Osteopathic Medicine FAQs

Osteopathic Exam and Treatment

Though each osteopathic physician is unique, a typical office visit usually consists of:

  • Medical history and conventional physical exam
  • Osteopathic structural exam
  • Osteopathic medical diagnosis
  • Osteopathic treatment

History and Physical Exam

Before treatment can begin, it is important to take a thorough medical history, including a detailed description of traumatic events.  The osteopathic physician is particularly interested in understanding the body’s adaptation to adverse influences.

Both trauma and illness can disturb the tissues and alter function. As the tissues twist and compress,  fluid continuity becomes compromised and normal physiology is impaired. If left untreated, this altered tissue function can remain present throughout a person’s life, long after the disruptive influence has passed.

An osteopathic history may include questions about:  birth, injuries, chronic use injuries, inflammatory disease processes, surgeries, dental procedure, and mental/emotional stressors.

The conventional physical exam is then used to assess specific medical conditions, symptoms and overall health as indicated in the history. It may include vital signs, a neurological exam and evaluation of cardiovascular, pulmonary, digestive and other systems as needed.

Structural Exam

A structural exam can be performed either sitting, standing or lying down. Wearing loose, comfortable clothing allows the physician to optimally evaluate areas of bony asymmetry, tissue texture abnormalities, and fluid congestion.  The osteopathic physician will typically place his or her hands underneath or over some part of the body. Tissue function is evaluated, and the quality of motion, balance and organization are noted.


A thorough osteopathic diagnosis connects the patient’s history and physical exam to the structural evaluation. As the physician places his or her hands upon the patient, structural dynamics are perceived, and can often be directly linked to the patient’s presenting complaint and trauma history. A “cause and effect” relationship frequently emerges, and is an essential component of the osteopathic diagnosis. Patients are often relieved to know that their symptoms finally make sense.


Treatment is typically very gentle. Tissues are supported and allowed to change. Usually very little force is used during treatment, but at times some force may be necessary. Diagnosis and Treatment blend into one another, since as the tissues change the physician learns more about their nature. As the nature of the tissue dysfunction is better understood, the therapeutic response deepens.

Each patient’s experience is unique. Some patients sense only a gentle touch, while others feel their body change immediately. Some patients simply feel a deep sense of relaxation, and others feel nothing at all.  Almost all patients, however, feel a distinct change following the treatment

Though osteopathic treatment is very gentle, patients can occasionally experience some discomfort during certain stages of the treatment, or even 1 or more days later. When this occurs, it is simply a part of the healing process. As the treatment progresses, the discomfort subsides.

Physicians practicing osteopathy in the cranial field will work anywhere on the body, and they may find it particularly important to diagnose and treat the head. Though styles of treatment may vary, the osteopathic physician will primarily focus on the body’s “mechanism” – the body’s natural striving for health and normal function.  All osteopathic physicians apply osteopathic principles in treatment. The styles of treatment in which these principles are applied vary from physician to physician.

Results depend upon many factors. Most significant are the body’s inherent vitality (ability to heal), the history of other insults to the body (e.g., illness, toxins, trauma, etc.) and the severity and duration of the problem. Some conditions will respond immediately; some will require a series of treatments. It is important to understand that cranial osteopathy is not a cure-all. It can benefit everyone, because everyone has been imprinted individually by the traumas of life, and everyone can benefit from a treatment that improves the functioning of the body, but it not always enough to address the presenting complaint. For some patients it might be necessary to include other types of treatment. For many, cranial osteopathy is “the solution” to their problems, often when more conventional medical treatments have failed. 


Benefits of Osteopathic Treatment

 Most people first seek osteopathic care for pain-related complaints.  These problems can be recent or long-term. They may be related to sports injuries, car accidents, falls, surgeries, birth or other traumas.  Others seek osteopathic care as an alternative to surgery or medication.  Common conditions treated include:

  • Head disorders, including migraines, TMJ dysfunction, trigeminal neuralgia, vertigo and tinnitus
  • Traumatic brain injury and post-concussion syndrome
  • Neck and back pain, including scoliosis, pinched nerves and sciatica
  • Joint pain, including tendonitis, carpal tunnel syndrome, rotator cuff strains/partial tears, rib strains, and hip pain
  • Chronic issues such as fatigue, and rheumatological conditions including fibromyalgia

Many patients find osteopathic treatment improves function, making it helpful for pregnant women, lactating mothers, and children. Osteopathy is particularly useful for babies with:

  • Latching/sucking problems
  • Torticollis and plagiocephaly
  • Reflux and colic
  • Ear infections
  • Difficult or traumatic births

Osteopathic care can also improve the function of many autonomic core body functions, alleviating symptoms that come from impediments to optimal physiology.

