chiropractic v.s. OMM (differences?)

Discussion in 'Medical Students - DO' started by 12R34Y, Apr 19, 2000.

  1. 12R34Y

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    I've been searching the past messages and can't really get a clear cut answer about what the difference between a chiropractor and a D.O. performing OMM is. Aren't they both manipulating the joints? Do the techniques differ? Is one safer the the other?
    thanks
     
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  2. dcdo

    dcdo Senior Member
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    the techniques are all the same. You are more apt to find a greater variety of techniques within the DO profession, but few DO's are very good at it, since they don't get a lot of practice.
     
  3. ewagner

    ewagner Senior Member
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    I think there is a huge difference, one can care for every aspect of the patient, the other can't. To me, OMM must take into account everything, and not just be about "pressing and guessing, racking and cracking" That means, ordering a MRI, CT, or ortho, neuro, or allied health. As well as NSAIDS, narcotics, SSRI's, etc.
     
  4. Smile

    Smile Senior Member
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    I am not in DO school yet, but my impression was that osteopathic manipulation does not involve simple cracking and realigning of bones. It involves many soft tissue techniques as well to both increase range of motion and decrease spasms... techniques such as strain-counterstrain and muscle energy. I thought chiropractors simply focused on high-velocity high-amplitude thrusts to simply "realign" the bones/joints. While osteopathic manipulation involves restoration of optimal structural positions for proper healing, chiropractic involves moving joints to realign them.

    Please correct me if I am wrong, but this was just my take on the primary difference, in addition to those mentioned by ewagner regarding knowledge of all other medical modalities.
     
  5. RockyMan

    RockyMan Member
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    I agree: technically-- i.e., considering the manipulative side-- OMM and chiropractic are in the end pretty much the same. They both involve identification of putatively 'out of line' joints and bones and other areas of 'dysfunction' in the body, then using your hands to try to 'correct' the restriction/subluxation/somatic dysfunction. The OMM practitioners have their own terminology to decribe diagnosis and treatment, but the things they end up doing to the patient are similar, and in many cases will overlap with therapeutic techniques employed by physical therapists and occupational therapists. In my own primary care clinical experience, I would say that unless they are OMM specialists, most DO's employ a fairly narrow range of manipulation techniques, certainly less than ten.



    Some DO's claim to use manipulation to treat non-musculoskeletal conditions such as hypertension, angina, etc., but there's very little evidence that they do anything beyond placebo-type effects in these cases. The same can be said for many chiropractic practitioners as well.



    Education for DO's is very similar is identical to MD's, at least insofar as the non-OMM part of the world is concerned (e.g., many MD and DO students and residents take the same board exams), but chiropractic school doesn't have nearly so much overlap.



    Finally, MD's and DO's are licensed to prescribe drugs, write hospital orders, and do other 'doctor' things that (at least in most states at present) chiropractors are not allowed to do.





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    Question Authority & Overturn Dogma
     
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  6. dcdo

    dcdo Senior Member
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    Rockyman, that's pretty much it in a nutshell. HVLA, muscle energy, cranial, indirect, counterstrain, whatever- you can find both DO's and DC's that do it. In fact, from my experience "straight DC's" are very similar to hard-core manipulating DO's. The medical training is the difference.

     
  7. ewagner

    ewagner Senior Member
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    Let me also state, that PT's do the same thing as well. In fact, the best rehab people and the most efficient that I have ever met have been PT's.
     
  8. Smile

    Smile Senior Member
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    I'd like to add to ewagner and dcdo's last comments: I am a practicing PT in outpatient orthopedics and I use (or am familiar) with the techniques listed above. They are by no means distinct to DO's or chiropractors only. PT's do use such techniques as appropriate because we have been adequately trained in them either in PT school or through continuing education courses. But of course we don't get into the medical management of the patient other than to fully know about their medical history/condition and be able to treat them within their individual parameters.

    ewagner, I do believe you have some merit in your last statement, when you say PT's are good rehab people and are efficient. Remember, that's what we are trained in!! Rehab is our job. Our entire focus with patients is how we can restore them back to full (or near full) function through therapy and rehab. Efficiency has primarily grown as a response to increased pressures of managed care. We have to maximize patients progress with each visit because sometimes 6 or 8 visits is all we are going to get! It can be frustrating but at the same time very rewarding.

    PT's make excellent complements in the overall care of patients under MD's or DO's, but in my experience they don't mix well with chiropractors. Our goals are usually different, as we focus more on returning to function while chiropractors wish more to restore "normal" alignment. Reason I quote the word normal is that perhaps a "malaligned joint" is simply normal for that patient. For example, if a chiropractor were to look at my back, which has a scoliotic curve, he would have a field day in trying to demonstrate how my back needs major chiropractic manipulations and realignments! BUT... am I symptomatic? Absolutely not. However, the next person may have the same curve as me and be in severe pain. So what gives? Point being, one must be careful when we hear them say "we want to restore proper alignment" as we must question the alignment in relation to what?
     
  9. Starflyr

    Starflyr Manic Faerie
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    Well, I was planning on asking my chiropractor this exact question tomorrow (I'll let y'all know what he says), but from my experience, the differences in technique arent very big. The training, now, that is different. Chiropractors go to school for (oh, ack...3? 4?) a number of years and learn in-depth the techniques and what nerves/systems/etc are affected by different spinal issues. They also use soft tissue techniques and pressure point massage to help. DO's also learn this, but I think its only 150 hours? And (at least *my* DO) they seem to be much more likely to prescribe painkillers for headaches then to do manipulations/realignments to relieve them. Anyway, like I said, Ill get back to you tomorrow.

    smiles,
    Star
     
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  10. UHS03

    UHS03 Senior Member
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    I was also under the impression that the outcomes DO's expect to get from spinal manipulation are very different from what chiropracters expect. This is because chiropracters are describing a different mechanism of pathology, specifically that nerve impingement/interruption is the primary sequela of an out of position vertebra(e). I am not well versed in chiropractic, so I am only stating what I had understood to be true. In what I have learned so far about OMM, rotation/sidebending of vertebrae is the sequela of muscle spasm or a viscerosomatic reflex causing the spasm. So, it seems to me, that in chiropractic, the "malaligned" vertebra is looked at as the cause of problems, whereas in OMM, the rotated/sidebent vertebrae are considered (usually) the result of some other pathology. Therefore, even though techniques may be similar, the underlying pathology is explained in very different ways. I would appreciate to hear any confirmation and/or corrections to my understanding of this. [​IMG]

    [This message has been edited by UHS03 (edited 04-20-2000).]
     
  11. ewagner

    ewagner Senior Member
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    Smile,
    Of course I agree with you, because prior to med school...I was (and am) a PT. PT and Chiropractic and also many aspects of OMM just don't mix. And, I find myself in conflict much of the time.
    But that is another story.
     
  12. Starflyr

    Starflyr Manic Faerie
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    Okies [​IMG] I talked to a chiropractor about this and this is his take on the difference(s)

    1) Chiropractors believe that manipulaitions affect the nervous system...and that by "fixing" the vertebral probalems, you get rid of the basic cause of whatever your problem is (headaches, whatever). Apparantly DOs believe that manipulations affect the vascular system and that the problems are symptoms, not causes. (?)

    2) The approach differs in that what DOs use is usually more "generalized". For example, when adjusting necks, DOs tend to go more for adjusting all 7 cervical vertebrae, while chiropractors try to focus on just adjusting one area.

    Anyway, like I said, this is one chiropractors point of view...any refuting statements or support of these views? [​IMG]

    blessings,
    Star
     
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