What Does a Doctor of Osteopathic Medicine Do?
Osteopathic doctors focus on treating the whole person rather than just the specific symptoms or body parts. Osteopathic medicine is based on the idea that all the body’s systems are interrelated. There were about 149,000 doctors of osteopathic medicine in the U.S. in 2023, a 30% increase in the past 5 years. And more than 1 in 4 U.S. medical students are on the path to becoming a doctor of osteopathic medicine (DO).
DOs are trained in the same way as MDs and can diagnose and treat ailments, perform surgery, and prescribe drugs. But DOs get extra training in manipulating the musculoskeletal system. This is your body's interconnected system of nerves, muscles, and bones. All DOs are trained in osteopathic manipulative treatment (OMT), sometimes called osteopathic manual manipulation or osteopathic manipulative medicine (OMM). This is a hands-on method to help diagnose and treat illnesses. Not all DOs use it regularly in their practice, though.
If you visit an osteopath with, say, knee pain, they are likely to look at more than just your knee. To prevent or treat health issues, DOs pay extra attention to how all your body parts work together.
DOs have held prominent medical positions in the U.S., for instance, as part of a NASA medical team. They also have been primary physicians for presidents from both political parties.
Tenets of Osteopathic Medicine
Here are the four tenets of osteopathic medicine, approved by the American Osteopathic Association as policy, along with some explanations:
The body is a unit; the person is a unit of body, mind, and spirit. No single unit functions by itself. If there's a problem in one area, all three will be affected. So, we need to include all the units in our practice.
The body is capable of self-regulation, self-healing, and health maintenance. The DO's job is to restore the body to its normal state so it can heal itself naturally. OMM aims to improve the body's self-healing capabilities.
Structure and function are reciprocally interrelated. Since the structure of a body decides its function, an abnormal structure will affect the functioning of the body.
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function. Osteopathic medicine requires using rational (appropriate) treatments with the understanding of the basic tenets listed above.
Osteopathic medicine dates back more than 100 years. Its founder, Andrew Taylor Still, thought that correcting problems with the body's structure could help the body heal itself. He developed osteopathic manipulation treatments with the goal of restoring the nerves to a healthy state and promoting circulation so the body could heal itself.
One key idea in this field is that many diseases result from, or cause, problems within the body's musculoskeletal system, which includes nerves, muscles, and bones.
How Are Doctors of Osteopathic Medicine Trained?
Most students who apply to osteopathic medical school first earn a bachelor’s degree and many also have a master’s degree or doctorate.
After 4 years of osteopathic medical school, DOs do a residency in their chosen area of specialty. Just like an MD, they may become a primary care doctor, a pediatrician, or a specialist such as a dermatologist or cardiologist. Doctors of osteopathic medicine get extra training in the musculoskeletal system.
Osteopathic vs. Naturopathic Practitioners
While osteopathy and naturopathy may sound similar, they’re quite different. A naturopathic practitioner’s goal is to heal you through natural substances such as food, herbs, and water, plus lifestyle changes such as exercise and lowering your stress.
Like DOs, naturopathic practitioners are trained, but the type of training varies. They aren’t licensed and take training programs that aren’t certified by the U.S. Department of Education.
Doctors of osteopathic medicine focus on hands-on diagnosis and treatment along with prescription medicine, surgery, and technology. They take internships and residencies at hospitals to prepare them to become licensed and board-certified.
An emerging field is naturopathic medicine. Naturopathic doctors (NDs) are trained in the same medical procedures as MDs and DOs, but they also learn complementary medicine practices, such as acupuncture, herbal medicines, homeopathy, counseling, and advanced nutrition principles. Just five schools in the U.S. offer degrees in naturopathic medicine.
Osteopathic Medicine vs. Allopathic Medicine
Allopathic medicine is another word for conventional medicine. Most of the doctors you encounter have been trained in allopathic medicine.
Requirements to be admitted to an allopathic program and an osteopathic program are about the same. You need a high GPA and high MCAT (Medical College Admission Test) scores. Many students apply to both programs. Once you're admitted to either program, you'll spend the first 2 years in a classroom setting and the next 2 years in a clinical setting (for instance in a hospital). Both MDs and DOs can apply to the same residency programs.
A key difference is DOs spend an extra 200 hours learning osteopathic manipulative treatment (OMT). This involves manipulating the patient’s muscles and joints with techniques such as stretching, resistance, and gentle pressure.
There is also a difference in philosophy. MDs focus on diagnosing and treating medical conditions and diseases. DOs look at the whole person, rather than just the body part giving trouble, and focus a lot more on prevention. There can be overlap as some MDs do give holistic treatment. About 57% of DOs go into primary care compared to 28% of MDs.
What to Expect From an Osteopath
An exam with a DO is similar to an exam with any other kind of doctor. You’ll get your blood pressure checked, and you’ll step on a scale. They’ll want to hear about your lifestyle — what you eat, what you do for exercise, and how stressed you feel — as well as any symptoms that bother you.
