cemented in place or inserted so that bone grows around the prostheses.

Mark Figgie, chief of surgical arthritis service at Hospital for Special Surgery in New York, says studies have shown that after 15 to 20 years, 90% of replacement joints are still in place and functioning. But joint-replacement surgery isn't cheap: Knees and hips range in cost from $25,000 to $40,000. Insurance coverage varies.

Use of Osteopathic Manipulative Treatment in Pregnancy. Why OMT offers the extra edge and a complete form of medical treatment.

Source: By Rick Clofine, D.O., F.A.C.O.O.G Please visit: http://www.millennium-healthcare.com/ Millennium Healthcare 4370 Georgetown Square Atlanta, GA 30338 Phone: 770-390-0012 Fax: 770-457-4428

One reason I chose to become an Osteopathic Physician, was for it’s holistic foundation and it’s tradition of hands on healing, Osteopathic Manipulative Therapy (OMT). I was fortunate to go to medical school with a strong department entirely devoted to OMT. My mentors were general practice physicians who integrated OMT into medicine long before the term ‘integrative medicine’ was ever coined. From the start of my training, I was particularly fascinated by the application of this hands on therapy to the pregnant woman.

The dramatic changes of pregnancy often times result in common musculoskelatally related complaints. These include headaches, neckache, backaches, exacerbation of preexisting strain problems and edema (swelling). The complaints of pregnancy shift with each progressive trimester (every 3 months). Once conception occurs, the woman rapidly enters a state, which is completely different in almost every way. The very biochemical, and hormonal, milieu of the blood and fluid, bathing every body cell, is completely changed from what she had always known before. Virtually EVERY body system is drastically affected by pregnancy, and these changes become even more dramatic as the woman approaches term.

The nonpregnant uterus (womb) is about the size of your fist. By the end of a average pregnancy this organ has grown large enough to hold a 7-8 pound baby!! As the uterus grows larger it generally gets a slight twist, known as a dextrorotation, which allows it to fit more easily in the abdominopelvic cavity. With progression of pregnancy, the bodies center of gravity shifts forward resulting an increase in the front to back spinal curves. This often leads to a ‘swayback’ or accentuation of the low back (lumbar) lordotic curve. This is responsible for a lot of low back pain in pregnancy. Due to this shift in center of gravity, some pregnant women feel off balance and may be more prone to falls.

Along with this there is often a subtle rotational component which causes a torsional stress pattern up the spine. This restricts motion of the spine and ribs and thus adversely influences the mechanisms of chest, rib and diaphragmatic motion which provides the pressure pumping mechanism to move air, lymph and venous fluid. This strain is distributed throughout the body via the fascia (strength layer) envelope that encases all the muscles bones and ligaments.
The hormones of pregnancy (such as progesterone, relaxin and human placental lactogen) tend to cause some muscle and joint relaxation. In fact the ligaments that hold the joints together tend to become softer and looser. This provides some ‘give’ to the pelvic bones when the fetal passenger makes it’s journey through this region. It also results in some give in all the other joints of the body, which may make them more vulnerable to trauma from repeated high impact activity (like jogging). This ligamentous loosening contributes to the strain pattern induced by the pregnancy.

As the uterus rapidly enlarges it takes up space in a new way. This influences many systems in the body. The bowels are pushed to the periphery of the abdominal cavity. The bladder often serves as a pillow for the head of the baby. All the blood vessels and nerves of the pelvis are compressed. Even the way the heart and lungs move blood and air are drastically altered.

ALL OF THESE CHANGES are normal adaptive processes to maintain balance and health. Our bodies are plastic and responsive to the demands placed upon it. The demands may be great enough, at times, that they manifest as symptoms. These aches and pains maybe treated symptomatically with pain medication. This is the common response of conventional obstetrics. Usually acetaminophen is the recommended pharmacy medicine to treat pain in pregnancy. While generally safe to use, there are many pregnant women who would like to resolve any risk associated with it, by not using it at all.

Sometimes pelvic tilt exercises and abdominal supports are prescribed. These both can be helpful, though they do little to address the underlying strain patterns caused by the progressing pregnancy. Beyond these measures, conventional obstetricians have little to offer.
Osteopathic Manipulative Therapy (OMT) is a complete method of diagnosis and therapy based on a thorough evaluation of the structure and function of the body. Osteopathic Medicine emphasizes that all body systems, including the musculoskeletal system, operate in unison, and disturbances in one system can alter the function of other systems. OMT evaluates and treats the entire structure and function of the body, not just the bones, muscles and joints!

OMT provides a therapeutic approach to address many of the root causes of common pregnancy complaints. By using a variety of hands on techniques in any one therapeutic session (determined by the specific clinical situation) much of the primary strain on the spine, and other organs, can be relieved. It is not magic. It is not a cure for all problems. It is extremely helpful in relieving physical and mental stress, which allows all other problems to be addressed from a more optimal physiologic state.

