Thursday, May 25, 2006

OMT in Action: 26-Year-Old Woman With Bell's Palsy

Osteopathic Manipulative Treatment of a 26-Year-Old Woman With Bell's Palsy
David G. Lancaster, DO; William Thomas Crow, DO
Copyright © 2006 by the American Osteopathic Association.
JAOA • Vol 106 • No 5 • May 2006 • 285-289

"Bell's palsy is caused by a lesion of the facial nerve and results in unilateral paralysis or paresis of the face. The condition affects approximately 23 in 100,000 persons, with onset typically occurring between the ages of 10 and 40 years........

The authors, who were guided by the four principles of osteopathic philosophy, report that the patient's symptoms resolved within 2 weeks, during which two sessions of osteopathic manipulative treatment, each lasting approximately 20 minutes, were held. Patient recovery occurred without the use of pharmaceuticals. "

Please read full article here from JAOA:

Wednesday, May 24, 2006

Don't rule out ART of Osteopathic Manipulative Treatment
April 2000 • Volume 6 • Number 4
Las Vegas FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.

Martin Offenberger, M.D., left, of La Habra, Calif., practices osteopathic manipulation techniques with Charles MacDougall, M.D., of Plano, Texas, at AAFP's course on the musculoskeletal system.
Allopathically trained physicians often dismiss manipulative medicine as an unproven alternative therapy, but research is beginning to show it can help patients regain range of motion and overall health.

"For example, manipulation in the acute setting has been shown to be an effective modality in low back pain," said Dennis Cardone, D.O., assistant professor and director of a sports medicine fellowship in the family practice department at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick. Cardone presented sessions on manipulative medicine techniques at the Office Procedures and Management of the Musculoskeletal System CME course Feb. 21-25.

He referred to the November 1999 New England Journal of Medicine, which featured results from a large study of patients with low back pain, comparing the use of traditional treatments alone with the use of those treatments augmented with osteopathic manipulation. The study found that manipulation decreased the need for pain medication and physical therapy.

Even some of the most basic, easy-to-learn techniques can have a dramatic impact on patient health, said Cardone. "It's not a panacea, it's not a cure-all, but when mixed in with the other modalities, it's effective," he said. "And it's definitely been shown that a physician's touch -- laying on of hands -- has healing powers unto itself."

Participants practicing the techniques on each other at the CME course frequently expressed surprise at the improvements they felt in their own bodies. "I heard people say that they never felt so relaxed, the muscles never felt so relaxed, they definitely felt an increase in their range of motion and the popping sensation wasn't as scary as they thought it might be," said Cardone.

He shared three fundamental osteopathic philosophies with attendees:

The body doesn't function as a collection of separate parts but as an integral unit.

An abnormality in the structure of any body part can lead to abnormal function, either at that body part or at some other location in the body. Therapeutic manipulation may be used to correct mechanical disorders of the body.

There are somatic components to disease that not only are manifestations of disease but also can contribute to ongoing physical problems.

Manipulation is indicated in patients with a somatic dysfunction -- a problem somewhere in the musculoskeletal system usually causing muscle pain or motion restriction, Cardone said. Specific criteria determine whether a patient has a somatic dysfunction. Just remember the ART of diagnosis:

Asymmetry -- Palpation of a joint with somatic dysfunction reveals that the bone involved is asymmetric with respect to its normal position and to the position of bones contiguous to it.

Restriction of motion -- A joint is restricted or meets an abnormal barrier in one or more planes of motion. Motion in the opposite direction is normal or free.

Tissue texture changes -- The soft tissues around the joint (skin, fascia or muscle) undergo palpable changes. Acute and chronic somatic dysfunctions present different tissue texture changes (see chart below).

If you suspect a somatic dysfunction, said Cardone, consider referring the patient to an osteopathic physician who practices manipulative medicine (not all D.O.s do it). Or better yet, learn how to do it yourself. Cardone emphasized that the techniques don't need to take much time: "A very focused treatment on a specific area takes just five minutes."