Since prevention is a big part of the osteopathic approach to medicine, your DO will probably give you advice to help you avoid injuries or diseases down the road. An osteopath can give you any vaccines you need and recommend routine medical tests such as mammograms or cholesterol blood tests. They may also suggest programs to quit smoking or screening tests for depression or other mental health problems.
Medicare and private insurance should treat your appointment the same as a visit to any other doctor.
Osteopathic Manipulative Treatment
DOs may use OMT to diagnose and treat illnesses. They believe tightness and restriction in your nerves and muscles can be caused by or lead to other problems. They use their hands to gently move your joints and tissues to correct any restrictions in your range of motion.
OMT uses 40 techniques, including:
- Soft tissue technique. You’ll feel stretching and pressure on your muscles.
- Muscle energy. You move your muscles in a specific direction while the DO counters that movement. Think push-pull.
- Myofascial release. Your DO uses firm but gentle pressure to release tension in the fascia — the layer of connective tissue that surrounds your bones, muscles, and organs.
- Osteopathic cranial manipulative medicine. Your DO applies soft pressure to your skull to stimulate healing.
Some find that this natural treatment works in place of drugs or surgery for some conditions. OMT is often used for muscle pain but can help treat a wide range of health problems, including:
- Low back pain
- Neck pain
- Sports injuries
- Repetitive stress injuries such as carpal tunnel syndrome
- Some headaches, including migraines
- Asthma
- Sinus problems
- Menstrual pain
Some pediatric DOs use OMT to help treat asthma, earaches, and colic. So far, only a small number of good studies have looked at the use of OMT in children. The results have been mixed.
You may feel soreness for a day or two after the treatment. There are usually no other side effects. Depending on your case, your DO may find that you also need other treatments, such as medicine or surgery.
Benefits of Osteopathic Medicine
Some of the advantages of osteopathic medicine are:
- It's noninvasive. Surgery is not required.
- It can complement or even replace medication in some instances.
- It can be used for a wide variety of ailments including back pain, neck pain, asthma, and chronic obstructive pulmonary disease (COPD).
- Regular treatments can help prevent pain from coming back and increase mobility.
- It may restore tissue and muscle balance.
- It may improve blood circulation.
- Your mental and spiritual health will be examined along with your physical health. Many times, physical problems are due to emotional trauma, diet, or environmental issues.
Disadvantages of Osteopathic Medicine
There are some drawbacks to osteopathic medicine:
- It's limited in scope for certain conditions. Osteopathy can't treat serious bone injuries or muscle disorders. These will require surgery. You also won't get relief from chronic pain associated with these injuries with osteopathy.
- Some spinal manipulation therapies have been linked to stroke, nerve damage, and prolapsed disk. The most common serious issue is damage to the vertebral artery, which can lead to a stroke.
- Studies show mixed results for treating back pain with spinal manipulation. Studies also don't show any benefit to using spinal manipulation to treat other types of pain.
Takeaways
Doctors of osteopathic medicine (DOs) get similar training to MDs, including 4 years of medical school, residency, and the option of specializing. They can prescribe drugs, perform surgery, and run tests just like an MD. A key difference is that DOs are also trained in osteopathic manipulative treatment, which involves manipulating the patient’s muscles and joints with techniques such as stretching, resistance, and gentle pressure. DOs also look at treating the whole person rather than just the problem.
Osteopathic Medicine FAQs
Why choose a DO over an MD?
You may choose a DO if you're interested in holistic treatment for your problem, as well as learning how to prevent it. This doesn't mean that MDs don't consider overall health or give you advice on prevention — but these are special focus areas of DOs. Doctors of osteopathic medicine also have extra training in manipulation of your muscles and joints, but not all of them use this in their practice. Most doctors in the U.S. are MDs, but many DOs go into primary medicine.
Is it better to see a chiropractor or osteopath?
That may depend on what you need help with. Both professionals use their hands to diagnose and treat spinal problems. Chiropractors are more likely to push on your spine with their hands, while osteopaths are more likely to push on your limbs and soft tissue. DOs are trained similarly to MDs but have additional training in manipulation of your muscles and joints. Chiropractors don't go to medical school. They usually have an undergraduate degree followed by 4 years at a chiropractic institution. Chiropractors can't write prescriptions, while osteopaths can. Osteopaths can usually handle a wider range of problems because of their medical training. Chiropractors focus more on spinal and other skeletal issues.
Why do I feel sick after osteopathy?
While some people feel great after osteopathy, some people have muscle soreness, pain, irregular bowels, or tummy ailments. Osteopaths say this is a natural part of the healing process if you've had muscle or bone manipulation. Symptoms usually go away in a day or two. If they persist longer and aren't getting better, see your DO. Your osteopath will probably tell you to rest and not do any heavy lifting or sports for a few days after treatment to help with healing.