Generally, after an OMT session, a woman feels a sense of relaxation and well being. OMT is about applying a proper stimulus to the body, so that the bodies’ response is one of healing and balance. Often times there is significant relief of back pain, neck ache and headaches. Patients frequently remark that they sleep better and have more energy. They feel like they can take a breath easier. It promotes the relaxation response, which lowers stress.

OMT does not remove the cause of these symptoms (the growing pregnancy). Rather it helps the body to have a more functional and adaptive response to these changes, thus the woman feels better. Repeated therapy sessions are often helpful because the strain patterns tend to intensify as the due date approaches. In my experience, this rarely requires more than once a month therapy. Although, frequency of treatments may increase near term.

A variety of hands on techniques are used in my OMT sessions. They may include soft tissue work which is massage like. Other methods include using the bodies muscles to move parts in a specific way (Muscle Energy Techniques). There are a variety of trigger point therapies. Myofascial Release and CranioSacral Therapy both originate in the Osteopathic profession. Sometimes high velocity low amplitude methods are helpful, these are gentle pressure maneuvers that create popping noise in the joints of the back or neck. There are a number of other methods as well.

While delivering babies for 10 years (I am now retired from Obstetrics) I was often asked by my patients if it was safe to see their chiropractor, or massage therapist, during pregnancy. Not knowing the individual practitioner, this was often a difficult question to answer. I fell that properly applied bodywork is safe in pregnancy. Properly applied means that the practitioner is educated in the specific needs of the pregnant patient. If inappropriately applied, manipulative therapy can cause problems. As with any other treatment, a thorough evaluation is required to determine the when indications or contraindications to treatment are present.
I feel uniquely qualified to treat the pregnant patient with bodywork. Being a board certified Obstetrician, I am fully cognizant of all the medical aspects of normal and high risk pregnancy. I am not interested in providing obstetric advice to these patients, they have their physicians and midwives for that purpose. As an Osteopathic bodyworker, I have been treating pregnant women with OMT for 20 years. I am well versed in the proper and safe approach to the pregnant woman and I have a wide range of therapeutic tools to draw upon. I find little more gratifying than providing manipulative therapy care to the pregnant woman.

On an almost daily basis a patient will inquire about the initials at the end of my name, D.O. as opposed to M.D. This may occur on the first visit, but often times will not come up till later in our relationship. They know they are seeing a board certified Obstetrician/Gynecologist, so what's up? What's the difference?

Osteopathic Medicine and Osteopathic Physicians have been a part of American Medicine since 1874. That is the year Andrew Taylor Still first espoused the philosophy and science of Osteopathic Medicine. Dr. Still was a former civil war physician and surgeon who was dissatisfied with the ineffectiveness of nineteenth-century medicine. Dr. Still developed an appreciation for the bodies ability to heal itself. Through intense study he came to understand the great importance of the musculoskeletal system, and its intimate relationship to all organ systems in the body, and to overall good health. He stressed preventative medicine, eating properly and keeping fit. He identified palpation and human touch as vital to gaining patient confidence and providing effective medical care. He introduced a system of manipulation as a noninvasive form of diagnosis and therapy. While originally a drugless school of medicine (due to the dangerous drugs of the day), as prescription of medication became a science, it was accepted by the profession.

Today, Osteopathic Medicine in the United States is fueled by 17 fully accredited osteopathic medical schools graduating about 1800 physicians annually. Approximately 38,000 Osteopathic Physicians (about 6% of the nations physicians) are licensed with FULL MEDICAL PRACTICE PRIVILEDGES in every state. Osteopathic postgraduate specialty training is available in 62 specialty and subspecialty areas of medicine. As opposed to in the past, today there are few institutions (hospitals or medical schools) that are composed of purely osteopathic or allopathic (MD) physicians. Almost all metropolitan hospitals are mixed staff; there are M.D.’s teaching at D.O. medical schools and vice versa.

Osteopathic medical education is very similar to M.D. training; an undergraduate degree followed by four years of medical school followed by post graduate training. There are several distinct differences in the training. Osteopathic training is oriented toward primary care medicine (family medicine, internal medicine, pediatrics and obstetrics/gynecology) with around 75% of Osteopathic Physicians practicing in primary care areas. Osteopathic Manipulative Therapy (OMT) is taught as part of the medical school curriculum. Osteopathic physicians are trained in hands on musculoskeletal diagnosis and manipulative therapy. While not all D.O.’s choose to utilize this training , all have had this exposure and are thus generally knowledgeable about the concepts involved and will refer for Osteopathic manipulation when indicated.
The knowledge of the bodies own inherent drive to heal is optimized through hands on treatment that maximizes the balanced well being of the structure. OMT is designed to support, stimulate and, in some instances, initiate the body’s trend toward health. When the bodies musculoskeletal structure is altered, abnormalities can occur in internal body systems. And, vice versa, when internal organ system dysfunction occurs, it is reflected in the musculoskeletal system. This knowledge is useful in both diagnosis and treatment.