Where can you get training in manipulative medicine? The AAFP will offer clinical seminars and procedures workshops at the Scientific Assembly Sept. 20-24 in Dallas. Assembly information will be mailed to all members in May. Or attend next year's musculoskeletal system CME course; look for details in a fall mailing.

Monday, May 22, 2006

Why become an osteopathic physician? Ask this person:

Scholarship puts Palm Bay woman on path to becoming doctor

Velma Claypool, a Brevard Community College graduate, was recently awarded the prestigious Jack Kent Cooke Foundation Scholarship, the nation's largest scholarship for community college students.

She is one of three students in the state to receive the scholarship. The foundation presented scholarships to 38 students to assist them financially as they transfer to four-year colleges and universities to complete their undergraduate degrees.

Claypool, who was selected from among 676 nominees from about 438 community colleges, could receive as much as $30,000 a year.

QUESTION: When did you graduate from BCC?

ANSWER: I obtained my associate of arts degree from BCC in the fall of 2005 and worked my way through college as a licensed massage therapist.

Q: Are you attending college now?

A: I'm a student at the University of Central Florida, where I plan to earn a degree in molecular biology and microbiology.

Q: What career plans do you have now?

A: I plan to pursue a career as an osteopathic physician with a specialty in cranial osteopathy.

Q: What does an osteopathic physician do?

A: An osteopathic physician is a medical doctor who can do manual manipulation, which is a combination of muscle and tissue release and skeletal adjustment.

Q: What is the difference between a massage therapist and osteopathic physician?

A: A basic difference is that a massage therapist only moves muscle, whereas the osteopathic physician is a medical doctor who can prescribe pills, X-rays, any kind of medical tests. They can also be a surgeon.

Q: You say your specialty would be cranial osteopathy. What does that mean?

A: That's the manipulation of the skull, which could help ease back pain, neck pain or other physical problems.

Q: Why did you choose this field?

A: I want to empower people to take responsibility for their own lives and make them realize their health is in their hands.

Q: I understand you are 34 years old. Has that made your goal to become a physician more difficult?

A: Yes, it is more challenging. It is hard to stop cleaning house and running errands in order to sit down and study. It's hard to commute to Orlando every day from Palm Bay.

Q: After your UFC graduation, what next?

A: I'll attend Pikeville College of Osteopathic Medicine in Kentucky, where I'll spend five years learning the craft. Once I pass all of my exams and the certifying board, I'll become an osteopathic physician.

Q: Any thoughts on receiving the Jack Kent Cooke Foundation Scholarship?

A: I'm extremely grateful, and it will help greatly. When it picks up in the fall, the scholarship money will enable me to maintain my full-time student status.

Q: Life lesson you've learned?

A: Never say never. When I was a child, my mother said, "One of my kids is going to be a doctor," and I told her to look at my sister because it wasn't going to be me.

Sunday, May 07, 2006

Defective Skeletal Posture Neural and Reconstructive Therapy using Osteopathic Manipulative Treatment

Supplement to The Art of Getting Well - Arithritis
Copyright 1992

As we age, our tendons and ligaments tend to stretch or can be torn from their connections to fascia through sports or accidents, or can be weakened through poor nutrition, disease or unbalanced chemistries. As the body's skeletal posture is held together by means of tendons and ligaments - not the muscles per se - a stretching of one set of tendons or ligaments will be unconsciously compensated for by other pulley and lever mechanisms in remote parts of the body. According to Thomas Gervais88, " Tendons are muscle ends. Fascia apparently gives ligaments and bones their proper place/structure. The fascial connective tissue thickens and becomes most rigid at places of greatest/most frequent use and demand. This 'ossification' process of fascia makes a return to good posture difficult." One compensatory mechanism is the production of Osteoarthritic spurs in the spine. Although the body's problem is lax or torn ligaments or tendons elsewhere, the body's chemistry attempts to compensate by creating calcium spurs along the spinal column. Were these calcium spurs cut out, the body's tendon and/or ligament problem would persist, and the body would attempt to compensate in another manner.

