OMT and chiropractic?

[jesse14]

Chiropractics castigators argue that the very tenet and surmise of the profession is founded in pseudoscience and, if i may, scam. However to truly answer the essence of the question posed before individuals with a so-called academical education began their ridiculous rhetoric was this: Why the animosity towards Chiropractic?

To answer this question in its most fundamental of degrees, i would like to pose my own question? Why dose the American Osteopathic Association promote osteopathic manipulative therapy for conditions such as asthma, carpal tunnel, and menstrual pain? Are Chiropractors not academically condemned and scrutinized for even considering to such interventions especially otitis media? (An argument into the difference between the two manipulative techniques is not necessary, those who are both DC and DO are aware to the reasons why) Maybe there is more to the picture than dogmatic debates will give insight into. Maybe if individuals had used their time to research literature as opposed to opinion they may have found solid research out there, or maybe Doctors of Osteopathic Medicine have aligned themselves much better with allopathic doctors and well, infer what one will to this comment. It certainly deserves inquire though, Why all the animosity towards chiropractic and not osteopathy? perhaps if half of your interventions are medication then the other half can be forgot.

American compared Canadian and Australian chiropractic education has large differences so perhaps everyone need to research this point before writing generalized and academically offensive postings.

Basically, I simply don't see the level of debate with OMT who profess to treat the conditions listed in the link below as I do with chiropractic. Why is that?

Thanks!


http://www.osteopathic.org/index.cfm?PageID=ost_omt

---

Members don't see this ad.

 

[JaggerPlate]

I'm sure a million people will storm in and answer this wayyy better than a foolish pre med (me), but it was my thought that OMT relies on (god this is probably wrong and I'm gonna get nailed) 'small area high velocity' manipulations where chiro uses 'large area larg velocity' manipulations. OMT seems to isolate where the problem lies and manipulate it without hyper extension of anything, where chiro is kinda all about popping and ripping stuff back into place. There is also the biggest difference, being that DOs are fully licensed physicians (because of the med school thing) where as DCs can't perscribe medicine, do surgery etc etc. This is why a lot of people have a beef with DCs selling herbal meds and such. However, I think your question was more on the differences in the manipulation techniques ... which someone else will answer better.

 

[Shinken]

The essence of the animosity between such lauded and celebrated professions such as chiropractic and osteopathy, lies in the historical remnants that such divergence in medical proclivities produced.

To say, nay, to assert that osteopathy has a higher academical standing among the giants of manual-derived therapeutic interventions is to infer that someone's way of thinking has, as a natural coherence, a special sort of cohesiveness such as may not be seen in other cultures or other modalities of patient-centered, manual-derived mechanomedical interventions.

Research, by its very nature, must conform to the eternal nagging nature of man's reasoning. Therefore, osteopathy must prove once and for all that the cosmic nature of its dealings has a higher purpose than those assigned to it by the erudites.

 

[spicedmanna]

OMT relies on (god this is probably wrong and I'm gonna get nailed) 'small area high velocity' manipulations where chiro uses 'large area larg velocity' manipulations.

Hmm... I don't know what chiros do, but OMT can consist of HVLA (high velocity, low amplitude), muscle energy (ME), strain/counterstrain, and myofascial release (MR). We do try to localize treatment as much as possible, although there are group dysfunctions, too.

However, I think the largest difference is that OMT is most often used in conjunction with standard medical intervention. This is something that chiropractors do not and cannot do. Treatment is considered in the context of the medical standard of care of patients. DO's are physicians, chiropractors are not.

In terms of asthma, there is a lot of legitimate OMM treatments for inhalation/exhalation dysfunctions, rib treatments, accessory muscle treatments, thoraco-abdominal diaphragm treatments, etc. These address any somatic dysfunctions involved in the condition and can have an impact in the quality of experience in asthma patients in conjunction with standard medical intervention. Most DO's probably wouldn't treat it with OMM alone, like chiros would treat with manipulation alone. No, we'd probably consider standard labs, run spirometry tests, peak-flow, etc., and determine the individual's asthma status and place the patient on appropriate meds (albuterol, inhaled steroids) as part of the total management plan.

This is a complex and involved topic. I have a test coming up, so I can't spend too much time chewing the fat, but this a good start here.

 

[DragonWell]

....
Basically, I simply don't see the level of debate with OMT who profess to treat the conditions listed in the link below as I do with chiropractic. Why is that?

Thanks!