So in practical terms, as an osteopathic physician, how do I treat my patients differently?? When I see patients in pregnancy I recommend manipulative therapy to help avoid the typical postural discomfort of pregnancy. When the aches and pains of advancing pregnancy exist, OMT is a safe and effective way of providing relief. I feel there is benefit to manipulative therapy before and after surgical procedures. Prior to surgery it helps optimize the system to deal with the upcoming stress. It is very common to have back and neck pain post operatively due to positioning on the operating room table in association with complete muscle relaxation. This responds very well to OMT. I have found OMT to be helpful in treating menstrual cramping and PMS. In cases of chronic pelvic pain it helps resolve musculoskeletal involvement ,thus making the evaluation less confusing, and sometimes avoiding surgery.

Osteopathic Medicine provides a needed alternative to the mainstream of conventional western medicine. It provides all the security and benefit of high-tech medicine implemented from a perspective that respects the bodies innate healing ability. Over the last 100 hundred years it has kept abreast of our rapidly advancing medical knowledge without discarding time proven hands on therapy.

By Rick Clofine, D.O., F.A.C.O.O.G
Please visit: http://www.millennium-healthcare.com/
Millennium Healthcare 4370 Georgetown Square Atlanta, GA 30338 Phone: 770-390-0012 Fax: 770-457-4428

Wednesday, December 14, 2005

Scared by Recent news about Vioxx and similar pain medications? Ask your physician about osteopathic manipulation treatment (OMT).

Source: www.immunesupport.com/library/ showarticle.cfm/ID/6220/e/1/T/CFIDS_FM/

Warnings about three common pain relievers prompt interest in nontraditional treatments.

Gwenn Herman knows chronic pain -- the regular backaches, the stiffness of her neck after her 1995 car accident, the pain that didn't respond, or responded inconsistently, to prescription and nonprescription painkillers.

That's why she learned, long before the recent rash of safety alerts about three commonly used pain medications, to explore alternative treatments such OMT. That view is likely to find more adherents following reports linking the prescription pain drugs Vioxx and Celebrex and, more recently, the popular over-the-counter painkiller Aleve (naproxen) to potentially life-threatening side effects.

Experts advise patients not to stop pain medications without consulting their doctor. The drugs now subject to so much publicity may remain the best choices for some patients. Nonetheless, the reports have focused more attention on alternative pain relief.

Bringing Osteopathic manipulation into mainstream treatment of pain.

Osteopathic manipulation -- Manipulation of the joints restores the normal range of motion of a particular joint and can restore the normal blood flow, said Martin Levine, a member of the board of trustees for the American Osteopathic Association. Growing evidence suggests that osteopathic manipulation may ease low back pain and be useful for a variety of other conditions, including depression, fibromyalgia, menstrual pain and neck pain.

To find a DO visit: http://www.osteopathic.org/index.cfm?PageID=findado_main

D.O.s bring something extra to medicine.

D.O.s comprise a separate, yet equal branch of American medical care. Together, D.O.s and M.D.s enhance the state of care available in America. It is, however, the ways that D.O.s and M.D.s are different that bring an extra dimension to your family's health care.

  • Osteopathic medical schools emphasize training students to be primary care physicians.
  • D.O.s practice a "whole person" approach to medicine. Instead of just treating specific symptoms or illnesses, they regard your body as integrated whole.
  • Osteopathic physicians focus on preventive health care.
  • D.O.s receive extra training in the musculoskeletal system -- your body’s interconnected system of nerves, muscles and bones that make up two-thirds of its body mass. This training provides osteopathic physicians with a better understanding of the ways that an injury or illness in one part of your body can affect another.
  • Osteopathic manipulative treatment (OMT) is incorporated in the training and practice of osteopathic physicians. With OMT, osteopathic physicians use their hands to diagnose injury and illness and to encourage your body’s natural tendency toward good health. By combining all available medical procedures with OMT, D.O.s offer their patients the most comprehensive care available in medicine today.

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What is the Fulford Percussion Hammer?

Source: www.kohngroup.com/treatments.htm

The Fulford Percussion Hammer was invented by Dr. Robert Fulford to help treat the fascial "stuckness" in the body. He was an engineer and an osteopathic physician who determined that the use of the percussion hammer through a vibrational frequency is very effective in "unlocking" stuck fascia.

How does it work?
The percussion hammer vibrates about the frequency of middle "C" on the piano, which is the frequency of the fascia in the body. Application of the percussion hammer on one side of the body and monitoring on the other side of the body will pick up the vibrational frequency of the percussion hammer on the opposite side of the body within about 2 minutes after placing it on the body. It is a very effective treatment tool, and can be used in patients of all ages, including infants. Physicians are trained through special courses in learning its use.

Tuesday, December 13, 2005

Osteopathic Manipulative Treatment for MDs, that to at Harvard University!