To illustrate: James A. Carlson, D.O. of Knoxville, Tennessee was asked to look at a patient's right index finger-joint nearest to the fingernail. The joint (betweenh 1st and 2nd Middle Phalanges) had been inflammed for months and was deforming. After study Dr. Carlson deduced that the cause was a left foot heel bone out of alignment. This may sound peculiar until one is versed with the manner in which the skeleton is held together, and the means by which the human body compensates. A bone awry at one place affects structure remotely connected. Using Osteopathic manipulation, he placed the heel bone back, and then using reconstructive therapy, Dr. Carlson placed near the proper tendons and ligaments substances that promote the body's ability to keep the bone in place.The finger immediately ceased its pain and deformation stopped.

In a similar instance, the finger nearest the small one on the left hand was unable to touch the palm of the hand. It was very stiff and often hurt. Dr. Carlson determined that the cause was an arch-bone in the left foot out of alignment. Again he manipulated the bone to its proper location and then used reconstructive therapy to place the bone permanently where it belonged. The pain immediately disappeared and the patient had restored ability to touch the palm of the hand with that finger10.

Many other instances -- much more spectacular8,9 -- can be described for all parts of the body where Osteoarthritis is presumed but in fact it is the slackness or disruption at the connective base of ligaments and tendons, through their interconnections via pulley and lever interconnections, that slowly create Osteoarthritic symptoms8.

Manipulation of the Spine: using Osteopathic Manipulative Treatment
Take from:
The Best of Both Worlds
Dr. Lawrence S. Glass is an osteopathic physician, or D.O. -- a doctor who combines the scientific training of an M.D. with the chiropractic skills of spinal manipulation.

D.O.'s and M.D.'s practice the same medical specialties. However, D.O.'s are distinguished by their expertise in musculo-skeletal medicine. D.O.'s focus on the role of the body's structure and function in disease and wellness.

As in integrative medicine, osteopathy emphasizes the body's ability to heal itself.

Dr. Glass' philosophy is based on a patient-centered approach to treating the the total person with conventional medicine, spinal manipulation, and proven complementary therapies, including prolotherapy.

DO's, or Doctors of Osteopathy, use diagnostic and treatment methods of allopathic medicine, but they also practice Manipulation of the Spine. Spinal manipulation is designed to affect the structure or function of the patient's spine by applying contact, force or leverage to the articular joints.

The theory behind osteopathic Manipulation of the Spine is based on the close association between the spinal vertebrae and the autonomic nervous system. The neuromuscular system connects the spinal vertebrae and the autonomic nervous system via the sympathetic trunk and ganglia. The goal of osteopathic spinal manipulation is to maintain balance by affecting the musculo-skeletal system. According to the philosophy of Osteopathy, once this balance or homeostasis has been achieved, the body can heal itself.

Osteopathic spinal manipulation is a generalized therapy that increases circulation at the site of an injury or problem area. However, osteopaths view structure and function of the body as inseparable. Therefore, treating one site can have favorable effects on other parts of the body.

By contrast, chiropractic adjustments are more specific than general. Chiropractors usually work only on the spine while osteopaths work on all joints and soft tissues as well as the spine. Osteopathic spinal manipulation includes stretching techniques and manipulative thrusts to spinal joints. More than 100 distinct therapeutic procedures are used in osteopathic manipulation of the spine.

Osteopathic physicians such as Dr. Glass may use both classic osteopathic manipulation and chiropractic techniques. The advantage of osteopathic spinal manipulation is that it can be used to treat a wide array of conditions that may not respond to chiropractic manipulation. In addition, osteopaths integrate manipulation of the spine with other therapies -- allopathic and complementary therapies -- in designing the optimum treatment plan for each patient.

Common Misconception about Osteopathic Medicine: "It is quite simple: osteopathic medicine is not limited to the musculoskeletal system."

Whole Person Medicine: A Definition Articulated Osteopathically

Portola Valley, Calif

"It is quite simple: osteopathic medicine is not limited to the musculoskeletal system. While the musculoskeletal system may be used to access total body physiology, the musculoskeletal system is a means, not the end. Andrew Taylor Still, MD, DO, stated quite clearly that osteopathic medicine is about all of anatomy and its function.