I think the answer to your question is pretty simple. DOs use manipulation in the context of all other medical modalities, and endeavor to find the best tool for the job, be it a pharmaceutical, surgery or manipulation. Even the DOs who are die-hard manipulators will acknowledge that an emergent cardiac patient needs a trip to the cath lab much more than they need their thoracic diaphragm re-domed. In many cases, OMM is used as an adjunctive treatment, rather than as a sole modality. If manipulation was more or less the only tool in the tool box, it'd be a much different story.


These topics have been discussed many, many times in the past.
http://forums.studentdoctor.net/showthread.php?t=378878&highlight=chiropractic
http://forums.studentdoctor.net/showthread.php?t=340147&highlight=chiropractic
http://forums.studentdoctor.net/showthread.php?t=423010&highlight=chiropractic
http://forums.studentdoctor.net/showthread.php?t=360274&highlight=chiropractic
http://forums.studentdoctor.net/showthread.php?t=360030&highlight=chiropractic

 

[spicedmanna]

Hey, DragonWell, we're on the same frequency here...

 

[nlax30]

The essence of the animosity between such lauded and celebrated professions such as chiropractic and osteopathy, lies in the historical remnants that such divergence in medical proclivities produced.

To say, nay, to assert that osteopathy has a higher academical standing among the giants of manual-derived therapeutic interventions is to infer that someone's way of thinking has, as a natural coherence, a special sort of cohesiveness such as may not be seen in other cultures or other modalities of patient-centered, manual-derived mechanomedical interventions.

Research, by its very nature, must conform to the eternal nagging nature of man's reasoning. Therefore, osteopathy must prove once and for all that the cosmic nature of its dealings has a higher purpose than those assigned to it by the erudites.

Mad props on working "nay" into a response. Too tired for eloquent writing tonight.

 

[DragonWell]

Hey, DragonWell, we're on the same frequency here...

Yeah, even to the same minute...What can I say, great minds....

 

[jesse14]

None of these replies answered my question. Did anyone read the link I posted?

Who Can Benefit From OMT?
OMT can help people of all ages and backgrounds. It can:

ease pain
promote healing
increase mobility
OMT is often used to treat muscle pain. But it can also help patients with a number of other health problems, among them:

asthma
sinus disorder
carpal tunnel syndrome
migraines
menstrual pain
When appropriate, OMT can complement––and even replace––drugs or surgery. In this way, OMT brings an important dimension to standard medical care.


If a chiro were to say that manual therapy could replace any surgery he/she would be torn apart. I've seen in many times. If a Chiro said they could treat menstrual pain with manual therapy (as DO's do as per the link) they would be mocked and chastised. It all seems a tad inconspicuous to me be honest. I don't see why one should be accepted and the other deemed quackery.

 

[DragonWell]

I think the answer to your question and the most important phrase of that line is the one you didn't bold - "When appropriate, OMT can complement––and even replace––drugs or surgery. In this way, OMT brings an important dimension to standard medical care"

In order to judge if it's appropriate, you have to consider all the treatment options, not just manipulation.

 

[spicedmanna]

If a DO chooses to use an OMT treatment in lieu of other medical intervention, he or she:

1) Medically evaluated the patient
2) Considered the standard of care
3) Can adjust to other modalities should reevaluation of the condition make it necessary

A chiropractor cannot do any of the above. Until a chiropractor is held to the same standard of care as physicians and receives the same training, they can't practice in the same way. I don't mock chiropractors, but plain and simple, chiropractors are not physicians.

 

[justletmeinplz]

The following may be inaccurate, as much of it is opinion based on observation, but I think the views expressed are indicative of the changing view of DOs in mainstream medicine. But anyways, here goes....

My dad is an MD, a well respected Rad Onc in our community. It's hard to explain to other applicants who don't have a physician as a parent how much different it really is for us. Believe it or not, if you haven't started med school yet, we know more about the medical field than you do. Trust me. We hear things talked about at the dinner table amongst doctors that you probably don't. You might have shadowed a physician for a week or a month or even a year, but we have our whole lives. I've heard more about medical politics, bizarre cases, and how difficult medical school is going to be than I've cared to, that's for sure. Let's just say that when it comes to knowing the opinions of doctors, we might not be bad people to ask. So you can trust me when I tell you, a DO that practices extensive OMM will likely not be respected by MDs or a growing number of DOs. That's the consensus around the water cooler of those "in the know." I've spoken with the son of a former president of the AOA, he and his brother are both DOs and ophthalmologists, and when I asked him about OMM he said, "Yeah, and at one time MDs were draining humors." I know 2 other DOs in Family Practice and as far as I can tell, they don't practice OMM either. I know an Ear, Nose, Throat DO, he and his partner (also DO) don't use it. The chief of staff at one of the hospitals my dad works at is a DO and I don't believe he practices OMM either. I've worked in neuroradiology at Shands... never once was a DO consulted to see if OMM was necessary on a spine patient (maybe they should have been?).