Source: Journal of the American Osteopathic AssociationWeb site for Journal of the American Osteopathic Association.www.jaoa.org/

Sunday, December 11, 2005

What Osteopathic Medicine Has To Offer‘ Golden Girls’

Source: AOA website http://www.Osteopathic.org

by Melicien A. Tettambel, DO

Osteopathic physicians have been trained to appreciate the role of the musculoskeletal system in the maintenance of health. Because physicians understand the reciprocal relationship of structure and function in the health of mature women, they also have opportunities to promote healthy aging.

Female healthcare consumers have been receiving education about menopause, osteoporosis, cancer and chronic disease processes that affect women through support groups, magazines, radio, the Internet, and other telecommunication media. They have been bombarded with information about exercise, nutrition, pharmacotherapy and other therapies.

During well-woman visits physicians offer additional counseling about healthy aging, cancer screening or laboratory evaluation. However, osteopathic physicians can further utilize clinical diagnostic skills of observation and palpation of the musculoskeletal system to positively influence total body function. It also gives physicians the opportunity to address other concerns including hormone therapy.

Physicians need to be prepared to discuss concerns women have about hormone therapy and identify ways to approach women who decide to stop appropriate hormone treatments. In addition, physicians should address these issues and be sensitive to women and the concerns they may have about sexuality. This is even more critical as women become widowed, retired and “empty nesters”. Those who might be considering becoming sexually active again have concerns about vaginal dryness, incontinence, or increased arthritic pain, which interferes with satisfying intimacy. Medications used to treat women for some of these issues may be too expensive or have unpleasant side effects. In addition, some patients may be too depressed to discuss any of these problems.

While it is true that women are twice as likely to be depressed, it is also true that there are many more “mature” women than men living past 70 years of age. They may fear that depression is a sign of senility or part of the aging process–which is incorrect!
Fear of consequences of aging, pain, and depression can create a complicated circuit when it comes to women and wellness. Healthcare professionals have recommended counseling, medication and some physical therapies.

Osteopathic physicians who provide Osteopathic Manipulation Treatments (OMT), stabilize body structure to facilitate physiological function. Therapists may then complement OMT with counseling or other physical therapies.

Evaluating Posture, Breathing
Posture is the result of one’s continuing ordeal with locomotion and gravity. With advancing age there may be spinal changes affecting spinal curves and gait. Weight gain or loss as results of nutrition or activity patterns also affects posture. Women lose height and develop increased thoracic kyphosis with osteoporosis. Arthritic diseases also can cause structural and gait deformities.

Soft-tissue, functional and indirect treatment techniques increase joint range of motion and mobilize tissue fluids to reduce inflammation and edema. The patient may be inclined to articulate other concerns about herself during the course of a treatment. This could be an opportunity to cultivate rapport in developing a treatment plan for other issues.
In addition to evaluating posture (structural health), the osteopathic physician can “read” a patient’s emotional status by observing her respiration and noting changes in tissue tension. Unusually slowed or rapid breathing may convey anxiety or depression. By focusing on the patient’s breathing, an osteopathic physician may also note how the respiratory system might be engaged to maintain general health. Manual treatment of the thorax can influence ones ability to fight infection, metabolize medicines, and reduce inflammation.

It is interesting that breathing may be affected by any or by all of the five most common fatal diseases in women. According to the National Women’s Health Information Center, US Public Health Service Office on Women’s Health, Department of Health and Human Services 1999 Report, 50% of the causes of all 10 leading killers in women include heart disease, cancer, stroke and lung disease.

By encouraging female patients to change poor lifestyle behaviors such as smoking, drinking and inactivity, young women could lower their risk of premature death and disability by as much as 50%.

Thoracic Spine Treatment
Treatment of the thoracic spine with OMT may influence the sympathetic nervous system’s effect on cardiac function. Mobilization of the rib cage may reduce strain of inhalation or exhalation while fighting lung infections. Improved breathing as a result of rib-raising techniques–or lymphatic drainage–aids in dissipating infection.
Altered respiration to encourage slow, deep breathing helps to relieve pain and “breathe away” toxins or drug metabolites. Treatment of the thoracic inlet with OMT decompresses tensions on the vascular and neural contents of the upper thorax to relieve edema. In addition to addressing restrictions of the rib cage, release of respiratory diaphragmatic tension facilitates motion of body fluids and lymphatic drainage.

Women with breast cancer may be treated by lymphatic massage therapists to
reduce incidence of postmastectomy lymphedema. These patients will derive greater benefit from their therapies if they also receive OMT to the thorax, spine and diaphragm.
Osteopathic physicians should keep in mind that treatment of the thorax with OMT may reduce the stress of breathing and congestion, and it may relieve pain. The American Lung Association promotes the slogan, “If you can’t breathe, nothing else matters.”

Treatment utilizing gentle OMT techniques that provide patient comfort is also beneficial in assisting respiration and general metabolism. The patient may be treated frequently and not become exhausted or stressed by vigorous handling of body tissues. Whether in the office or in the hospital, OMT to the thorax need not take more than 10 minutes.

