OMT vs. Chiropractic

[DocBR]

Ok, first - Please do not let this degenerate into a flame war. I honestly would like to know the answer to this, and I do not know enough about either type of treatment to even form an opinion, so if I am wrong about something - I am sorry.

The general trend in a lot of previous DO vs. DC threads is the belief that chiropractic medicine is often unsupported by solid evidence, where as OMT has a broad base of scientific support for many treatment types.

So, how does OMT differ from Chiropractic medicine in treating something like sciatica or low back pain?

I know that the chiropractic treatment would be to align the spine, correct the 'subluxation', and problem solved. But if this treatment has little scientific support, what would OMT offer that is both different and empirically superior.



Also, I know there are like a zillion and one 'DO vs DC' threads, and one of them may touch on this topic, but I was unable to weed through them all to find an answer b/c most of them end up as pi$$ing matches between the two fields that seem to go on forever.

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[DragonWell]

Even though my gut reaction is that any thread which begins "Please do not let this degenerate into a flame war..." should be closed immediately with no questions asked, I'll offer an opinion, albeit one you probably won't like.

The pat answer to your question is that OMT incorporates more soft tissue techniques than chiropractic. We use things like counterstrain, muscle energy, myofascial release, inhibition, etc in addition to the HVLA ("cracking") most people associate with chiropractic.

Chiropractic, however, is a diverse field. There are some docs that are great at treating musculoskeletal complaints and some not so great docs. Saying that DCs only use HVLA is like saying DOs only use cranial, or that PTs only do stretching - it's a gross oversimplification.

I would encourage you to look beyond the question of who has the best Kung-Fu. IMO, it is not a productive question. Searching for the answer to this question on a DO board will give you information with a certain bias; perform the same inquiry on a DC, PT, or LMT board and you will get a different set of answers. The causes and treatments for musculoskeletal dysfunctions are complex, and while there are studies which provide at least some support for many different modalities, there is no overwhelming body of evidence which proves that one modality is superior to the others. Even if such a comparison did exist, it would probably be of limited use, since the effectiveness of any technique will also depend greatly on the skill and experience of the practitioner providing it.

 

[SM-UCLA tech]

here is the best answer i can give. i'm a 4th year student about to graduate and have done omt maybe twice in 2 years of clinical rotations. even on my OMM 4 week rotation coming up, i will probably only use it on 30-40% of the patients i see in the office. and that will be with a family physician who is known to use omt "a lot".

the truth of the matter is that a HUGE majority of DO's never do OMT. the last figure i read in a DO journal is that only 10% of DO's ever use it. it's a nice tool to know how to use and has its time and place to be used. but in the end, it's the thing that separates us from MD's. ( but i'm really thinking that this whole DO thing should probably merge itself with the MD world and have OMT taught at all medical schools ).

even other allopathic schools are starting to introduce it, and at last years AAFP national conference, there was a course offered that taught some omt for CME credit.

 

[JasonUD]

One thing I've noticed....when I go to my chiropractor and he cracks my back he basically just goes and does all the verts at once, in both directions. Osteopaths feel each individual vert and then when we find one out of whack we crack only that one back into place- sort of a why fix it if its not broken spiel. I guess chiropractics is a bit more generalized where we are focused onto where the exact spot is.

 

[SM-UCLA tech]

One thing I've noticed....when I go to my chiropractor and he cracks my back he basically just goes and does all the verts at once, in both directions. Osteopaths feel each individual vert and then when we find one out of whack we crack only that one back into place- sort of a why fix it if its not broken spiel. I guess chiropractics is a bit more generalized where we are focused onto where the exact spot is.

actually.....that's what we are taught to do....but the DO's that do hvla quite often also do a shotgun approach to their patients. it's quick, easy....and patients love it.

and this is the last thing i'm going to post on this thread because i really am not a big fan of omt and i'm getting really bored thinking about it!

