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Other common
name(s): osteopathic medicine
Scientific/medical
name(s): none
Description
Osteopathy is a form of physical manipulation (moving the
joints and muscles) used to restore the structural balance of the
body's system of bones and muscles. The word osteopathy comes from 2
Greek words meaning "bone" and "disease." Osteopathic physicians may
combine this physical treatment with standard medical care.
Overview
There is little scientific evidence that osteopathic medicine
is effective in treating cancer or any condition other than
musculoskeletal problems. Doctors of osteopathy (called DOs) are
educated in standard medical practices, and most of the methods that
they use are based on the same scientific studies that medical doctors
(MDs) use. In addition to bone and muscle movement, DOs prescribe drugs
and generally do everything that MDs do.
How is it promoted for use?
Osteopathy is based on the belief that all systems in the
human body work together. Doctors of osteopathy observe the patient,
ask questions about health history, and use their hands to diagnose and
correct muscle, tendon, and joint abnormalities, which they claim are
the cause of many diseases. Some osteopaths claim that if bones and
muscles are in balance and functioning properly, the body can heal
itself. Practitioners most often recommend osteopathy for head, neck,
and back pain, headaches, joint pain, muscle strain, repetitive strain
injuries, and sports-related problems.
Osteopathy is sometimes promoted as an alternative method to
ease pain, improve quality of life, minimize the side effects of
treatment, enhance other types of treatments, and extend the life of
some cancer patients. Some proponents claim that people with cancer,
heart disorders, high blood pressure, stomach disorders, and a variety
of other conditions can benefit from osteopathy. Some supporters claim
that osteopathy, when used with conventional medicine, can reduce the
pain from arthritis, chronic fatigue, and some gynecological problems.
What does it involve?
In treating people with various conditions, DOs use several
different forms of physical manipulation:
- Articulation involves moving the patient's joints through
the normal range of motion.
- Counterstrain techniques involve placing a joint or muscle
in a relaxed position and then pulling to stretch and loosen it.
- Cranial techniques involve the moving of bones in the
skull, especially in the jaw, to relieve pain and treat other
conditions.
- Functional techniques involve gently moving the patient's
joints until the practitioner finds restrictions to movement.
- Muscle energy techniques involve stretching the patient's
muscles and then forcing the muscles to move against resistance.
- Hands-on massage may also be used in osteopathy.
These techniques are sometimes used alongside standard medical
treatment or after conventional treatment has failed. For example, an
osteopath who treats cancer patients may use the same chemotherapy,
radiation therapy, or surgical treatments as a physician, but may also
look at how the disease has affected the patient's body structure and
provide osteopathy to correct other physical abnormalities.
Some DOs limit their practice to conventional medicine only,
while others may practice manipulative therapy almost exclusively. In
recent years, there are fewer differences between the practices of
osteopaths and conventional medical doctors.
What is the history behind it?
Originally started in the 1800s as a reaction to conventional
medicine's reliance on drug therapy, osteopathy today is quite similar
to conventional medicine, except for its use of osteopathic
manipulative therapy. Andrew Taylor Still, MD, first expressed the
philosophy and principles of osteopathy in 1874. Dr. Still rejected
reliance on drug treatment and considered surgery a last resort in
treating diseases. He believed that diseases could be cured through the
manipulation of misplaced bones, nerves, and muscles, which cleared
"obstructions."
In 1892 he founded the first osteopathic medical school in
Kirksville, Missouri, to promote his philosophy of medicine. Today,
there are 20 osteopathic medical colleges in the United States, and
osteopathy has evolved to incorporate the theories and practices of
conventional medicine as well. There are nearly 60,000 DOs practicing
in the United States, about half in general practice or one of the
primary-care specialties -- family practice, internal medicine,
pediatrics, and obstetrics and gynecology. Osteopaths make up about 5%
of the doctors practicing in the United States but represent almost 10%
of primary-care providers.
Doctors of osteopathy are allowed to do more in the United
States than in any other country. Laws in every state and in the
military permit DOs unlimited medical practice once they are licensed
by the state, following training in an accredited osteopathic medical
school and a one-year internship in an approved hospital. Osteopaths
may also undertake residency training in any medical specialty and
become board certified by passing a certification exam.
Once barred from conventional hospitals and restricted to
their own hospitals, most osteopaths now receive at least some of their
training in conventional hospitals and may practice in conventional
medical settings. Osteopathic medical schools have education programs
that are similar to conventional medical schools, with the exception
that they include up to 300 hours of training in manipulation therapy.
What is the evidence?
Although most osteopaths use standard medical treatments that
are proven in scientific studies, a few osteopaths use unproven
methods, such as craniosacral therapy and chelation therapy. Available
scientific evidence does not support claims that osteopathic
manipulation alone is helpful in most diseases, although studies have
indicated that the therapy may help relieve some musculoskeletal
problems and related pain. A review of research studies that looked at
lower back pain suggested that osteopathic manipulation was no better
or worse than the usual medical management.
Are there any possible problems or
complications?
As with any medical treatment, osteopathic manipulation may
carry risks of failure or may have serious effects. There may be some
risk of injury or fracture to anyone with bone cancer or severe
osteoporosis. People who have cancer and chronic conditions such as
arthritis and heart disease should consult their physicians before
undergoing any type of therapy that involves manipulation of joints and
muscles.
Relying on osteopathic manipulation alone and avoiding or
delaying conventional medical treatment for cancer can result in
serious consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Assendelft WJ, Morton SC, Yu EI, et al. Spinal manipulative
therapy for low back pain. Cochrane Database Syst Rev.
2004;(1):CD000447.
Barrett S. Dubious aspects of osteopathy. Quackwatch Web site.
Accessed at http://www.quackwatch.org/04ConsumerEducation/QA/osteo.html
on August 18, 2003. Accessed May 30, 2008.
Lesho EP. An overview of osteopathic medicine. Arch Fam Med.
1999;8:477-484.
Magee M. Rethinking physician supply [transcript]. Health
Politics with Dr. Mike Magee. Health Politics Web site. Accessed at
http://www.healthpolitics.org/program_transcript.asp?p=prog_52 on June
3, 2008.
Osteopathic fact sheet. Oklahoma State University Center for
Health Sciences Web site. Accessed at
http://www.healthsciences.okstate.edu/student/factsheet.cfm on June 2,
2008.
Still AT. Autobiography with a history of the discovery and
development of the science of osteopathy. Reprinted, New York, NY: Arno
Press and the New York Times; 1972.
Wood DL. Research lacking in osteopathic medical profession. J Am Osteopath Assoc.
1997;97:23.
Note: This information may not cover
all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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