Final Notes
OMT offers “golden girls” pain relief, increased physical mobility, improved metabolism, and antidepressant relief through manual treatment. It may reduce the need to add more pharmaceuticals to a treatment regimen to achieve similar goals of improved circulation, and nerve and joint functions, as well as reduced pain and inflammation. OMT techniques have few side effects or cross-reactivity with medication. They may aid in the promotion of longevity and independent living.

Melicien A. Tettambel, DO, is a member of the AOA’s House of Delegates. She also is a fellow of the AAO and ACOOG. She can be reached by calling (660) 627-1812, by fax at (660) 627-4799 or via e-mail at [email protected].

Osteopathic Manipulative Technique (O.M.T.) and Sports Medicine

Source: www.xprss.com/robeygroup/appreciation_x10.asp

Osteopathic Manipulative Technique (O.M.T.) is used frequently in sports medicine. It is used in the recovery from sports injuries, to enhancement performance in athletes and can be used successfully in high-impact sports such as running, basketball, tennis, football and baseball. O.M.T. techniques vary depending upon the physical injury. We use "high velocity manipulation" for acute injures to the spine. If an athlete is impacted from the side, his cervical, thoracic or lumbar vertebrae may be knocked out of alignment. High velocity, low impact adjustments, a.k.a. cracking of the spine, can gently move the segment or segments instantly back into place. If done right after the insult, you can prevent the soft-tissue damage often associated with chronic injuries, from occurring. On the other hand, soft tissue manipulation, where one gently moves the tissues through the barriers of pain and restriction, are useful in chronic injuries. The tissue changes associated with this type of injury are much harder to treat and require frequent visits to the osteopath. Another type of manipulation is called, "muscle energy". This is where the physician finds the barrier, such as a limitation in cervical rotation to the right, and gently holds the neck while the patient uses his own muscles at his own pace to turn in the opposite direction of the barrier. After a couple of seconds, the patient relaxes and the doctor would turn the neck incrementally towards the restriction slowly, taking up the slack and substantially increasing range of motion to the neck. There are many more techniques for many types of injuries and some used for the prevention of injuries.

OMT and Sports

Do you have Neck Stiffness?

Source: www.joselitodelacruz.com/Neck_Pain.htm
Osteopathic Treatment of Neck Problems

Muscle Strain
Most neck stiffness comes from muscle tightness of the trapezius and levator scapulae muscle, as shown in the diagram.

Cause: poor sitting posture, awkward sleeping position, sudden neck movements

Treatment: locate the muscle injury, reduce inflammation, promote lengthening of muscle and reduce pain. Ultrasound therapy may be used. Balancing muscle groups.

Background: Osteopaths manipulate these muscles so that they become lengthened and flexible. Massage works mainly to relax muscles but does not lengthen muscles; they tend to work on the surface rather than deep soft tissue release as an osteopath would. Osteopaths release tension in the muscles and improve circulation. The osteopath will rely on their skill to feel damaged tissue causing the problem. Osteopaths then go beyond the muscles and assess the spine, joints and other tissues in the area. The findings will link to your posture at work, home and sleep. Massage will not work on deeper structures and will only follow meridian channels.

Common Neck problems
Muscle strain
Joint strain/lock
Upper Rib problems
Trapped nerve

Saturday, December 10, 2005

Why Choose a D.O. when you have lower back pain?

Source: Works Cited
ACOFP website:
Sloane, PD, Slatt LM, Curtis P. Essentials of Family Medicine. 2nd ed. Baltimore, Williams and Wilkins, 1993.

Osteopathic Family Physicians offer several advantages in the treatment of lower Back Pain.

First something about Back Pain:
Back pain is the most common chronic pain complaint seen in the office with ten percent of patients having acute low back pain that develops into a chronic problem. Also, backache is the most frequent cause of limitation of activity under the age of 45.

What D.O.'s can offer to their patients:

Structural causes account for the great majority of low back pain complaints and reflect the anatomy, physiology, and mechanics of the spine.

  1. Training in OMT: Osteopathic manipulation, in conjunction with other treatment modalities, can be used to quickly and effectively reduce the low back pain caused by radicular and discogenic pathology. Soft tissue and myofascial release techniques are easy to employ and can be used to treat both problems.Gentle gapping techniques, counterstrain, and direct inhibitory pressure of the piriformis can be used for patients with radicular complaints.
  2. Like M.D.s, D.O.s can also prescribe anti-inflammatory medications in addition to using OMT.
  3. Result: A multidimensional treatment approach including the use of anti-inflammatory medications, manipulation, and a home exercise program has been shown to help reduce the infirmity caused by low back pain.

