Osteopathic manipulative treatment

Osteopathic manipulative medicine

This is the main article for the Categorization Osteopathic manipulative medicine.

Osteopathic Manipulative Medicine (abbreviated as OMM) is an approach to manual therapy, form of therapy that uses physical contact, used to improve the impaired or altered function of the musculo-skeletal system (somatic dysfunction). With roots in ancient Greek "frictions," manual manipulation has long been a part of health care. Today's OMM was first practiced by Andrew Taylor Still, M.D., the founder of modern osteopathic medicine. In the United States, its country of origin, OMM is used by Doctors of Osteopathic Medicine (D.O.s) along with surgery and medication in treatment of patients. Outside the United States, practitioners of osteopathy (who may have the qualification of D.O. as a Diploma of Osteopathy, but do not necessarily have the same medical training as American-trained D.O.s) generally limit their scope to manual manipulation.

There are different techniques applied to the musculoskeletal system as OMM. These techniques can be applied to the joints, their surrounding soft tissues, muscles and fasciae.

Also, OMM is a treatment that is intended to be used in conjunction with mainstream treatments where it is deemed appropriate. It is rarely used as a primary treatment regimen unless the D.O. is absolutely certain that the patient's problems are a result of a musculoskeletal somatic dysfunction. Furthermore, as with other medical treatment methodologies, there are certain situations where use of OMM is strictly contraindicated (for example, cervical spine HVLA techniques may never be used on patients with Down Syndrome).

While this OMM practice is traditionally ascribed to D.O.'s, it should also be noted that there are M.D. practitioners of OMM since many Osteopathic medical schools have created training programs for their M.D. counterparts. Recently OMM training programs have likewise been extended to other medical professionals including, but not limited to: Physician Assistants, Nurse Practitioners, Nurses, etc.

Some techniques used in OMM are:

It is probably the comprehensive and eclectic style of OMM that distinguishes it most from that employed by most other manual therapists. The immediate goal of musculoskeletal manipulation is to restore maximal, pain-free movement of the musculoskeletal system in postural balance.


The Cochrane Library has systematically reviewed evidence on the effectiveness of spinal manipulation for a number of conditions. The conclusions are summarised in the table below. Note that in many cases the manipulation was carried out by chiropractors or osteopaths rather than by osteopathic doctors.


Treatment studied


Dysmenorrhoea (painful menstrual cramps)

spinal manipulation (using hands to put pressure on certain parts of the back bone)

No effect

neck pain, neck pain plus related headache

exercises plus mobilisation [movement imposed onto joints and muscles] or manipulation

These treatments when combined were better than no treatment.

neck pain, neck pain plus related headache

Manipulation alone

No effect

migraine headache

spinal manipulation

May be effective, with a short-term effect similar to amitriptyline.

chronic tension-type headache

spinal manipulation

Less effective than amitriptyline during treatment. More effective than amitriptyline in the short term after end of treatment

cervicogenic headache

spinal manipulation

Effective at least in the short term


Spinal manipulation, chest tapping, shaking, vibration, postures, massage

Not enough evidence

Low-back pain

Spinal manipulation

No more or less effective than pain medication, physical therapy, exercises, back school or the care given by a general practitioner.
More effective than sham (fake) therapy.


Manipulation and other treatments

Not enough evidence

See also


  • Gevitz, Norman; Grant, U. S. (2004). The D.O.s (2nd ed.). Baltimore: The Johns Hopkins University Press. ISBN 0-8018-7834-9.
  • Ward, Robert C. et al; Foundations for Osteopathic Medicine (2nd ed.). Philadelphia: Lippincot Williams and Wilkins. ISBN 0-7817-3497-5.


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