 

[Seger]

here is the best answer i can give. i'm a 4th year student about to graduate and have done omt maybe twice in 2 years of clinical rotations. even on my OMM 4 week rotation coming up, i will probably only use it on 30-40% of the patients i see in the office. and that will be with a family physician who is known to use omt "a lot".

the truth of the matter is that a HUGE majority of DO's never do OMT. the last figure i read in a DO journal is that only 10% of DO's ever use it. it's a nice tool to know how to use and has its time and place to be used. but in the end, it's the thing that separates us from MD's. ( but i'm really thinking that this whole DO thing should probably merge itself with the MD world and have OMT taught at all medical schools ).

even other allopathic schools are starting to introduce it, and at last years AAFP national conference, there was a course offered that taught some omt for CME credit.

3.5 years of studying osteopathic medicine and you think OMT is "the thing" that distinguishes DO's from MD's? You're right, you should be an MD.

Oh, and if you look at the trends, the MD world is actually merging itself into the DO world....it just refuses to acknowledge it.

 

[MirrorTodd]

3.5 years of studying osteopathic medicine and you think OMT is "the thing" that distinguishes DO's from MD's? You're right, you should be an MD.

Oh, and if you look at the trends, the MD world is actually merging itself into the DO world....it just refuses to acknowledge it.

Couldn't it be that they're both merging into each other. Why does it have to be MD merging into DO?

 

[McDoctor]

3.5 years of studying osteopathic medicine and you think OMT is "the thing" that distinguishes DO's from MD's? You're right, you should be an MD.

Oh, and if you look at the trends, the MD world is actually merging itself into the DO world....it just refuses to acknowledge it.

What trends are you talking about?

 

[McDoctor]

The general trend in a lot of previous DO vs. DC threads is the belief that chiropractic medicine is often unsupported by solid evidence, where as OMT has a broad base of scientific support for many treatment types.

So, how does OMT differ from Chiropractic medicine in treating something like sciatica or low back pain?

In regards to the first statement, there isn't a whole lot of good scientific evidence to support OMT. There are alot of studies out there, but few have large numbers of subjects and even fewer are double blinded and placebo controlled. There are some well designed studies that show benefits for painful musculoskeletal complaints, but chiropractic manipulation is probably similarly effective in this regard.

In regards to the second statement, a DO is more likely to make sure that your pesky low back pain or sciatic pain is really due to a musculoskeletal problem and not a dissecting abdominal aortic aneurysm before he or she cracks your back. And thats a huge difference between the two.

 

[Seger]

What trends are you talking about?

treatment of the patient as a whole, rather than treatment of only the disease...OMT...emphasis on primary care & family practice...

 

[McDoctor]

treatment of the patient as a whole, rather than treatment of only the disease...OMT...emphasis on primary care & family practice...

Every MD I have ever known "treats the patient as a whole", whatever that means. Also, I have never seen an MD do OMT or yearn to do OMT for that matter. I realize that OMT is offered to MD's as CME, but so is traditional chinese medicine and acupuncture. This doesn't mean anything.

 

[NickRiviera]

the last figure i read in a DO journal is that only 10% of DO's ever use it.

I don't see the usefulness in this number unless there is another study showing any other skill learned in medical school is used more than 10% of the time. I'd guess there are doctors who never do IVs, never intubate, never push a certain drug, etc.

Are there secondary benefits from learning OMT instead of using that skill directly, such as generally being better with your hands, having keener hands-on diagnostic skills, or understanding the MSK system a little better?

 

[DropkickMurphy]

I don't see the usefulness in this number unless there is another study showing any other skill learned in medical school is used more than 10% of the time. I'd guess there are doctors who never do IVs, never intubate, never push a certain drug, etc.

That's the one of the wisest statements I've ever heard in preosteo. Nicely put Nick.

 

[drusso]

To the OP:

Here's a nice commentary dealing with some of the issues you raised.

http://www.om-pc.com/content/1/1/7

 

[J1515]

treatment of the patient as a whole, rather than treatment of only the disease...OMT...emphasis on primary care & family practice...

Those damn MDs keep treating their patients as halves.

Notice how it's only premeds who say that DOs treat their patients as a whole.