Thursday, December 08, 2005

Effects of osteopathic manipulative treatment on pediatric patients with asthma

Source: http://www.jaoa.org/cgi/content/full/105/1/7

Asthma is a common chronic condition that has long plagued the pediatric patient population. Asthma in children can cause excessive school absenteeism, hospitalizations, and even death. Osteopathic manipulative treatment (OMT) is an underutilized noninvasive treatment method for patients with asthma. The use of OMT may help decrease mortality and morbidity rates among this patient group. The authors conducted a randomized controlled trial attempting to demonstrate the therapeutic relevance of OMT in the pediatric asthma population. With a confidence level of 95%, results for the OMT group showed a statistically significant improvement of 7 L per minute to 9 L per minute for peak expiratory flow rates. These results suggest that OMT has a therapeutic effect among this patient population. The authors suggest that more clinical trials are required to better demonstrate the effectiveness of OMT in patients with asthma.

Palpatory diagnosis and manipulative management of carpal tunnel syndrome.

Source: J Am Osteopath Assoc. 1994 Aug;94(8):632, 640.

Carpal tunnel syndrome was studied by use of supplemental palpatory diagnosis in 20 abnormal wrists. Restriction in motion at the carpal tunnel was quantified with a rating system. All wrists with carpal tunnel syndrome revealed at least moderate restriction to motion, as compared with only mild or no restriction in 20 wrists in normal, symptom-free subjects. Several participants (16 abnormal wrists) underwent osteopathic manipulative treatment, including a new "opponens roll" maneuver, and self-stretching, or a similar treatment accomplished by use of a self-treatment accomplished by use of a self-treatment appliance. In those treated, palpatory restriction decreased into the normal range, often before symptoms decreased. Improvement in nerve conduction studies usually followed within 1 to 3 months. Palpatory diagnosis is a useful adjunctive method of assessing patient status in carpal tunnel syndrome and helpful in prognosticating outcome. The modified manipulative technique described for the treatment of mild to moderate carpal tunnel syndrome may be effective in more severe cases.

Osteopathic Manipulative Treatment Benefits Go Beyond Back Pain

Source: www.osteopathic.org/email/012004/OMT_jan04.doc

Public awareness about Osteopathic Manipulative Treatment (OMT) is on the rise as medical studies prove the benefits of using OMT to treat back pain and health conditions like asthma. However, osteopathic physicians (D.O.s) will be quick to tell you that OMT has many other benefits, such as aiding in the treatment of pregnant mothers and their babies.

“As a D.O., I try to educate my patients about OMT by letting them know that it is one of the most unique and distinctive tools of osteopathic medicine,” says Melicien Tettambel, D.O., an osteopathic physician who practices in Kirksville, MO. “I also let them know how the use of OMT might benefit their individual health care needs.”

OMT requires a hands-on, whole body approach to diagnose health problems; treat dysfunctions; preserve good health; and prevent the spread of disease. In addition, OMT can enable D.O.s to treat and diagnose injuries or illnesses and has been found to be an effective treatment for individuals suffering from conditions ranging from carpal tunnel syndrome, menstrual pain, sinus disorders, and migraines.

Dr. Tettambel, states that OMT can benefit women during pregnancy by helping their bodies adjust to a growing uterus and displaced organs. OMT also can be used to help pregnant women with their posture by adjusting the body mechanics to work more efficiently.

“The ways that OMT can benefit a pregnant woman even extends to the delivery room,” says Dr. Tettambel. “For example, OMT used during labor can help a woman reduce the number of times she needs to push,” says Dr. Tettambel.

Infants can also benefit from OMT in a number of ways. Dr. Tettambel notes that OMT can help prevent abnormal physical development caused by how the infant reshaped his or her body to pass through the birth canal. And, recent findings show that infants and toddlers who suffer from repeat ear infections can find relief from OMT. The treatment requires the physician to put their fingers on the bony prominence behind the ear and applying a gentle rocking motion. This enables fluid to flow more freely through the ear.

“Best of all, children who received this treatment used less antibiotics and had fewer surgeries,” says Dr. Tettambel.

As complete physicians, D.O.s are able to prescribe medication, perform surgery and can be found practicing in all areas of medicine. D.O.s can also use their hands to help diagnose and treat injury and illness and to encourage the body’s natural tendency toward good health through the use of Osteopathic Manipulative Treatment (OMT).

Osteopathic Management Case Study: Somatic Dysfunction Causing Adolescent Chest Pain – Counterstrain Treatment

Source: www.acofp.org/member_publications/0405_4.htm

An example of a seated counterstrain treatment for a patient with anterior right fifth rib tenderpoint.

Chest pain is a common reason for patients to present to the osteopathic family physician's office. Chest pain can be complicated, even with adolescents and children. It is important to consider visceral etiologies, such as heart disease and upper gastrointestinal pathologies, but it is also important to diagnose and treat the musculoskeletal aspects of these patients (especially when visceral pathology has been ruled out). Counterstrain is one form of osteopathic manipulative medicine (OMM) that lends itself well to this situation of acute pain in an adolescent. This case illustrates the use of treating a young adolescent with chest pain.

Name of Technique: Counterstrain treatment for anterior fifth rib tenderpoint with patient seated.

