Osteopathic Manipulative Treatment (OMT) is a hands-on approach that may be used by Doctors of Osteopathic Medicine (DOs) to treat aspects of the body’s structures—such as the musculoskeletal, nervous or lymphatic systems—when they are impaired. These impairments are called “somatic dysfunction”
According to Lauren Noto-Bell, DO, FNAOME, professor, clinician and faculty member in the PCOM Department of Osteopathic Manipulative Medicine, OMT is part of a whole-person approach to care in which DOs utilize health strategies that not only combat illness and disorder but also work to prevent them.
OMT and Osteopathic Manipulative Medicine (OMM) fall under a larger category called Osteopathic Principles and Practice that encompasses the philosophies, history, and concepts related to osteopathic medicine. While OMM is the medical care that DOs provide to patients that includes diagnosis and treatment of somatic dysfunction, OMT is the category of the manual techniques used to treat the somatic dysfunction. Key principles of OMT include:
OMT involves the application of specific movements, pressure, and sometimes patient activation. Dr. Noto-Bell notes that OMT does not treat conditions, but “in the correct clinical context, the techniques of OMT treat the existing somatic dysfunction which may assist the effectiveness of any appropriate medication, surgery, lifestyle changes or exercise.”
A common example of how OMT can help somatic dysfunction is in the case of chronic obstructive pulmonary disease (COPD). COPD, Noto-Bell explained, is the underlying pathology and DOs may use OMT to help with the secondary somatic dysfunctions that are associated with COPD.
As COPD worsens, musculature next to the spine can become tight and tender, further limiting the mobility of the ribs. DOs can use OMT to ease restricted muscles and rib movement.
“Ultimately, employing OMT can help to improve their primary medical condition a bit more quickly than they would otherwise,” Noto-Bell said.
DOs use the TART diagnostic framework to identify areas that may benefit from OMT. TART stands for:
The results of this assessment in each patient’s clinical context determine if and which manual techniques will be applied.
Regardless of the specialty they pursue, a DO may find good use for OMM/OMT in their practice. OMT can provide health benefits including:
Noto-Bell noted that even in a psychiatric setting, osteopathic physicians can improve a patient's experience with OMT because some techniques can be useful in calming down a heightened neurological system.
“In the throes of an anxiety attack, for example, patients may have medication to stabilize their mood or keep neurotransmitters balanced, and they may also utilize self-directed techniques like breathing exercises and visualization,” she explained. “But there are also manual OMT techniques that can help to calm down the nervous system.”
Noto-Bell explained that touch can be therapeutic in and of itself, by activating receptors that release “feel-good” chemicals in the body, which have body-wide effects, such as decreasing blood pressure, heart rate, pain sensitivity, and anxiety.
OMT, she added, is a precisely-delivered therapeutic touch that allows the nervous system to function in a more optimally-balanced way.
The principles of osteopathic medicine recognize that the body is a functional unit, and if any sort of disruption occurs in one aspect of a person's life—whether internal or from external environmental factors—it will impact their overall health and well-being. This principle means DOs approach patient care with a different perspective, Noto-Bell explained.
“If a patient comes in with neck pain, some physicians may immediately begin treatment by addressing only the symptoms of neck pain by suggesting an X-ray or writing a prescription for a muscle relaxant,” she said. “An osteopathic physician may instead begin by asking the patient about their lifestyle—do they have poor posture, or do they sit at a desk all day for work?”
A DO, she noted, is well-positioned to recognize that the patient’s neck pain might stem from poor postural mechanics due to prolonged sitting. Treatment might begin by addressing posture through exercises, physical therapy, or OMT.
OMT is an important aspect of osteopathic medical school training. At PCOM, students are introduced to OMT right away in their training, learning practical skills that set the foundation for future patient care. Watch the video below for a behind-the-scenes look at how osteopathic medical students practice osteopathic diagnosis and treatment in a dynamic lab setting.
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