  • Breathing (including asthma )
  • Digestive disorders (including reflux and irritable bowel syndrome)
  • Poor sleep

As osteopathy involves a truly holistic approach, it supports the body’s ability to self-regulate by restoring its normal structure and function. Therefore, osteopathic manipulation can be beneficial in helping to restore health in many situations, regardless of the underlying complaint. 


FAQ About Osteopathic Medicine

What is the difference between a D.O., an osteopath, and an osteopathic physician?

These terms may describe the same person, so they are often just differences in terminology and emphasis. In the U.S., D.O. (Doctor of Osteopathic Medicine) is one of 2 degrees that qualifies a person to become a licensed physician (the other is M.D.).  Because of this any D.O. can be called an “osteopathic physician”, or simply a physician.All D.O.’s are trained in medical school in the basics of osteopathic manipulative treatment, just as they are trained in the other basic practices of medicine, including obstetrics, pediatrics, psychiatry, and surgery.  Some D.O.’s will specialize in osteopathic manipulative medicine (OMM) also referred to as neuro-musculoskeletal medicine (NMM).  We sometimes call them “traditional osteopaths”, or just osteopaths for short.Most doctors that practice osteopathic manipulative medicine are specialists – it is the primary or sole focus of their medical practice.  In addition, there are many primary care D.O.s who offer some level of OMM treatment as part of their more general practice.  Less frequently, a D.O. in a specialty field such as neurology, orthopedic surgery, or physiatry may offer OMM treatment as well.Occasionally, you may encounter a practitioner who trained outside of the U.S.  These people hold Diplomates of Osteopathy;  unless they also hold a M.D. degree, they are not licensed physicians.  These practitioners are also often referred to as osteopaths in their home countries.

What is the difference between cranial osteopathy and craniosacral therapy?

Physicians who practice cranial osteopathy are fully licensed doctors who specialize in osteopathic manipulative medicine (OMM) diagnosis and treatment.  During four years of osteopathic medical school, D.O.’s receive extensive training in anatomy, physiology, neurology, orthopedics, and other core areas of medicine.  In addition, all D.O.s have an initial minimum foundation of over 400 hours training specifically in OMM, plus elective training, and they must pass several board licensing exams. D.O.’s must complete an internship and often finish residency training in any medical specialty and/or in OMM. Cranial osteopaths then complete extensive post-graduate training in this sub-specialty of the field, with an emphasis on the autonomic nervous system and what is known as the primary respiratory mechanism – the inherent motion of the central nervous system, cerebrospinal fluid, the surrounding connective tissue, and its manifestations throughout the body.There is no standardized training or certification that a person must complete before calling him/herself a craniosacral therapist;  craniosacral therapists are non-physicians who have taken at least one 25 hour class in craniosacral therapy.  Craniosacral therapy is a highly simplified protocol derived from cranial osteopathic principles. Most craniosacral therapists are massage therapists, and therefore are not licensed medical professionals.

What is the difference between osteopathy and chiropractic?

There are a few key differences between osteopaths and chiropractors.Traditionally, chiropractic theory has emphasized the impact of the spinal nerves on functioning of the body, and therefore focused on treating the spinal part of the skeleton. In contrast, osteopathic medicine emphasizes treatment of the muscles, bones, connective tissue, and joints of the whole body, because of the effect on the blood vessels, lymphatics, and both peripheral and central nervous systems throughout the entire person, including the autonomic nervous system.Osteopaths are licensed physicians.  Physician licensure includes training in a full spectrum of medicine, from outpatient and clinics, to surgery, emergency medicine, intensive care and other acute pathology.  This allows us to appropriately identify if and when a more intensive treatment regime might be needed, and to manage osteopathic treatment in the context of complex medical situations.Most, although not all, chiropractors focus on high-velocity, low amplitude adjustments (“cracking”). This is one of the many techniques learned by osteopathic physicians.  Some osteopaths employ high velocity manipulations as part of their treatment when appropriate;  others rely solely on more gentle manipulations to achieve the treatment goals.