Diagnosis: Tenderpoint at right fifth rib laterally at the anterior axillary line. This is termed a “depressed” rib in counterstrain terminology and it responds to treatment with a position of ease that further depresses the rib anteriorly.Patient Position:Seated on a low exam table.Physician Position:Standing behind the patient on the side opposite the dysfunctional rib, in this case standing to the left side. Physician places their left foot on the table next to patient with a small pillow on top of that knee.


  1. Locate the right fifth rib anterior tenderpoint, at the anterior axillary line, with the right index or long finger. Test the point with brief firm palpation. Have the patient gauge the tenderness on a scale of one to ten.
  2. Patient places the left forearm and arm (flexed at the elbow) over the physician's knee. Translate the patient gently to the left, localizing side bending to the right at the fifth rib tenderpoint. Not much side bending is needed.
  3. Hold the patient's head and neck with your left forearm and hand. Then flex the head forward, with some side bending to the right to relieve tension at the tenderpoint. Add rotation to fine tune localization. Usually rotation is needed toward the involved side, but occasionally it will be needed in the opposite direction.
  4. Fine tune all planes of motion, including subtle rotation of the trunk.
    Reassess the tenderpoint. There should be a 70 percent, or greater, reduction in tenderness. Then monitor the point with very gentle pressure. Remember, this is not an inhibitory pressure technique.
  5. Hold for approximately 90 seconds. You should feel a gradual softening of the involved tissues. Sometimes, you may feel a therapeutic pulsation. This indicates a good response to treatment.
  6. Slowly move the patient back to an independent seated position. The first few degrees of movement should be very slow, and then the rest may be done more quickly.
    Reassess the tenderpoint with firm localized palpation. A reduction in tenderness of at least a seventy percent indicates a therapeutic response.
For physicians who want to learn more about counterstrain OMT, Laurence Jones' book, Jones Strain-Counterstrain (1995) is the definitive text and is easy to read.

Wednesday, December 07, 2005

Query: What is the specialty college of Osteopathy called?

FAAO American Academy of Osteopathy
FACOFP American College of Osteopathic Family Physicians
FACN American College of Neuropsychiatrists
FACOEP American College of Osteopathic Emergency Physicians
FACOI American College of Osteopathic Internists
FACOOG American College of Osteopathic Obstetricians and Gynecologists
FACOP American Osteopathic College of Pathologists
FACOPMS American College of Osteopathic Pain Management and Sclerotherapy
FACOS American College of Osteopathic Surgeons
FAOAAM American Osteopathic Academy of Addiction Medicine
FAOAO American Osteopathic Academy of Orthopedics
FAOCA American Osteopathic College of Anesthesiologists
FAOCAI American Osteopathic College of Allergy and Immunology
FAOCD American Osteopathic College of Dermatology
FAOCP American Osteopathic College of Pathologists
FAOCOPM American Osteopathic College of Occupational and Preventive Medicine
FAOCPR American Osteopathic College of Proctology
FAOCR American Osteopathic College of Radiology
FAOCRH American Osteopathic College of Rheumatology
FAOCRM American Osteopathic College of Rehabilitation Medicine
FOCOO American Osteopathic College of Ophthalmology and Otorhinolaryngology
FAOASM American Osteopathic Academy of Sports Medicine

Tuesday, December 06, 2005

Cost-Effectiveness of Osteopathic Manipulative Treatment

Source: JAOA article:
A Literature Review of Cost-effectiveness Analyses for Osteopathic Manipulative Treatment Russell Gamber, DO, MPH; Shane Holland, DO; David P. Russo, DO, MPH; des Anges Cruser, PhD, MPA; Peter E. Hilsenrath, PhD

Despite the value that osteopathic manipulative medicine (OMM) may offer to healthcare consumers in a managed care, evidence-based healthcare system, very little research has been published on the cost-effectiveness of osteopathic manipulative treatment compared with other treatment modalities. The authors searched MEDLINE and OSTMED for English-language articles published between January 1966 and June 2002 using the key terms cost-effectiveness, osteopathic medicine, workers' compensation, hospital length of stay, healthcare providers, and manipulative medicine. The authors then extended their search by reviewing the reference lists provided in the articles initially identified as relevant by these databases. The purpose, methods, findings, and conclusions of each study were evaluated for how the cost-effectiveness of OMM was analyzed. The authors conclude that the osteopathic medical profession needs to conduct and publish research that is consistent with current practices in the conventional medical literature.

Go to article

Monday, December 05, 2005

An Interview about OMT.

Source: www.holisticjunction.com/displayarticle.cfm?ID=1248

Recently, I had the unique privilege to interview Miriam V. Mills, (M.D., FAAP) from the Young People's Clinic in Tulsa, OK. Dr. Mills is credited for directing the landmark research project (at the Oklahoma State University College of Osteopathic Medicine) on the study of Osteopathic manipulative treatment for ear infections in children. The study was first publicized in the MD (allopathic) literature and more recently in the Sept 2003 issue of the Archives of Pediatrics and Adolescent Medicine.

