What is Osteopathic Manipulative Treatment (OMT)?

What is osteopathic manipulative treatment (OMT)? For many patients, it’s the key to relieving pain, treating migraines and more.

OMT therapy involves the use of manually guided forces by a doctor of osteopathic medicine (DO) to improve structural and physiologic function. It involves the gentle realignment of the spine, joints and tissues for relief of strained or spastic musculoskeletal areas. OMT does not involve the use of pain medications, surgery or needles, but instead involves hands-on manual treatment to reduce dysfunction and pain.

“I like to describe OMT as if a chiropractor and physical therapist had a baby – a little bit of both combined,” said Dr. Abby Dwyer, DO, a family medicine resident at Mercy Clinic Primary Care – Chaffee Crossing in Fort Smith.

The most common ailments treated through OMT are lower back and neck pain, as well as general aches and pains. It’s also used for migraines and can help with constipation, edema, breathing issues, colic in babies and more. 

OMT can be used for patients of all ages, said Dr. Andrew Ryals, DO, family medicine physician with Mercy Clinic Primary Care – Chaffee Crossing. This includes newborn to end-of-life care and those with acute and chronic problems. Additionally, it is safe to perform during pregnancy

There are multiple different technique modalities that can be performed, which allows patient of all conditions to have manipulations performed on them, Dr. Ryals continued.

“OMT uses the tenants of osteopathic medicine,” he explained. “The first tenant is that the body is a unit of mind, body and spirit. The second tenant is that the body is capable of self-regulation, self-healing and health maintenance. The third tenant is that structure and function are interrelated. This culminates to the fourth tenant. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation and the interrelationship of structure and function.

“With these tenants in mind, OMT uses various techniques to help restore function to the body through manipulation,” Dr. Ryals continued. “These techniques may be active and require effort from the patient or be passive and the physician does all the work.” 

OMT sessions will vary just like all other physician appointments. It will start with getting the patient’s history and performing a physical examination.

“We discuss the issue at hand, identify the cause of the issue and then discuss potential ways that we can treat the issue,” Dr. Dwyer said. “There are several ways that we can approach an issue, hitting it from multiple different angles for best results. I like to know if a patient has had any injuries to the areas where they would like manipulation. I also like to ask about any malignancies, any skin infections, any conditions like osteoporosis, rheumatoid arthritis, genetic conditions, seizures or prior adverse reactions to manipulations.” 

The discussion with patients prior to OMT will vary based upon the patient and the issues that they are currently having, Dr. Ryals added.

“Gathering a history of the patient is needed,” he said. “On the first visit, it is always good to discuss with the patient what to expect from OMT. This may include the need for multiple sessions to maximize improvement. Like every physician visit, managing the expectations needs to be set. For example, performing a treatment may only be temporary relief if the patient is still performing bad habits or postures that caused that pain.”

The procedures are often performed right then and there during a visit. Following an OMT session, there may be some soreness similar to that from a deep tissue massage, which will resolve with rest and adequate hydration. At any time the treatment becomes painful, doctors stop the treatment and move to something less intense, Dr. Dwyer said. 

Many patients do not need multiple OMT sessions in order to resolve their issues, she added. 

“The purpose of OMT is to help allow the body to self-regulate,” Dr. Dwyer said. “However, some patients will require multiple sessions, and other patients request multiple sessions because they are usually feeling better after the visit.”