Once again, I'm not saying OMM has been discredited or even should be. I'm sure it has it's uses. I'm just saying that from what I can gather if a DO practiced OMM the way A.T. Still would have intended it, the profession would soon be laughed into obscurity. (He claimed to be able to cure whooping cough with a "wring of the neck," and scarlet fever by shaking a child.) The profession has evolved....in the right direction.

DOs are gaining respect BECAUSE they are distancing themselves from (or perhaps just limiting the use of) OMM. My dad has told me that he often recommends, without hesitation, DOs he knows to be competent when a patient asks if he knows a "good doctor" they can see for another ailment. (If they say "yeah, but 'so and so' is a DO, isn't there a difference?" my dad responds "not really." And this was happening long before I was considering DO school.) I can assure this would not be the case if the DOs were glorified chiropractors.

The fact is osteopathic physicians have, and will continue to, align themselves with the more traditional aspects of medicine and shy away from the more "alternative" ones. I'm fine with OMM training being a part of a DO education, as learning its usefulness and understanding its limitations can't hurt. I do wish there was less of it though, perhaps an overview course mandatory with additional training available for those who will actually use it. DO schools are doing a fine job of producing well trained physicians. That the schools continue to place such an emphasis on OMM when the graduates really aren't using it seems odd to me.

Anyways, to answer the question (finally) DOs don't take crap about OMM the way chiropractors do for practicing their "art" (which as I understand it...or misunderstand it... is different(OMM is "better") in many ways) because DOs simply aren't using OMM to a great enough extent to warrant "concern."




**Sorry, I'm really bored and no longer have cable.

 

[J1515]

If a chiro were to say that manual therapy could replace any surgery he/she would be torn apart. I've seen in many times. If a Chiro said they could treat menstrual pain with manual therapy (as DO's do as per the link) they would be mocked and chastised. It all seems a tad inconspicuous to me be honest. I don't see why one should be accepted and the other deemed quackery.

Because OMM is only one of many treatments a DO can prescribe, while manipulations are the ONLY treatment a chiropractor can prescribe. It's quite simple. Sure there are rare circumstances where a pt with carpel tunnel syndrome is scheduled for surgery only to see a drastic effect from an OMM treatment and thus may choose to put off the surgery. I wouldn't say that's an extremely common occurance but then again I don't practice OMM on a regular basis (this would be a good place for JPH to chime in - oh wait, he's banned because of the SDN crybabies).

I've heard of chiros treating asthma patients. I don't mock or chastise it if it works for someone. But if it doesn't work, DOs can prescribe corticosteroids right there IN ADDITION to the treatment.

The bottom line is OMM is accepted (well, relative to chiropractic manipulations) because DOs don't have to claim it will cure everything. It is simply another treatment to try and if it fails to work, we have other modalities of treatment. I think chiropractors are a little more desperate to see their treatments work since they have nothing else to fall back on and this leads to some quacks in the field hurting patients.

 

[justletmeinplz]

Because OMM is only one of many treatments a DO can prescribe, while manipulations are the ONLY treatment a chiropractor can prescribe. It's quite simple. Sure there are rare circumstances where a pt with carpel tunnel syndrome is scheduled for surgery only to see a drastic effect from an OMM treatment and thus may choose to put off the surgery. I wouldn't say that's an extremely common occurance but then again I don't practice OMM on a regular basis (this would be a good place for JPH to chime in - oh wait, he's banned because of the SDN crybabies).

I've heard of chiros treating asthma patients. I don't mock or chastise it if it works for someone. But if it doesn't work, DOs can prescribe corticosteroids right there IN ADDITION to the treatment.

The bottom line is OMM is accepted (well, relative to chiropractic manipulations) because DOs don't have to claim it will cure everything. It is simply another treatment to try and if it fails to work, we have other modalities of treatment. I think chiropractors are a little more desperate to see their treatments work since they have nothing else to fall back on and this leads to some quacks in the field hurting patients.

