OMM question

TheTruckGuy

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Hey, I was wondering if y'all could answer some questions for me regarding what y'all are taught about OMM. My understanding is that you're trying to fix stuff that is out of alignment, but what I want to know is how long do your adjustments typically last for? Is there any time when you wouldn't do OMM on someone that's young and healthy and without any contraindications? And do y'all typically refer to PT, or teach the patients ways to permanently fix their misalignments?

I'm an MD resident rotating through a clinic that previously had a DO, and a patient came in asking for me to adjust him and said he'd get periodic adjustments whenever his back was acting up on him. Since I couldn't do it, obviously, my only option was to refer to PT but he declined.

Thanks
 

trs88

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I'm just a 3rd year, so I can't go into too much detail. But it 100% varies based on: patient vitality, the problem being worked on, and the severity of it.

To stick with your patient who wanted their back worked on. Nothing will be a permanent fix for the spine, so I imagine based on how the patient takes care of themselves they can prolong going without a treatment or shorten the time between treatments. For example, if the patient does core exercises, keeps good posture they can go without a treatment.

Also, sometimes people are just out of alignment. Take myself, we were working on rib adjustments in lab one day. You can run your hand down my left anterior ribcage and feel that "oh, this one rib pokes out a bit". It doesn't bother me in anyway, but lets practice a treatment on it. So, my classmates did the treatment correctly. We all could feel that the rib was no longer sticking out. However, I took in a really deep breathe and it popped right back out.

If I was more experienced, I could answer the rest of the questions. So this will be my opinion. If there is a 'something' that is bothering the patient, they give consent to the treatment, and it helps them feel better quickly, I don't see a reason why I wouldn't do OMM. There are some good "social" effects as well. The patient feels like you actually did something so they feel like their got their moneys worth, the placebo effect for some/most instances, and then insurance can pay $50 or more for something that took me a minute to do.
 
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12glaucoma34

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Hey, I was wondering if y'all could answer some questions for me regarding what y'all are taught about OMM. My understanding is that you're trying to fix stuff that is out of alignment, but what I want to know is how long do your adjustments typically last for? Is there any time when you wouldn't do OMM on someone that's young and healthy and without any contraindications? And do y'all typically refer to PT, or teach the patients ways to permanently fix their misalignments?

I'm an MD resident rotating through a clinic that previously had a DO, and a patient came in asking for me to adjust him and said he'd get periodic adjustments whenever his back was acting up on him. Since I couldn't do it, obviously, my only option was to refer to PT but he declined.

Thanks

Then general rules for OMM are make it up as you go. Generally speaking, there are no hard rules. Patients often feel better simply having the adjustment even though you likely didn't really realign anything. My general thought process is this: think back to anatomy about all the muscles, tendons, and ligaments attached to bone or touching them. Doing one treatment isn't going to fix all that stuff. Think about sacral, no way on earth any of these treatments do anything when you consider all the attachments. I believe much of OMM is a placebo. But if placebo reduces narcotics or nsaids, then i'm all for it.
 
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Drrrrrr. Celty

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It'll depend on the patient and what they're doing. If I have back pain and get OMM done, it'll significantly relieve the pain and i'll feel like inclined to go popping my back every 30 minutes. But it'll be back in 2-3 days because I'm going to go back to sitting on my butt, being hunched over, etc.
 
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Drrrrrr. Celty

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Then general rules for OMM are make it up as you go. Generally speaking, there are no hard rules. Patients often feel better simply having the adjustment even though you likely didn't really realign anything. My general thought process is this: think back to anatomy about all the muscles, tendons, and ligaments attached to bone or touching them. Doing one treatment isn't going to fix all that stuff. Think about sacral, no way on earth any of these treatments do anything when you consider all the attachments. I believe much of OMM is a placebo. But if placebo reduces narcotics or nsaids, then i'm all for it.

I don't really think sacral really works the way it's made out to work. But I think that at least functionally it has a really good tendency to relieve tightness and pain. I think there's probably a good amount of tension at the L5-S1 area and getting L5 to move a bit and getting the muscles around there to relax is always nice.
 
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