Dr. Mills remarked: "Osteopathic manipulative treatment was developed by Andrew Taylor Still (who was himself an MD, but who established osteopathy) over 100 years ago. One of his students, William Garner Sutherland, expanded the manipulative treatments to include the head and related structures, which is called osteopathy in the cranial field. There is not one "technique" that is used, but a variety of approaches, depending on the problem encountered. This has been taught for over 50 years. The experience of most practitioners of these methods find remarkable benefit from them, though there has been little in the literature to document these experiences.

I am a pediatrician in private practice (Young People's Clinic, PC, in Tulsa, OK (www.youngpeoplesclinic.yourmd.com/miriammills), and I find that in my general pediatric practice, having used these manipulative techniques for the last 10 years (as am MD, I learned these techniques after being in practice already awhile), I have less problems with colic and feeding problems, headaches, ear infections, and complications of upper and lower respiratory infections. I admit fewer children to the hospital and have to refer fewer children for sub-specialist care than my pediatric colleagues.

Since the development of osteopathy in the cranial field, other practitioners (including chiropractors, massage therapists, and physical therapists) have utilized some of the same methods, going by the name of `cranio-sacral therapy.' I cannot vouch for exactly what these methods are, or their effectiveness, as they are not what was studied in my research." According to Dr. Mills, the study was performed under controlled, blinded groups of children across four (4) sites in the nation. Of these groups, 32 children were in the control group and 25 were in the treatment group. The study produced phenomenal findings. The culmination of a six-month observation period demonstrated that there was a statistically significant difference in (within treatment group) episodic ear infections.
Of the control group, 8 children reverted to tube installation as opposed to 1 in the treatment group. Dr. Mills explained, "...There was a trend, though not quite statistically significant, to having fewer antibiotics prescribed to children in the treatment group."

As indicated by Dr. Mills, sessions with children can last from 20-40 minutes, and can take 3-4 sessions every 2 weeks to see a notable difference. In Dr. Mills' own practice, children are seen periodically over 4-6 month duration to be certain that these children are responding well to the treatment. As children develop and incur physical changes or injuries with relation to body tissues, this observation period is necessary. Dr. Mills further explained that most initial compressions are results from childbirth.

Osteopathic manipulation treatment can range in cost from $75 - $150, depending on individual needs. Dr. Mills also mentioned, "...since many physicians' services are covered by insurance, this may cover a large part of the cost of osteopathic manipulation..." Ultimately, the patient's treatment cost is usually his or her copay for office visits.
Collaborative efforts of the research team documented a comparison of children who received conventional medical treatment (with or without manipulation). To Dr. Mills' knowledge, there has not been a comparison study of osteopathic manipulation (alone) to medical treatment (alone). However, the Osteopathic Manipulation Treatment did present a remarkably decreased need for surgical treatment in the reported study.

Osteopathic Manipulation is a noninvasive treatment that is mild and accepted well. Dr. Mills commented, "...though the children sometimes need to be distracted with toys in order to lie still for the length of time involved. There is no popping or cracking involved in the treatment, when applied to young children."

Osteopathic practitioners who are involved in the cranial field are doctors or dentists who are most often members of the Cranial Academy (http://www.cranialacademy.org/). Dr. Mills also relayed that nationwide demand for Osteopathic medicine is immense, therefore more interest in this field is prompting physicians to receive adequate training.
Based on these findings, one can only naturally assume that osteopathic manipulation treatment is a welcomed alternative innovation within the medical community. As society is realizing the potential benefits and effectiveness of natural medicine and noninvasive medical procedures, Osteopathic Manipulation is gaining lead-way in modern health treatments - especially for chronic ailment sufferers.

To learn more about Dr. Miriam V. Mills' Practice, go to: www.youngpeoplesclinic.yourmd.com/miriammills.

Saturday, December 03, 2005

Book Pick!

Source: Amazon.com review
A Good Book to Read........

An Osteopathic Approach to Children presents a comprehensive general overview of pediatric medicine from an osteopathic perspective. Many different groups of healthcare providers are now considering the merits of applying the principles of manual medicine and manual therapy in the care and treatment of children. The existing textbooks of medical pediatrics and physical therapy available for reference may address selected orthopedic problems in children but they are limited in scope and they rarely include the use of osteopathic principles. Members of the osteopathic profession have a hundred-year history of treating children using the manual application of osteopathic principles. Most of this information has been handed down through mentoring, apprenticeship and lecture. Very little of this information is actually available to interested clinicians in published form. An Osteopathic Approach to Children has been written to provide a comprehensive textbook and reference source which deals specifically with the osteopathic treatment of children. An Osteopathic Approach to Children is probably the first pediatric textbook book to discuss clinical problems from the perspective of the interrelatedness of structure and function. This unique approach will make it an invaluable source of reference for all those interested in using an osteopathic approach to the treatment of children in their care. Clinicians will find it an invaluable help in their efforts to provide safe and effective healthcare to children.

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