RIGHT! Limited and responsible use earns respect. Across the board cure all does not. That seems to be true of a lot of things in medicine though, not just manipulation.

 

[Pansit]

I think the answer to your question and the most important phrase of that line is the one you didn't bold - "When appropriate, OMT can complement––and even replace––drugs or surgery. In this way, OMT brings an important dimension to standard medical care"

In order to judge if it's appropriate, you have to consider all the treatment options, not just manipulation.

OP, forget all the other posts, because the quote above is the true answer.

 

[metalmd06]

I think that one of the main reasons that chiropractors are denigrated is because the manipulation techniques do not permanently fix anything. I work for a chiro in a multi-specialty practice that also includes Family Medicine by a DO, PT and Acupuncture. Most of the patients that Dr. B sees come in for relief of chronic pain due to some sort of injury. While a Chiropractic adjustment may make a patient feel instantly rejuvinated, the benefit is short lived. As a result, patients sometimes come in twice a week for chiro therapy. Since it seems the benefits of chiro really just mask the symptoms, many other practitioners don't see it as an important additional therapy.

My girlfriend is a PT and she thinks chiro is a scam, but I'd like to compare chiro's to PTs. Overall, I think the long term benefit of PT is much greater since it promotes strengthening and healing. However, the proven benefits of manipulative therapy promote to a chiro's utility in a patient's treatment regimen.

Another point for those who adhere to my original point. Even though Chiros may give some of their patient's a false sense of hope with the short lived dissolution of pain symptoms, it does seem to work every time. Think of all the people in America with chronic back pain. They take pain killer, anti-inflammatory drugs and muscle relaxants. Do any of those drugs ever fully reslove the problem? No, in fact, many times they seem to exacerbate it. Whether the benefits are diluted from long term use, or the pain magnified when prescriptions are dicontinued, drugs are certainly not the best solution. This is where DO's and OMT come in. The combination of manipulative therapies and medication could work out to be the best option for some, if not all patients. The DO's ability to use similar techniques supplemented with medical treatment can reduce the patient's dependence on drugs and improve their quality of life.

This is just my opinion, feel free to agree or bash

 

[DadAndPreDOinMO]

I think that one of the main reasons that chiropractors are denigrated is because the manipulation techniques do not permanently fix anything. I work for a chiro in a multi-specialty practice that also includes Family Medicine by a DO, PT and Acupuncture. Most of the patients that Dr. B sees come in for relief of chronic pain due to some sort of injury. While a Chiropractic adjustment may make a patient feel instantly rejuvinated, the benefit is short lived. As a result, patients sometimes come in twice a week for chiro therapy. Since it seems the benefits of chiro really just mask the symptoms, many other practitioners don't see it as an important additional therapy.

My girlfriend is a PT and she thinks chiro is a scam, but I'd like to compare chiro's to PTs. Overall, I think the long term benefit of PT is much greater since it promotes strengthening and healing. However, the proven benefits of manipulative therapy promote to a chiro's utility in a patient's treatment regimen.

Another point for those who adhere to my original point. Even though Chiros may give some of their patient's a false sense of hope with the short lived dissolution of pain symptoms, it does seem to work every time. Think of all the people in America with chronic back pain. They take pain killer, anti-inflammatory drugs and muscle relaxants. Do any of those drugs ever fully reslove the problem? No, in fact, many times they seem to exacerbate it. Whether the benefits are diluted from long term use, or the pain magnified when prescriptions are dicontinued, drugs are certainly not the best solution. This is where DO's and OMT come in. The combination of manipulative therapies and medication could work out to be the best option for some, if not all patients. The DO's ability to use similar techniques supplemented with medical treatment can reduce the patient's dependence on drugs and improve their quality of life.

This is just my opinion, feel free to agree or bash

I know this isn't across the board, but in my personal experiences I have been the a chiro 5-6 times in high school. It helped the first time (dislocated jaw) It helped for about a day each time after that (low back). The last time I went I could hardly walk out of the office and was in pain for 3 days until I had an OMM treatment and the pain was gone, though I was still sore. I will NEVER go back to a chiro, and I plan to do an OMM fellowship after my 2nd year. Also I plan to incorporate OMM in my practice. The chiro I went to was in practice for ~20 years and popular in my community, though the OMM practitioners in my community are very popular as well.
Sorry for the rant.