Osteopathic manipulative medicine (OMM) is a comprehensive approach to health care in which osteopathic physicians (DOs) apply osteopathic philosophy, structural diagnosis and use of osteopathic manipulative treatment (OMT) in the diagnosis and management of patients.
Its art and science pertain to the assessment of the impact of the malfunctioning neuromusculoskeletal systems on health and disease, and designing appropriate interventions which often include some form of OMT. There are approximately 15 major types of OMT and more than 1,000 individual techniques.
At its heart, osteopathic manipulative medicine is the knowledge base that allows the osteopathic physician to determine which patients will derive the greatest benefit from OMT and which specific techniques should be applied.
If it’s crooked, make it straight. If it is stiff, make it move. At its most basic, this is the biomechanical approach. The musculoskeletal system is the primary machinery of life. The more efficiently it works, the less energy is expended in just day-to-day living. This has a beneficial impact on a host of conditions, most notably cardiopulmonary disease and diabetes mellitus. Additionally, mechanical problems are a common source of musculoskeletal pain syndromes, so this approach is commonly used for back pain, neck pain, headache and many other painful conditions.
Restricted movement of the musculoskeletal system can provoke the development of inappropriate reflex neural responses that will have an adverse effect on the function of the individual. These may take the form of somato-visceral reflexes—those affecting the internal organs—and somato-somatic reflexes—those affecting other parts of the musculoskeletal system. Less commonly, musculoskeletal dysfunction can directly impinge on neural structures. Examples of this include thoracic outlet syndrome and sciatica due to compression by the piriformis muscle.
Compression of the components of the vascular system by abnormal position or tension in the neuromusculoskeletal structures can lead to tissue ischemia, congestion and edema. There are also manual medicine techniques to improve circulation to and from various parts of the body in the presence of other disease states.
If you can’t move air in and out of your lungs, you die. Disease and dysfunction of the neuromusculoskeletal system can impair this life sustaining function. The lungs may be healthy, but it is rib and diaphragmatic motion that create the intrathoracic pressure gradients that move the air.
Several manipulative techniques have been demonstrated to increase the body’s response to infection, regardless of type or location. This generalized improvement in the immune response has been shown to prevent respiratory failure and death in elderly patients with pneumonia.
Human beings are designed to be touched. Without the caring touch of other human beings, we wither and die. Touch breaks down the barriers to communication that separate patients from their caregivers. The more intimately a physician knows his or her patient, the better the care plan can be personalized to the needs of the individual.