Examples of "whole body" osteopathy are abundantly represented throughout Dr Still's writings. For example, in Philosophy of Osteopathy,1 Still writes, "The Osteopath seeks first physiological perfection of form, by normally adjusting the osseous frame work, so that all arteries may deliver blood to nourish and construct all parts." In this same work, Still1 elaborates further on the role of the osteopathic practitioner:

Your duty as a master mechanic is to know that the engine is kept in so perfect a condition that there will be no functional disturbance to any nerve vein or artery that supplies and governs the skin, the fascia, the muscle, the blood or any fluid that should freely circulate to sustain life and renovate the system from deposits that would cause what we call disease.

Osteopathic medicine is about health. It is about understanding the nature of physiologic function with our hands and minds—and the use of the physician's hands and mind to restore normal physiology in our patients.

While it is certainly important to consider the whole person in medical care, this is not the sole jurisdiction of osteopathic medicine. The "whole person" should be the consideration of any good physician. "

OMT relives pain associated with fibromyalgia syndrome

Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project.

Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR.
Department of Osteopathic Manipulative Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth 76107, USA. [email protected]

Osteopathic physicians caring for patients with fibromyalgia syndrome (FM) often use osteopathic manipulative treatment (OMT) in conjunction with other forms of standard medical care. Despite a growing body of evidence on the efficacy of manual therapy for the treatment of selected acute musculoskeletal conditions, the role of OMT in treating patients with chronic conditions such as FM remains largely unknown.

Twenty-four female patients meeting American College of Rheumatology criteria for FM were randomly assigned to one of four treatment groups: (1) manipulation group, (2) manipulation and teaching group, (3) moist heat group, and (4) control group, which received no additional treatment other than current medication. Participants' pain perceptions were assessed by use of pain thresholds measured at each of 10 bilateral tender points using a 9-kg dolorimeter, the Chronic Pain Experience Inventory, and the Present Pain Intensity Rating Scale. Patients' affective response to treatment was assessed using the Self-Evaluation Questionnaire. Activities of daily living were assessed using the Stanford Arthritis Center Disability and Discomfort Scales: Health Assessment Questionnaire. Depression was assessed using the Center for Epidemiological Studies Depression Scale. Significant findings between the four treatment groups on measures of pain threshold, perceived pain, attitude toward treatment, activities of daily living, and perceived functional ability were found.

All of these findings favored use of OMT. This study found OMT combined with standard medical care was more efficacious in treating FM than standard care alone. These findings need to be replicated to determine if cost savings are incurred when treatments for FM incorporate nonpharmacologic approaches such as OMT.

Lincoln Memorial University breaks ground on DeBusk Osteopathic College

Lincoln Memorial University broke ground Friday on a new College of Osteopathic Medicine.

The DeBusk College of Osteopathic Medicine will be a $25 million facility located on LMU's campus in Harrogate.

Chairman of the Board of Trustees, and namesake of the DCOM, O.V. "Pete" DeBusk joined University President Nancy B. Moody and other LMU officials to celebrate the groundbreaking.

"This is a very historic day for Lincoln Memorial University and the people of the Appalachian region," DeBusk said. "This building and the College of Osteopathic Medicine it will house is destined to be a landmark in this community."

The University announced plans to pursue accreditations for the DCOM on January 18 after it was granted pre-accreditation status by the American Osteopathic Association's Commission on Osteopathic College Accreditation (AOA COCA) in mid-December.

The new program represents LMU's first Level V (doctoral/professional) degree program and requires approval from both the Commission on Colleges (COC) of the Southern Association of Colleges and Schools (SACS) and AOA COCA.

Recruitment of students will begin following the approval of both accrediting agencies. A targeted goal for the beginning of classes is the fall semester, 2007.

The state-of-the-art DCOM building is estimated at 105,000 square feet with four floors and will house lecture halls, faculty and administrative offices, laboratories, research space, examination rooms and classroom space.

The completion date for the new DCOM building is set for July 2007.

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